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AMA 101
Communications in
Health Care
Communication Cycle
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Message
Encodes
Sender
Receiver
Decodes
Feedback
Clarification
Health Care Employee Role in Communication
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Communicates effectively, accurately and appropriately with
physicians, staff members and patients
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Use proper grammar
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Be professional
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MA often is the first person the patient meets, you represent your physician
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Positive attitude
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Therapeutic communication
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Clarify confusing messages
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Confirm or validate patient’s perceptions
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Adapt messages to patient’s level of understanding
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Ask for feedback
Verbal & Non-Verbal Communication
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Verbal – exchange of messages using words or language; most
common
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Polite
Professional
Proper grammar
Gear conversation to patient’s educational level
Paralanguage – tone, quality, volume, pitch and range
Non-language – laughing, sighing, sobbing, grunting, etc…
Written – clear, concise, accurate
Non-Verbal – exchange of messages without using words (body
language); may reflect more accurately a person’s true feelings
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Kinesics – body movements, facial expressions, gestures and eye
movements
Proxemics – spatial relationships or physical proximity; personal space; 3
feet
Touch – therapeutic indicates support, concern, feeling; use good judgment,
read body language first
Interview Techniques
Active listening – give full attention, try not to interrupt, observe body
language or non-verbal as well as verbal, ask appropriate questions,
record answers; use the following techniques:
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Reflecting – repeat what patient says using open-ended questions;
allows for further comments
Paraphrasing – repeat what you hear, using your own words or
phrases; allows for clarification
Clarification – asking patient to give an example; helps to understand
what patient is saying and gives insight on perception
Open-ended questions – best way to obtain info; allows for
elaboration; use questions that start with: what, when or how, do not
use why. Close-ended questions are answered by yes or no, avoid
these
Summarizing – review of info for clarification or organization
Allowing silence – natural and gives time for thought formulation
Barriers to Communication
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Clichés – do not use, can be demeaning
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Culture – be sensitive to differences in beliefs, body language
can be misunderstood
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Stereotyping – holding opinion of all members of a particular
culture or race; discriminatory
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Bias – personal opinions; treat all patients fairly, respectfully and
with dignity regardless of who they are
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Language – use an interpreter, do not shout, use simple English
if possible, avoid slang, learn basic phrases in other languages
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Hearing impairment – talk face to face, use interpreter, use
written notes, use visual aids
Barriers cont…
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Sight impairment – identify yourself, do not raise voice, describe what
you are doing each time, offer your arm, orient patient spatially, explain
sounds of machines to be used
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Speech impairment – allow patients time to gather thoughts, allow time to
communicate, offer note pad to write
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Mental health issues – explain what to expect, keep conversation focused, do
not be demanding or forceful, orient patient to reality if needed, do not confirm
hearing voices or seeing nonexistent objects
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Anger – remain calm, be open and honest, be supportive, do not belittle or
provide false assurances, ensure your own safety
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Children – be at eye-level, keep voice gentle, use slow movements, explain
procedures, rephrase to ensure understanding, use play, understand if child
reverts to lower developmental levels due to fear, allow expression of fear,
assess situation with teens before including parent, do not judge
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Grief – be empathetic, know Kubler-Ross’ stages of grief, allow time for
expression, use therapeutic touch, do not show pity
Elizabeth Kubler-Ross
Defense Mechanisms
Mental devices used to feel more comfortable and make behavior seem
more reasonable to self and others; protect us from loss of self-esteem
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Rationalization- offering a socially acceptable explanation for behavior when
true reason is too painful; excuses
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Projection – placing blame on someone else or attributing one’s own
unfavorable characteristics or desires to someone else
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Displacement – redirection of strong feelings about one person to someone
else; taking feelings out on another person
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Daydreaming – escape device of substituting fantasy for reality
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Escape into Illness – using illness to be rewarded with attention or concern;
learned behavior from childhood
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Repression – forcing unpleasant memory into subconscious mind
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Withdrawal – shutting off communication or removing oneself from a
threatening situation
Roadblocks to Communication
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Belittling – making light of patient’s fears
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Disagreeing – indicates belief that patient is incorrect
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Defending – repelling a verbal attack
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Stereotypes – statements that are not sincere; are biased and
discriminatory
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Changing the subject – prevents talking about topic that causes
anxiety or fear
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Reassuring cliché – insincere statement
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Giving advice – shows you think you know what is best for patient or
what they should do
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Agreeing – shows patient’s message is correct even if not so, may not
be real concern of patient
Positive Relationships
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Be a role model – earn trust of patients
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Use professional communication – be respectful, use appropriate demeanor
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Use proper forms of address – show respect, do not use pet names, use Mr. or Mrs. If
applicable, use last names
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Professional distance – do not become too personally involved, be objective, create
therapeutic environment
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Teaching patients – be knowledgeable of current medical trends, issues, etc.., be aware
of special services, allow time, use quiet space, be clear, encourage questions, use openended questions, invite follow-up phone questions
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Communicating with peers – be team player, avoid non-work related topics except on
breaks, be honest
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Communicating with physicians – be professional, use appropriate terms, address as
Dr. unless told otherwise, use proper medical terms, be confident, admit mistakes, ask
questions
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Communicating with other facilities – maintain confidentiality, be professional, you
represent your physician, observe legal requirements, facts only, do not judge, confirm
messages are received