Fichas
Module 3
Fichas del conjunto (101)
- 1Theories that impact communication across cultures● Power distance
● Uncertainty avoidance
● High/low context
● Formal v informal
● Individualist v Collectivist
● Context ambiguity
● Masculine v feminine
● Direct v indirect
● Sequential v synchronic - 2How are professions becoming more diverse?● multidisciplinary teams and case-based work loads
● requires communication competence in many areas of health - 3Where is culture first learned?Begins with family beliefs, behaviours and traditions
(Bronfrenbrenner’s ecological model) - 4What is cultural awareness?Knowledge of cultural practices and beliefs
- 5What is cultural competence?the application of this knowledge in appropriate and sensitive behaviour
- 6What are the postitives & negatives effects of culture in communication when your culture is not the same as the dominant culture?● Influences the way you make decisions about communicating to someone else
● Self-aware - think outside the norm, i.e. reaction, discrimination, self-awareness.
● Perspective of minority groups (i.e. refugee groups, etc.) are largely ignored
● Lack of: awareness of Indigenous contexts and issues, and client-centred speciics; capacity to reflect on how these values may impact Indigenous clients; plethora of other practical problems, including not having the strategies to understand, deal with, and challenge prejudice, discrimination, ethoncentricism and xenophobia, or engage in issues of human rights at a proactive level of advocacy.
● Chances of effective communication are limited without awareness of relevant cultural context off clients and the impact of these differences on accessing healthcare. - 7How skills, or lack thereof, in cultural communication can influence health outcomes for people of a different culture to you?● Culturally inappropriate health services contribute to
persistent health inequalities. - 8What does ' culture' mean?● Belief system and a particular set of value orientations and senses of meaning that influence customs, what are considered to be normal beliefs, values and practices, and social institutions.
● characteristics and knowledge of a particular society;
● the cumulative deposit of knowledge, experience,
beliefs, values, roles and customs acquired by a group of people in the
course of generations
● the attitudes, meanings, ideas, notions of time,
● roles, spatial relations, concepts of the universe, understanding of
material objects, art, music, beliefs around possessions, ways of
interacting and behaving specific to a particular people group;
● shared social heritage evident in patterns of behavior and
● interaction of a particular society, group, place, or time - 9What does ' Individualist' mean?● Less likely to discuss concerns with other people
● Assumption that other doesn’t know already
E.g. Australia / Most commonly a feature of Western societies
● Individualist culture = 'self' and 'I'
● Values being 'independent' and 'autonomous' and striving for a cultural idea of 'sucess' that is measured at an individual level (i.e. your income).
● Families tend to be nuclear and few resources are shared (i.e. lawnmower/car is not shared between neighbours). - 10What does ' collectivist' mean?● More likely to discuss concerns with other people
● Assume others already know
● E.g. Japan
● Group is valued over the individual
● Homes include more than two generations living together (unlike nuclear families)
● Resources more likely to be shared - 11What does ' ethnocentrism' mean?The belief that the cultural group you identify with is superior to all other cultural groups. (Contrast with xenophobia - The fear of people from a different culture)
- 12Language is a powerful tool when...Communicating with people from diverse populations
● A fundamental aspect of communication - critical to social relations - 13Specific skills to communicate with deaf people● Number One Rule – Use a SIGN LANGUAGE INTERPRETER.
● Develop resources – visual resources rather than just text are
often more accessible for everyone – i.e.
● Deafness Awareness Training/Hearing Loss Training
● Workplace Auslan classes if people are interested
● Encourage people who have an interest in sign language
● Respect Deaf culture
● Learn some meet and greet signs
● Learn to finger spell your name - 14What to do when in doubt in communicating with a person from a diverse population?Get help e.g. a translator, family member, pen and paper
- 15What is the ‘message’ approach when communicating with people with dementia?● MAXIMISE attention
● EXPRESSION and body language
● KEEP it simple
● SUPPORT the conversation
● ASSIST with visual aids
● GET their message
● ENCOURAGE and engage in communication - 16Inclusive language examples?● Use ‘we’
● Eye contact - 17Communicating with children requires?Care and awareness of their cognitive and developmental abilities, strength-based, and positive.
