Evidence-Based Practice: Although the average person in the U.S. may read at an eighth-grade level, there are many who can only read at a fifth-grade level or below. Around 20% of people in the U.S. are considered illiterate, and 30% are marginally literate. This may also equate to the language used verbally, which is why plain language is important (CDC, 2022b). Self-Assessment Quiz Question #1 Talking and providing information in a way that most people understand is a description of:
also important, as people who are too hot or too cold may not be able to fully concentrate (Stans et al., 2017). Studies have shown that patients and families have expecta- tions for information sharing. Plain language should be used, and the information given should be timely, correct, complete, and applicable to the current situation (Institute for Patient- and Family-Centered Care, n.d.). It is important that the healthcare professional not overcomplicate information. Plain or common language means talking and providing information in a way that most people understand, rather than using technical jargon or other colloquialisms, abbreviations, or complex verbiage associ- ated with higher levels of education (CDC, 2022a). First impressions and developing rapport First impressions are important when working to develop rapport with patients and families. There are many components that are required each time healthcare professionals interact with patients. Preparation before interactions assists in recharging to focus on the patient and be present in interactions. Immediate acknowl- edgment of the patient and others (such as family) is essential. An approach that is warm and open, courteous, attentive, and mindful can also assist in developing trust and rapport. Introduc- tions should be made immediately after acknowledgement. Ask- ing how the patient would like to be addressed is also important, which aligns with respect and confidence (Maryniak, 2019; Na - tional Healthcare Communication Programme, n.d.; Wirth, 2017). Nonverbal communications should also be considered. Main- taining eye contact and upholding focus show attentiveness and presence in the moment. Appropriate space should be given so there is comfort during the conversation. Personal space is gener- ally two feet apart but still close enough for the healthcare profes- sional to show caring. Healthcare professionals must have aware- ness of facial expressions. A warm facial expression, such as a genuine smile, can make patients feel at ease. However, facial expressions must also be appropriate. If the patient shares fear or sadness, the healthcare professional’s expression must match the mood of the conversation. Open body language can influence the effectiveness of communication. It is important to also sit at the same level as the patient. Body language should be relaxed and leaning toward the person who is speaking. This demonstrates interest and that the discussion is not rushed. Linguistic cues are needed, such as a warm tone and slow pace. Therapeutic touch can demonstrate empathy and caring when used appropriately. This may include a gentle touch if a patient becomes upset, un- less the patient refuses (AHRQ, 2020b; Maryniak, 2019; National Healthcare Communication Programme, n.d.; Wirth, 2017). Involvement of the patient is crucial for developing rapport and successful teaching. Ensuring a patient is comfortable and can hear, see, and understand what the healthcare professional is say- ing or showing is important. Explanations are needed throughout a conversation, including the purpose of the discussion and any rationale as appropriate. Healthcare professionals should ask per- mission prior to doing anything with or to patients. Additionally, Health literacy assessments Many patient assessments are needed to determine appropriate teaching strategies. Assessment of the patient’s health literacy is essential for deciding the level of conversation, reference ma- terials, and resources. The Agency for Healthcare Research and Quality (AHRQ) is one source that has developed effective health literacy assessment tools that healthcare professionals can use (AHRQ, 2019). One tool is the Short Assessment of Health Literacy (SAHL), which is available in both English and Spanish. With this tool, the health- care professional presents a set of words for the patient. Prior to the test, the patient is instructed that they will be shown cards with three words on each card. The patient must read the first
a. Colloquialisms. b. Plain language. c. The universal approach. d. Health literacy.
sharing thought processes with patients further involves them and builds confidence (Maryniak, 2019; National Healthcare Commu - nication Programme, n.d.; Wirth, 2017). Open-ended questions are important to use when communicating with and teaching patients. Closed-ended questions only encour- age a yes or no answer. Many patients, when asked if they under- stand information, will answer yes. However, this doesn’t confirm there is any actual comprehension, and if there is comprehension, to what degree it exists. Closed-ended questions also can have a dismissive feel, so the discussion may be cut short. Using open- ended questions invites patients to talk more, which provides a clearer picture for healthcare professionals. Using open verbiage is also vital for a question-and-answer dialogue. If the healthcare professional asks, “Do you have any questions?” the likelihood is that the patient will respond that they do not. They may not know what to ask or feel that they are wasting time. A strong ques- tion for healthcare professionals to ask is “What questions do you have for me?” This implies a continued discussion, and patients are free to ask questions (AHRQ, 2020b; Maryniak, 2019; National Healthcare Communication Programme, n.d.). Demonstrating empathy is powerful when building strong rela- tionships between healthcare professionals and patients. Patients associate empathy with caring, vigilance, mutuality, and healing. For empathy to be successful, recognizing the patient’s emo- tions is important. Healthcare professionals need to identify the feeling and asking will help to clarify if the emotion is correct. Acknowledging the patient’s feelings helps them feel validated. The action of empathy is not to fix a problem associated with the emotion, but rather to connect, explore the feeling, and try to understand where the patient is coming from (Maryniak, 2019; National Healthcare Communication Programme, n.d.). Self-Assessment Quiz Question #2 Providing explanations throughout a conversation assists with:
a. Nonverbal behaviors. b. Showing sympathy. c. Involving the patient. d. Self-preparation.
word out loud and decide which of the words that follow is more like the top word, associating healthcare terms with one another. The patients can also respond with “I don’t know.” A correct an- swer for each test item is counted when there is both correct pro- nunciation and accurate association, and this is worth one point. A test item is given a zero if the patient pronounces the word correctly but cannot associate it with the appropriate healthcare term, or vice versa, or if they answer that they don’t know. When the test is finished the healthcare professional sums up the total points, to a maximum of 18. A score less than 14 suggests the patient has low health literacy (AHRQ, 2019).
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