Self-Reflection in Communication: Difference between revisions

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== Intro ==
== Intro ==
Effective healthcare communication has beneficial effects on patients including decreased pain and anxiety, increased satisfaction, improved vital signs and treatment outcome and increased participation in interventions.<ref name=":0" />In a successful two-way dialogue between provider and patient, both parties speak and are listened to without interruptions, asking questions for clarify. Both parties should feel they are able to exchange information while expressing their opinions.  
Effective healthcare communication has beneficial effects on patients including decreased pain and anxiety, increased satisfaction, improved vital signs and treatment outcome and increased participation in interventions.<ref name=":0">Pangh B, Jouybari L, Vakili MA, Sanagoo A, Torik A. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6589483/ The effect of reflection on nurse-patient communication skills in emergency medical centers]. Journal of caring sciences. 2019 Jun;8(2):75.</ref>In a successful two-way dialogue between provider and patient, both parties speak and are listened to without interruptions, asking questions for clarify. Both parties should feel they are able to exchange information while expressing their opinions.  


Since patient-centered communication can facilitate positive health outcomes, provider be responsive and individualised to patient health concerns.  Providers must be mindful of the barriers that different values and beliefs can cause to patient communication.<ref>Kwame A, Petrucka PM. [https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-021-00684-2 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.</ref>
Since patient-centered communication can facilitate positive health outcomes, provider be responsive and individualised to patient health concerns.  Providers must be mindful of the barriers that different values and beliefs can cause to patient communication.<ref>Kwame A, Petrucka PM. [https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-021-00684-2 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.</ref>
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=== Relationship of Values ===
=== Relationship of Values ===
Among these 10 values, there are two-dimensional structures that can re
These 10 values can be co-mingled to form two different subsets of values:


''The relationships among values can also be summarised in terms of a two-dimensional structure [10,16]. The first dimension contrasts conservation values, which emphasise self-restraint, the preservation of traditional practices, and safeguarding stability, to openness to change values, which emphasise the relevance of change, independence, and freedom. The second dimension captures the conflict between self-enhancement values, which emphasise the pursuit of one’s own interests and relative success and dominance over others, to self-transcendence values, which emphasise concern for the welfare and interests of others. Moreover, Schwartz [17] categorised these value dimensions based on their focus (personal vs. social) and their orientation (self-protective vs. self-expansive). Accordingly, self-enhancement and openness to change values share a personal focus, while self-transcendence and conservation values share a social focus. Finally, conservation and self-enhancement are labelled self-protective values because they are, respectively, oriented to avoiding conflicts and maintaining the social order or oriented to actively control others and situations. On the contrary, openness to change and self-transcendence are labelled self-expansive values because they express anxiety-free motivations, promoting a flourished growth<ref name=":2" />''
# self-transcendence:
#* welfare and concern for others
#* openness to change values
#* preserves tradition
#* self-restraint
#* concern for welfare and interest of others
#* social focus
# self-enhancement  
#* success and dominance over others
#* pursuit one's one interest
#* personal focus
#* self-protective
#* avoiding conflict to control situations<ref name=":2" />


== Beliefs ==
== Beliefs ==
While values capture what people consider as important, beliefs capture what people consider to be true.alues determine ''what'' goals to pursue, while beliefs determine ''how'' to pursue the respective goals<ref name=":1" />
Values identify what people feel are important and what goals to pursue.  Beliefs determine what people consider to be true and how they will pursue their respective goals.  Beliefs offer a individuals a casual explanation (rooted determining factor) for perceived individual differences and observed behaviour. Stereotypes and prejudice and specific behavioural and cognitive tendencies that are associated with beliefs.<ref name=":1" />  Stereotypes is the association and attribution of specific characteristics to a group.  It is the image that comes to mind when one thinks about a particular social group.  Prejudice is an attitude often negative reflecting an overall evaluation of a group. <ref>Fourie, M.  Self-Reflection in Communication. Plus. 2023</ref>
 
key element of essentialist beliefs is that they offer a causal explanation for observed behavior and perceived individual differences: People are who they are because of some determining factor rooted somehow deep insid. essentialist beliefs are associated with specific cognitive and behavioral tendencies such stereotyping and prejudice ( <ref name=":1" />