- 18specific strategies you can use for communicating with people who have autism, or who experience mental health issues that impact on their capacity to understand you.Important to check understanding
- 19Filters we may use when communicating with people from diverse populations● Different populations take different meaning from your words, visuals and non-verbal communication
● Mistakes: assuming mutual meaning, communicating clearly the message and how it's gotten across, non-disclosure of autism/other mental illnesses to health practitioner - 20What does ' Congruence' mean?Telling one thing and behaving another - i.e. children say what they think they should, rather than what is correct.
- 21Bronfrenbrenner’s Ecological Model (transcends beyond the aspects of the 'intrapersonal').● Perceives cultural/beginnings of changes as fluid: impacted by religion, gender, traditional taboos/cultural differences.
● Individual > Family > Company > National
● Individual -> Proximate culture (microsystem - school, family, neighbourhood) -> Distal culture (macrosystem - history, law & politics, social conditions).
● Influential: microsystem = macrosystem, though we are more likely to see the impact of our more immediate circle.
● Significant impact on mental health, beliefs, values, expectations, goals and support networks - essential to understand at even a cursory level
●
- 22What is a cultural norm?● Each culture has set rules that its members take for granted -
taught or absorbed subconsciously
● a culture's norms are based on local knowledge, life rules, religious
beliefs, group values,
● Taboos are based on rules phobias and anxieties. - 23Our Personal Cultures (Bronfrenbrenner’s Ecological Model)● How we define ourselves (Bronfenbrenner)
● First culture ie family
● We often belong to multiple overlapping cultures – can be difficult
● Multiple cultural memberships
● Find a unique sense of self in the face of our own conflicting cultural
identities, be sensitive about others’ identities (Trenholm, 2005) - 24Formal v Informal (Theories of cultural communication)FORMAL:
● Value silence
● Physical closeness
● Soft eye-contact
● Minimal body language
● Formal greeting
● High context
INFORMAL:
● Avoid silence
● Physical distance
● Direct eye-contact
● Animated body language
● Short greeting
● Low context - 25Direct v Indirect (Theories of cultural communication - Communication Styles 1)DIRECT:
● Individual
● Self-asserting
● Use of 'I'
● Focus on what is said
● Disagreement is valued
INDIRECT:
● Not personal 'face'
● Unassuming
● Uses 'we'
● Focus is on what is implied
● Harmony valued - 26Collectivism /Individualism (Theories of cultural communication - Communication Styles 2)Important to remember that features of a collectivist culture may not necessarily apply to an individual.
- 27Sequential v Synchronic (Theories of cultural communication)SEQUENTIAL:
● time is a linear commodity to "spend," "save," or
"waste."
● In sequential cultures (like North American, English, German, Swedish, and
Dutch), people give full attention to one topic after another
● Synchronic – time is a constant flow to be experienced in the
moment.
● In synchronic cultures (including South America, southern Europe and Asia)
the flow of time is viewed as a sort of circle, with the past, present, and
future all interrelated.
[Western (linear) v. Middle Eastern (spiral) v. Eastern (circle)] - 28Context and Ambiguity (Theories of cultural communication)Meaning of the message:
● Low context communication = meaning is conveyed verbally
and is explicit
● High context communication = meaning is conveyed by
situation and context
● Uncertainty avoidance (Hofstede)
● Tolerance of ambiguity and uncertainty
● High uncertainty avoidance cultures = avoid ambiguity and
uncertainty - 29Power distance (Theories of cultural communication)● Power distance is the extent to which a culture values
status and power and expect that these are distributed
unequally.
● Low power distance cultures - more consultation or democracy
● High power distance cultures - structured and hierarchical approach to
communication with those in power
● The culture of a family, work environment and society influence the degree of power distance in those environments - 30Masculine v Feminine cultures and communication (Theories of cultural communication)● Gender and culture is complex (remember the iceberg)
● Masculine cultures value assertiveness and dominance - based on strength, assertiveness,
dominance, and material success
● Feminine cultures value nurturing/caring and cooperation - based on helping others and creating a
supportive, cooperative environment - 31Overt and Covert communication● How does this impact on communication behaviour?
● Non-verbal communication
● What do you say or do that reflects your cultural
communication?
● Is it positive or negative?
