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Communication skills.

Communication skills.

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Communication skills.

  1. 1. Dr. Dalia El-Shafei Assistant professor, Community Medicine Department, Zagazig University
  2. 2. “We are born to see, but have to train ourselves to observe”
  3. 3. What (Definition ) Why (Importance ) How (Elements & Principles) By what (Forms) Why not (Barriers )
  4. 4. WHAT IS COMMUNICATION?  Communication is sending or receiving ideas, thoughts or feelings from one person to one or more persons in such a way that, the person receiving it understands it in the same way the sender wants him/her to understand.  The term ‘Communication’, derived from a Latin term ‘Communicare’.  Also known as “people skills” or “soft skills”.  Ranked in a survey as the most important requirement for successful job performance.
  5. 5. Continuous Dynamic Transactional Irreversible Communication
  6. 6. SENDER MESSAGE CHANNEL RECEIVER Context FEEDBACK THE COMMUNICATION PROCESS The person initiating the communication, or broadcasting the message. The specific set of words, gestures and images that the sender uses to convey what he or she wants to say. The channel through which the message moves. Receivers (or the audience for the message) - from whom the receiver often expects a response. The response from the receiver to the sender.
  7. 7. WHY WE STUDY COMMUNICATION SKILLS? • 60% to 80% of diagnosis. History taking • >50% of patients deviate from the doctors’ advice or do not follow it at all. Good communication provides information to the patient • Doctors interrupt patients very early. • Patients do not understand what the doctor is saying. • Advice is too difficult to follow. Poor quality of communication leads to patient’s dissatisfaction
  8. 8. COMMUNICATION PRINCIPLES Listening (not HEARING) Probing (encourage) Observing (non- verbal) Informing (4 Cs = Clear, Correct, Concise, Complete)
  9. 9. 1- LISTENING: Active process (Not hearing), it involves a conscious effort to listen to words; to the way they are said, to be aware of the feelings shown and attempts to hide feelings. Focus your attention; avoid barriers. Show that you are listening (verbally & nonverbally). Understand ideas and pick key words. Retain information (memory, notes). Reflect or give your feedback.
  10. 10. 2- PROBING: - What clients think/know.  Encourage them to talk: tell them that are really listening & wanting to hear more.  Ask questions.  Keep Privacy, listen.
  11. 11. 3- OBSERVING: Nonverbal communication through: Facial expressions Voice tone Body language
  12. 12. 4- INFORMING In a Clear, Correct, Concise, Complete way. Consider: Needs, Language, Obstacles. Summing-up briefly. Check back with the speaker to ensure that the statement is accurate.
  13. 13. Change behavior Get action Ensure understanding Persuade Get & give Information COMMUNICATION GOALS
  14. 14. Environmental • Loud sounds • Activities of nearby people • Interruptions from others • Physical discomfort Physiological • Deafness • Blindness • Learning disabilities • Illness. Language • Different language • Specific terminology Personal • Socioeconomic conditions • Values & beliefs • Previous experience • Not valuing themselves, not believing that their health is important. Psychological • Stress Frustration • Anger, tiredness, distracted, preoccupied. Barriers to the Communication
  15. 15. SENDER MESSAGE CHANNEL RECEIVER Context FEEDBACK THE COMMUNICATION PROCESS OR ELEMENTS Knowledge Formulation Language Tone Personality Ambiguity Interest Clearness Confusion Objectivity Noise Accessibility Adaptation Decoding Physiology Personality Preparation Time Selection bias Formulation
  16. 16. Body Language 55% Words 7% Tone of Voice 38%
  17. 17. MEANS OF COMMUNICATION Verbal Oral Written Non-verbal Body movement Posture Gesture Facial expressions Eye contact Space Touch Time Personal appearance Paralanguage
  18. 18. NON-VERBAL COMMUNICATION
  19. 19. Non-verbal communication can Reinforces, Complements, Contradicts, Regulates, or Replaces a verbal message.