== Self-Reflection ==
== Self-Reflection ==


The healthcare provider must understand that their own rooted values and beliefs can hinder effective communication with their patients.  Providers that examine and explore their own attributes and perspective through self-reflection will gain insight in how to improve in the future. <ref name=":3">Anderson B. [https://www.britishjournalofnursing.com/content/professional/reflecting-on-the-communication-process-in-health-care-part-1-clinical-practice-breaking-bad-news/ Reflecting on the communication process in health care. Part 1: clinical practice—breaking bad news.] British Journal of Nursing. 2019 Jul 11;28(13):858-63.</ref>In order to begin the process of reflection, one needs to recall, reconsider and reevaluate their own experiences.<ref name=":0" />  Intentional reflection on actions, emotions and experience is critical to informing the individuals existing knowledge base and making contextually appropriate changes.<ref name=":3" />Reflective thinking should be learned and used continuously as a proof of professional behaviour and professionalism in clinical performance.<ref name=":0" />


The art of reflection encourages the person to search for and evaluate solutions in equivocal and complicated situations.10 The experience of utilizing the reflection process in a clinical setting causes a sense of ownership towards the created knowledge in nurses, because they achieve this knowledge through focusing on their own experience, using creative methods.11 The process of reflection starts when the person refers to his/her own experience and recollects what has occurred, reconsiders the experience, and reevaluates it.12 This effective strategy also improves critical thinking and problem-solving skills in nurses.13 Reflection is regarded as a proof of professionalism and is used as a skill related to clinical performance and professional behavior.14 Reflective thinking in recent years has been considered as a learning strategy for nursing students while not being used by novice nurses in practice.15 Studies have suggested that reflective thinking as a skill should be learned and used continuously.16,17 In general, nurses should know how to have reflection on their clinical performance and practice it re<ref name=":0">Pangh B, Jouybari L, Vakili MA, Sanagoo A, Torik A. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6589483/ The effect of reflection on nurse-patient communication skills in emergency medical centers]. Journal of caring sciences. 2019 Jun;8(2):75.</ref>
Below are some examples of reflective thinking prior to taking a history from a patient:


