Building Emphaty Giving Information

Building EmphatyGiving Information

A simple way to be an amazing CommunicatorFilm Patch AdamsWhat is Empathy ?Empathy is the capability to share another being's emotions and feelingsBuilding Emphaty (1)The Basic Formula Basic empathic understanding can be expressed in the following stylized formula:

You feel[name the correct emotion expressed by the patient) Because[indicate the correct experiences and behaviors that give rise to the feelings].

Building Empathy (2)Two Stages Process :

Building Empathy (3)Respond Accurately to patients Feelings, Emotions and MoodsRespond Accurately to the Key Experiences and Behaviors in Patients Stories verbal & non verbal byEncouragementSilence RepetitionInterpretation

Verbal vs Non VerbalVerbal Using open & close question appropriatelyParaphrasingclarifying

Non Verbal responses:Listen attentivelyEye Contact & smileLean forwardNod your headSerious mimicMirroring

ECCS (Byloun,and Makoul, 2005)

ECCS (Byloun,and Makoul, 2005)

The Empathy Communication Coding System (ECCS)Level 0 : Dokter Menolak Sudut Pandang PasienContoh : Ya, kalau gitu operasi saja sekarang

Level 1 :Dokter mengenali sudut pandang pasien secara sambil laluContoh : Dokter sambil menulis, menyiapkan alat, membalikkan badanBylund & Makoul (2005)Level 2 : Dokter mengenali sudut pandang pasien secara implisitLevel 3 : Dokter menghargai pendapat pasienContoh : O jadi bapak merasa sedih ya, bisa diceritakan lebih jauh pak keadaan di rumah yang membuat bapak sedihBylund & Makoul (2005)Level 4 : Dokter menkonfirmasi kepada pasienContoh : Bapak sepertinya jarang di rumah ya, apa ada kesempatan olahraga pak?

Level 5 : Dokter berbagi perasaan dan pengalamanContoh : Ya saya mengerti anda berdua khawatir dengan pengalaman aborsi anda yang pertamaOther Way of Empathy

Some Things that Should be AvoidedNo responseDistracting questionsClichsInterpretationsAdviceParrotingSympathy

Cliches : A phrase which has been used too often and has become meaningless contoh kata kata sabar dapat menjadi cliches dan kurang ampuh karena terlalu sering diucapkan pada orang sakit tanpa penjelasan yang benarParroting : mem beo tanpa makna14Giving InformationGiving Information (1)Describe what information you plan to giveResults of the physical examinationResults of testsDiagnosisCause of the problemsTreatment Modality plannedPrognosisAdvice about lifestyleGiving Information (2)Summarize patients problemContoh : Jadi bapak ada keluhan nyeri di ulu hati dan kadang dada terasa panas. Bapak sering mendapatkan serangan ini di malam hari. Betul begitu pak ?Find out the patients understanding of their conditionContoh : Barangkali bapak sudah pernah membaca atau mengetahui informasi tentang gejala seperti ini sebelumnya ?Giving Information (3)Outline structure of interviewContoh : Baik, pak sekarang saya akan menjelaskan tentang gejala bapak, pertama tentang kemungkinan penyakitnya, kedua tentang penyebabnya, ketiga tentang pemeriksaan lanjutan yang bapak butuhkan dan terakhir tentang penangananyaUse appropriate languageGive the most important information firstAvoid medical jargonUse short sentence, be specific

Giving Information (4)Use DrawingsGunakan gambar, model, foto dllExplore patients view & check understandingContoh : Bagaimana bapak sudah memahami tentang masalah bapak, atau ada yang perlu bapak tanyakan ?Negotiate ManagementBerikan advis gaya hidup (Ajari caranya !!!)Berikan realistic target

Tips from NLP approach (1)(Hypnotic Language Patterns)Tag QuestionsSaya yakin bapak bisa, bukan begitu pak ?Metaphors Pak, luka di lambung bapak seperti juga luka di kulit jika terkena sesuatu yang kecut aka terasa nyeri. Karen itu bapak harus membatasi makanan yang terlalu kecut dan pedasQoutesMemang dari penelitian tentang autis, penderita disarankan diet GF/CF Glucose free Casein free Atau anak ibu harus membatasi gula dan kasein seperti..NLP adalah neuro lingustic programming, sebuah pendekatan psikologi komunikasi terapan berdasarkan peelitan kerja otak20Tips from NLP approach (2)(Hypnotic Language Patterns)Testimony (Gunakan Pihak Ketiga)Contoh : Saya juga pernah punya pasien seperti bapak, dan dia dapat meninggalkan kebiasaan makan kecutnyaSingle banding (Moreand more)Contoh : Semakin bapak menunda untuk memeriksakan anak bapak, semakin besar kemungkinan komplikasi dan biayanyaDouble bandingContoh : Kira-kira bapak akan ke periksa laboratorium sore ini atau besok pagi ?Delivering Bad NewsBad NewsWhy is it difficult to give bad news ?The messenger may feel responsible and fears being blamedNot knowing how best to do itFear of the patients emotional reactionFear of the implications for the patient. E.g. disfigurement, pain, social and financial lossesThe Process of Giving Bad NewsBreaking Bad News (1)Personal preparationThe physical setting:Shouldnt do: Give bad news at the end of a physical examinationGive bad news in corridors & over the telephoneLooking out of the window

Breaking Bad News (2)Talking to the patient & responding to concerns.Requires:-empathy-starting with what patient knows/understands-find what they want to know-active listening/give info-eliciting the patient own resources for coping

Breaking Bad News (3)Arranging for follow up or referralFeedback & handover to colleagues

Calibrating EmotionRUMUS WAKATWa WajarKa KarenaT Tetapi

Contoh : Saya mengerti ibu khawatir, beberapa orang yang akan operasi juga merasakan kekhawatiran seperti ibu. Masalahnya, kalau kekhawatiran itu berlebihan, justru kurang baik bagi kesehatan ibu.

Giving Lifestyle Advice (1)Enquire about the patients attitudes to healthUsing Health Belief Model : a Predictive model used to predict what a person is going to doPerceived of SusceptibilityPerceived of SeriousnessPerceived of BenefitsPerceived of Barriers

HEALTH BELIEF MODEL (Detailed)

Giving Lifestyle Advice (2)Giving InformationNegotiatingSupporting patient (motivate patient)ConceptDefinitionApplication

Perceived SusceptibilityOnes opinion of chances of getting a conditionDefine population(s) at risk based on a persons features or behaviour.

Heighten perceived susceptibility

if too low

Perceived SeverityOnes opinion of how serious a condition and its sequelae areSpecify consequences of risk and condition

Perceived BenefitsOnes opinion of the efficacy of the advised action to reduce risk or seriousness of impact

Define action to talk: how, where, when; clarity the positive effects to be expected

Perceived BarriersOnes opinion of the tangible and psychological costs of the advised action

Identify and reduce barriers

through reassurance, incentives, assistance

Cues to ActionStrategies to activate readiness

Provide how-to information, promote awareness, reminders

Self-EfficacyConfidence on ones ability to take actionProvide training, guidance in performing action