Basic-Concepts-of-Communication-with-Patient-and-Family-ppt.ppt

BASIC CONCEPTS
OF MEDICAL
COMMUNICATION
PUTU SUTISNA

Lecture’s main objectives:
 To describe the importance of good
communication with patients
 To describe the factors that may influence the
outcome of communication between the
doctor and patient
 To explain the technique of conducting
effective communication with patients that
involves questioning, listening and facilitating

Communication
imparting, conveying or exchanging of ideas,
news, knowledge etc.

Several methods of communication:
 Two friends talking
 Radio/ TV
 Newspaper/book
 Wrting a letter
 Telephoning/fax
 Teaching/lecturing
 Doctor or nurse with patient

Purposes of Communication
are to:
 form & maintain relationship
 give information
 convey feelings
 persuade
 solve problems
 alleviate distress
 make decisions
 give reassurance

Aim of a physician
(since ancient time):
“To cure sometimes,
relieve often,
comfort always……”

Communication in Medicine
• Doctor – patient/family
• Doctor – doctor
• Doctor – community

Main areas covered in Block MC
1. A.Taking medical history and review of body
systems
B. Giving information to patient
C. Special approach to specific patient/situation
2. Paper presentation and discussion
3. Writing medical letters & notes, and CV
4. Scientific writing
(5. Health education & health promotion for
community at large)

Good communication skills can be learned.
Prerequisites:
 Written instructions (references)
 Opportunities to practice
 Feedbacks (SGD)
 Discussion on performance (SGD)

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

 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

Guidelines for conducting
interview with patient
A. 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

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

7. Clarify what patient has told you
8. Encourage patient to be relevant
C. Ending
1. Summarize what patient has told you
2. Ask if patient wants to add anything
3. Thank patient

• Key skills for communicating effectively with
patient
 Questioning
 Listening
 Facilitating

1. Questioning
 Main purpose of interviewing patient:
to obtain information about patient’s
condition  accurate, complete and relevant
 Good communication with patient alone
contributes to correct diagnosis in 80% of
cases

• 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

• Closed questions
– Give patient little choice in the way to answer
– Usually elicits little information, only “yes” or
“no”.
“Have you been feeling unwell today?”
“I see from your GP’s 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?”

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

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

Non-verbal cues:
Eye contact
Posture
Gestures
Facial expressions
Way voice is used

3. Facilitating
 Related with effective listening. Aim to help patient
to talk fully about problems.
 Verbal way
“Please go on and tell me more about your pain”.
“Yes, I understand—please continue”.
 Non verbal ways:
 Leaning slightly forward toward patient
 Making eye contact
 Nodding head at appropriate time

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 affect
other family members

NO’S
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

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 cues
 ask easy-to-understand questions

Summary
 The ability to communicate effectively and
sensitively is essential in medicine
 Communicating effectively with patients involves the
core skills of questioning, listening and facilitating
 Good communication leads to: accurate history
taking and diagnosis, patients’ compliance with
treatment plan, patients’ satisfaction with the care
given
 The skills of good communication can be learnt and
retained

Basic-Concepts-of-Communication-with-Patient-and-Family-ppt.ppt

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