Patient Interaction and Communication病人的互动和沟通

Face-to-face Telephone Written Third party (the worst type usually)
Barriers to Communication

Prejudice Closed words

Never, always, etc



May not be the message you intend to send

Can compliment, repeat, contradict or accent one’s verbal and vocal message
Non-Verbal Communication

Physical characteristics
Judging Use of slang or jargon Emotions if upset Inability or unwillingness to listen

Hearing deficit, defensiveness, noise
Active Listening

Paraphrasing a speaker’s words to clarify if you have caught the meaning

When someone is angry or upset Match anger at a lower intensity, then lead to lower the anger level by speaking a little louder and quicker, then pace by speaking softer and slower

Can help change a person’s behavior

Person should then follow you

Then Pace

Can then slow or speed up the process

Especially helpful in intense emotional communication


Restate: repeating words as you have heard Reflection: verbalize content AND implied feelings of sender Clarification: summarize sender’s thoughts and feelings into concise statement “what I’m hearing is…Is that what you meant?”

More effective as a health care provider if you can educate effectively

Optimizes the therapy that you KNOW Art versus Science in PT

Who cares how much you know unless you can effectively get people to apply it, and be motivated and excited to do what you prescribe
Matching

Match small hand movements, body movements, head movements

Distribution of weight, posture Voice intonation, speed, volume, rhythm Vocabulary Should happen naturally

Hand gestures
Verbal Communication

Can be affected by:

Sender’s meaning versus receiver’s meaning Interference

Noise between sender and receiver

Channels of communication:
Therapeutic Communication

Facilitates the healing process Accomplished verbally and non-verbally

3 parts to a message:

Verbal (actual words): 7% Vocal (tone or inflection): 38% Nonverbal (physical aspects): 55%
Learning Styles
3 main learning styles: (Can be a combo of those below)

Kinesthetic – direct involvement with subject

Doesn’t like discussion as much as “doing” May seem distracted or fidgety as you are explaining Enjoys discussions, talks self through problems Excess noise in area is very distracting Likes descriptions and sometimes stops to imagine a scene Can concentrate intensely, often has a vivid imagination Sounds NOT generally bothersome


Ex: if someone is fidgety, don’t fidget also, but gently sway Goal is to “understand” the person, not copycat
Leading and Pacing

Once you have matched, then lead
Patient Interaction and Communication
Brian T. Larsen, DPT, MS
Objectives





Be familiar with what constitutes non-verbal and verbal communication and know how to be effective at both. Be familiar with the barriers to communication and know the parts to active listening. Understand the importance of obtaining rapport with patients, and understand how to match, lead and pace when communicating with your patients. Understand the 3 different learning styles in this lecture, and be prepared to give examples of each. Be familiar with the different steps in the Trans-theoretical Model of Behavior Change, and know how to assess which stage a person is in.
“actions speak louder than words”

Verbal and nonverbal messages often conflict

Non-Verbal Communication


Gestures, facial expressions, inaudible expressions Used to transmit a message

Studies have shown that rapport:


Fosters an atmosphere of confidence and trust with your patients

Warm, caring attitudes help, cold distant attitudes hinder the healing process
Rapport

Build on similarities

Find out about the person, small talk helps

3 Key steps in establishing rapport

Matching – different than mimicry Leading – posture, tonality, speed Pacing – helps control the situation



Study no 1: pts only needed ½ as many analgesics Study no 2: pts showed a decrease in BP Study no 3: compliance increased in pts who viewed their doctor as “friendly”

If unsure about speaker’s message…ASK