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Difficulties with Communication

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Discuss the consequences of poor communication. ... Histrionic. Narcissistic. Obsessive Compulsive. Blocking Behaviours: Distancing ... – PowerPoint PPT presentation

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Title: Difficulties with Communication


1
Difficulties with Communication
  • Kara Fereday

2
Aims/Objectives
  • By the end of this session you should be able to
  • Discuss the consequences of poor communication.
  • Identify issues which might contribute to poor
    communication for patients and carers.
  • Recognise blocking techniques and instances when
    they could be used

3
(No Transcript)
4
Harmful consequences of poor communication
  • Alienated and frustrated patients
  • Rejection of management plan
  • Health Outcomes
  • Reduction of anxiety levels
  • Improved recall

5
  • Think about your clinical practice . Can you
    recall a time where you experienced difficulties
    with communication, either with a colleague,
    manager, patient or carer?
  • What caused these difficulties?
  • Consider personality types, ways of
    communicating, levels of understanding, emotions.

6
  • Social
  • Death Denial
  • High Expectations
  • Materialism
  • Changing Role of Religion
  • (Buckman 1998)

7
Barriers to effective communication
  • Patient Related
  • Reluctance to disclose concerns
  • Burdening, Ungrateful, Confirmation.
  • Preferences for modes of
  • communication

Communication
8
  • Cross cultural issues
  • Egan(1998)
  • The needs of the patient
  • Carers values
  • Cultural Stereotyping

9
Patient Related
  • Fear
  • Symptom Distress
  • Denial
  • Age
  • Family Related
  • Hospital Restrictions
  • Family Conflict

10
  • Professional Related
  • Values, attitudes and beliefs.
  • Skills deficits
  • Sympathetic Pain
  • Personal History

11
Professional related
  • What patients want
  • An apology
  • An exploration/answer
  • Accountability
  • Help
  • Change
  • Strong Emotions
  • Techniques for dealing with
  • Acknowledge distress
  • Reason

12
Situations/People
  • Withdrawn
  • Dependent
  • Histrionic
  • Narcissistic
  • Obsessive Compulsive
  • Discussions about CPR
  • Withdrawal of treatment
  • Organ donation
  • Disclosure of errors

13
  • Blocking Behaviours
  • Distancing
  • Ignoring emotional cues
  • Collusion, denial, false reassurances
  • Avoidance Tactics

14
When you think you want to say
Try
  • You are going to be just fine
  • Dont talk like that you can beat this
  • I cant see how anyone can help
  • Are there some things that worry you?
  • This must be hard to come to terms with
  • We will work with you

15
Which one
  • Ignorer
  • Facilitator
  • Informer
  • What would you change about interactions?

16
Barriers to Communication
  • Selective Listening
  • Doing Harm
  • Documentation
  • Knowing what to say
  • Time
  • Emotions

17
Barriers to Communication
  • Culture
  • Language
  • People came to pay their respectsmy heart kept
    falling I felt as if my head was about to burst.
    Id tie my head and hold itI do all this
    thinking in my heart.I know it affects the
    brain, but what can I do? That blow hit me as if
    my heart had stopped.I think,I think, in my
    heartthis built up pressure I my head.
  • Stereotyping

18
Resources
  • Bowler I (1993) Stereotypes of women of Asian
    descent in midwifery some evidence. Midwifery 9
    (1) 7-16
  • Buckman R (1998) in Doyle D, Hanks GWC,
    Macdonald N (1998) Oxford Text Book of Palliative
    Medicine. 2nd Ed Oxford University Press.
    Oxford.
  • Fallowfield L, Hall A, Maguire G, Baum M (1990)
    Psychological outcomes of different treatment
    policies in women with early breast cancer
    outside a clinical trial British Medical
    Journal, 301, 575-80
  • Faulkner A (1998) Effective Interaction with
    Patients. Churchill Livingstone. New York.

19
  • Heaven C , Maguire P (1997) Disclosure of
    concerns by hospice patients and their
    identification by nurses. Palliative Medicine,
    11, 283-90
  • Jenkins V, Fallowfield L (2002) Can Communication
    skills training alter physicians beliefs and
    behaviour in clinic? Journal of Clinical
    Oncology. 20,765-9
  • Macdonald E (2004) Difficult conversations in
    medicine. Oxford University Press. Oxford
  • Maguire P (1999) Improving Communication with
    Cancer patients. European Journal of Cancer 35,
    14, 2058-65

20
  • Maguire P, Faulkner A, Booth K (1996) Helping
    cancer patients disclose their concerns. European
    Journal of Cancer 32 78-81
  • Regnard C, Mathews D , Gibson D, Clake C (2003)
    Difficulties in identifying distress and its
    causes in people with severe communication
    problems. International Journal of Palliative
    Nursing, Vol 9,no 4.page 173 -176
  • Wilkinson S (1999) Factors which influence how
    nurses communicate with cancer patients. Journal
    of Advanced Nursing. 16, 677-88
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