Modes of Communication
Top Contributors - Robin Tacchetti, Jess Bell, Naomi O'Reilly and Tarina van der Stockt
Introduction[edit | edit source]
Communication is defined as the method of sending and receiving messages to share skills, knowledge and attitudes.[1]
Communication in the healthcare environment entails transmitting and receiving of information between clinician and their patients . Good communication is a fundamental clinical skill that establishes the therapeutic relationship between the clinician and their patients. Studies show that clinicians who explain, listen and empathise with their patients produce a profound effect on their patients health status and functioning as well as overall satisfaction in the medical care. [2]
Historically, medical settings incorporated direct face-to-face communication to relay information. In this format, patients could not only hear the information, but were able to see facial expressions and body language to help better understand the meaning behind the words. Direct interactions are decreasing as indirect interactions like video conferencing increase. Technological advances have also aided written communication (emails, texts, etc) between providers and patients. As many patient prefer written communication, it also has many other advantages in medical care:
- traceability
- medico-legal value
- easily distributed
- educational[3]
Medical Dialogue[edit | edit source]
Medical communication entails exchanging of information by verbal, nonverbal, written or electronic means. [4]This two-way dialogue between patient and healthcare provider should incorporate the following components for both parties involved:
- exchange of information
- ability to speak and listen without interruption
- ability to express their opinions
- ability to ask questions for clarity[5]
Clinical communication interactions that are respectful enhance patient engagement in decision making, increase patient adherence to treatment and patient satisfaction and reduce anxiety and uncertainty.[5]
** The environment for verbal communication should be in a caring surrounding. This allows the patient to feel physiologically and psychologically safe.[6]
Communication Delivery[edit | edit source]
Communication is delivered through the combination of verbal and nonverbal components. [2] Verbal communication is delivered through spoken words or written language. Nonverbal communication displays emotional information through reactions of the voice, body or face. [1]. Both verbal and non-verbal communication can be influenced by a number of factors:
- volume and pace of the interaction
- spatial proximity
- extent or limit of physical contact
- style of communication: friendly vs. authoritative[2]
Verbal[edit | edit source]
Verbal communication encompasses both written and oral forms. Written communication is generally used to relay information in a permanent manner. With advances in technology written communication has increased over recent years. Examples of written communication include:
- emails
- reports,
- text messaging
- social media platforms
- discussion forums
- electronic medical records
Oral communication, also known as spoken communication includes:
- telephone calls
- face-to-face interactions
- video conferencing
- public speeches
- in-person meetings[7]
** Effective oral communication requires active listening.[7]
Listening[edit | edit source]
Active listening is a critical component of good communication which involves giving the speaker your full attention without distractions or interruptions. Active listening is more than simply listening to the speaker. The components below detail what is involved in active listening:
- Reflect: confirm your understanding by paraphrasing or repeating what they have said
- Clarify: ask questions to better understand what they said
- Summarise: provide a brief summary of what they said
- Empathise. attempt to understand their feelings and perspective
- Non-verbal cues: pay attention to body language, tone of voice and facial expressions
- Avoid interruptions/distractions: allow them to finish without interruption/distractions[7][2]
Non-Verbal[edit | edit source]
Non-verbal communication is a way of conveying information without using words. It comprises a wide range of physical signs such as:
- facial expressions/gestures
- tone of voice
- body language/posture
- eye contact
- shrugging
- pointing
Non-verbal communication can help provide additional information or even contradict the spoken message. To respond appropriately to non-verbal cues, one needs to be an active listener noticing any subtle cues. Equally important is to note your own non-verbal cues and how they might be interpreted or perceived by others.
** Note that individual and cultural differences can impact non-verbal communication due to different norms[7]
Barriers[edit | edit source]
Depsite understanding good communication practices, there are always barriers to good communication within the healthcare environment. One of the most common barrier for providers is an institutional barrier of staffing shortages and high workloads ultimately lead to burnout. In this scenario, providers have limited time to interact with each patient as they have too many patients to attend to in a day. [4][5]As their interaction time is decreased, patients might not have the opportunity to provide all the details the provider needs to care for them appropriately. In addition, the patient may not have the opportunity to ask questions which could alter their adherence to treatment or medication.[5] Decrease time with patients is not the only barrier leading to misunderstood treatment and medication instructions. A poor communicator or language barrier could alter how a patient understands what their interventions are and how to perform them correctly. Hiring translators and interpreters would assist with interactions when language barriers exist.[5]Along with
Environmental Challenges[edit | edit source]
Environmental challenges are hindrances within the medical setting that impede communication. Some of these obstacles include:
- distance of health professional from patients' bedside[4]
- noisy surrounding
- unkept rooms/beds
- lack of privacy
- lighting
** All of the above barriers can limit or prevent the patient from expressing their healthcare needs[5]
Personal and Behavioural Related[edit | edit source]
Many demographic factors can play a role in hindering communication between clinician and patient. Some of the factors are listed below:
- lack of availability of patients or family members time that coincides with healthcare worker[4]
- cultural background
- beliefs
- worldview about health and medicine[5]
References[edit | edit source]
- Hall, M. L., & Dills, S. (2020). The limits of “Communication mode” as a construct. Journal of Deaf Studies and Deaf Education, 25(4), 383-397. https://doi.org/10.1093/deafed/enaa009
- ↑ 1.0 1.1 Wanko Keutchafo EL, Kerr J, Baloyi OB. A Model for Effective Nonverbal Communication between Nurses and Older Patients: A Grounded Theory Inquiry. InHealthcare 2022 Oct 22 (Vol. 10, No. 11, p. 2119). MDPI.
- ↑ 2.0 2.1 2.2 2.3 Chichirez CM, Purcărea VL. Interpersonal communication in healthcare. Journal of medicine and life. 2018 Apr;11(2):119.
- ↑ Vermeir P, Vandijck D, Degroote S, Peleman R, Verhaeghe R, Mortier E, Hallaert G, Van Daele S, Buylaert W, Vogelaers D. Communication in healthcare: a narrative review of the literature and practical recommendations. International journal of clinical practice. 2015 Nov;69(11):1257-67.
- ↑ 4.0 4.1 4.2 4.3 Ozavci G, Bucknall T, Woodward‐Kron R, Hughes C, Jorm C, Manias E. Creating opportunities for patient participation in managing medications across transitions of care through formal and informal modes of communication. Health Expectations. 2022 Aug;25(4):1807-20.
- ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 Kwame A, Petrucka PM. A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC nursing. 2021 Dec;20(1):1-0.
- ↑ Iedema R, Greenhalgh T, Russell J, Alexander J, Amer-Sharif K, Gardner P, Juniper M, Lawton R, Mahajan RP, McGuire P, Roberts C. Spoken communication and patient safety: a new direction for healthcare communication policy, research, education and practice?. BMJ Open Quality. 2019 Sep 1;8(3):e000742.
- ↑ 7.0 7.1 7.2 7.3 Giesbrecht, J. Modes of Communication. Plus. 2023