{| class="wikitable"
{| class="wikitable"
|Reflective Practice
|Reflective Practice
|Consideration
|Act
|-
|-
|How are you feeling?
|Emotions
|Nurses are not exempt from life circumstances that can cause uncomfortable emotions like sadness, anger, frustration, as well as other emotions such as happiness and gratefulness. While it may be impossible to put aside your emotions, having a sense of your emotions and their cause is a very powerful tool to avoid inadvertent miscommunication.
|
* consider your current emotions:  frustration, anger, sadness, happy
* having a sense of your current emotions prior to the interaction may help avoid miscommunication
|-
|-
|What is occupying your thoughts?
|Thoughts
|It can be helpful to step outside of the narrative in your mind. It is not abnormal for a thought to pervade your thinking, but suspending such thoughts and being in the moment with the client can assist with better communication. Consider if something is weighing on you. Are you ruminating about an event, a person, an idea?
|
* it may be difficult to stop a thought from invading your mind
* be mindful of that thought and try and suspend it when you are with the patient
|-
|-
|In what ways are you physically expressing your emotions and thoughts?
|Non-verbal cues
|Your emotions and thoughts are sometimes physically expressed through facial expressions, hand gestures, and body language. Can someone tell that you are happy or sad by looking at you? Being aware of the physical expression of your emotions and thoughts can assist you in your communication with others and enable you to convey emotions like empathy, compassion, and concern.
|
* are your current emotions/thoughts tied to your non-verbal cues
* be mindful of your non-verbal cues
|-
|-
|How is your health and wellbeing?
|Physiological triggers
|Often physiological and psychological/emotional events like hunger, fatigue, body aches, and sadness can shape your mood. Reflect on how you are feeling in relation to your body and mind and pay attention to your body’s cues.
|
* is your body telling you something
* hunger, sadness, fatigue can be tied to non-verbal cues
* be mindful of physiological cues and how they might shape your non-verbal cues
|-
|-
|What is the environment surrounding you?
|Environmental triggers
|Even when you think you are accustomed to the work environment, subtle triggers can affect your ability to effectively communicate. A beeping machine, foul smell, or bright lights may affect your ability to focus, show concern, and actively listen. Reflect on yourself in relation to the environment and consider what factors you can and cannot control.
|
* do environmental triggers affect your ability to listen
* be mindful of subtle triggers such as foul smell, bright light, beeping machines that may affect your ability to communicate effectively
|}
|}
<ref>Lapum, J., St-Amant, O., Hughes, M., Garmaise-Yee, J. and Lee, C., 2020. [https://pressbooks.library.torontomu.ca/communicationnursing/ Introduction to communication in nursing].</ref>
<ref>Lapum, J., St-Amant, O., Hughes, M., Garmaise-Yee, J. and Lee, C., 2020. [https://pressbooks.library.torontomu.ca/communicationnursing/ Introduction to communication in nursing].</ref>
reflection enables a personal insight into the communication process and highlights the inherent challenges of communication and their pertinence to patient care and clinical practice outcomes.  Reflection is a process of exploring and examining ourselves, our perspectives, attributes, experiences, and actions and interactions, which helps us gain insight and see how to move forward (Gillett et al, 2009:164). Reflection is a cycle (Figure 1; Gibbs, 1988), which, in nursing, enables the individual to consciously think about an activity or incident, and consider what was positive or challenging and, if appropriate, plan how a similar activity might be enhanced, improved or done differently in the future (Royal College of Nursing (RCN), 2019).  Reflective practice is the ability to reflect on one's actions and experiences so as to engage in a process of continuous learning (Oelofsen, 2012), while enhancing clinical knowledge and expertise (Caldwell and Grobbel, 2013). A key rationale for reflective practice is that experience alone does not necessarily lead to learning—as depicted by Gibbs' reflective cycle (1988). Deliberate reflection on experience, emotions, actions and responses is essential to informing the individual's existing knowledge base and in ensuring a higher level of understanding (Paterson and Chapman, 2013). Reflection on practice is a key skill for nurses—it enables them to identify problems and concerns in work situations and in so doing, to make sense of them and to make contextually appropriate chang<ref>Anderson B. [https://www.britishjournalofnursing.com/content/professional/reflecting-on-the-communication-process-in-health-care-part-1-clinical-practice-breaking-bad-news/ Reflecting on the communication process in health care. Part 1: clinical practice—breaking bad news.] British Journal of Nursing. 2019 Jul 11;28(13):858-63.</ref>




Revision as of 15:50, 20 May 2023

Intro[edit | edit source]

Effective healthcare communication has beneficial effects on patients including decreased pain and anxiety, increased satisfaction, improved vital signs and treatment outcome and increased participation in interventions.[1]In a successful two-way dialogue between provider and patient, both parties speak and are listened to without interruptions, asking questions for clarify. Both parties should feel they are able to exchange information while expressing their opinions.

Since patient-centered communication can facilitate positive health outcomes, provider be responsive and individualised to patient health concerns. Providers must be mindful of the barriers that different values and beliefs can cause to patient communication.[2]

Values[edit | edit source]

Values are described as context-independent, abstract and steady goals which people strive to achieve in life. They guide peoples' perception, behaviour and attitudes and represent positive end-states. They are distinct from from norms, attitudes and beliefs but are related. [3] Values are relatively stable through the lifespan, context and situations but do have the ability to change.[4]

10 Basic Values[edit | edit source]

The Theory of Basic Human Values identifies 10 basic values that are each characterised by a different motivational goal.

  1. power: dominance over resources and people, social status
  2. achievement: own personal success according to social standards
  3. hedonism: gratification or pleasure for oneself
  4. stimulation: novelty, challenge or excitement
  5. self-direction: independence in action and thought
  6. universalism: welfare, understanding and concern for all people and nature, tolerance
  7. benevolence: enhancing the welfare of people whom one is close
  8. tradition: commitment and respect to religious or cultural ideas
  9. conformity: restraint of actions that may harm others or violate social expectations
  10. security: stability and safety of relationships, self and society[4]

Relationship of Values[edit | edit source]

These 10 values can be co-mingled to form two different subsets of values:

