Y khoa - Dược - Chapter 4: Interpersonal communication

4Interpersonal CommunicationLearning Outcomes4.1 Identify elements and types of  communication. 4.2 Relate communication to human  behavior and needs. 4.3 Categorize positive and negative  communication.4-*Learning Outcomes (cont.)4.5 Carry out therapeutic communication skills. 4.6 Use effective communication strategies  with patients in special circumstances. 4.7 Carry out positive communication with  coworkers and management.4-*IntroductionMedical assistants mustRecognize human behaviorsCommunicate effectivelyProfessionallyDiplomatically Recognize obstacles that affect communication4-*Elements of CommunicationCommunication circleMessageSourceReceiver 4-*Elements of Communication (cont.)FeedbackVerbal or nonverbalVerification of understandingNoiseSoundsPhysical or emotional discomforts 4-*4-*Apply Your KnowledgeWhat are the elements of the communication circle and what can cause interference in the process?ANSWER: The elements are: message, source, and receiver. Noise can interfere with the communication circle.Good!Human Behavior and NeedsDifferent personality types – require different communication stylesHumanistic role in the healthcare processAttentionrespect4-*Developmental Stages of the Life CycleInfant0 to 1 year oldTrust vs. mistrustToddler2 to 3 years oldAutonomy vs. shame and doubtPreschooler3 to 6 years oldInitiative vs. guilt4-*Developmental Stages of the Life Cycle (cont.)School age7 to 12 year oldIndustry vs. inferiorityAdolescence 12 to18 years oldEgo identity vs. role confusion4-*Developmental Stages of the Life Cycle (cont.)Young adult20sIntimacy vs. isolationMiddle adultLate 20s – 50sGenerativity vs. stagnationOld Adult60s and olderIntegrity vs. despair4-*Maslow’s Hierarchy of Human Needs1-*Physiological Safety Love/BelongingEsteemSelf-actualizationMaslow’s Hierarchy (cont.)Deficiency (basic) needs PhysiologicalSafetyLove/belongingEsteem Self-actualization 4-*Human Behavior and NeedsConsidering patient’s needsDetermine area of deficiencyAdjust communication style 4-*4-*Apply Your Knowledge You can communicate with all people in the same way. Is this statement true or false, and why?ANSWER: The statement is false. Not all people are at the same place on Maslow’s hierarchy of human needs. To communicate effectively with a person, you need to understand what he or she is deficient in. For example, you would use different communication styles when talking to a homeless person who may have psychological and safety needs than when talking to an elderly person who is lonely and depressed due to the recent loss of his or her spouse. Good Answer!4-*Types of CommunicationPositive or negativeVerbal or non-verbalWrittenPositive Verbal CommunicationCommunication promotes the patient’s comfort and well-beingSets the stageExamples 4-* Negative Verbal CommunicationCurb negative communication habitsPay attention to others in service-oriented workplaces4-*4-*Nonverbal CommunicationBody languageFacial expressionEye contactPosture4-*Nonverbal Communication (cont.)TouchPersonal space4-*Apply Your KnowledgeMr. Garcia comes to the desk to check in and asks if he will be seen on time. The receptionist continues with her paperwork, points to the sign-in sheet, and tells Mr. Garcia: “Just sign in. The doctor will be with you when he can.” Explain why this is an example of negative communication.ANSWER: This is an example of negative communication because the receptionist: Did not stop what he or she was doing – was not friendly or  attentive Did not greet Mr. Garcia or make eye contact with him Did not give a satisfactory answer to Mr. Garcia’s question Did not make sure Mr. Garcia understood when he would be  seenYEA!Improving Your Communication SkillsListening skillsInterpersonal skillsAssertiveness skills1-*Listening SkillsPassive listeningActive listening4-*Improve Listening SkillsPrepare to listenRelax and listen attentivelyMaintain eye contactMaintain personal spaceThink before you respondProvide feedback4-*Interpersonal SkillsWarmth and friendlinessEmpathyRespect4-*Interpersonal Skills (cont.)GenuinenessOpennessConsideration and sensitivity4-*Assertiveness Skills (cont.)AssertiveOpenHonestDirectAggressiveBossy Quarrelsome Manipulative 4-*4-*Apply Your KnowledgeWhat is the difference between being aggressive and being assertive?ANSWER: Assertiveness means standing by your principles while showing respect for others. You trust your instincts, feelings, and opinions and act on them. An aggressive person tries to impose his or her own position on others or tries to manipulate them. He or she is bossy, may be quarrelsome, and does not consider another’s feelings, needs, thoughts, ideas, or opinions.GoodAnswer!4-*Therapeutic Communication SkillsBeing silentAcceptingGiving recognitionOffering self Giving a broad opening4-*Therapeutic Communication (cont.)Offering general leadsMaking observationsEncouraging communicationMirroring Reflecting 4-*Therapeutic Communication (cont.)Focusing Exploring Clarifying Summarizing Ineffective Therapeutic Communication ReassuringGiving approval DisapprovingAgreeing/disagreeingAdvising1-*Ineffective Therapeutic CommunicationProbingDefendingRequesting an explanationMinimizing feelingsMaking stereotyped comments4-*Defense MechanismsAdaptiveNonadaptive 4-*Defense Mechanisms (cont.)CompensationDenialDisplacementDissociationIdentificationIntrojection ProjectionRationalizationRegressionRepressionSubstitution4-*Apply Your Knowledge Check those of the following that are