introduction to healthy communication assistant prof.dr. muharrem ak inonu university faculty of...

Introduction to Healthy

Communication

Assistant Prof.Dr. Muharrem AKInonu University Faculty of Medicine

Department of Family Medicine

19.04.23 1"Communication Skills"

DefinitionDefinition ImportanceImportance Health communication conference Health communication conference Components of effective communicationComponents of effective communication Nonverbal communicationNonverbal communication How effective was IHow effective was I ConversationConversation Understanding patients and doctorsUnderstanding patients and doctors Hand on the dorknobe syndromeHand on the dorknobe syndrome


HealthHealth 1948, the World 1948, the World

Health Organization Health Organization defined health as ‘a defined health as ‘a complete state of complete state of physical, mental physical, mental and social well and social well being’ and not being’ and not merely the absence merely the absence of disease and of disease and infirmity.infirmity.

Toronto Toronto

Feeling vital and full of energy.Feeling vital and full of energy. Experiencing a sense of control Experiencing a sense of control

over one’s life and living conditionsover one’s life and living conditions Being able to do things pose in lifeBeing able to do things pose in life Experiencing being part of a Experiencing being part of a

communitycommunity

Relaxation To shape and continuation of

relationsProblem Solving

CommunicationExpression of

Emotions

PersuasionDecision İnformation

Relieving Stress

1.1. Two or more communicators (i.e. a Two or more communicators (i.e. a source and a receiversource and a receiver).).

2.2. AA messagemessage (the content of the communication(the content of the communication))

3.3. The mediumThe medium or the particular means of conveying the message, or the particular means of conveying the message, with thewith the three main types being presentational (e.g. voice, body), three main types being presentational (e.g. voice, body), representationalrepresentational (e.g. books, photos) and technological (e.g. (e.g. books, photos) and technological (e.g. television). The first is pivotaltelevision). The first is pivotal in interpersonal communication in interpersonal communication

4.4. The channelThe channel (i.e. what connects the communicators and (i.e. what connects the communicators and accommodatesaccommodates the medium; e.g. vocal–auditory, gestural–visual). the medium; e.g. vocal–auditory, gestural–visual).

5.5. A codeA code (i.e. system of meaning shared by a group, such as the (i.e. system of meaning shared by a group, such as the EnglishEnglish language language

6.6. Noise Noise (this is not just mere sounds but includes any (this is not just mere sounds but includes any interference with theinterference with the success of the communicative act).success of the communicative act).

7.7. FeedbackFeedback


Traditional skills

To think constructively To argue coherently To judge dispassionately To solve problems creatively


Contemporary Skills

To communicate ideas and concepts to the non-expert

To work effectively and efficiently as a member of a multi-disciplinary team

To manage knowledge – that is to find, evaluate, summarise, synthesise and

share information To adapt appropriately to change


Non-verbal communicationNon-verbal communication

Although the Although the verbal component of verbal component of interactions is clearly important, interactions is clearly important, research has shownresearch has shown that the non-that the non-verbal elements can account for up verbal elements can account for up to 80 per cent of theto 80 per cent of the content or content or meaning that is conveyed in face-meaning that is conveyed in face-to-face interactionsto-face interactions


19.04.23 13"Communication Skills" Yrd.Doç.Dr.Muharrem AK


Non-verbal communication has Non-verbal communication has been noted to perform a number ofbeen noted to perform a number of different functions in social different functions in social interactionsinteractions


11. . To replace To replace verbal verbal communication in communication in situations where situations where it may be it may be impossibleimpossible

or inappropriate or inappropriate to talk.to talk.


22. . To support and validate our To support and validate our verbal messages. Thus, facial verbal messages. Thus, facial expressions andexpressions and gestures should gestures should reinforce what is being said, rather reinforce what is being said, rather than conveying athan conveying a different different message.message.

