Download COMMUNICATION

Dr Nesif Al-Hemiary
MBChB – FIBMS(Psych.)
International Associate of the Royal College of
Psychiatrists(UK.)
Definition
Communication is commonly defined as
"the imparting or interchange of thoughts,
opinions, or information by speech, writing,
or signs".
 Although there is such a thing as one-way
communication, communication can be
perceived better as a two-way process in
which there is an exchange and progression
of thoughts, feelings or ideas (energy)
towards a mutually accepted goal or
direction (information).
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Communication are a process whereby
information is enclosed in a package and is
discreted and imparted by sender to a receiver
via a channel/medium. The receiver then
decodes the message and gives the sender a
feedback.
 Communication requires that all parties have
an area of communicative commonality.
 Communication is thus a process by which we
assign and convey meaning in an attempt to
create shared understanding.
 This process requires a vast repertoire of skills
in intrapersonal and interpersonal processing,
listening, observing, speaking, questioning,
analyzing, and evaluating.
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Types of communication
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There are three major parts in human face to
face communication which are body language,
voice tonality, and words.
According to the research:
55% of impact is determined by body language—
postures, gestures, and eye contact,
38% by the tone of voice, and
7% by the content or the words used in the
communication process .
Although the exact percentage of influence may
differ from variables such as the listener and the
speaker, communication as a whole strives for the
same goal and thus, in some cases, can be
universal.
Verbal communication
Human spoken and written languages can be
described as a system of symbols (sometimes
known as lexemes) and the grammars (rules)
by which the symbols are manipulated.
 The word "language" is also used to refer to
common properties of languages. Language
learning is normal in human childhood.
 Most human languages use patterns of sound
or gesture for symbols which enable
communication with others around them.
 There are thousands of human languages, and
these seem to share certain properties, even
though many shared properties have
exceptions.
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Nonverbal communication
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is the process of communicating through sending and
receiving wordless messages .
Such messages can be communicated through gesture,
body language or posture; facial expression and eye
contact, object communication such as clothing ,
hairstyles or even architecture.
Nonverbal communication plays a key role in every
person's day to day life, from employment to romantic
engagements.
Speech may also contain nonverbal elements known
as paralanguage, including voice quality, emotion and
speaking style, as well as prosodic features such as
rhythm , intonation and stress.
Likewise, written texts have nonverbal elements such
as handwriting style, spatial arrangement of words, or
the use of emoticons.
Body language
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Body language is a term for communication
using body movements or gestures instead of,
or in addition to, sounds, verbal language or
other communication.
It forms part of the category of paralanguage,
which describes all forms of human
communication that are not verbal language.
This includes the most subtle of movements
that many people are not aware of, including
winking and slight movement of the eyebrows.
In addition body language can also
incorporate the use of facial expressions.
Why do we communicate?
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To satisfy needs.
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To gain information.
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To manage relationships.
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To derive pleasure and entertainment.
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To get self-validation.
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To coordinate and manage tasks.
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To persuade and gain something from
others.
Patient-Doctor Relationship
The quality of patient-doctor relationship is crucial
to the practice of medicine.
 The capacity to develop an effective relationship
requires a solid appreciation of the complexities of
human behavior and a rigorous education in the
techniques of talking and listening to people.
 To diagnose, manage, and treat an ill person,
doctors and therapists must learn to listen.
They need the skills of active listening,
which means listening both to what they
and the patient are saying and to the
undercurrents of the unspoken feelings
between them .
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Rapport
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An effective relationship is characterized by good
rapport.
Rapport is the spontaneous, conscious feeling of
harmonious responsiveness that promotes the
development of a constructive therapeutic alliance.
It implies an understanding and trust between
the doctor and the patient.
Frequently, the doctor is the only person to whom
the patients can talk about things that they cannot
tell anyone else.
Most patients trust their doctors to keep secrets,
and this confidence must not be betrayed.
Patients who feel that someone knows them,
understands them, and accepts them find
that a source of strength.
Empathy
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Empathy is a way of increasing rapport. It is an
essential characteristic of a doctor but it is not a
universal human capacity.
Although empathy probably cannot be created, it can
be focused and deepened through training,
observation, and self-reflection.
It manifests in clinical work in a variety of ways.
An empathic doctor may anticipate what is felt
before it is spoken and can often help patients
articulate what they are feeling.
Nonverbal cues, such as body posture and
facial expression, are noted.
Patients' reactions to the doctor can be
understood and clarified.
Patients sometimes say, How can you
understand me if you haven't gone through
what I'm going through? however, it is not
necessary to have other people's literal
experiences to understand them.
 The shared experience of being human is
often sufficient.
 Whether in an initial diagnostic setting or in
ongoing therapy, patients draw comfort
from knowing that doctors are not
mystified by their suffering.
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Listening skills
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Greet your patient.
Introduce your self.
Put your patient at ease (help your patient to
relax).
Smile.
Keep eye to eye contact.
Encourage your patient to talk.
Do not interrupt frequently.
Reflect what you hear from the patient.
summarize and ask if any thing was missed or if
your patient had forget to tell something.
Attend to non-verbal cues.
Open versus close ended questions
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Interviewing any patient involves a fine balance between allowing the patient's
story to unfold at will and obtaining the necessary data for diagnosis and
treatment.
Most experts agree that an ideal interview begins with broad, open-ended
questioning, continues by becoming specific, and closes with detailed direct
questioning.
An example of an open-ended question is (Can you tell me more about
that?). A closed-ended question would be (How long have you been taking
the medication?).
Closed-ended questions can be effective in generating specific and quick
responses about a clearly delineated topic.
Closed-ended questions have also been found effective in assessing such
factors as the presence or absence, frequency, severity, and duration of
symptoms
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YOU