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Communication

Communication

Gjyn O'Toole

(2012)

Additional Information

Abstract

This text introduces health sciences students to the various interpersonal communication skills that are commonly used within health settings to establish relationships with clients and fellow professionals, and improve therapeutic outcomes. It focuses on developing self awareness and skills for use in health settings and covers the types of scenarios commonly encountered in health settings that are rarely covered in generic professional communication texts. Perspectives and examples are drawn from a wide range of health professions. The book includes activities that will enable students to reflect on their experiences and practice using the skills.

  • Ancillary package including MCQs
  • Scenarios
  • Reflection questions
  • Health professions focus
  • Specific chapters on -
    • communicating with indigenous peoples
    • Culturally appropriate communication
    • Reflective practice
    • Self awareness

Table of Contents

Section Title Page Action Price
Front Cover cover
Half title page i
Splash page ii
Communication iii
Copyright Page iv
Table Of Contents v
How to use this book xi
Reviewers xiii
Preface xv
Acknowledgements xvii
One The Significance of Interpersonal Communication in the Health Professions 1
1 Defining effective communication for health professionals 3
Chapter objectives 3
Why learn how to communicate? – Everyone can communicate! 4
A guiding principle 4
Factors to consider when defining effective communication 4
Mutual understanding 5
A common understanding of words 6
Factors external to the sender and receiver 6
Factors specific to the sender 7
Factors specific to the receivers or ‘audience’ 7
Chapter summary 8
References 9
2 The overall goal of communication for health professionals 11
Chapter objectives 11
A model demonstrating the importance of communication 12
A model to guide the general purpose of communication for the health professions 13
Mutual understanding 14
A therapeutic relationship 16
Family/Person-centred goals and practice 17
Chapter summary 17
References 18
3 The specific goals of communication for health professionals: 20
Chapter objectives 20
Making verbal introductions 21
Introducing oneself and the associated role 22
Introducing the unfamiliar environment 23
Providing information: a two-way process 24
Chapter summary 26
Answers to Review Questions 29.e1
Chapter 3 The specific goals of communication for health professionals: 1 29.e1
Review questions 27
References 28
4 The specific goals of communication for health professionals: 30
Chapter objectives 30
Interviewing and questioning to gather information 31
Questioning: the tool 31
Why use questions? 32
Types of questions and the information they gather 32
Closed questions 32
Open questions 33
Questions that probe 33
Questions that clarify 34
Questions that ‘lead’ 34
Comforting: encouraging versus discouraging 35
Characteristics of encouragement and discouragement 35
Confronting unhelpful attitudes or beliefs 37
Chapter summary 39
Answers to Review Questions 43.e1
Chapter 4 The specific goals of communication for health professionals: 2 43.e1
Review questions 40
References 42
Two Developing Awareness to Achieve Effective Communication in The Health Professions 45
5 Awareness of and need for reflective practice 47
Chapter Objectives 47
The ‘what’ of reflection: a definition 48
The result of reflection: achieving self-awareness 49
The ‘why’ of reflection: reasons for reflecting 50
The ‘how’ of reflection: models of reflection 52
Reflection on using humour 56
Reflection upon barriers to experiencing, accepting and resolving emotions 56
Chapter summary 59
Answers to Review Questions 64.e1
Chapter 5 Awareness of and need for reflective practice 64.e1
Review Questions 60
References 62
6 Awareness of self 65
Chapter Objectives 65
Self-awareness: an essential requirement 66
The benefits of achieving self-awareness 66
Beginning the journey of self-awareness 67
Individual values 69
Is a health profession an appropriate choice? 69
Values of a health professional 70
Characteristics and abilities that enhance the practice of a health professional 71
Personal unconscious needs 71
Conflict between values and needs 73
Perfectionism as a value 74
Self-awareness of personal communication skills 75
Self-awareness of skills for effective listening 76
Barriers to listening 77
Reasons for the use of barriers to listening 78
Self-awareness of skills for effective speaking 78
Preferences for managing information and resultant communicative behaviours 79
Personality and resultant communicative behaviours 81
Chapter summary 81
Answers to Review Questions 87.e1
Chapter 6 Awareness of self 87.e1
Review Questions 82
References 85
7 Awareness of how personal assumptions affect communication 88
Chapter objectives 88
Reasons to avoid stereotypical judgement when communicating 89
Stereotypical judgement that relates to roles 90
Expectations of a health professional 90
Developing attitudes that avoid stereotypical judgement 92
Overcoming the power imbalance: ways to demonstrate equality in a relationship 93
