Hospital Practice 4Hospital Practice 4

Communicating with patientsCommunicating with patients

Communication with patients Communication with patients • The RT has to give messages/information to The RT has to give messages/information to

patient and to receive patient and to receive messages/information from the patient. messages/information from the patient.

• If this is to be effective it is essential that If this is to be effective it is essential that the RT has a good understanding about the the RT has a good understanding about the state of mind of the patient. state of mind of the patient.

• When a person becomes ill his mental When a person becomes ill his mental process becomes different from that of a process becomes different from that of a normal person. normal person.

• This is because his needs will be different. This is because his needs will be different. • It is important to assess the patient’s needs It is important to assess the patient’s needs

correctly.correctly.

Health & Needs Health & Needs How to assess Patient’s needs?How to assess Patient’s needs?

What is Health?What is Health? Health is a perceptual state of being. Health is a perceptual state of being.

All persons have a unique way of All persons have a unique way of defining their own state of being defining their own state of being healthy. healthy.

Health is often seen as being on a Health is often seen as being on a continuum. continuum.

Best health

Illness / State of despair (close to death)

People with Normal health

100% 0%

At the positive end of the continuum, At the positive end of the continuum, all body organs are in top working all body organs are in top working order with one’s mental faculties order with one’s mental faculties working at their best.working at their best.

At the negative end , a person is At the negative end , a person is close to death or in a state of close to death or in a state of despair.despair.

In the middle are persons in all states In the middle are persons in all states of mental an physical well-being of mental an physical well-being ranging from good health to illness ranging from good health to illness and death.and death.

People’s Needs People’s Needs

All persons have basic needs that All persons have basic needs that govern their lives. govern their lives.

When their basic needs are met, When their basic needs are met, other needs emerge that are called other needs emerge that are called higher needs. higher needs.

Abraham Maslow, a recognized Abraham Maslow, a recognized psychologist, placed the needs of psychologist, placed the needs of man in the following orderman in the following order

Hierarchy of needsHierarchy of needs

3. Need for Love & Belongingness

2. Safety & Security Needs

1. Physiologic Needs (Basic needs) :-food, shelter, air, water, sleep, sexual fulfillment

4. Esteem needs ( Self esteem & esteem of others )

5. Self actualization (spiritual Needs)

IIllness & needsllness & needs Persons whose state of mental and Persons whose state of mental and

physical health are at the most physical health are at the most positive end of the health-illness positive end of the health-illness continuum have their basic needs continuum have their basic needs met and are pursuing self-met and are pursuing self-actualization.actualization.

When illness, whether it be physical When illness, whether it be physical or emotional, overtakes an or emotional, overtakes an individual, he losses his state of well individual, he losses his state of well being.being.

He no longer perceives himself as one He no longer perceives himself as one whose basic needs for food, water, air, whose basic needs for food, water, air, love, belonging, and self-esteem are being love, belonging, and self-esteem are being met.met.

Illness may mean the loss of one’s ability Illness may mean the loss of one’s ability to maintain social and economic status.to maintain social and economic status.

One’s place in his social group is One’s place in his social group is threatened.threatened.

As illness progresses, the realization of As illness progresses, the realization of unmet basic needs increases, and feelings unmet basic needs increases, and feelings of great anxiety overwhelm the ill person.of great anxiety overwhelm the ill person.

When one’s level of wellness has been When one’s level of wellness has been compromised and the satisfaction of his compromised and the satisfaction of his basic needs is threatened, what ever the basic needs is threatened, what ever the cause, regressive behaviour may result.cause, regressive behaviour may result.

A person in such a state has difficulty in A person in such a state has difficulty in communicating effectively.communicating effectively.

He may resort to aggressive demands or He may resort to aggressive demands or may withdraw in silence and not be able to may withdraw in silence and not be able to make his needs known at all.make his needs known at all.

It will be the RT’s first obligation to assess It will be the RT’s first obligation to assess his patient’s needs and be able to his patient’s needs and be able to communicate with him in a communicate with him in a therapeutic therapeutic manner.manner.

IIllness & communicationllness & communication

ImportantImportant

RT must remember that his patient is RT must remember that his patient is feeling threatened and is not feeling threatened and is not functioning at his best.functioning at his best.

He must do everything possible to He must do everything possible to reassure and comfortreassure and comfort the patient the patient while providing care.while providing care.

CommunicationCommunication

DefinitionDefinition Communication is a constantly Communication is a constantly

changing process made up of both changing process made up of both spoken and unspoken messages that spoken and unspoken messages that go from the sender to the receiver. go from the sender to the receiver.

Components of communicationComponents of communication

Sender (source)

Message

Media (Channel)

Media (Channel)

Receiver

Feedback

Context

Context

RT-Patient CommunicationRT-Patient Communication

Health care is centered around Health care is centered around communication. communication.

All members of the health-care team must All members of the health-care team must learn to communicate clearly, effectively, learn to communicate clearly, effectively, and therapeutically with their patients. and therapeutically with their patients.

In order to become a successful In order to become a successful communicator, one must develop communicator, one must develop skills in listening, observing, skills in listening, observing, speaking, and writing.speaking, and writing.

Limitations in Perceiving othersLimitations in Perceiving others

All of us are limited in our abilities to All of us are limited in our abilities to perceive others because of our perceive others because of our learned attitudes. learned attitudes.

In order to communicate in a therapeutic In order to communicate in a therapeutic manner, the RT must first understand manner, the RT must first understand himself. himself.