19.04.23 "Communication Skills" 16

33. . To communicate our feelings and To communicate our feelings and emotions (such as anger, fear, emotions (such as anger, fear, happiness).happiness).

19.04.23 17

"Communication Skills"

44. . To regulate interactions and To regulate interactions and provide feedback. Non-verbal provide feedback. Non-verbal signals, such assignals, such as

shifts in posture and raised shifts in posture and raised eyebrows, can be used to initiate eyebrows, can be used to initiate and terminateand terminate

interactions and to regulate the interactions and to regulate the flow of messagesflow of messages..


For self-presentation and For self-presentation and maintenance of self-image, for maintenance of self-image, for example byexample by choice of clothes, choice of clothes, hairstyle and so onhairstyle and so on..


Social leakageSocial leakage

Influential source of feedback, as Influential source of feedback, as non-verbal communication tends non-verbal communication tends to be more automatic and less to be more automatic and less open to control by othersopen to control by others

People may say one thing verbally People may say one thing verbally but their body language or facial but their body language or facial expression may portray a different expression may portray a different picture picture

HOW HOW EFFECTİVE EFFECTİVE WAS I ?WAS I ?


Medical Education CycleMedical Education Cycle

11. Getting acquainted with the patient. . Getting acquainted with the patient.

(Does he/she introduce himself/herself (Does he/she introduce himself/herself to him/her? to him/her?

Shaking hands? Shaking hands?

Does he/she ask his/her nameDoes he/she ask his/her name??19.04.23 25"Communication Skills"

2. 2. Does he/she set up a communication Does he/she set up a communication level by making the patient feel betterlevel by making the patient feel better??


3. 3. Does he/she start with open-Does he/she start with open-ended questions and end with ended questions and end with closed-ended questionsclosed-ended questions


4. 4. Does he/she set up a history-Does he/she set up a history-composition? composition?


5.Does he/she make chapter 5.Does he/she make chapter summaries by orienting the patient summaries by orienting the patient toward his/her goal?toward his/her goal?


6. 6. Facilitating skills. Facilitating skills.


7. 7. Does he/she use the Does he/she use the communication skills? communication skills?

reflectionreflection empathyempathy respectrespect supportsupport


88. Does he/she transfer the . Does he/she transfer the explanatory information to the explanatory information to the patient in a simple way and patient in a simple way and language?language?

Patient educationPatient education The level of psychological distress in patients with serious illness is The level of psychological distress in patients with serious illness is

less when they perceive themselves to have received adequate less when they perceive themselves to have received adequate information.information.


9. 9. Does he/she make summaries Does he/she make summaries and clarificationand clarification


10. 10. Does he/she make regulations for Does he/she make regulations for next step and end visit properlynext step and end visit properly


DDifferentifferent E Elements of lements of CConversation onversation

being openings,being openings, turn taking,turn taking, closure,closure, questioning,questioning, listening, listening, using non-verbal communication,using non-verbal communication, and recognizingand recognizing feedback. feedback.19.04.23 35"Communication Skills"

The opening of a The opening of a conversationconversation

CCan be done verbally (e.g. throughan be done verbally (e.g. through

standard greetings, such as ‘good standard greetings, such as ‘good morning’ or ‘hello’) and/or non-morning’ or ‘hello’) and/or non-verballyverbally

(e.g. using eye contact, facial (e.g. using eye contact, facial expression, touch, proximity, and expression, touch, proximity, and so on).so on).


Turn TakingTurn Taking

In most conversations, each person In most conversations, each person finishes speaking beforefinishes speaking before another starts.another starts.

Such signals include using intonation of Such signals include using intonation of the voice or eyethe voice or eye contact or other contact or other gestures, or by asking an explicit gestures, or by asking an explicit question such as ‘what doquestion such as ‘what do you think? you think?


