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Communication In Healthcare New

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    Communication In Healthcare New Communication In Healthcare New Presentation Transcript

    • COMMUNICATION IN HEALTHCARE Datuk Dr. Ahmad Tajudin Jaafar Allianze College of Medical Sciences
      • Subject of communication has become prominent in healthcare for the last 50 years
      • It is now an established subject in most medical curriculum
      • Evidence is that healthcare fails without a conscious informed effort of communication which is the personal and professional responsibilities of all care givers
      • It is a major issue in the strategies of all health organisation
      • Healthcare is a complex intervention of at least four elements
        • Physical care
        • Cognitive care
        • Behavioral care
        • Psychological care
      • The aim and mission is to provide care that is evidence-based, patient-centred and in collaborative partnership with the patient
      • Effective communication is an absolute necessity at every stage of the clinical interview
      • Communication whether good or bad affects everyone of the four aspects of care
    • Health Outcome
      • Effect of communication on case and its outcome
      • The best outcome depend on accurate diagnosis and appropriate treatment
      • Communication styles that are ‘Patient Centred’ provide a more complete picture which lead to improvement in health outcome e.g.
        • Symptom resolution
        • Psychological distress reduced
      • (cont’)
        • Health and functional states improved
        • Pain control improved
        • Patient anxiety reduced
      • Patient also describe several consisted failure of communication
        • 54 % of complaint not elicited
        • 45% of their concerns not elicited
        • 50% of psychological problem not elicited
      • (cont’)
          • In 50 % visits, patient and doctors disagreed on main presently problem
          • In 50% cases, their history was blocked by interruption within 24 seconds
          • These lead to an incomplete history and poor professional relationship
    • Adherence To Treatment
      • Health outcome also depend on the extent to which patient adhere to their clinical advice
      • Adherence and clinical advice is dependent on effective communication
      • Factors in communication which improved patient adherence and clinical advice are:
          • Clinicians understands the patient
          • Clinician’s tone of voice
          • (cont’)
          • Clinicians elicits all the patient’s health concerns
          • Patient is comfortable asking questions
          • Patient perceived that sufficient time is spent with the clinician
    • Social Outcome
      • Patient satisfaction is the result of their;
        • knowing that they are getting the best appropriate care
        • knowing that they are being treated as individuals and not items on a conveyor belt
        • being treated in a humane manner
        • These are all related to good communication
    • Discord Between Patient And Clinician
      • An increasing number of complaints and lawsuits due to poor communication
      • Factors cited by 75 % of complaining patients as the cause of their complaint against their doctor:
      • (cont’)
        • feeling deserted
        • feeling devalued
        • information poorly delivered
        • lack of understanding
      • In contrast, the qualities that patient described in interviews with primacy care physician are
        • oriented patient to the process of the visit
        • use of facilitative comments
          • ask patients their opinions
          • use active listening
          • use humor and laughter
          • conducted slightly longer visits
    • Clinician Satisfaction
      • It is the quality of their relationships with their patients and colleagues which bring about clinician satisfaction and happiness
    • Poor Communication Between Doctors And Patients
      • Difficulties clinician have in communicating with patients
        • Lack of knowledge
        • - Concentrate on biomedical model rather than psychosocial model of clinical practice
      • illness have physical symptoms without organic basis
      • physical illness prolonged by psychological factors
      • 20 % of patients have psychiatric disease
        • Attitude
        • - authoritarian role = paternalistic
        • - negative attitude to shared care
        • Lack of Skill
        • - due to time constrains and uncomfortable topics to patients
          • Failure of Empathy
          • - empathy is described as ‘imagination for others’
          • - demonstrate genuine interest in patient experience
          • - key skill in building doctor-patient relationship
          • Personal Failure
          • - unhappiness, short tempered, rushed and interrupted on the part of the doctor can affect effective communication building between doctor and patient
    • Difficulties For Patients In Communicating With Doctors
      • Inferiority
      • Anxiety and its consequences
      • Misconceptions
      • Conflicting information
      • Forgetfulness
      • Disinclinations to disclose their concerns
      • Impaired faculties of communication