- 32Emotional Language● Affective language
● cultures with high affect show their feelings plainly by
laughing, smiling, grimacing, scowling, shouting, etc
● Neutral language
● neutral cultures do not telegraph their feelings, but keep
them carefully controlled and subdued - 33Facework in cultural communication● Facework is the act of communicating in a way that maintains
the ‘image’
● how you present yourself so others ‘see’ you in a particular
way for acceptance and group membership
● Present an image so others will not impose their values - rather, they will
accept individuality - 34Where is facework found?More evident in HIGH power distance cultures and EQUAL in collectivist and individualist cultures (but collectivist cultures respect and support others 'face')
- 35Keys to Effective Cross-Cultural communication● Ask questions
● Distinguish perspectives
● Build self-awareness
● Recognise the complexity
● Avoid stereotyping
● Respect differences
● Listen actively
● Be honest
● Be flexible
● Think twice - 36What makes up cultural competence?Cultural compotence = Knowledge + Skills + Awareness
Awareness: reflects a person's conscious understanding that there are intricate cultural issues that have a variable impact on people
Knowledge: direct facts you have laerned about a particular culture
Skills: Tools in your toolkit that equip you to combine knowledge and awareness to effectively communicate with a person who comes from a cultural context different to your own. - 37Developing Cross-Cultural Communication skills (Broad ideas)● be open to new ideas and ways of doing things
● learn about the culture
● look for similarities and accept differences
● examine yourself for prejudices and assumptions
● be responsible in the way you communicate
● Using micro-skills:
● Build rapport by listening and observing
● Paraphrase for understanding
● be open and empathic
● Be aware of sensitive issues/taboos - 38Cross-cultural communication (3 Rs)Recognition + Respect + Reciprocity
- 39What in particular to focus on when assessing culture? And how?● Take care with context, situation, timing and audience
● The more we communicate with people from other
cultures, the more we learn – about them, and about us! - 40Impeding Communication? Loss of meaning within a health context = ?Verbal+ non-verbal + power + context = loss of meaning
- 41Why is the meaning lost?Because of -
● Lack of control
● Different modes of discourse
● Topic (biomedical)
● Lack of shared knowledge
● Linguistic and cultural distance
● Lack of awareness - 42Cultural training for health workers (Downing, Kowal and Parades, 2011) + Why it is important + Models relevant to cultural training● Culturally inappropriate health services contribute to
persistent health inequalities.
● Behaviour considered normal or abnormal in one culture can be defined differently in another - health professionals need to be awre of these deviations i.e. respect for individuals who hear sounds/have visions in South Africa would be considered negatively in AU.
● Mental health is not part of the individual, but perceived as an external factor -i.e. in Indigenous culture, it may be due something a person did as against traditional law.
Six models relevant to cultural training
● cultural awareness
● cultural competence
● cultural safety
● cultural security
● transcultural care
● cultural respect - 43Cultural CompetenceCultural competence:
● perceived as a continuum (begin: being aware of cultural nurances --> end: becoming culturally compotent)
● set of congruent
behaviours, attitudes and policies’
● that will prevent
the negative effects that may arise from
disregarding culture
● in the provision of health
services
EXAMPLE: thinking’ within the other culture’s
framework, while observing, listening, responding
without prejudice are necessary skills. - 44Transcultural care● Defines transcultural care is:
● “formal areas of study and
practice in the cultural beliefs, values and life
● ways of
diverse cultures and
● in the use of knowledge to provide
culture-specific or culture-universal care to individuals,
families and groups of particular cultures.”
● This model focuses on issues of power relations, racism,
and the conceptualization of identities
i.e. emphasize a
process of self-awareness as well as knowledge and
acceptance of cultural ‘differences’. - 45Cultural Security● The ‘cultural security’ model emphasizes that the
responsibility for culturally secure health services
lies with the system as a whole, rather than
individual health workers.
● Despite its broader systemic approach, cultural
security still appears to rely on cultural training that
will teach participants about ‘indigenous culture’ - 46Cultural RespectThe goal of cultural respect is
● ‘uphold the rights …
● people to maintain, protect and develop their
● culture and achieve equitable health outcomes’..
● cultural respect’ translates cultural knowledge and
● awareness into attitudinal and behavioural change
for individual health workers
● as well as changing
policy and practice for health care systems. - 47Cultural Awareness● Cultural awareness training generally aims to
increase participants’ awareness of ‘cultural, social
and historical factors, promoting participants’ self reflection
on their own culture and ‘tendency to
stereotype’ .
● Cultural knowledge will assist health workers to
become more ‘tolerant’ and, accordingly, adjust
their practice with people from other cultures. - 48Cultural Safety *● Cultural safety aims to recognize and protect a person’s cultural
identity (and hence maintain their cultural safety) within the
health service.
