COMMUNICATION SKILLS
Effective Communication Requires the Ability of Sender and Receiver to:
• Listen
• Pay attention
• Perceive what the other is trying to communicate
• Respond verbally or non-verbally (i.e. use feedback)
Effective Communication Skills and Rapport
• Effective communication skills involve:
Ø Active listening/reflective listening
Ø Attending to a patient
Ø Demonstrating a caring, respectful attitude
Ø Praising, encouraging patient
Ø Speaking clearly and simply at a level the patient can understand
Ø Encouraging patient to ask questions
Ø Paraphrasing and summarising
Ø Asking checking questions
Effective communication
• Good communication starts when the health worker sees the patient promptly and addresses the patient in a respectful manner.
• In every culture there are distinctive ways of communicating, expressing feelings and dealing with difficult circumstances. It is important to convey respect of the culture.
• Ways of communication will vary according to age, social class, urban and rural setting and the health status of the patient.
• Effective communication is not only needed for relaying information about care and treatment, it is critical to encourage patients to return for the next treatment visit.
• Surveys have shown that one of the main reasons for a patient stopping treatment is the attitude of the health worker.
• Patients who stop treatment often report that the health worker was rude, hurried or seemed too busy to care.
Building Rapport
• Rapport is:
a) Building a comfortable connection so that people can share information
b) Creating a relationship based on trust and respect
v Created through both verbal and non-verbal actions
• Establishing rapport is the first phase of effective communication, which includes:
- Greeting
- Welcoming
- Offering a seat
- Showing that you care and have time for the patient
How to build rapport
- Shake hands
- Introduce yourself
- Use same language as patient
- Show patience
- Do not interrupt
- Make eye contact
- Do not attend to other patients while busy with another
- Say ‘yes’, ‘um-hum’ or use a non-verbal gesture so they know you are interested
- Effective communication in a healthcare setting includes using simple and well understood language and avoiding the use of medical terminology and jargon.
- The counsellor should try to speak at the same level of language as their patient.
Barriers to Effective Communication
• Consequences of Negative Non-verbal Communication
ü Information is not shared or understood
ü The patient may ask fewer questions
ü Problem may be difficult to understand
ü Situation may be uncomfortable
ü Lack of adherence to medical appointments and/or treatment
Barriers to Communication
v Messy desk, with other patients’ information all over the table
v Interruptions and distractions
v The door is open and there are people nearby who can hear their interaction, so there is no privacy to ensure confidentiality
v Not looking directly at someone when he/she is talking. Looking out the window
v Looking at the clock or watch
v Starting to speak to someone else
v Taking a call on a mobile phone while in conversation with a patient/colleague
v Shuffling papers
Barriers from the Sender
• The sender has the primary responsibility for starting an effective communication flow:
Ø Talking too much, not giving patient time to express him or herself
Ø Being critical and judgmental
Ø Laughing at or humiliating the patient
Ø Showing signs of being upset
Ø Not listening or accepting feedback
Ø Using an inappropriate channel
Ø Not listening, not paying attention
Ø Lack of knowledge on the subject of discussion
Ø Using difficult or different language
Ø Contradictory verbal information with non-verbal gestures
Barriers from the Receiver
v Using the inappropriate channel
v Not listening, not paying attention
v Interrupting before sender completes the message
v Not sending feedback
Barriers to Communication in Healthcare
q Advice-giving and moralising
q Arguing
q Preaching
q Storytelling
q Showing discomfort, embarrassment if patient is upset
q Not respecting patient’s beliefs or way of life
q Not creating trust or rapport
How to Overcome Barriers
Ø Using the appropriate channel
Ø Creating good rapport
Ø Being attentive both verbally and non-verbally
Ø Using a common language
Ø Avoiding medical terminology and jargon
Ø Being self-aware
Ø Using from each other
Ø Asking questions for clarification in order to understand feedback feedback
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