Transcript FAME

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Communication
&
Patient Interviewing
Aim & objectives
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Objectives:
Knows basic principles of communication
Knows the place of verbal and nonverbal communication
in patient interview
Is aware of the importance of nonverbal clues
Know the importance of hidden agenda
Can explain the interview process
What is Communication?
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A process of production and submission of
knowledge / symbols, which are received
and interpreted by the other party.
The communication Model
Signal
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Source
Sender
Channel
Noise
Receiver
Target
‫‪The communication Model‬‬
‫حدث‬
‫‪Signal‬‬
‫‪(7+-2Chunks‬‬
‫)‪134 BPS‬‬
‫الحالة الشعورية‬
‫الحذ‪D‬‬
‫في‬
‫تشو‬
‫‪D‬‬
‫تعميم‪ G‬التمثيل‬
‫ة‬
‫الداخلي‬
‫تصر‬
‫ف‬
‫‪Action‬‬
‫الحالة الفسيولوجية‬
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‫‪A‬‬
‫‪M‬‬
‫‪E‬‬
Patient Communication
70% of the patients can be diagnosed by only
communication.
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Doctors who are good communicators are less
suited by their patients.
M
Patient satisfaction increases when he/she can
have a good communication with the doctor.
E
However ……
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69 %
Doctors interrupting patients speech
within the first 18 seconds
77%
Patients didn’t even express their reason
for encounter:
Moreover
50% of patients leaving doctors office who
do not have enough information on their
illness:
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50% of patients who do not know how to use
their medication
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22-70% of patients not adhering to the
suggestions of their doctor
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Components of face to face
communication
Verbal (% 7)
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Paralanguage (% 38)
Body language (% 55)
Components of face to face
communication
7%
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38%
55%
Components of face to face
communication
90%
80%
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70%
M
20%
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90%
60%
‫لغة المفردات‬
‫لغة الجسد‬
50%
40%
30%
10%
10%
0%
Reference: (McCaskey 1979 )
Non-Verbal Communication
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S (smile)
O (open posture)
F (forward lean)
T (touch)
E (eye contact)
N (nod)
Hand Shaking
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Forward Lean
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Facial Communication
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Facial Communication
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Facial Communication
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Facial Communication
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Hand Communication
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Hand Communication
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Body space
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Body space
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Intima
te
zone
Private
zone
Social
zone
Public
zone
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15 - 46 cm
46 cm - 1.2 m
1.2 m - 3.6 m
> 3.6
The Environment
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Dr.
Pt.
Couch
The Environment
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Couch
Dr.
Pt.
The Environment
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The Environment
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The Environment
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The Environment
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Hands & body posture
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Sitting Position
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Sitting Position
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Hand Movements
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‫حركات‬
‫راحة اليد‬
‫‪Hand Movements‬‬
‫حركات‬
‫راحة اليد‬
‫لغة التهديد‬
‫التوسل‬
‫لغة االمر‬
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‫‪A‬‬
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‫‪E‬‬
Hand Movements
‫حركات الذراعني‬
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‫‪Hand Movements‬‬
‫حركات الذراعني‬
‫موقف عدائي‬
‫دفاعي سلبي‬
‫‪F‬‬
‫‪A‬‬
‫‪M‬‬
‫موقف متعالي‬
‫‪E‬‬
Legs Movements
‫حواجز الرجلني‬
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‫‪Legs Movements‬‬
‫حواجز الرجلني‬
‫متعال‬
‫مجادلة‬
‫ومنافسة‬
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‫‪A‬‬
‫‪M‬‬
‫واقعي وعنيد‬
‫اظهار االستياء‬
‫‪E‬‬
‫‪Hand & Face Movements‬‬
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‫‪A‬‬
‫مخادع‬
‫ترديد كذبة‬
‫غير متأكد‬
‫خائف‬
‫‪M‬‬
‫‪E‬‬
Negative communication
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Negative communication
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Negative communication
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Negative communication
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Mirroring
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The body Language
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Hand On doorknob Syndrome
Sometimes what patient says at the door is
his/her real reason for coming.
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The door is safe; patient can leave easily if
refused.
Ask at the end: “Is there anything we have
not covered or anything else you would like
to ask me?”
Patients Interview
Summary sentences
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Recognize deviations in
perception/expectations
Patient empowerment
Patient participation
Attentive listening
Traps in the Interview
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Direct questions
“Why” questions
Guiding questions
Yes-No questions
Sudden topic changes
Loss of eye contact
Loss of feedback
Problem patients
Defensive patient
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Anxious patient
Angry patient
Selfish and demanding patient
Changing Reactions
It is possible to change the process
and initiate a new behavior
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How did I interpret the patient’s
statements or behavior to make myself
angry?
Is there another way to interpret the
patient’s behavior?
Summary
• What is communication?
• What models of communication do you know?
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• 1/3rd of communication is by body language.
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• In which body position is the patient most receiving
if you give some kind of education?
E
• The best doctor-patient interview is by sitting on
both sides of the table.
• Nonverbal messages are produced intentionally.
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Thanks