● Emphasis is placed on assisting the health worker
to understand processes of identity and culture, and how power
imbalances or relationships can be culturally unsafe.
● This model encouraging health workers to be more aware of the
social, political and historical processes that influence health
practice and also places an emphasis on the health worker
understanding their own culture and identity, and how this
manifests in their practice. - 49Findings – Awareness vs CompetenceCultural Awareness:
● self-reflection on own culture and know own discrimination and
stereotyping
● awareness of cultural, social and historical factors
● Acquire skills to adjust behaviour with people from other cultures
● More of a realistic goal
Cultural Competence:
● May not be a realistic goal
● More than just being aware of cultures - includes understanding and identifying your own cultural assumptions, values, beliefs with a view of seeing through the eyes of others.
● Developing an understanding of other cultures
● Thinking within ‘other’ culture framework
e.g. observing, listening, responding
● Acquire skills to adapt communication to other cultural settings - 50Cultural humility“…a commitment and active engagement in a lifelong process
that individuals enter into on an ongoing basis with patients,
communities, colleagues, and with themselves”
(Tervalon, p.118) - 51How can culture be explained?● Culture can be explained in a number of ways
● Identification; Power relationships; behaviour and
communication styles - 52Define 'enculturation'● The process of absorbing and internalising the rules of the culture we live in
- 53Each culture has _____ _______ that its members take for ______________. How are some of the culture's knowledge, rules, beliefs, values, phobias and anxieties taught?a) Each culture has set rules that its members take for granted
b) They are taught explicitly and most of the information is absorbed subconsciously. - 54According to psychologist Bronfenbrenner, we define ourselves through what four terms?1. Identity
2. Uniqueness
3. Self-concept
4. Self-esteem - 55We often belong to multiple overlapping cultures and this can be difficult. Multiple cultural memberships are often based on what five factors?1. Geography
2. Gender
3. Occupation
4. Interests
5. Common experiences - 56Define Integration/acculturation.Maintain own culture but also relating to and absorbing host culture
- 57Define fusion.Fusion is combining both cultures to form a new culture.
- 58Define the terms Alteration and Assimilation.a) Alteration is being bi-culturally competent, maintaining both cultures and alternating between them as necessary.
b) Assimilation is giving up own culture and embracing host culture. - 59Explain the term 'Separation/Marginalisation'a) Maintaining own culture and being isolated from or failing to relate to host culture.
- 60Culture diversity works best when:a) Different groups identities and practices are respected
b) Relations to other groups are cooperative rather than competitive - 61Deaf – with a capital ‘D’ is the term for a person who: (3)● has some degree of hearing loss (usually a severe to
profound loss- often from an early age)
● identifies as belonging to the “Deaf community”-
sharing common values and behaviours, known as ‘Deaf
culture’
● uses a sign language as their preferred language - 62Hearing loss?● hearing impaired; hard of hearing or hearing
loss are terms used for a person who:
● Has some difficulty hearing speech sounds
● Uses a spoken language as their preferred
language eg speaking and listening - 63Deaf culture values?● Auslan (ESL)
● Information presented visually
● Stories/narrative
● Deaf history
● Community/Social connection
● Equal access - 64Deaf culture behaviours?● Getting attention
● Deaf nod
● Expressive language
● Long goodbye - 65Auslan and fingerspelling● AU (Australian) S (Sign) LAN (Language)
● Different countries have different sign languages
depending on the deaf history of that country
● Visual/spatial language
● Different grammar to English
● Fingerspelling used for specific purposes. - 66Why is lip-reading ineffective?Not everyone can read lips.
Even the best lip reader picks up only about
30% of spoken words. The rest is worked out
in context. - 67Technology to communicate with deaf populations?● Visual alerts – fire; doors; phone; baby cry;
● Vibrating alerts
● Text communication – msn/email/sms/NRS
● Visual communication – VRS; booking
interpreters;
● Captioning- training dvd’s?
