Administrative medical assisting 5th by lindh chapter05

May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part... May not be scanned, copied or duplicated, or posted to a publicly accessible

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Chapter 5

Therapeutic Communication Skills

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or duplicated, or posted to a publicly accessible website, in whole or in part

Importance of Communication

• Therapeutic communication

– Introduces element of empathy

– Specific and well-defined professional skills

– Foundation of all patient care

– Nontechnical language

– Technically accurate

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The Communication Cycle

• Two or more individuals exchanging

information

• Sending and receiving messages

• Four basic elements

– Sender

– Message and channel or mode of communication – Receiver

– Feedback

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The communication cycle and

channels of communication >>

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• The sender

– Encoding or creating message to be sent

• The message

– Content being communicated

– Must be understood clearly by receiver

– Four modes of communication

• Speaking

• Listening

• Gestures or body language

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• The receiver

– Recipient of sender’s message

– Must decode (interpret) meaning of message

– Sensory skill in verbal communication is listening

• Feedback

– After receiver has decoded message sent by

sender

– Receiver’s way of ensuring message that is

understood is same as message sent

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• Listening skills

– Active listening: received message sent back to sender, worded a little differently, for verification from sender

– Listening with a “third ear”

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• Listening skills

– Listening goals

• Improve listening skills so patients are heard accurately

• Listen either for what is not being said or for information transmitted only by hints

• Determine how accurately message has been received

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Types of Communication

• Verbal communication

– Takes place when message is spoken

– Sender and receiver must apply same meaning to spoken words

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– Good communication skills necessary in

establishing rapport with patients

– Patients feel respected and validated when called

by full name

– Patients should be encouraged to verbalize their feelings and concerns

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– Patients should be given technical information in manner that they can understand

– Patients should be allowed to make practical

application to their personal health needs

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Body language can communicate more than spoken words >>

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• Nonverbal communication

– Body language

• Expressions that accompany speech

• Kinesics is study of body language

• Body language learned first

• Body language influenced by primary caregivers and culture

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• Tone of voice communicates 23% of message

• Spoken word communicates 7% of message

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– Facial expression

• Eyes reflect feelings

• Staring is invasion of privacy

• Cultural influences affect facial expressions

– Personal space

• Comfortable with others while communicating

• Handled differently by various cultures

• Beneficial to explain procedures that invade another’s space

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– Posture

• Relates to position of body or parts of body

• Involves at least half the body

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– Gestures and mannerisms

• “Talk” with hands

• Enhances spoken word

– Touch

• Communicates what cannot be expressed in words

• Requires use of good judgment on part of professional

• Linked closely to personal space

• Not all patients are comfortable with touch

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Congruency in Communication

• Verbal and nonverbal messages must agree

• Meaning of mixed messages

• Clustering: grouping of nonverbal

messages into statements or

conclusions

• Masking: attempt to conceal or repress true feeling or message

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Congruency in Communication

• Perception

– Conscious awareness of one’s own feelings and the feelings of others

– Sense another’s attitudes, moods, feelings

– Follow perceived assessments with verbal

validation

– Easily misinterpreted

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Factors Affecting Therapeutic

Communication

• Barriers

– Age

– Economic

– Education and life experience

– Bias and prejudice

– Verbal roadblocks

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Communication

• Patient with special needs

– English as a second language

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Establishing Multicultural

Communication

• The patient must trust the professional

• Steps to building trust:

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Communication

• Cultural brokering

– Bridging, linking, mediating between groups or

persons through process of reducing conflict or

producing change

– Cultural broker serves as go-between

– One who advocates on behalf of another individual

or group within health care community

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Communication

– Interpreters do not provide word-for-word

equivalence, but rather focus on accurate

expression of equivalent meaning

– Remember to speak directly to patient, not to interpreter

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Communication

– Family member may serve as interpreter

– Family member may not understand medical terminology

– Difficult for family member to share a

life-threatening diagnosis or a poor prognosis

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Therapeutic Communication in Action

• Interview techniques

– Closed questions: answered with simple yes or no – Open-ended questions: patient required to

verbalize more information

– Indirect statements: elicit response from patient without patient feeling questioned

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• Point of care techniques

– Location where patient and provider or patient and office personnel physically interact

– Barrier to communication is emotional tension

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