Chapter summary 94
Answers to Review Questions 99.e1
Chapter 7 Awareness of how personal assumptions affect communication 99.e1
Review questions 95
References 98
8 Awareness of the ‘Person/s’ 100
Chapter objectives 100
Who is the Person/s? 101
The purpose and benefit of an essential criterion: respect 101
Defining respect 101
Demonstrating respect 103
Cultural expectations 103
Using names as a sign of respect 104
Confidentiality demonstrates respect 104
What information will assist the health professional when relating to the Person/s? 104
The whole ‘Person’ 105
Physical aspects of the Person 106
Emotional aspects of the Person 107
Validation 107
Clarification within validation 107
Empathy 108
The importance and result of empathy for the seeker of assistance 110
Touch 112
Silence 113
Sexual aspects of the Person 114
Cognitive aspects of the Person 114
Social needs of the Person 116
Spiritual needs of the Person 117
Chapter summary 118
Answers to Review Questions 122.e1
CHAPTER 8 Awareness of the ‘Person/s’ 122.e1
Review questions 119
References 121
9 Awareness of listening to facilitate Person/s-centred communication 123
Chapter Objectives 123
Defining effective listening 124
Requirements of effective listening 124
Results of effective listening 125
Benefits of effective listening 126
Barriers to effective listening 126
Preparing to listen 126
Cultural expectations change the requirements for effective listening 126
Characteristics of effective listening 127
Disengagement 128
Chapter summary 129
Answers to Review Questions 134.e1
CHAPTER 9 Awareness of listening to facilitate Person/s-centred communication 134.e1
Review Questions 130
References 133
10 Awareness of different environments that can affect communication 135
Chapter objectives 135
The physical environment 136
Physical appearance: dress and odour 136
Familiarity with the physical environment and the usual procedures 137
Person/s seeking assistance 137
Health professional 138
Rooms 138
Furniture placement and physical comfort 138
Waiting rooms 139
Treatment rooms and rooms with beds 139
Avoiding distractions and interruptions 140
Temperature 141
The physical ability of the person 141
The emotional environment 142
Formal versus informal environments 142
Emotional responses to environmental demands 142
Emotional responses to the immediate environment 142
Emotional responses to an external environment 143
The cultural environment 143
Personal space 143
Colour 145
Time 145
Environments relating to sexuality 146
The social environment 146
Family 147
Pets 147
Friends, neighbours, interest groups and sporting teams 147
Institutions 147
The spiritual environment 148
Chapter summary 148
Answers to Review Questions 151.e1
CHAPTER 10 Awareness of different environments that can affect communication 151.e1
Review questions 149
References 150
Three Understanding and Managing Realities of Communication in the Health Professions 153
11 Communication with the whole Person/s 155
Chapter objectives 155
Defining the whole Person/s 156
Holistic care 157
Holistic care includes consideration of context 158
The requirements of holistic care 158
Holistic communication 160
Chapter summary 161
Answers to Review Questions 164.e1
CHAPTER 11 Communication with the whole Person/s 164.e1
Review questions 162
References 163
12 Non-verbal communication 165
Chapter Objectives 165
The significance of non-verbal communication 166
The benefits of non-verbal communication 166
The effects of non-verbal communication 166
The components of non-verbal communication 167
Environment 167
Body language 167
Facial expression 167
Eye contact 168
Gesture 168
Space or proximity 169
Suprasegmentals: prosodic features of the voice 169
Volume 169
Pitch 170
Rate 170
Suprasegmentals: paralinguistic features of the voice 170
Emphasis 170
Pauses 171
Tone 171
Communicating with the Person/s who has limited verbal communication skills 172
Chapter summary 173
Answers to Review Questions 178.e1
CHAPTER 12 Non-verbal communication 178.e1
Review Questions 174
References 177
13 Conflict and communication 179
Chapter Objectives 179
Conflict during communication 180
Causes of conflict 180
Identifying emotions during conflict 181
Choosing to ignore 181
Resolving negative attitudes and emotions towards another 182
Patterns of relating during conflict 182
Aggressive 183
Passive 183
Assertive 183
Bullying 183
How to communicate assertively 185
Chapter summary 187
Answers to review questions 190.e1
Chapter 13 Conflict and communication 190.e1
Review Questions 187
References 189
14 Culturally competent communication 191
Chapter objectives 191
Introduction 192
Defining culture 192
Cultural identity affecting culturally competent communication 193
Defining culturally competent communication 193
Why consider cultural differences? 195
A model of culturally competent communication 195
Language 197
Understanding context 198
Ethnocentricity 198
Managing personal cultural assumptions and expectations 200
Strategies for demonstrating culturally competent communication 202
Self-awareness 203
Personal commitment to understanding differences 203
Exposure and learning 203
