Han 335 Review

Communication between HCPs and patients or families to advance patient well-being and care.

What is therapeutic communication?

Collect health information; give healthcare feedback/education; assess and, when appropriate, modify behavior.

What are the three purposes of therapeutic communication?

Support, clarity, and empathy.

What three qualities characterize therapeutic communication?

Successful transfer of a message AND its meaning from one person or group to another.

How does the textbook define communication?

Sender has an idea to communicate.

Communication process—step 1?

Sender encodes the idea in a message (words, symbols, or gestures).

Communication process—step 2?

Message travels through a channel.

Communication process—step 3?

Receiver decodes (interprets) the message.

Communication process—step 4?

Receiver understands and sends feedback to the sender.

Communication process—step 5?

The means used to send a message: spoken conversation, phone, email, writing, or gesture.

What is a communication channel?

Anything that disrupts clear transmission or understanding—even when it is not audible sound.

What is noise in communication?

Pain, anxiety, language barriers, distractions, sensory impairment, or faulty technology.

Name four possible types of communication noise.

Invite the patient to paraphrase or explain it back; clarify misunderstandings.

How does an HCP check that a message was understood?

It tells the sender whether the intended message was received and understood.

Why is feedback important?

Messages conveyed without words, such as body movement, facial expression, gaze, distance, and touch.

What is nonverbal communication?

Reinforce or contradict words; express emotion/attitude; shape relationships; provide feedback; regulate conversation.

What are the major functions of nonverbal communication?

Nonverbal communication through body movements: gestures, facial expressions, and gaze patterns.

What is kinesics?

Movements of the head, hands, eyes, or body that communicate meaning; e.g., nodding.

What are gestures?

A deliberate gesture that clarifies or emphasizes spoken instructions, such as showing where to place an arm.

What is an illustrator gesture?

Unintentional behavior that reveals feelings despite the spoken message, such as nervous fidgeting.

What is nonverbal leakage?

Emotions such as happiness, sadness, fear, anger, disgust, and surprise.

What are facial expressions used to communicate?

Interest, attention, engagement, or discomfort; cultural context affects interpretation.

What do gaze patterns communicate?

The use of physical distance in communication: territoriality/personal space, position, and posture.

What is proxemics?

The physical area people feel belongs to them; entering it without care may cause discomfort.

What is territoriality/personal space?

How people arrange themselves relative to one another, such as sitting at the patient’s level.

What is position in nonverbal communication?

The way a person holds the body; leaning forward can communicate attention.

What is posture?

It may reassure or discomfort; explain necessary touch and respect consent and culture.

How can touch affect healthcare communication?

Body language and spoken words convey a consistent message; incongruence can reduce trust.

What does nonverbal-verbal congruence mean?

A single gesture has many possible causes; look for patterns and ask the patient.

Why not interpret one gesture in isolation?

Notice the mismatch without assuming: “You seem concerned. Would you like to talk?”

A patient says “I’m fine” but frowns. What should you do?

Communication using spoken words and sounds.

What is verbal communication?

Clear, familiar words accurately convey meaning; jargon or ambiguity creates confusion.

Why are content and word choice important?

Correct grammar and pronunciation improve clarity, confidence, and rapport.

How do grammar and pronunciation affect care?

Vocal features apart from word meaning: speech rate, rhythm, volume, pitch, inflection, and tone.

What is paralanguage?

Talking too fast can overwhelm patients; adjust pace for understanding.

Why does speech rate matter?

Changes in vocal pitch or emphasis that influence meaning.

What is speech inflection?

Directive, expressive, and problem-solving.

What are the three tones discussed in Chapter 3?

Authoritative or judgmental tone used to direct, order, or assert rank; often poor for patient rapport.

What is the directive tone?

A tone focused on the speaker’s feelings or opinions; may shift attention away from the patient.

What is the expressive tone?

Collaborative, helpful tone used to gather information and discuss care solutions with patients.

What is the problem-solving tone?

Understanding another person’s feelings from that person’s point of view.

What is empathy?

Feeling sorrow or pity for another person’s suffering; can unintentionally create distance.

What is sympathy?

Empathy means feeling with/understanding the patient; sympathy means feeling sorry for the patient.

Empathy vs. sympathy: key distinction?

Invites a fuller answer, often starting with “how” or “what”; e.g., “What brought you in?”

What is an open-ended question?

Seeks a short, specific response, often yes/no; e.g., “Does your left knee hurt?”

What is a closed-ended question?

Offers options; e.g., “Would you rather bathe before or after breakfast?”

What is a multiple-choice question in patient care?

Start broadly to hear the story, then use focused questions to fill gaps.

When should HCPs use open-ended vs. closed questions?

Restating the patient’s message in your own words to verify understanding and show you listened.

What is paraphrasing?

Interrupting, unsolicited advice, turning focus to yourself, or claiming you know exactly how the patient feels.

Name three verbal communication practices to avoid.

Tactfulness, courtesy, respect, empathy, genuineness, appropriate self-disclosure, and assertiveness.

What interpersonal qualities does Chapter 4 emphasize?

Disagreeing or addressing problems without belittling others; e.g., declining workplace gossip respectfully.

What are tactfulness and diplomacy?

