Communication in the health care setting

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Communication in the health care setting

• Matthew Oates
• Lecturer,
• Department of Podiatry

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Lecture Outline

• What is communication?
• Why is it important?
• Issues in communication
• Types of communication
• The communication process
• Models of communication
• Purpose of communication
• Principles in Strategies for effective
  communication
• Culturally appropriate communication
• Challenging communication situation

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What is communication?

• Communication is conferring through speech,
  writing, or nonverbal means (including body
  language) to create a shared meaning. (Higgs et
  al, 2005, p4.)
• 2-way process involving 2 or more people sharing
  information
• Effective communication occurs when what people
  intended to say has been heard and those involved
  have reached a point of shared meaning (Higgs et
  al, 2005)

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Effective communication requires

• An intention to share information
• A desire to reach a common understanding
• Active listening or reading by the receiver
• An understanding by both parties of the person
  they are communicating with (inc. relevant
  background culture)
• A commitment by the sender to use language in a
  way that the receiver (eg. family and client) can
  understand
• A mutual willingness to understand the other
  persons point of view.
• Higgs et al (2005)

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Why is communication important in health?

• Allows us to facilitate quality services for our
  clients.
• A client-centred approach requires us to
  understand our clients needs and desires for
  their health.
• It allows us to then develop shared goals
  priorities in discussion with the client and
  their family.

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• Often we have to function as part of a health
  care team in order to deliver health care
  services which requires good communication among
  team members.
• To meet legal requirements (eg. documenting
  client encounters, assessments, other
  investigations, management plans, etc.)
• Health professionals need to communicate in a
  range of styles and media (eg. Oral, written,
  electronic)

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Issues in communication

• Think about what it would be like as a health
  professional.
• What are some of the issues that you may need to
  be mindful of which may impact on the
  communication you have with
• your clients?
• your colleagues (from your own discipline other
  disciplines)?

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Issues in communication
From Higgs et al (2005, p5)
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Types of communication

• Informal versus formal
• Formal
• Associated with systems organisations
• Often very explicit official information
• Might refer to language of this type of
  communication as scholarly, scientific,
  professional, academic.

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Types of communication

• Informal
• Spontaneous eg. In groups, among friends or
  colleagues, between practitioners clients
  during consultations.
• Language more casual, informal colloquial.
• Use of jargon (eg. SMS texts)
• Consider use of jargon between clients
  practitioners
• Need to de-jargon your language, use lay
  terminology

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The communication process

• Many theories of communication exist in the
  literature.
• Compare and contrast the diagrammatic
  representations of two communication models on
  the next two slides.
• Linear communication model
• Transactional communication model

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Linear communication model
From Higgs et al (2005, p8)
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Transactional communication model
From Higgs et al (2005, p9.)
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Purpose of communication

• What might be the purpose of talking with
  colleagues, patients, and carers?
• To inform
• To educate
• To correct
• To negotiate
• To support

• To counsel
• To give feedback
• To confront
• To create maintain social bonds
• Higgs et al (2005)

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Principles of effective communication

• Communication is dynamic and rapidly changing
• It is transactional not linear
• It is both verbal and nonverbal consider the
  use of body language to convey information
• It involves redundancy
• Messages can have multiple layers of meaning
• The message intended is not always sent
• The message sent is not always received
• Communication is culturally based

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Strategies for effective communication

• Minardi Riley (1997) suggest the following key
  elements for effective interpersonal
  communication
• Introducing yourself
• Establishing rapport
• Using positive interpersonal behaviours
• Using active listening skills

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Introducing yourself

• Always introduce yourself and make your status
  known.
• Make it known that you are a student.
• Check with your patients how they want to be
  addressed
• As a general rule, address older people people
  from other cultures using their title (eg. Mr,
  Mrs, Miss, Ms, Reverand, Dr) unless they suggest
  otherwise.

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Establishing rapport

• Rapport an affinity, sympathetic relationship
  or a therapeutic alliance (Sharpley et al, 2000).
• Achieved via active listening (verbal nonverbal
  actions that indicate you are listening inc.
  nodding, smiling, saying yes) and positive
  interpersonal behaviours (eg. Respect, empathy,
  genuineness)

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Culturally appropriate communication

• Australia is a culturally linguistically
  diverse country
• The health care system is a culturally
  linguistically diverse workplace
• Accepted communication strategies and behaviours
  can vary from culture to culture.
• Eg. Touching (hand-shaking), eye contact, sitting
  position.
• Refer to the handout on Intercultural
  Communication from Higgs et al (2005, pp239-246)

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Challenging communication situations

• Need to be able to adjust your communication
  style when involved in challenging communication
  situations
• Consider these challenging situations
• Communicating with an upset or angry client
• Communicating with a person with a communication
  impairment
• Delivering bad news
• Being drawn into communication on subjects
  outside your area of expertise
• Being drawn into collusion with clients
• Communicating across cultures
• Confronting someone
• Delivering or receiving negative feedback
• Read the handout from Higgs et al (2005, pp
  224-228)

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References

• Higgs J, Sefton A, Street A, McAllister L, Hay I.
  Communication in the health and social sciences.
  Oxford. 2005.
• Minardi HA Riley MJ. Communication in health
  care a skills-based approach. Butterworth-Heinema
  nn, Oxford. 1997.