Effective communication Quick establishment of a therapeutic relationship and rapport be- tween patients and families is vital to identifying and addressing teaching moments. Creating good first impressions, as discussed earlier, begins the relationship. Sitting with the patient gets the healthcare provider on their level, which shows respect, and that the conversation is valuable and not rushed. Communica- tion should be respectful and courteous, responsive, and caring. Healthcare professionals need to be attentive to patients’ verbal statements and nonverbal cues. There are differences between everyone that must be acknowledged and respected. The ideas, opinions, and needs of the patient are upheld, and it is important to explore underlying needs and concerns. Compassion can be demonstrated through empathy (HCEA, 2021; Maryniak, 2019; National Healthcare Communication Programme, n.d.). Successful speaking and listening are main components of ef- fective communication. Effectual speaking is clear, with informa- tion given in small amounts to help with understanding. Active listening includes focusing on the speaker so that not only are words heard but the whole message and meaning are communi- cated. The intent of active listening is to understand rather than just respond. Eye contact, attention to nonverbal behaviors, and presence are essential for active listening. Active listening uses open-ended questions, paraphrasing, clarifying, summarizing, and a nonjudgmental attitude (CDC, 2019; HCEA, 2021; Maryn- iak, 2019). Personality and communication styles can also influence commu - nication and must be taken into consideration. Indirect commu- nication focuses on the context or meaning of the message. This type of communication may not be clear, and it can take longer to get the message from the speaker to the listener. Direct commu- nication is based on the content of the message. Direct communi- cation may be considered blunt by some, is shorter, and does not have implied meaning (Maryniak, 2019; Stoain, 2020). Patients should always be encouraged to ask questions, with re- sponses given each time. The ability to ask questions is another component of effective communication. Phrasing of questions can create a sense of trust or distrust. Questions that are used to elicit concerns involve you, for example, “What concerns you about this procedure?” Questions to test knowledge emphasize me and I so that patients don’t feel pressured or tested, for ex- ample, “I want to make sure I did a good job telling you about the medicine. Tell me in your words why you are on this medicine?” Incorrect information Misinformation is described as false or inaccurate information that may be deliberately provided or manipulated (World Health Organization [WHO], 2022). Healthcare professionals must deter- mine if patients have been misinformed or provided with incor- rect healthcare information. Inaccurate information can be passed along from multiple sources and others in the community such as family and friends, traditional media, and social media. The advent of social media has increased the ease and spread of in- formation, and studies are now examining the effects of misrepre- sentation of healthcare topics. Effective communication between healthcare professionals and patients can uncover misinformation or inaccurate information, which can present as a teaching mo- ment (Khullar, 2022; Murthy, 2021). Evidence-Based Practice: One systematic review was per- formed following the start of the COVID-19 pandemic to exam- ine the level of misinformation on social media. Results showed that up to 28.8% of the content on four major social media sites involved healthcare misinformation (Borges do Nascimento et al., 2022; WHO, 2022). Misinformation or incorrect information is an opportunity for healthcare professionals to provide correct evidence and build trust. It is important to note that some misinformation may con- nect to patient beliefs. Healthcare professionals should determine
Questions that include how and what help keep the focus on con- tent. Questions with why should be used cautiously, as they may put people on the defensive, for example, “Why do you believe that?” The intent in that question may be to elicit more informa- tion, but it can be interpreted as questioning the person’s belief. Open-ended questions give patients the ability to speak their thoughts how they want to, which can provide valuable insight for healthcare professionals (HCEA, 2021; Maryniak, 2019). Healthcare Consideration: Open-ended questions elicit rich information from patients. There are times when closed-ended questions are appropriate. Eliciting yes and no responses dur- ing a patient history, for example, works well. Electronic health records have sections that allow for only yes, no, or N/A re- sponses. Here are some examples of questions healthcare professionals can use with patients: ● “What concerns you the most about your high blood pres- sure?” ● “How do you feel today compared to yesterday?” ● “Tell me about how you manage your pain at home.” ● “Tell me what you would do if you had questions when you get home.” ● “What questions do you have for me?” There are times when patients don’t provide many details, even when an open-ended question is used. Probing questions are used to gather more information and encourage further discus- sion. These questions can also summarize and clarify, for example, “Tell me more,” “I want to make sure I understand—tell me more about that,” and “How did that affect you?” (HCEA, 2021; Lapum et al., 2020). Self-Assessment Quiz Question #2 Which of the following is an appropriate open-ended question? a. “Tell me why you think you don’t need a flu shot.” b. “Do you have pain?” c. “Do you understand what we just talked about?” d. “What works best to help you sleep at home?” ● “What are your goals in life?” ● “What are your goals today?” ● “How do you take your medicine?” patients’ beliefs, values, lived experiences, and knowledge while engaging and establishing relationships with them. Communi- cation about misinformation and incorrect information requires empathy and personalization of the conversation to the patient (Khullar, 2022; Murthy, 2021). Plain language is essential, and health literacy promotion is needed to overcome misinformation and inaccurate information. Use of resources and materials that are evidence based, at an appropriate level, can also assist with correcting misinformation. Theories of improving health literacy stress that each person has a right to health information for decision making and that health- care should be developed in a manner that is understandable and valuable to health, long life, and quality of life. Health literacy can be improved through providing accurate healthcare (CDC, 2022). Healthcare professionals are in positions of trust and can influ - ence the knowledge and decisions that patients have and make about their health and healthcare. It is important that all informa- tion given to patients and families during teaching moments and while providing education be accurate and unbiased. Healthcare professionals must identify their own personal biases and provide facts to patients. An example that has been seen in recent years is related to vaccinations. Another consideration is that if patients and families ask questions to which healthcare professionals do not have immediate answers, it is vital to not use a guess or spec-
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