Courtesy considers others’ needs; respect communicates that the person has worth and dignity.

How do courtesy and respect differ?

Being sincere, open, and honest in words and actions.

What is genuineness?

Brief personal sharing that helps the patient, without shifting focus or one-upping the patient.

What is appropriate self-disclosure?

Assertiveness states needs/opinions respectfully; aggression attacks or puts down others.

How is assertiveness different from aggressiveness?

Allow the patient time to gather thoughts and continue speaking without interruption.

Therapeutic skill: remaining silent?

Do not criticize a patient’s beliefs or behavior; remain focused on care.

Therapeutic skill: remaining nonjudgmental?

Listen and acknowledge the patient’s account without expressing personal approval.

Therapeutic skill: showing acceptance?

Notice progress or positive changes; reinforce effort without passing judgment on the person.

Therapeutic skill: giving recognition?

Make it clear you are professionally available to support the patient’s needs.

Therapeutic skill: offering yourself?

Invite the patient to introduce what matters: “What would you like to discuss?”

Therapeutic skill: giving the patient the opening?

Gently guide conversation so important or difficult information is explored.

Therapeutic skill: leading the discussion?

Describe what you notice without blame: “I notice that your knee is swollen.”

Therapeutic skill: making observations?

Invite clarification and details instead of assuming: “Can you tell me more?”

Therapeutic skill: encouraging communication?

Repeat meaning in your own words to verify the message and strengthen rapport.

Therapeutic skill: paraphrasing?

Promises such as “Everything will be fine” that dismiss uncertainty or feelings.

HCP roadblock 1: easy reassurance?

Downplaying patient concerns, such as “It’s nothing to worry about.”

HCP roadblock 2: minimizing feelings?

Judging the patient as good/bad instead of addressing behavior and health effects.

HCP roadblock 3: approving/disapproving?

Turning the patient’s experience into a debate over who is right.

HCP roadblock 4: agreeing/disagreeing?

Offering unsolicited personal recommendations rather than appropriate healthcare guidance.

HCP roadblock 5: giving your own advice?

Pressuring a patient to disclose something they do not wish to discuss.

HCP roadblock 6: prying?

Reacting to complaints by protecting yourself or the institution instead of listening.

HCP roadblock 7: becoming defensive?

Interrogating the patient about behavior rather than exploring it supportively.

HCP roadblock 8: demanding explanations?

Using clichés or superficial remarks that do not address the patient’s concern.

HCP roadblock 9: commonplace comments?

Overemphasizing a strength to cover a perceived weakness in another area.

Coping behavior: compensation?

Rejecting an unpleasant feeling, need, fact, or diagnosis.

Coping behavior: denial?

Redirecting feelings toward a safer substitute, e.g., anger at a clinician instead of illness.

Coping behavior: displacement?

Separating painful feelings from the memory or idea of an event.

Coping behavior: dissociation?

Imitating another person’s behavior to conceal one’s own perceived inadequacy.

Coping behavior: identification?

Attributing your own uncomfortable feelings to another person.

Coping behavior: projection?

Using plausible-sounding excuses to justify unacceptable behavior.

Coping behavior: rationalization?

Reverting to earlier or immature behaviors under stress.

Coping behavior: regression?

Keeping distressing thoughts or feelings out of conscious awareness.

Coping behavior: repression?

Recognize anger, remain calm, listen, show empathy, avoid arguing or defensiveness, and focus on care.

How should an HCP respond to an angry patient?

Recognize and acknowledge anxiety; use calm voice/body language; support comfort; avoid minimizing; alert physician.

How should an HCP respond to an anxious patient?

Health Insurance Portability and Accountability Act.

What does HIPAA stand for?

Treatment, Payment, and healthcare Operations.

What does TPO mean under HIPAA?

Using/sharing needed health information among care professionals to treat the patient.

What is HIPAA “treatment” in TPO?

Using/sharing needed information for billing, claims, and collections.

What is HIPAA “payment” in TPO?

Activities such as quality control, employee training, and accreditation.

What are HIPAA “operations” in TPO?

No. Do not disclose a patient’s private health information socially.

HIPAA: should you share a patient story with friends?

A long-lasting condition that often develops gradually and rarely resolves completely.

What is a chronic illness?

Diabetes, hypertension, coronary artery disease, rheumatoid arthritis, or multiple sclerosis.

Give four examples of chronic illnesses.

Chronic conditions persist; acute illnesses/injuries usually have shorter, more predictable recovery.

Chronic vs. acute illness: key distinction?

Changes in physical function or appearance, social roles, work, independence, and autonomy.

What losses may accompany chronic illness?

The patient; the HCP should work as a respectful consultant and partner.

Who is the expert on day-to-day life with chronic illness?

Ask about coping, expectations, priorities, support, quality of life, and need for control.

What communication helps a patient with chronic illness?

Progressive illness not adequately treatable and often expected to result in death within about six months.

What is terminal illness as discussed in the text?

Advanced pancreatic cancer, advanced heart disease, late-stage Alzheimer disease, or ALS.

Give examples of terminal illness.

Care focused on symptom relief, comfort, and quality of life rather than cure.

What is palliative care in terminal illness?