Communication in Healthcare

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Introduction: Barriers to communication in Healthcare

Resource Aim

To highlight the need for ongoing communication skill development for AHPs and provide a resource which can be used to facilitate this process

Learning Outcomes

1. To encourage AHPs to critically reflect on their existing communication skills and their impact on patients

2. Recognise and assess patient perceptions of how AHPs currently deal with difficult issues to improve future AHP practice

3. To critically evaluate the evidence underpinning the use of current and emerging approaches to sensitive issues with the aim of enhancing communication between patients and practitioners

4. To recognise and appraise the changing patient demographics and the role of AHPs in their treatment (eg: younger orthopaedic surgeries and sexual issues)

5. By the end of this package the reader will be able to apply advanced communication techniques to sensitive issues

Ineffective Communication

Sexual Activity

Sexuality and intimacy are components of patients lives which are often avoided, overlooked and under-treated when rehabilitating patients (Hordern et al.  2009). Sex is a topic of conversation which is commonly avoided both by health professionals and patients as many people are not comfortable discussing sexual issues openly. When this topic arises in a health care setting, both health care professionals and patients can find the topic an embarrassing and difficult one to discuss (Hordern et al. 2009). Orthopaedic, respiratory, surgical, oncology and general practice are a few of the healthcare areas in which the patient may raise concerns about sexuality (Brandenburg and Bitzer, 2009). Although there is a need for a conversation between patients and professionals regarding sexuality and intimacy in variety of areas, many AHP's and patients are still uncomfortable discussing the topic (Hordern et al. 2009). A survey of 170 patients who attended a GP appointment found that 35% of the males and 42% of the females had some form of sexual dysfunction (Gott et al. 2004). However, only 2% of the GP notes recorded that a discussion about sexuality had taken place even though 70% of the patients perceived that the GP was the person with whom they should discuss their sexual health (Gott et al. 2004).

The barriers to communicating about sexual health between patients and professionals have been found to be lack of time, embarrassment and lack of knowledge (MacDowall et. al. 2010). Time constraints is the most commonly reported barrier to communication about sexual health (Gott et al. 2004; Hordern et al. 2009). AHPs have referred to the conversation as 'opening a can of worms' and state that once the conversation has started you have to see it all the way through no matter how limited your time or resources (Gott et al. 2004). The fact that sexual health takes specialist knowledge has also resulted in some AHPs feeling ill-prepared to address patient concerns (Hordern et al. 2009). Studies have shown that health professionals’ skills and attitudes are addressed during professional education and training courses, however dedicated courses are usually poorly attended (Macdowall et al., 2010). Although dedicated courses exist to address these barriers, many AHPs report that they would rather not ask about sexual health unless the patient raises any concerns (Macdowall et al. 2010). However, this may be problematic as a study by the Association of Reproductive Health Professionals (2008) found that 68% of patients did not approach the topic of sex with health professionals for fear of being embarassed. Participants have also reported being surprised when sexual activity was mentioned as they had not previously considered it as a problematic physical activity (Brandenburg and Bitzer, 2009). This supports the need for health professionals to initiate a conversation regarding sexual health.

References

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