● Cochlears and hearing aids? - 68The power of language in the context of the deaf community?● Language is not neutral
● Reflects the values and knowledge of the people using it
● Can reinforce both negative and positive perceptions about
other people
● Powerful role in contributing to and in eliminating
discrimination
● Discriminatory language can be hurtful, demeaning and
offensive
● Exclusive language is harmful because it can inhibit or
prevents people from reaching their full potential
● Inclusive language…
● Sometimes called non-discriminatory
language
● acknowledges, in a positive and
constructive way, that people have
differing cultural and religious norms,
experiences and values
● Does not demean, insult, exclude,
stereotype, or trivialise people based on
“difference”
● avoids terminology that may be
offensive or portray any group in a
stereotypical way (including positive
stereotyping)
● This is not about being "politically
correct" but rather it is about using
language that is acceptable to the
people being described - 69Inclusive language examples for people with disabilities?● Put the person not the disability first
● E.g. "people with disability", "a person with a hearing
impairment"
● Phrases such as "suffers from", "stricken with" or "victim of"
should not be used
● People with disabilities do not necessarily suffer, nor do they
wish to be seen as victims
● Refer to "people without disabilities" rather than "normal"
or "able-bodied" people
● Be aware of limiting talk… so someone is not ‘confined to a
wheelchair’ because a wheelchair can liberate
● If you are unsure whether you are behaving appropriately
or using the right language, just ask the person! - 70Dementia? Characterisation? Decline in what characteristics?● Dementia = several diseases characterised by
decline in mental ability, memory, thinking,
problem-solving, concentration and perception
Involves loss of:
● Memory
● Intellect
● Rationality
● Social skills
● ‘Normal’ emotional reactions - 71Common communication problems for people with dementia?● Difficulty finding words
● Using speech that doesn’t make sense
● Inability to understand what you are saying
● Deteriorated writing and reading skills
● Loss of normal social conventions of conversation
(e.g. interruptions, ignoring, failing to respond
when spoken to)
● Difficulty expressing emotions
● Some people can still read from pre-prepared text
or sing songs - 72Barriers to effective communication1. Patient
● Extent of decline ● cognitive abilities and capacity to understand
● Possible sensitivity to emotional distress / mood disturbances
2. Institutional
● Staff-patient ratios ● Time with each person
● Medical policies ● Patient confidentiality – not including 3rd party;
e.g. Hospital staff ask family to leave when consulting person – c/f
specialists who know the importance of including 3rd party
3. Environmental
● Unfamiliar environments challenging
● Familiar environments and routines can be comforting ● reduces
the person’s stress and confusion
● Important that if a person is in an institution that familiar objects
are present - 73Dementia Behaviour - communication● 1: Aggressive Speech or Actions
• Unpredicable mood changes
• ‘hidden’ language
● 2: Confusion About Time or Place
• “Often people are trying to go back to a place where they
had more control in their lives.”
● 3: Poor Judgment or Cognitive Problems
• Financial and legal - 74How NOT to communicate with someone who has dementia● Argue
● Order the person around
● Tell someone what they can’t do (instead focus on
what they can do)
● Be condescending (talking down) – tone of voice
might be understood even if words aren’t
● Don’t ask a lot of direct questions that rely on a
person’s memory
● Don’t talk in front them as if they aren’t there - 75Some communication strategies to remember when communicating with those with dementia?● Talk to a person, not about them
● Address a person by their preferred name, not ‘dear’ or ‘love’
● Tell a person what you are doing or going to do
● Focus your full attention on the person and make eye contact
● Use words and sounds of encouragement
● Do not use a demeaning or condescending tone of voice or hostile gestures or
stance
● Do not invade a person’s personal space
● Speak at a slower pace
● Pause between one topic and the next
● Use prompts such as pictures, photographs and simple signs - 76Some more communication strategies -● Accept a person’s feelings
● Use non-threatening physical contact
● Do not make abrupt changes to routines
● Get to know a person’s life story so you have a store of background
information for questions and conversations.
● Use individualised memory
books to improve and keep communication skills.
● Use written and pictorial signs in significant places around the facility
● Place memory charts containing photographs, brief statements about the
person and conversation topics on bedroom walls and other appropriate
places to aid communication
● Use other techniques and therapies that help communication like
aromatherapy, attention focusing, bright light therapy, massage, music
therapy, pet therapy, reminiscence sessions and walking - 77Principles of Good Communication with a Child (Principle 1?)Be age appropriate and child-focused
● Children have different communication needs at different stages of
development and experiences
• Physically get down to the child’s level then talk.
• Be open to the child’s communication needs
● - eye contact, space, play
• Paralanguage like tone, volume, non-verbal
● Encourage and model interaction - let the child know that you are
interested and involved
• Turn off the television or put the phone down when the child wants to converse
• Avoid taking a calls/texts when the child has something important to tell you.