He must become aware of his own He must become aware of his own limitations and understand any feelings limitations and understand any feelings and attitudes that might lead to bias or and attitudes that might lead to bias or discrimination in interactions with others. discrimination in interactions with others.

Attitudes & BiasesAttitudes & Biases

Biases are brought about by Biases are brought about by attitudes. Attitudes are a set of attitudes. Attitudes are a set of beliefs, that a person holds toward beliefs, that a person holds toward issues or persons that cause the issues or persons that cause the person to respond in a person to respond in a predetermined manner and may predetermined manner and may eventually affect his general eventually affect his general behaviour. behaviour.

a person reacts not to a particular a person reacts not to a particular event, but to a personal perception event, but to a personal perception of that event., a perception that is of that event., a perception that is the result of learned attitudes. the result of learned attitudes.

The RT must understand this and not The RT must understand this and not expect patients to feel as he does in expect patients to feel as he does in any situation. For instance, the any situation. For instance, the patient who is experiencing pain will patient who is experiencing pain will react to pain in a manner learned react to pain in a manner learned from his past life experience.from his past life experience.

The RT will be better be able to The RT will be better be able to understand and communicate with understand and communicate with others in a therapeutic manner if he others in a therapeutic manner if he examines his own background and examines his own background and considers the source of his own considers the source of his own attitudes, beliefs, prejudices, and attitudes, beliefs, prejudices, and values. values.

Then, with a new understanding of Then, with a new understanding of himself, he can try to put aside his himself, he can try to put aside his own biases and look at each patient own biases and look at each patient as an individual, with needs and as an individual, with needs and perceptions different from his own.perceptions different from his own.

Nonverbal CommunicationNonverbal Communication

The unspoken or nonverbal aspects The unspoken or nonverbal aspects of communication can be defined as of communication can be defined as all stimuli other than the spoken all stimuli other than the spoken word involved in communication.word involved in communication.

E.g. facial expressions, body E.g. facial expressions, body movements, hand signals, nodding, movements, hand signals, nodding, head shakinghead shaking

Factors that affect communicationFactors that affect communication

Cultural VariationsCultural Variations para-languagepara-language (sound of speech) (sound of speech) Age groupAge group Educational & social levelEducational & social level Hearing problemsHearing problems Physical conditionPhysical condition environmentenvironment

FeedbackFeedback In order to be certain that the message In order to be certain that the message

you are transmitting has been correctly you are transmitting has been correctly received, feedback must be obtained. received, feedback must be obtained.

If the message was misunderstood, the If the message was misunderstood, the patient will not respond in the manner that patient will not respond in the manner that was anticipated. If he does not, it will be was anticipated. If he does not, it will be the RT’s responsibility to restate that the the RT’s responsibility to restate that the patient will understand and will patient will understand and will demonstrate understanding by giving the demonstrate understanding by giving the correct feedback.correct feedback.

Developing a harmonious Developing a harmonious working relationshipworking relationship

Although interactions with a patient Although interactions with a patient will often be brief, the patient should will often be brief, the patient should be made to feel that he is a partner be made to feel that he is a partner in the examination process, for in the examination process, for indeed the most important member indeed the most important member of the health team. He should be of the health team. He should be made to feel that he is sharing in the made to feel that he is sharing in the process. process.

Communication techniquesCommunication techniquesThere are a series of communication techniques There are a series of communication techniques

that the RT student should cultivate that will help that the RT student should cultivate that will help him to become a therapeutic member of the him to become a therapeutic member of the health team. They include;health team. They include;• establishing communication guidelinesestablishing communication guidelines• reducing distancereducing distance• listeninglistening• using therapeutic silenceusing therapeutic silence• responding to the feeling and the meaning of the responding to the feeling and the meaning of the

patient’s statementspatient’s statements• restating the main idearestating the main idea• reflecting the main ideareflecting the main idea• making observationsmaking observations• exploringexploring

1.1. introducing yourself, explanation of introducing yourself, explanation of the examination or the treatment, the examination or the treatment, what will be expected of the what will be expected of the patient, what he can expect of the patient, what he can expect of the radiology staff.radiology staff.

2.2. reduce the physical distance, make reduce the physical distance, make eye contact, do not cross arms or eye contact, do not cross arms or legs during communication, do not legs during communication, do not perform any other tasks while perform any other tasks while attempting to communicate, attempting to communicate,

3.3. when the patient is speaking “shut when the patient is speaking “shut out” your own feelings and assume out” your own feelings and assume a totally nonjudgmental attitude.a totally nonjudgmental attitude.

4.4. related to listening is the related to listening is the therapeutic use of silence. Short therapeutic use of silence. Short periods of silence give the patient periods of silence give the patient time to arrange his thoughts and time to arrange his thoughts and consider what he wants to say. This consider what he wants to say. This will help the RT to assess the will help the RT to assess the patients non verbal communication patients non verbal communication as well as his own.as well as his own.

Blocks to therapeutic communicationBlocks to therapeutic communication

There are several factors that actually block There are several factors that actually block or destroy the possibility of crating a or destroy the possibility of crating a therapeutic atmosphere in communication.therapeutic atmosphere in communication.

• Speaking rapidly.Speaking rapidly.• Using complex medical terminology.Using complex medical terminology.• Distracting environment such as a noisy waiting Distracting environment such as a noisy waiting

roomroom• Language problemLanguage problem• Failing to explore the patient’s description of a Failing to explore the patient’s description of a

problemproblem

End of lesson 4End of lesson 4

Next :- The grieving process Next :- The grieving process