H4
Patient-provider communication: core skill for physicians in all provision of health care.
- It is patient-centered; care in which the doctor responds to the patient in such a way
that It allows the patient to express all of his/her reasons for coming.
Provider-centered (previously): the provider provides all the information and knowledge and
is centered. Therefore, the patient doesn’t have the change to explain himself.
Purposes why communication is so important (Ong et al., 1995):
- Creating a good relationship: talk is the main ingredient in medical care and it is the
fundamental instrument by which therapeutic goals are achieved (patients should be
feeling comfortable to share information).
o Tricks to make patients feel comfortable: small talk, mutual trust and
empathy.
- Exchanging information: the exchange of information consists of information-seeking
and information giving.
o It is a two-way information traffic, because patients have to share their
conditions, but providers have to advice the patients for medication etc.
- Decision making: a choice must be made between several alternatives, often
involving trade-offs of harms and benefits.
o It has to be an informed decision making.
o There are different situations: Sometimes people want to decide
together/alone with(out) the doctor, but sometimes they want to give the
doctor the responsibility.
There are different behaviors:
- Instrumental vs affective
- Verbal vs non-verbal
- Privacy
- High vs low controlling
- Medical jargon.
Instrumental behavior:
- Patients have different needs:
o Need to know and understand (cognitive need (instrumental))
If people are diagnosed with something, they really want to know
what is going on in their body and what is going to happen (ASKING
FOR INFROMATION AND ADVICE)
o Need to feel known and understood (affective need (emotional))
People have concerns and really want to be listened to and want
empathy from others (EXPRESSING CONCERNS FOR BEING
DIAGNOSED).
, Verbal and non-verbal communication:
- Only 7% of the emotional communication is communicated verbally.
- 22% is transferred by voice tone.
- 55% is non-verbal communication.
- Non-verbal communication can be operationalized in: tone of voice, gaze, posture,
laughter, facial expressions, touch and physical distance.
Privacy behaviors:
- Information privacy: dealing with personal data.
- Psychological privacy: the right to determine with whom and under what
circumstances (the patient) will share thoughts and feelings.
- Social privacy: the degree of formality.
- Physical privacy: intimacy.
High vs low controlling behavior:
- Health care should be patient-centered. But there should be known that it was
provider-centered before.
Medical jargon: doctor telling you your diagnosis and you don’t have any clue what the
doctor is telling you. Better known as using difficult medical words.
The effectiveness of adequate communication
- Patients satisfaction: an indication of the quality of communication. This is the extent
to which patients perceive that the communication has met their needs.
o Patient-centered communication – tailored to the situation of the patient.
- Recall/understanding: recall of information (i.e., the ability to understand and
reproduce medical information)
o Between 40% and 80% of medical information is almost immediately
forgotten.
o Recall of information is a essential for successful treatments
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