introduction to block medical communication

7/30/2019 introduction to block medical communication

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INTRODUCTION TO

BLOCK MEDICAL

COMMUNICATION

Putu Sutisna


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Communication

imparting, conveying or exchanging of

ideas, news, knowledge etc.

There are several methods of

communication.


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Purposes of Communication

to form & maintain relationship

to give information

to convey feelings

to persuade

to solve problems

to alleviate distress

to make decisions

(to give) reassurance


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Ancient aim of a physician:

To cure sometimes,relieve often,

comfort always


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Communication in Medicine

Doctor patient/family

Doctor doctor

Doctor community


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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 specificpatient/situation

2. 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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BASIC CONCEPTS OFCOMMUNICATION

WITH PATIENT

AND FAMILY

Putu Sutisna

D t P ti t


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Doctor-Patient

Communication:

Influencing 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)

Interview setting requirements

- Privacy- Comfortable surroundings

- Appropriate seating arrangement


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Guidelines for conducting

interview with patient

A. Beginning

1. Greet patient by name, shake hand (?)

2. Ask patient to sit down3. Introduce yourself

4. Explain purpose of interview

5. Say how much time available6. 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. Ending1. Summarize what patient has told you

2. Ask if patient wants to add anything

3. Thank patient


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Key skills for communicating effectivelywith patient:

Questioning

Listening Facilitating


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1. Questioning

Main purpose of interviewing patient:to obtain information about patients

condition that is accurate, complete and

relevant Good communication with patient alone

contributes to correct diagnosis in about

80% of cases


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Open questions should be used as much as possible

to obtain great deal of information from patient

Examples: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.

Examples:

Have you been feeling unwelltoday?

I see from your GPs notes that you have hadchest pain. Do you still have the pain?

Was ittight or dull pain?Did itgo down your arm?

Did itget worse when you exercised?


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What are the advantages of open

questions? More relevant information in given time

Patient feels more involved

Patient can express all concerns andanxieties about problems

When to useclose questions?

Obtain specific information not yet givenby 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 ofwhat 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

Part of effective listening. Aims to help patient totalk fully about problems.

By 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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Pitfalls in communication!

Asking too many or complicated questions

Not allowing patient to tell story in ownwords

Unnecessary interruption

Failing to pick up important verbal & non-verbal cues


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Communication

with Family

How family can help?

Provide emotional & social support

Provide practical support

Provide understanding of beliefs about illness &treatment

Provide information about family history

Help avoid/overcome bad patient compliance

Overcome difficulties arising from secrets

Anticipate/address problems that may affectother family members


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Conclusion

Dr Rene Laennec (1781-1826)

Listen to your patient. They are giving you

the diagnosis


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THANK YOU

introduction to block medical communication

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