• The best communication between you and the child will occur when together
and/or alone. - 78Principles of Good Communication with a Child (Principle 2?)Principle 2: address the child holistically
● all aspects of child development are interconnected
• physical, social, emotional and cognitive development
● Use an integrated rather than single-modal approach
• Children learn using all their senses
• Communication also involves
● Paralanguage
● Non-verbal
● Listening skills
● Filtering
● Provide a positive communication model
• Listen carefully and politely. Don’t interrupt the child when he is trying to
tell his story. Be as courteous to your child as you would be to your best
friend.
• Create “safe havens” as part of communication - 79Principles of Good Communication with a Child (Principle 3?)Principle 3: be positive and strength based
● Develop capacity and resilience
• show ways children can help themselves when they are afraid
• model ‘do as I do’
● Build self-confidence
• Reinforce the child for keeping communication open
● Show that you accept the child, regardless of what he/she has or has not
done.
● accept and praising her/his efforts to communicate.
● Do not harm!
• Reality vs trauma
• provide physical and emotional “protection” when presenting
sensitive issues - 80Strategies to help a child problem-solve● Listen carefully and politely. Don’t interrupt the child when he is trying
to tell his story. Be as courteous to your child as you would be to your
best friend.
● Don’t be a wipe-out artist, unraveling minor threads of a story and
never allowing the child’s own theme to develop.
● Don’t ask why, but do ask what happened.
● If you have knowledge of the situation, confront the child with the
information that you know or have been told.
● Keep adult talking and moralizing to a minimum because they are not
helpful in getting communication open and keeping it open.
● Assist the child in planning some specific steps to the solution. - 81Words of encouragement● Children thrive on positive attention. ● Children need to feel loved and appreciated.
● Most
parents find that it is easier to provide negative feedback rather than positive feedback. By
selecting and using some of the phrases below on a daily basis with your child, you will find
that he will start paying more attention to you and will try harder to please. - 82Austistic Spectrum Condition● Autism is a spectrum!!!
● History of ASD
male dominated
• research
Asperger
Women
• Autism? OR emotional and personality disorder
● Stigma and discrimination -> Assumptions
• Anti-social
• Impulsive
• Lack empathy and other emotions
• Act inappropriately
• Are a burden - 83Austistic Spectrum Condition disclosure in health environment - positives and negatives
- 84Communication with a person with ASC (Austistic spectrum condition)● Acknowledge social differences
● Cognitive
● Sensory
● Language
● Fear of the patient/person impedes communication
● Increase your knowledge
● Communication is an interaction
● Be aware of your own communication limitations
● Sensory awareness
● Improves: Trust, compliance, health seeking behaviour, diagnostic
reasoning, quality screening
● Check for understanding –for yourself and patient - 85Barriers to communication with people with ASC● Patronise, demean or stereotype
● Reinforce stigma
● Talk down or exclude –
● Poor eye contact does not mean the person is not
listening
● Get offended by frank and honest responses
● Make assumptions!
● Overload multiple senses!
● Generalise – we all have individual differences - 86Persons with a mental illness● Mostly, no special communication needed
● Powerful negative stigma attached to mental illness, especially the
more severe forms, like schizophrenia
● Media fuels stereotypes about mental illness and dangerousness
● Can’t just go on ‘face value’ though
● Careful with how we respond to people’s communication - Look for
alternative explanations
• Are they rude or are they scared?
• Are they avoiding eye contact and being aggressive or are these symptoms
of the disorder?
● MANY forms of mental illness
● One in five (20%) Australians aged 16-85 experience a mental
illness in any year
● Most common: depression, anxiety and substance use disorders - 87Communication strategies for use with patients who are acutely psychotic● Notice, do not ignore
● Be encouraging, supportive
and gentle
● Show empathy and concern
● Honesty and respect
● Observe first
● Consult case notes
● Slow your speech/pace
● Use simple vocabulary and
short sentences
● Be comfortable with silence
● Be flexible
23 (from Bowers, Grennan, Winship and Theodoridou, 2009)
● Consult friends/family
● Choose best time of day
● Choose location
● Give advance notice (where
possible) that you’d like to
talk
● Provide positive feedback
and encouragement
● Be assertive
● Be more visual or
demonstrative than usual
● Listen to their experience - 88Palliative care communicationSteps taken to improve the quality of life of patients and their familities facing life-threatening illness. Underlying principles that death, dying and beravement are all integral to life.