therapeutic?ANSWER: Reassuring Offering self Mirroring Being silent Giving approval Accepting Probing Defending Making Observations Giving a broad opening Disapproving4-*Right!Communicating in Special CircumstancesSome special circumstances inhibit communicationHeightened emotionsCultural differencesImpairment or disabilityTerminal illnesses4-*The Anxious PatientMay not listen well or pay attention to what you are sayingObserve for signs Acknowledge Identify sourceUse communication skills4-*The Angry PatientReasons for angerDo not take personallyGoal ~ help refocus to solve problem4-*4-*Patients of Other CulturesUnique beliefs, attitudes, values, use of language and world viewsAvoid stereotypingAvoid generalizationCommunicating in Special Circumstances4-*Cultural differencesLanguage barriersCommunicating in Special Circumstances4-*Limited reading skillsCultural competence The Patient Who is Mentally or Emotionally DisturbedDetermine what level of communication the patient can understandSuggestionsRemain calm if the patient becomes agitated or confusedAvoid raising your voiceAvoid appearing impatient4-*Terminally Ill Patients4-*Respect rightsTreat with dignityKübler-Ross’s Stages of Dying DenialAngerBargainingDepressionAcceptance 4-*Patient’s Families and FriendsAcknowledge family members and friendsKeep them informed about patient’s progressRemember to protect patient confidentiality4-*The Patient With AIDS or the Patient Who is HIV-PositiveStigma of diseaseHave accurate information about the disease and the risks involved Provide human contact and treat with dignity4-*Apply Your KnowledgeWhat can you do to better communicate with the anxious patient?ANSWER: Identify signs of anxiety, acknowledge the patient’s anxiety, identify possible sources of the anxiety, ease any physical discomfort, and create a climate of acceptance and trust. Use appropriate communication skills: do not belittle the patient’s thoughts and feelings, be empathetic to the patient’s concerns. Help the patient recognize and cope with the anxiety.Right!Communicating with CoworkersPositive communication Develop rapportRules for the medical office Use proper channelsHave a proper attitudePlan an appropriate time for communication4-*4-*Communicating with ManagementKeep supervisor informedAsk questionsMinimize interruptionsShow initiativeDealing With ConflictDo not feed into negative attitudesBe personable and supportive of coworkersDo not judge or stereotype othersDo not gossipDo not jump to conclusions 1-*Setting Boundaries in the Healthcare EnvironmentBoundaries may be physical or psychological Limits undesirable behaviorAction will depend uponwho the aggressor is4-*4-*Apply Your KnowledgeANSWER: You can use the following strategies to avoid conflict in the workplace: Do not “feed into” others’ negative attitudes Be personable and supportive Refrain from passing judgments Do not gossip Do not jump to conclusionsWhat strategies can you use to avoid conflict in the workplace?4-*In Summary4.1 The communication circle involves a message being sent, a source, and a receiver that responds. Feedback is the response to a message, and noise is anything that may interfere with or change the message.4-*In Summary4.2 Understanding human behavior and needs, and their correlation with professional relationships, is necessary to practicing as a medical assistant. Understanding the various stages of human life assists you in your communication skills with patients.4-*In Summary (cont.)4.3 Communication that promotes comfort and  well-being is considered positive  communication. Negative communication can  be a turn-off. Lack of eye contact with  patients, except in specific cultures, or  speaking sharply to a patient is considered  negative communication. 4-*In Summary (cont.)4.4 Listening and other interpersonal skills can  be improved by becoming more involved in  the communication process by offering  feedback or asking questions of the patient. Understand that assertive medical assistants  trust their instincts. They respect their self- worth, while still making the patient feel  comfortable and important. Aggressive medical assistants try to impose  their positions through manipulation  techniques.In Summary4.5 Therapeutic communication is the ability to  communicate with patients in terms that they  can understand and, at the same time, feel at  ease and comfortable in what you are saying. Positive therapeutic skills can enhance  communication. Be aware of negative  therapeutic skills that can disrupt the  communication. Recognize defense mechanisms in patients  and note whether the patient is using them to  cope or is not able to cope. 1-*4-*In Summary4.6 Learning about the special needs of patients  and polishing your communication skills will  help you become an effective communicator. This will assist you with handling diversity in  the workplace, handling anxious and annoyed  patients, and in dealing with patients who may  have language barriers.4-*In Summary4.7 The quality of communication you have with  your coworkers and your supervisor greatly  influences the development of a positive or  negative work climate. Use proper channels of communication. Be  open-minded. Keep supervisors informed of  office problems as they arise and show  initiative in your work habits.4-*Often during life-altering experiences, patients and their loved ones need a shoulder to cry on or someone to comfort them. It is important for them to know support is there.—Lindsey D. Fisher (The Healers Art)End of Chapter 4