  20. 20. CATEGORIES OF NONVERBAL COMMUNICATION Body movement: Way of walking Posture: Way of sitting, standing Gesture: Movements of hands, legs, arms & feet Facial expressions & eye contact Space: Place of sitting, distance Touch: Shake hands, patting on the back Time Personal appearance: Clothes, hair, jeweler Paralanguage: Vocal characteristics (pitch, volume, rate & quality), vocal interferences (umm, uhh)
  21. 21. Smiling Eye contact How you look Shaking hands +ve Non-Verbal Communications
  22. 22. > 360 cm 120 – 360 cm 45 – 120 cm 15 – 45 cm
  23. 23. WHEN YOU INVADE MY SPACE  Reactions to an invasion of your space  Feel troubled  Get defensive  Become aggressive
  24. 24. COUNSELLING Counselling is a process that uses communication skills to help client/patient to reach an informed decision/choice Counselling will provide customized, client-oriented information and negotiate available alternatives to help take a decision based on clear information. Helping a person or a group to develop self-help & self-care abilities.
  25. 25. CONSULTATION & COUNSELING Consultation • Process of a dialogue that leads to a decision Counseling • Helping a person or a group of people to develop self help
  26. 26. CONSULTATION After each consultation session 5 things must be established Discover the reasons of patient attendance Define clinical problem (HPT, DM) Address the patient’s problem (details) Explain the problem to the patient Make effective use of the consultation
  27. 27. PRINCIPLES FOR GOOD COUNSELLING Treat each client well Interact actively Give the right amount of information Tailor & personalize the information Use & provide memory aids Provide the services that satisfy the client’s expectations. Help clients remember instructions. Confidentiality
  28. 28. COUNSELING Preparing a counseling session Physical setting Timing Interpersonal space
  29. 29. 1. Physical setting Privacy: in a quiet, calm & no interruption Proper lightening & temperature. 2. Timing 45-60 minutes
  30. 30. 3. Interpersonal space 4-9 feet D D P D P P (√) (√) (×)
  31. 31. COUNSELING, CONSULTATION, COMMUNICATION PROCESS Initiating the session Gathering Information Building Relationship Explanation & Planning Closing the sessions
  32. 32. THE ELEMENTS OF COUNSELLING G A T H E R Greet Ask Tell Help Explain Return visit
  33. 33. GREET  Give the clients your full attention as soon as you meet them.  Be polite, friendly and respectful.  Introduce your self and offer them seats.  Ask how you can help?  Explain what will happen during the visit.  Conduct counselling privately
  34. 34. ASK ABOUT  Reasons for coming.  Their experience with the health matter that concerns them.  Any information needed to complete client records.  Ask Clients about themselves & their families as appropriate.
  35. 35. TELL CLIENT -To decide what choices and decisions. -To express their feelings, needs, wants, & any doubts, concerns or questions.  Keep questions open, simple and brief.  Look at your client as you speak.  Listen actively to what the client says.  Show your interest and understanding all the time.  Tell the clients about their condition or Choices  Help clients understand their possible condition  Information should be: Simple, correct and relevant
  36. 36. HELP CLIENT TO UNDERSTAND  Help the clients think about the results of each possible choice.  Ask if the client wants anything made clearer, repeat and rephrase information as needed.  Check whether the client has made a clear understanding . “What have You understood?” “What have you decided to do?”  Wait for the client to answer.
  37. 37. EXPLAIN WHAT TO DO  Give supplies, if appropriate.  If the service cannot be given at once, tell the client how, when & where it could be provided.  Describe possible side effects & what to do if they occur.  Ask the client to repeat instructions.  Make sure the client remembers & understands.  If possible give the client printed materials to take home.  Explain when to come back & why.
  38. 38. RETURN VISIT  Check if the client is using the Treatment correctly.  Ask if the client has any Question or anything to discuss. Consider all concerns seriously.  Ask if the client is Satisfied, has there been any problems since last visit???  Help the client handle any Problems.  Refer client who need specialized care.

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