Basic Concepts of Communication with Patient and Family.ppt
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Transcript of Basic Concepts of Communication with Patient and Family.ppt
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BASIC CONCEPTS
OF MEDICAL
COMMUNICATION
PUTU SUTISNA
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Lectures main objectives:
To describe the importance of goodcommunication with patients
To describe the factors that may influence the
outcome of communication between thedoctor and patient
To explain the technique of conductingeffective communication with patients thatinvolves questioning, listening and facilitating
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Communication
imparting, conveying or exchanging of ideas,
news, knowledge etc.
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Several methods of communication:
Two friends talking
Radio/ TV
Newspaper/book
Wrting a letter
Telephoning/fax
Teaching/lecturingDoctor or nurse with patient
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Purposes of Communication
are to:
form & maintain relationship
give information
convey feelings
persuade
solve problems
alleviate distress
make decisions
give reassurance
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Aim of a physician
(since ancient time):
To cure sometimes,relieve often,
comfort always
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Communication in Medicine
Doctorpatient/family
Doctordoctor
Doctorcommunity
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Main areas covered in Block MC
1. A.Taking medical history and review of bodysystems
B. Giving information to patient
C. Special approach to specific patient/situation2. Paper presentation and discussion
3. Writing medical letters & notes, and CV
4. Scientific writing
(5. Health education & health promotion forcommunity at large)
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Good communication skills can be learned.
Prerequisites:
Written instructions (references)
Opportunities to practice
Feedbacks (SGD)
Discussion on performance (SGD)
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Doctor-Patient
CommunicationInfluencing Factors
Patient-related factors
- Physical symptoms
- Pathological factors related to illness
- Previous experience of medical care
- Current experience of med care
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Doctor-related factors
-Training in communication skills- Self-confidence in ability to communicate
- Personality
- Physical factors (e.g. tiredness)
- Psychological factors (e.g. anxiety)
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Interview setting requirements
- Privacy
- Comfortable surroundings- Appropriate seating arrangement
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Guidelines for conducting
interview with patientA. Beginning
1. Greet patient by name, shake hand (?)
2. Ask patient to sit down
3. Introduce yourself
4. Explain purpose of interview
5. Say how much time available
6. Explain need to take notes
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B. Main part of interview
1. Maintain +ve atmosphere, warm manner,
eye contact
2. Use open questions, esp at beginning
3. Listen carefully
4. Be alert and responsive to verbal & non
verbal cues
5. Facilitate patient verbally & non-verbally
6. Use closed questions when appropriate
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7. Clarify what patient has told you
8. Encourage patient to be relevant
C. Ending
1. Summarize what patient has told you2. Ask if patient wants to add anything
3. Thank patient
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Key skills for communicating effectively withpatient
Questioning
Listening
Facilitating
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1. Questioning
Main purpose of interviewing patient:to obtain information about patients
conditionaccurate, complete and relevant
Good communication with patient alonecontributes to correct diagnosis in 80% of
cases
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Open questions should be used as much as possible
to obtain great deal of information from patient
Would you please tell me how you have been
feeling in the past few days?
I understand that you have had pain. Would you
please tell me more about it?
Can you tell me what brings it on?etc
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Closed questions
Give patient little choice in the way to answer
Usually elicits little information, only yes or
no.
Have you beenfeeling unwell today?I see from your GPs notes that you have had chest
pain. Do you still have the pain?
Was it tight or dull pain?
Did it go down your arm?
Did it get worse when you exercised?
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Advantages of open questions
More relevant information in given time Patient feels more involved
Patient can express all concerns and anxieties
about problems
When to use close questions?
To obtain specific information not yet given by
patient
In emergency cases
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2. Listening
Features of active and effective listening:
Gathering and retaining information
accurately
Understanding implications for patient of
what is being said
Responding verbal & non-verbal signals or
cues
Demonstrating you are paying attention and
trying to understand
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Non-verbal cues:
Eye contact
Posture
Gestures
Facial expressions
Way voice is used
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3. Facilitating
Related with effective listening. Aim to help patientto talk fully about problems.
Verbal way
Please go on and tell me more about your pain.
Yes, I understandplease continue.
Non verbal ways:
Leaning slightly forward toward patient
Making eye contact
Nodding head at appropriate time
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Communication
with FamilyHow family can help?
Provide emotional & social support
Provide practical support
Provide understanding of beliefs about illness
& treatment
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Provide information about family historyHelp avoid/overcome bad patient compliance
Overcome difficulties arising from secrets
Anticipate/address problems that may affectother family members
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NOS
Too many or complicated questions
Not allowing patients to tell story in their own
words
Unnecessary interruption
Failing to pick up verbal & non-verbal cues
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Patients respect doctors who
are warm and sympathetic
are easy to talk to
introduced themselves
appear self-confident
listen to the patients and respond to their
verbal cuesask easy-to-understand questions
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Summary
The ability to communicate effectively andsensitively is essential in medicine
Communicating effectively with patients involves thecore skills of questioning, listening and facilitating
Good communication leads to: accurate historytaking and diagnosis, patients compliance withtreatment plan, patients satisfaction with the care
given
The skills of good communication can be learnt andretained
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THANK YOU