● Person before condition/illness
● -- Emotion vs facts
● Difficult conversations
●-- Pre and Post Diagnosis
● -- End of life
● --- Family and friends - 89Delivering bad or sad news S.P.I.K.E.SS—SETTING – Private setting, with significant others and no interruptions
P—Assessing the Patient's PERCEPTION – Checking what the patient has already
been told and checking their understanding of the situation
I—Obtaining the Patient's INVITATION – Some patients don’t ask about the situation,
so asking about how they would like the information (e.g. all at once, alone, etc)
K—Giving KNOWLEDGE and Information to the Patient – Can start by ‘warning’ the
person that they are about to be told bad or sad news. Can be useful to give info in
chunks and check understanding as you go along
E—Addressing the Patient's EMOTIONS with Empathic Responses – Observe and
identifying the emotions apparent, connect the emotion with the reason, ask if
unsure
S—STRATEGY and SUMMARY – Checking in with the patient before looking at
treatment plans if they are ready to discuss. Collaborative approach = shared
responsibility with the patient to lessen the burden of the decision-making. - 90Tips for communicating with deaf clients● Ask about their preferred communicative approach
● Engage patient warmly and directly with eye-contact as long as possible, and make it clear when the focus needs to shift
● Be aware of restricted effectiveness and fatigue of lip-reading
● Ensure patient has best possible view of your face - do not stand in front of a light source
● Speak using simple language and short sentences at a natural speed and volume: give clear, concrete examples and avoid vague general terms and jargon
● Avoid simultaneous comments and examination: communicate first and then examine
● Good communication with deaf patients takes more time than with hearing patients - thus, plan longer patient visits
● Check for comprehension: ask patient to summarise essential points, since 'Do you understand?' and nodding might not indicate comprehension. - 91Cultural identity? (3)● Life experience;
● Biology;
● What we learn purposefully. - 92There is more commonality between cultures than differences. (T/F?)True. People from one cultural group may vary to a GREATER extent from each other THAN the whole group differs from another cultural group.
i.e. A person living in an individualistic culture that subscribes to/lives within a more collectivist framework. - 93Culture reflects not only a person's race or ethnic identity, but also...A person's identity within a social grouping.
Examples: Cultural context specific to the deaf community, intellectually/visually impaired, minority sexual orientation, etc. - 94A person is shared by cultural forces that...Impact many of their communication behaviours.
- 95IntrapersonalPertaining to factors that exists within a person; like age & gender
- 96Competency scale factors (that influence a person's ability to provide culturally appropriate counseling).● Knowledge of mental health issues
● Health skills and abilities
● Organisational capabilities (including resource and networking capacity)
● Beliefs and attitudes toward working in the Aboriginal mental health context - 97Ethical values that maximise chances of successful communication between all persons● Reflect - Understand your own stereotypes, preconceptions and bias to entertain those of others - you are a product of your own culture.
● Learn - Be responsible in learning about cultural differences/similarities; the relativity of particular beliefs with regard to interactions; the influence of culture on interventions.
● Respect - Treat everyone equally regardless of differences; respect the context the client dwells in
● Privilege - Maintain client confidentiality as a privileged learner of another person's story/carer for another's physical self
● Do no harm - If you do not feel compotent to help another person, refer them to someone who can or to a place where they may find assistance
● Listening - Use more than ears; listening requires attention to many things, including face, tone, body and affect.
● Promote social justice - do not condone discrimination/ethnocentricism by remaining silent; advocate agaist someone who demostrates these behaviours proactively.
● Social inclusion - May need to include a broader context of people such as family members and religious leader. - 98What is pallitative care?The steps taken to improve the quality of life of patients and their families facing life-threatening illnesses.
- 99Deaf community?Includes people who are either hard-of-hearing, people who are completely deaf or children who have deaf community.
- 100Autism spectrum disordersA number of different developmental disorders which have at their heart, problems with communication or repetitive behaviours.
- 101Strategies to promote effective communication with person who has dementia● Approach the person from the front
● Face patient when speaking to them
● Give person some cues - arm touches, use person's name before conversation
● Ensure environment is quiet and free from distractions
● Use simple language and speak slowly
● Use short/simple language
Información
- Descripción
- PYB007 Fichas sobre Module 3, creado por Ramisa Raya el 29/06/2017.
- Creado por
- Ramisa Raya
- Visitas
- 7
- Valoración