Flashcards
Lecture 22 - Communication
Flashcards do conjunto (15)
- 1List the ways in which risk can be communicated1. Words
2. Stories
3.Relative risk
4. absolute risk
5. pie charts
6. 100 person diagrams
7. Horizontal bars
8. survival graph - 2Explain absolute and relative risk as a method of communicationAbsolute risk : risk of developing the disease over a period of time
Relative risk : risk of one group, compared to another e.g. taking treatment X will double your risk of developing ovarian cancer *however, the base rate of developing ovarian cancer is 1 in 3,000 (so you've increase it to 2 in 3,000)
CONS: doesn't tell you anything about the actual risk
HOWEVER, people are more likely to take up the treatment when presented with this option - 3Explain patient stories as a method of communicationThis makes info more salient and memorable.
It can facilitate informed decision making (hearing how others decided, the "trade offs" and the emotional aspects)
HOWEVER, it may impede informed decision making (making decision based on others' situations) - 4Explain 100 person/dot diagrams as a method of communicationResults in a better understanding among both older and younger patients, and reduces the impact of patient stories.
People don't like them all that much, but they're understood very well. It assists in showing how likely/unlikely a side effect is to occur
randomising the "side effect" icons make it clearer that the side effects are random (e.g. they don't just occur to the last 8 people) - 5Explain simplification of riskMost people convert numerical risk into categorical risk - will it or will it not happen to me?
Analogies are helpful, as they can place the situation into perspective. e.g. low risk: the risk of cancer coming back is the same as getting hit by lightning, or winning the lottery; high risk: the risk of the cancer coming back is about the same as the risk of getting a cold this year - 6What are the key points when examining risk communication techniques?1. Use consistent framing - emphasis both gains and losses
2. provide base rates of outcomes
3. use absolute risk
4. provide info on the consequences of the risk
5. graphical formats are not always the most understood
6. 100 person diagrams lead to greater understanding
7. check and re-check understanding - 7Explain the communication frameworkthis highlights the complexity of communication. It considers the personal factors of the dr and patient, as well as the external factors (e.g. is the doctor rushed, is the patient preoccupied)
- 8What do patients expect from their doctors?1. Technical expertise
2. Accurate info
3. EMPATHY AND SUPPORT
4. access to services
5. continuity and coordination of care
overall, most patients (80-90%) are very satisfied with the medical care even when needs are not met - 9Explain why drs addressing psychosocial issues is importantA metaanlaysis found that informational and emotional support led to faster recovery amongst patients, greater cooperation with treatment and fewer post-hospital complications
However, there are many barriers when it comes to disclosing psychological issues - 10What are some barriers that can occur when disclosing psychological issues?Patient's feel: it is not a dr's role, the dr is too busy, they feel embarrased, fear breaking down, don't know how to describe how they feel
Doctors barriers : insufficient training; lack of evidence - why should I; difficulty; vulnerability (can't cope); attitudes (not my job); system constraints - don't have time - 11Explain emotional cuesverbal or non verbal message from the patient that contains some reference to emotional content
drs can engage in blocking or facilirating behaviours to encourage emotional cues - 12Explain the 2003 Duric et al. study on empathyMethod: consultation b/w genetic counselors and women at high risk of breast cancer were audio-taped, and emotional cues and counsellor behaviour was coded
Patients whose first cue was responded to with empathy gave sig. more cues and has sig. reduced depressive symptoms, 3 weeks later - 13Explain the Fogarty et al. (1999) study on compassionThis study found that 3-4 additional statements and non-verbal empathetic cues (in total 40seconds) lead to patients being sig. less anxious, and the dr was perceived as warmer, more pleasant and sensitive
- 14What is the BATHE technique?This is useful when psychosocial concerns have been detected:
BACKGROUND: "tell me what's been happening"
AFFECT: "how does that make you feel"
TROUBLE: "what's upsetting you most"
HANDLING: "how have you been handling that"
EMPATHY: "that must have been difficult" - 15What are the key concepts in communication skills training?1. establishing the patient-health professional team : introduce joint decision making; check understanding; invite questions/comments; the patient is active
2. aiding patient understanding : summarise; use diagrams; avoid jargon; provide rationale
3. disclosure and avoiding coercion : spend the same amount of time on all options; avoid minimising side effects of one treatment; encourage individual choice; ensure sufficient time to discuss; disclose e.g. availability of trial treatment off-trial
4. following a consultation pathway
CST courses appear effective in improving information gathering skills and supportive skills; however, unclear which CST programs are likely to work
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- Applications of Psychology (Health Psych Ilona (patient needs to Survivorship II)) FlashCards sobre Lecture 22 - Communication, criado por amanda_211 em 06-11-2014.
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- amanda_211
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