Investment of time to negotiate meaning and ensure understanding 203
Anticipation of difficulties 204
Using an interpreter 204
Essential steps when using an interpreter 205
The culture of each health profession 206
The culture of disease or ill-health 206
Chapter summary 207
Answers to review questions 211.e1
Chapter 14 Culturally appropriate communication 211.e1
Review Questions 207
References 209
15 Communicating with Indigenous Peoples 212
Chapter objectives 212
Correct use of terms 213
The 4 Rs for reconciliation: Remember, Reflect, Recognise, Respond 213
Remember 213
Reflect 214
Recognise 214
Respond 214
The complexity of cultural identity 215
Principles of practice for health professionals when working with Indigenous Peoples 216
Creating cultural safety for Indigenous Peoples in health practices 216
The importance of history 218
Pre-contact history 218
Post-contact history 218
Other factors 219
Factors contributing to culturally safe communication with Indigenous Peoples 222
Barriers to culturally safe communication 225
Chapter summary 225
Answers to review questions 231.e1
Chapter 15 Communicating with Indigenous Peoples 231.e1
Review questions 226
References 229
Further Reading 230
Websites and/or Organisations 230
16 Misunderstandings and communication 232
Chapter objectives 232
Communication that produces misunderstandings 233
Factors affecting mutual understanding 233
Causes of misunderstandings 235
Attitudes 235
Emotions 235
Relevance of context to determine meaning 235
Expectations of styles of communication 236
Expectations of the event or procedure 237
Expectations governed by cultural norms 237
Strategies to avoid misunderstandings 237
Reducing the incidence of misunderstandings 238
Resolving misunderstandings 239
Steps to resolving misunderstandings 239
Chapter summary 240
Answers to review questions 243.e1
Chapter 16 Misunderstandings and communication 243.e1
Review questions 241
References 242
17 Ethical communication 244
Chapter objectives 244
Respect regardless of differences 245
Honesty 246
Clarification of expectations 247
Consent 247
Agreement about information 247
Informed consent 248
Confidentiality 249
Protecting shared information 249
Protecting ethical responsibility 249
Protecting the health professional 250
Protecting the Person/s from gossip 250
Boundaries 250
Roles 250
Relationships 250
Self-disclosure 251
Over-identification 252
Ethical codes of behaviour and conduct 252
Chapter summary 252
Review questions 253
References 255
Further reading 257
Useful websites 257
Codes of conduct (mainly Australian) for some health professions 257
Informed consent 258
A fully informed consent letter 258
Answers to review questions 259.e1
Chapter 17 Ethical communication 259.e1
18 Remote communication 260
Chapter objectives 260
Characteristics of remote forms of communication for the health professional 261
Principles that govern professional remote communication 263
Documentation: written reports, medical records and letters 263
Consider the audience or reader 263
Abbreviations 263
Formatting 264
Points to remember 264
Databases 264
Telephones 264
Strategies for using a telephone 265
Answering a call 265
Making a call 265
Strategies for using short messaging service (SMS) 266
Strategies for using an answering service or voice mail 266
Video/teleconferencing or using Skype 267
Benefits 267
Strategies for using video/teleconferencing 267
The Internet 268
Email 268
Search engines 269
Online collaboration tools 269
Professional chat rooms and wiki spaces 269
Social networking sites 269
Chapter summary 271
Answers to review questions 276.e1
Chapter 18 Remote communication 276.e1
Review questions 271
References 274
Four The Focus of Communication in the Health Professions: Person/s 277
Introduction 278
Small group activity 279
Scenarios 279
Guidelines for discussion prior to exploring each case scenario 280
Procedure if using role-plays after completing the above 280
Procedure if using discussion points after completing the above guidelines 281
Person/s experiencing strong emotions 281
Person/s behaving aggressively 281
Definition of aggression 281
Behaviours related to aggression 282
Individuals most susceptible to behaving aggressively 282
Possible reasons for aggression 282
Principles for effective communication with a Person/s behaving aggressively 282
Strategies for communicating with a Person/s behaving aggressively 283
Person/s experiencing extreme distress 284
Definition of extreme distress 284
Behaviours related to extreme distress 284
Individuals most susceptible to extreme distress 284
Possible reasons for extreme distress 284
Principles for effective communication with a Person/s experiencing extreme distress 285
Strategies for communicating with a Person/s experiencing extreme distress 285
Person/s reluctant to engage or be involved in communication or intervention 286
Definition of reluctance to engage 286
Behaviours related to feeling reluctant to engage 286
Individuals most susceptible to feeling reluctant to engage 286
Possible reasons for reluctance to engage 287
Principles for effective communication with a Person/s reluctant to engage 287
Strategies for communicating with a Person/s reluctant to engage 287
