the doctor-patient communication
Post on 13-Jan-2017
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“If you want to study a human being, do
not pay so much attention to what s/he
says, rather look at the way s/he acts,how s/he comes into a room, how s/he
seats and walks around ……”
Zen Osho Rajneesh
Is it possibile not to comunicate?
The first principle of communication
pragmatics states that: We cannot avoidcommunication
P. Watzlawick
Let’s reflect on the very act of communication:
• Both in a private and a public structure, any
communication process is basically an exchange
process which can influence the relationships
between collegues, patients and their relatives…
• Both in a private and a public structure, any
communication process is basically an exchange
process which can influence the relationships
between collegues, patients and their relatives…
• Lets’s imagine ourselves while
dealing with our office or ward
head, or with anyone who can
manage the group and replace the
head. …….
• “How can we handle such stream of
communication?”
• Which strategies can we adopt?
• Who are our interlocutors?
• Where can we find appropriate information functional to manage communication?
• When can we choose the right moment for a better handling of this stream?
• How can we valuate the positive ornegative aspects of the relationshipbetween my colleague and me?
• Why do we need to pay particular attention to the process of communication that makes us waste psycho-physical energies?
• Probably we state that the lack of a correct management of communication is related to how and what we communicate. The resulting process of evaluation can have a negative impact on the decisional process, that is we could take harmful decisions both for ourselves and the other(s):patients, colleagues, heads, relatives…
So, let’s ask:what is communication?
• It’s a
• relational process
• an exchange of opinions
• ideas,
• feelings,
• emotions,
• tensions,
• experience,
• perception,
Communication is a process which involves two main instances:
• Content or rationality
• Relation or emotivity
• If coherence emerges from these
two aspects, we can figure out
whether the message is true and
persuading.
• We must admit that thanks to our
gestures, postures, distance, eyes,
we actually comunicate our
feelings, wishes, beliefs, opinions,
etc..
• let's read now the three levels of communication:
• Technically coomunicating “simply” means:
• “to transfer and receive information”• Basically the transfer of messages is
carried out by three main tools:• VERBAL– content, that is words used to
transfer data and information• PARAVERBAL –form, that is the way we
pronunce words, our tone, volume, rhythm, fastness, pauses
• NON-VERBAL –interpretation, miming, gesturing, postures, eyes.
• When the received concept corresponds
to what has been transmitted we can
state that communication has succeed.
Thus, when our interlocutor fails learning
information and concepts, we are
responsible for this failure.
Communication styles:
1. Passive communication:- aggressive communication- assertive communicationCommunication Typology1. to win/to lose2. to lose/to win
3. to lose/to lose
4. to win/to win
According to your experience, which is theso-called “differential advantage” of
communication?
Listening
Are you able to listen to someone's message?
It is really essential for a doctor to know how tolisten and how to be respondent to the patient’s“load”, that is how s/he describes the problem,her/his emotional experience and interpretations,the emerging dis/advantages, his/her worries,hopes, disappointments; how s/he is emotionallyinvolved in solving her/his pathology; what’sher/his life (origins, education, job, family, home),that is investigating on his/her emotional –affective-bodily-social- "global field".
Passive listeningInterlocutor:
• s/he doesn’t react
• s/he doesn’t make questions
• s/he doesn’t agree
• s/he doesn’t participate
• s/he doesn’t give opinions
Active listening
• The interlocutor:
• reacts
• makes questions
• agrees
• participates
• gives opinions
• wants and receives FEED-BACK
Pro-active listening
• The interlocutor actively participates
to the process of communication
showing empathy and providing
possibile solutions
TEST
Working in pair: perform a communication with a patient of yours who will act as a a) passive, b) active and c) pro-active listener.
• We can say that:
• sharing the map is essential for both verbal and non-verbal communication
• a geographical map can represent a symbolic outline of a determined land as well as a metal map can serve as a perceptive construct of a determined and symbolic reality.
• The geographical mapa helps us to move across a land, whereas the mental map determines the way we interpret experiences and situations.
• Anytime there are two or more interlocutors, two or more comparable mental maps will emerge.
Difficult communication
• Such elements as discussion, content area, thoughts and feelings contribute to the process of communication. This is the area of relations.
• The main problem is to combine what is
simply said with what is really acted.
• What we need is to focus on:
• Objective analysis of “what happened”
• Analysis of feelings (“are my feelings good”?
• Analysis of identity (self-dialogue)
Complex conversations are mainly
based on perceptions, interpretations
and values. Thus, we turn to focus
not on what is true, but on what is
more important for us.
• Communication between doctor and patient:
• Is a therapeutical moment
• Includes a request of technical help
• Is a need of relation
Internal Communication
• This kind of communication concerns
the so-called internal public which
takes place daily with colleagues and
patients
From the doctor-patient communication some obstacles emerge when:
• Is a very important therapeutic time
• Includes a request for technical help
• Is a need to report
la comunicazione medico -
paziente
Barriers between doctor-patient communication arise when:
We are not able to listen to someone else.
• The patient’s disappointment for an unsuccessful communication counts more than the disappointment for the technical skills.
CONCLUSIONS
• when we communicate, we need to
remember that our image is
perceived and "portrayed" by the
listener’s/observer’s senses and
emotions.
SOME USEFUL TIPS:1. The doctor is supposed to be
“neutral”, that is without any prejudices towards the patient who could have got different life styles, attitudes and values (the doctor should pay particolar attention to his/her attitude because his/her main worry must concern the patient's health).
2. To know how to “comunicate” (being collaborative) and to explain to the patient a) the steps of the diagnosis track in few and simple words; b) the meaning of the tests; c) special advice and therapies
10 simple rules to improbe the doctor-patient communication:
• Do not express too many concepts simultaneously
• Speak directly to the patient • Infor also the patient’s relative with
respect to important information• Repeat information several times,
especially id the patient is not well-educated
• Focus on the most important points both at the beginning and at the end of your communication
• Give examples which can help the patient to understand better any matter.
• Sometimes use colloquial or informal expression to acquire more familiarity with the patient
• Give detailed and practical examples of medicines and therapies and make sure that the patient understands every information.
• show positive attitudes and encourage the patient in any diffucult situation. A negative attitude could influence the patient’s view of the therapy.
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