Self-Reflection in Communication

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.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.

Values

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. Values are relatively stable through the lifespan, context and situations but do have the ability to change.

10 Basic Values

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

Relationship of Values

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

Beliefs

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. 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.

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. In order to begin the process of reflection, one needs to recall, reconsider and reevaluate their own experiences. Intentional reflection on actions, emotions and experience is critical to informing the individuals existing knowledge base and making contextually appropriate changes.Reflective thinking should be learned and used continuously as a proof of professional behaviour and professionalism in clinical performance.

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

Resources

• Personal Values and Beliefs
• Communication Skills
• Culture and Communication