ClosureClosure

The nature of the relationship, the context, and the The nature of the relationship, the context, and the precedingpreceding conversation will influence the way it is conversation will influence the way it is closedclosed. . LessLess formal conversations might end with a formal conversations might end with a smile or hug, or a phrase such as ‘bye’smile or hug, or a phrase such as ‘bye’ or ‘see you or ‘see you later’. later’. ,,

Non-verbal signals, such as breaking eye contact, Non-verbal signals, such as breaking eye contact, standingstanding up or straightening papers may also be up or straightening papers may also be used to effect closure.used to effect closure.

An idealAn ideal closure is where both participants leave closure is where both participants leave the interaction feeling satisfied withthe interaction feeling satisfied with it and happy to it and happy to re-engage with each other when requiredre-engage with each other when required


QuestioningQuestioning

A A question is any statemequestion is any statement that nt that invites answer. invites answer.

Open questions (such as ‘how wasOpen questions (such as ‘how was your holiday?’)your holiday?’)

CClosedlosed questions (such as ‘did you questions (such as ‘did you go to Paris this year?’) often go to Paris this year?’) often encourage simpleencourage simple yes/no answers. yes/no answers.


Hand on the dorknob Hand on the dorknob syndromesyndrome


TIPSTIPS


Understanding PatientsUnderstanding Patients Whole person medicine is a cornerstone of Whole person medicine is a cornerstone of effective communicationeffective communication it is dynamic rather than static. Its elements are structured around five themes it is dynamic rather than static. Its elements are structured around five themes

oror questions in the patient’s mind:questions in the patient’s mind: (1) identity: what is it?(1) identity: what is it? (2) timeline: how long will it last?(2) timeline: how long will it last? (3) cause: what caused it?(3) cause: what caused it? (4) consequences: how will it/has it affected me?(4) consequences: how will it/has it affected me? (5) cure/control: can it be cured or controlled?(5) cure/control: can it be cured or controlled?


Understanding DoctorsUnderstanding Doctors Doctors’ behaviour in consultations varies widely between doctors.Doctors’ behaviour in consultations varies widely between doctors. 2. The variation in doctors’ behaviour in consultations is based in part on the2. The variation in doctors’ behaviour in consultations is based in part on the doctor’s ‘understanding’ that is influenced by cognitive, emotional, anddoctor’s ‘understanding’ that is influenced by cognitive, emotional, and other behavioural factors.other behavioural factors. 3. The doctor’s behaviour is also influenced by a variety of other immediate3. The doctor’s behaviour is also influenced by a variety of other immediate contextual factors, some of which are patient-related.contextual factors, some of which are patient-related. 4. Outcomes for the doctor can be seen in terms of perceived rewards and4. Outcomes for the doctor can be seen in terms of perceived rewards and punishments that accumulate to determine the doctor’s job satisfaction.punishments that accumulate to determine the doctor’s job satisfaction. 5. Effective feedback for doctors is hard to come by and needs to be actively5. Effective feedback for doctors is hard to come by and needs to be actively sought from patients and peers.sought from patients and peers. 6. It is important to maintain the doctor’s mental and physical health for the6. It is important to maintain the doctor’s mental and physical health for the

sake of both parties.sake of both parties.


WHAT WE HAVE WHAT WE HAVE

HEARD & LEARNEDHEARD & LEARNED? ?


ReferencesReferences

Textbook of Textbook of FFamily amily MMedicine / Ian R. edicine / Ian R. McWhinney,McWhinney,Ian R.Ian R. Thomas Freeman. 3rd Thomas Freeman. 3rd ed.ed. 2009 by Oxford University Pre2009 by Oxford University Press.ss.

Health Communication Theory and Health Communication Theory and Practice. Dianne Berry 2007. Open Practice. Dianne Berry 2007. Open University Press.University Press.

The New Consultation: Developing The New Consultation: Developing doctor patient communication David doctor patient communication David Pendleton.2003 Pendleton.2003 Oxford University Press Oxford University Press..


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