CH 4 Notes PDF

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Comprehensive notes on each chapter covered in this class ...

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Chapter 4 Therapeutic Communication Vocabulary: Congruence- Being in agreement, harmony, or correspondence; conforming to the circumstances or requirements of a situation Stereotype- Something conforming to a fixed or general pattern; a standardized mental picture that is held in common by many and represents an oversimplified opinion, prejudiced attitude, or uncritical judgement First Impressions

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Includes attitude, compassion, and therapeutic communication skills We must communicate effectively with patient and provide a warm, caring environment Because medical care by nature is extremely personal, a medical assistant must always remember that each patient is an individual with certain anxieties Forget one's self-interest and focus on the patient's needs

Patient-Centered Care

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Providers and employees must be prepared to identify and address not just the clinical aspects of care, but also the spectrum of each patient's demographic and personal characteristics

Communication Paths 1. Verbal Communication  Oral communication Sending a patient a voice related message. o Methods:  Face-to-face discussions  Telephone conversations  Voicemail  Television or radio advertisements  Videos o Affected by many factors:  Tone of voice  Enunciation of words  Use of therapeutic pauses  Emphasis on certain terms  Choice of words such as medical or lay language  Written communication Put our thoughts to paper o Methods:  Patient education handouts  Written provider orders  Emails describing lab results or appointment reminders

 Letters  Faxes  Articles  Hand written notes  Text messages  Documentation in health record o

Written carries a legal burden so it must be accurate and comprehensive

2. Nonverbal Communication: Learned behaviors that are greatly influenced by our backgrounds Body naturally expresses our true feelings 90% of communication is nonverbal Nonverbal communication can seriously affect the therapeutic process

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Therapeutic nonverbal communication  Put patient at ease with tone of voice  Facial expressions  Ease and confidence of movements demonstrate sincere interest in patient  Therapeutic use of space and touch  Establish eye contact  Sit in a relaxed but attentive position  Avoid using furniture as a barrier  Give patient undivided attention  Let you body inform the patient you are interested in their medical problem Key to successful patient interaction is congruence between words used and body language observed Effective therapeutic communication means we need to constantly be aware of our body language and make sure our body language matches our words

3. Recognizing and responding to verbal and nonverbal communications  MA must observe the patient to interpret the person's message and level of understanding  Therapeutic communication skills:

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Active listening techniques Open and closed questions and statements Positive nonverbal skills Effective observation of the patient's body language

Communication Barriers

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Providing Unwarranted Assurance

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"Don't worry I'm sure everything will be fine" indicates that her anxiety is insignificant

Instead, acknowledge feelings and demonstrate empathy and willingness to listen to concerns Giving Advice

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Encourage further discussion with doctor Using Medical Terminology

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If patient asks "What would you do?" don't tell them your opinion because that removes accountability for decision making from them to you Instead, ask what they think they should do

Adjust vocabulary to fit patient

Biggest problem is misinterpreted communication and patients have problems understanding medical terminology If they look confused ask them to repeat it back to know they fully understand o Leading Questions "You don't smoke do you?" indicates the preferred answer and makes them feel if they o answer yes you will disapprove Keep questions positive o Talking too much Listen more than you talk o

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Pay attention to patient's body language to make sure they are given ample opportunity to discuss the health problem Stereotyping

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Oversimplified opinion or a prejudiced attitude

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Use descriptive language when speaking to vision impaired

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Use gestures and more body language to communicate

MA should see beyond preconceived notions and look at the individual to build a relationship Physical Impairment A person with diminished hearing- make sure you have their attention and you are face to face with them Involve family members or assistive devices to help communicate efficiently with o patients Language Be alert for the possibilities of misunderstandings Ask listener or present family members to repeat to ensure understanding

Sensitivity to Diversity

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Empathy is the key to creating a caring, therapeutic environment Attempt to see the person's health problem through their eyes Evaluate your individual value system- why do you have certain attitudes or beliefs about the worth of individuals or things? Determine whether it could affect your method of interaction Personal biases or prejudices are monumental barriers to the development of therapeutic relationships

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Points to consider when working with diverse groups of patients:

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Asian cultures find it rude to establish eye contact Personal space can be an issue for many people Older patients- focus patient teaching and information toward the patient and not family members Using religion to guide healthcare decisions may result in a conflict with the provider's recommendations. Try to find a balance between respect for a patient's beliefs and delivery of healthcare

Overcoming Barriers to Communication

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MA can nurture communication skills by using patience, observation, and sensitivity to patients' needs Communication during difficult times  MA must be able to understand why a patient or coworker is unable to communicate  Patient or family member may be reacting to strong emotions such as fear, anger, doubt, inadequacy etc. Therapeutic Techniques  Linear communication model:

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Sender of message

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Restatement

Receiver or message

Feedback to confirm reception of message  You have a specific context in mind when you send the message but the receiver puts their own interpretations on them Active Listening Techniques  Listening is different from just hearing. Listening = paying attention to sound, hearing something with thoughtful attention  No matter what outside factors may make listening difficult, MA must be diligent not only in hearing the words being spoken, but also in listening to them and what the patient is communicating  Encourages patients to expand on and clarify the content of the message  Processes involved in active listening: Reflection  Repeating the main idea of the conversation while also identifying the sender's feelings  Not only listening to words but also attending to their feelings

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Clarification  Asking sender to summarize thoughts and feelings to clear up any confusion  Help patient focus on chief concern Listening is not passive

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Listen to the main points of the discussion Attend to both verbal and nonverbal messages

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Be patient and nonjudgmental

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Asks for general information

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Asks for specific information

Do not interrupt

Never intimidate patient Open and Closed Questions and Statements  Open question or statement

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Allows patients to express themselves fully and provide comprehensive information Closed question or statement

Communication across the life span Children:  Get down on child's level  Establish eye contact  Use gentle but firm voice  Explain all procedures in a language they understand  Also communicate with guardian to ensure accuracy during intake  Guidelines:

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Provide safe and attractive environment Don't keep children and guardian waiting too long Don't give child option for treatment Praise child and direct questions to them Permit child to manipulate equipment if possible Look for signs of anxiety and involve guardian in making child feel safe

Listen to guardian's concerns and answer truthfully School age children  Give them a sense of control  Option to have parent present  Where to inject insulin/ have them do it themselves etc. Adolescents  Respect privacy, keep body exposure to a minimum  Prepare them of procedures  Keep them informed about findings  Encourage questions  Take opportunity to educate patients Adults  Use language they understand  Involve patient in treatment decisions Get to know adult patients and emphasize preventative healthcare when possible Aging patients  Show respect

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Explain purpose and procedure before beginning Face patient and use touch to get their attention before speaking Expanded speech- lower pitch of voice and speak firmly Gestures and demonstrations If repetition necessary, paraphrase in another way Observe nonverbal cues Adequate lighting Allow time to process information and to take care of themselves Communicate in quiet room without distractions Involve family members when needed Telephone messages- speak slowly and clearly and repeat...