Person/s experiencing depression 289
Definition of depression 289
Behaviours related to feelings of depression 289
Individuals most susceptible to feelings of depression 289
Possible reasons for feelings of depression 289
Principles for effective communication with a Person/s experiencing depression 290
Strategies for communicating with a Person/s experiencing depression 290
Person/s in different stages of life 291
A child 291
Definition of a child 291
Behaviours related to being a child 291
Children most susceptible to experiencing difficulties when attending a health service 292
Possible emotions a child might experience when attending a health service 292
Possible reasons for these emotions 292
Principles for effective communication with a child 292
Strategies for communicating with a child 293
An adolescent 294
Definition of an adolescent 294
Behaviours related to being an adolescent 295
Adolescents most susceptible to experiencing difficulties when attending a health service 295
Possible emotions an adolescent might experience 295
Possible reasons for these emotions 295
Principles for effective communication with an adolescent 296
Strategies for communicating with an adolescent 296
An adult 298
Definition of an adult 298
Behaviours related to being an adult 298
Adults most susceptible to experiencing difficulties when attending a health service 298
Possible emotions an adult might experience when relating to a health professional 298
Possible reasons for these emotions 298
Principles for effective communication with an adult 299
Strategies for communicating with an adult 299
A person who is older 300
Definition of a person who is older 300
Behaviours related to being an older person 300
An older person most susceptible to experiencing difficulties when attending a health service 301
Possible emotions an older person might experience 301
Possible reasons for these emotions 301
Principles for effective communication with an older person 301
Strategies for communicating with an older person 302
Person/s fulfilling particular life roles 303
Person/s fulfilling the role of a colleague 303
Definition of a colleague in the health professions 303
Attitudes and/or behaviours expected of a health professional 303
Attitudes and/or behaviours not expected of a health professional 303
Possible emotions a colleague might experience 303
Possible reasons for these emotions 304
Principles for effective communication with a colleague 304
Strategies for communicating with a colleague 304
Person/s fulfilling the role of carer for Person/s 305
Definition of a carer 305
Behaviours related to being a carer 305
Possible emotions a carer might experience 306
Possible reasons for these emotions 306
Principles for effective communication with a carer 306
Strategies for communicating with a carer 306
Person/s fulfilling the role of parent to a child requiring assistance 307
Definition of a parent 307
Behaviours related to being a parent with such a child 307
Parents in these situations most susceptible to experiencing difficulties when attending a health service 308
Possible emotions such a parent might experience 308
Possible reasons for these emotions 308
Principles for effective communication with a parent in this situation 309
Strategies for communicating with a parent in this situation 309
Person/s fulfilling the role of single parent to a child requiring assistance 310
Definition of a single parent 310
Characteristics single parents may expect of themselves 310
Possible emotions a single parent might experience 311
Possible reasons for these emotions 311
Principles for effective communication with a single parent in this situation 311
Strategies for communicating with a single parent with a child requiring assistance 311
Person/s fulfilling the role of a student 313
Definition of a student in the health professions 313
Behaviours related to being a student 313
Possible emotions a student might experience 313
Possible reasons for these emotions 314
Principles for effective communication with a student 314
Strategies for communicating with a student 314
Groups in the health professions 315
Types of groups offered in health services 316
Stages of group growth 316
Emotions typically experienced in a group 317
Overall group aims 318
Events of specific group sessions and associated emotions 318
Group norms: expectations of group behaviour 318
Principles for effective communication within groups 319
Strategies for communicating as a group leader 319
Person/s experiencing long-term conditions 320
Person/s experiencing post traumatic stress disorder and complex PTSD 320
Definition of PTSD 320
Behaviours typical of a Person/s with PTSD 320
Susceptibility to PTSD 321
Possible emotions a Person/s with PTSD might experience 321
Possible reasons for these emotions 321
Principles for effective communication with a Person/s experiencing PTSD 321
Strategies for communicating with a Person/s experiencing PTSD 321
Person/s with decreased cognitive function 323
Definition of decreased cognitive function 323
Behaviours related to being a Person/s with decreased cognitive function 324