  1. self-transcendence:
    • welfare and concern for others
    • openness to change values
    • preserves tradition
    • self-restraint
    • concern for welfare and interest of others
    • social focus
  2. self-enhancement
    • success and dominance over others
    • pursuit one's one interest
    • personal focus
    • self-protective
    • avoiding conflict to control situations[4]

Beliefs[edit | edit source]

Values identify what people feel are important and what goals to pursue. Beliefs determine what people consider to be true and how they will pursue their respective goals. Beliefs offer a individuals a casual explanation (rooted determining factor) for perceived individual differences and observed behaviour. Stereotypes and prejudice and specific behavioural and cognitive tendencies that are associated with beliefs.[3] Stereotypes is the association and attribution of specific characteristics to a group. It is the image that comes to mind when one thinks about a particular social group. Prejudice is an attitude often negative reflecting an overall evaluation of a group. [5]

Self-Reflection[edit | edit source]

The healthcare provider must understand that their own rooted values and beliefs can hinder effective communication with their patients. Providers that examine and explore their own attributes and perspective through self-reflection will gain insight in how to improve in the future. [6]In order to begin the process of reflection, one needs to recall, reconsider and reevaluate their own experiences.[1] Intentional reflection on actions, emotions and experience is critical to informing the individuals existing knowledge base and making contextually appropriate changes.[6]Reflective thinking should be learned and used continuously as a proof of professional behaviour and professionalism in clinical performance.[1]

Below are some examples of reflective thinking prior to taking a history from a patient:

Reflective Practice Act
Emotions
  • consider your current emotions: frustration, anger, sadness, happy
  • having a sense of your current emotions prior to the interaction may help avoid miscommunication
Thoughts
  • it may be difficult to stop a thought from invading your mind
  • be mindful of that thought and try and suspend it when you are with the patient
Non-verbal cues
  • are your current emotions/thoughts tied to your non-verbal cues
  • be mindful of your non-verbal cues
Physiological triggers
  • is your body telling you something
  • hunger, sadness, fatigue can be tied to non-verbal cues
  • be mindful of physiological cues and how they might shape your non-verbal cues
Environmental triggers
  • do environmental triggers affect your ability to listen
  • be mindful of subtle triggers such as foul smell, bright light, beeping machines that may affect your ability to communicate effectively

[7]


Marcelin JR, Siraj DS, Victor R, Kotadia S, Maldonado YA. The impact of unconscious bias in healthcare: how to recognize and mitigate it. The Journal of infectious diseases. 2019 Aug 20;220(Supplement_2):S62-73. https://academic.oup.com/jid/article/220/Supplement_2/S62/5552356

Ponizovskiy V, Grigoryan L, Kühnen U, Boehnke K. Social construction of the value–behavior relation. Frontiers in Psychology. 2019 May 1;10:934.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6504687/

Gamage KA, Dehideniya DM, Ekanayake SY. The role of personal values in learning approaches and student achievements. Behavioral sciences. 2021 Jul 16;11(7):102.https://www.mdpi.com/2076-328X/11/7/102/htm

  1. ↑ 1.0 1.1 1.2 Pangh B, Jouybari L, Vakili MA, Sanagoo A, Torik A. The effect of reflection on nurse-patient communication skills in emergency medical centers. Journal of caring sciences. 2019 Jun;8(2):75.
  2. ↑ 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.
  3. ↑ 3.0 3.1 Kesberg R, Keller J. Personal values as motivational basis of psychological essentialism: An exploration of the value profile underlying essentialist beliefs. Personality and Individual Differences. 2021 Mar 1;171:110458.
  4. ↑ 4.0 4.1 4.2 Russo C, Danioni F, Zagrean I, Barni D. Changing personal values through value-manipulation tasks: a systematic literature review based on Schwartz’s theory of basic human values. European Journal of Investigation in Health, Psychology and Education. 2022 Jun 28;12(7):692-715.
  5. ↑ Fourie, M. Self-Reflection in Communication. Plus. 2023
  6. ↑ 6.0 6.1 Anderson B. Reflecting on the communication process in health care. Part 1: clinical practice—breaking bad news. British Journal of Nursing. 2019 Jul 11;28(13):858-63.
  7. ↑ Lapum, J., St-Amant, O., Hughes, M., Garmaise-Yee, J. and Lee, C., 2020. Introduction to communication in nursing.
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