Individuals with decreased cognitive function most susceptible to experiencing difficulty when relating to a health professional 324
Possible emotions a Person/s with decreased cognitive function might experience 324
Principles for effective communication with a Person/s with decreased cognitive function 325
Strategies for communicating with a Person/s with decreased cognitive function 325
Person/s experiencing a life-limiting illness and their family 326
Facts about people who know they are dying and their families 326
Core values of Palliative Care Australia (www.pallcare.org.au) 327
Definition of a life-limiting illness 327
Behaviours a Person/s experiencing a life-limiting illness might exhibit 327
Possible emotions a Person/s experiencing a life-limiting illness, their family members and friends might experience 327
Principles for effective communication with a Person/s experiencing a life-limiting illness, their family members and friends 328
Strategies for communicating with a person experiencing a life-limiting illness or with their family and friends 329
Person/s experiencing a mental illness 330
Definition of a mental illness 330
Behaviours related to a Person/s experiencing a mental illness 330
Individuals most susceptible to experiencing a mental illness 330
Individuals with a mental illness most susceptible to experiencing difficulty when relating to a health professional 330
Possible emotions a Person/s with a mental illness might experience 331
Principles for effective communication with a Person/s experiencing a mental illness 331
Strategies for communicating with a Person/s experiencing a mental illness 331
Person/s experiencing long-term (chronic) or multiple physical conditions 333
Definition of long-term or multiple physical conditions 333
Behaviours typical of a Person/s with long-term or multiple physical conditions 333
Susceptibility to acquiring long-term or multiple physical conditions 333
Individuals with long-term or multiple physical conditions most susceptible to experiencing difficulty when relating to a health professional 333
Possible emotions a Person/s with long-term or multiple physical conditions might experience 334
Possible reasons for these emotions 334
Principles for effective communication with a Person/s experiencing long-term or multiple conditions 334
Avoid saying 334
Strategies for communicating with a Person/s experiencing long-term or multiple physical conditions 334
Person/s experiencing a hearing impairment 336
Definition of a hearing impairment 336
Behaviours typical of a Person/s experiencing a hearing impairment 336
Individuals most susceptible to a hearing impairment 336
Possible emotions a Person/s with a hearing impairment might experience 337
Possible reasons for these emotions 337
Principles for effective communication with a Person/s experiencing a hearing impairment 337
Strategies for communicating with a Person/s experiencing a hearing impairment 337
Person/s experiencing a visual impairment 339
Definition of a visual impairment 339
Behaviours related to a Person/s experiencing a visual impairment 339
Individuals most susceptible to a visual impairment 340
Possible emotions a Person/s experiencing a visual impairment might experience 340
Possible reasons for these emotions 341
Principles for effective communication with a Person/s experiencing a visual impairment 341
Strategies for communicating with a Person/s experiencing a visual impairment 341
Person/s in particular contexts 342
Person/s experiencing an emergency 342
Definition of a Person/s experiencing an emergency 342
Behaviours related to being a Person/s experiencing an emergency 343
Individuals most susceptible to emergencies 343
Possible emotions a Person/s with an emergency might experience 343
Principles for effective communication with a Person/s experiencing an emergency 343
Strategies for communicating with a Person/s experiencing an emergency 344
Person/s experiences domestic abuse 345
Definition of domestic abuse 345
Behaviours related to being a Person/s experiencing domestic abuse 346
Possible emotions a Person/s experiencing domestic abuse might experience 346
Possible reasons for these emotions 346
Principles for effective communication with a Person/s experiencing domestic abuse 347
Strategies for communicating with a Person/s experiencing domestic abuse 347
Person/s speaking a different language to the health professional 348
Definition of a Person/s speaking a different language to the health professional 348
Behaviours related to being a Person/s speaking a different language to the health professional 348
Possible emotions a Person/s speaking a different language to the health professional might experience 349
Possible reasons for these emotions 349
Principles for effective communication with a Person/s speaking a different language to the health professional 349
Strategies for communicating with a Person/s speaking a different language to the health professional 349
References 351
The focus of communication 351
Glossary 353
Index 361
A 361
B 361
C 361
D 362
E 363
F 364
G 364
H 364
I 364
J 365
K 365
L 365
M 365
N 366
O 366
P 366
Q 367
R 367
S 368
T 369
U 369
V 369
W 369