Patient Interactions

Patient Interactions

Objectives

  • Identify qualities needed to be a caring radiologic technologist.
  • Specify needs that cause people to enter radiologic technology as a profession.
  • Discuss general needs that patients may have according to Maslow’s hierarchy of needs.
  • Relate differences between the needs of inpatients and those of outpatients.
  • Explain why patient interaction is important to patients as well as their family and friends.
  • Analyze effective methods of communicating with patients of various ages.
  • Explain appropriate interaction techniques for various types of patients.
  • Discuss considerations of the physical changes of aging with regard to radiologic procedures.
  • Discuss appropriate methods of responding to terminally ill patients.

Patients’ Needs

  • Patients would naturally choose a nice restaurant over visiting the x-ray department.
  • Patients are in an altered state of awareness.
  • Fear of the unknown is profound.
  • They fear loss of control.
  • Emotions may be unnatural.

Technologist's Personal Needs

  • Helping others.
  • Working with people.
  • Making a difference.
  • Thinking critically.
  • Demonstrating creativity.
  • Achieving results.
  • Meeting personal needs increases confidence in technical abilities, which patients perceive as competence.

Maslow’s Hierarchy of Human Needs

  • People strive from a basic level of physiologic needs toward a level of self-actualization.
  • Each level of needs must be satisfied before an individual proceeds to the next level.
  • Patients are often at the lower levels of Maslow’s hierarchy.

Patient Dignity

  • Deals with a patient’s self-esteem
  • Patients feel a strong loss of power over their fate.
  • Embarrassing situation that they feel isolates them from others
  • Loss of privacy and access to loved ones
  • Feelings of guilt on several fronts

Communication Importance

  • Improving the effectiveness of communication on all levels—written, oral, and electronic—has the greatest impact on patient safety.
  • Communication is critical to success

Communication Process

  • Message
  • Receiver
  • Feedback
  • Sender

Communication Essentials

  • Patient care communication must be patient-focused.
  • Communication needs to be accurate and timely.
  • Always remember to consider communication and relating with patient’s family and visitors.
  • As a technologist, communicate within your scope of practice.

Verbal Communication

  • Spoken words
  • Written words
  • Voice intonation
  • Slang and jargon
  • Organization of sentences
  • Humor

Nonverbal Communication

  • Paralanguage
  • Body language
  • Touch
  • Professional appearance
  • Physical presence
  • Visual contact
  • Personal hygiene

Touch

  • Proper palpation is accomplished by using fingertips to provide precise and gentle localization information.

Points to Consider

  • The average American reads at the eighth to ninth-grade level.
  • 44% of people age 65 and older read at about the fifth-grade level or lower.
  • 48% to 80% of patients age 60 and older have inadequate functional health literacy.

Common Patient Types

  • Seriously ill and traumatized patients
  • Visually impaired patients
  • Speech- and hearing-impaired patients
  • Non–English-speaking patients
  • Mentally impaired patients
  • Substance abusers

Mobile and Surgical Patient Communication

  • These unique patient care environments require special patient communication considerations.
  • Begin by calling the patient’s name, identifying yourself and your qualifications to the patient, and explaining the procedure.

Communication with Patient Family and Friends

  • Professionally introduce yourself.
  • Briefly explain the procedure.
  • Explain why they must leave the immediate area during exposure.

Age as a Communication Factor

  • Patient age must be factored into communication techniques.
  • Age is not a barrier to effective communication.

Age Groups

  • Infant
    • Birth to 1 year old
  • Toddlers
    • 1-3 years old
  • Preschoolers
    • 3-5 years old
  • School-aged children
    • 5-10 years old
  • Adolescents
    • 10-25 years old
  • Young adults
    • 25-45 years old
  • Middle-aged adults
    • 45-65 years old
  • Mature adults
    • 65 years old and older

Pediatric Patients

  • Come down to their eye level to talk.
  • Speak softly and less authoritatively.
  • Set up equipment before the child enters the exam room.
  • Soften room lighting.
  • Avoid loud and dramatic equipment movements.
  • Use gentle touch.
  • Maintain eye contact.

Physical Changes of Functional Aging

  • Slowing psychomotor responses
  • Slowing of information processing
  • Decreased visual acuity
  • Decrease in senses

Respiratory System Changes

  • Decreased cough reflex
  • Shallow breathing
  • Decreased pulmonary capacity
  • Kyphosis

Musculoskeletal System Changes

  • Osteoporosis
  • Arthritis
  • Decreased muscle strength
  • Atrophied muscle mass
  • Fear of fractures

Cardiovascular System Changes

  • Decreased cardiac efficiency
  • Orthostatic hypotension
  • Arteriosclerosis
  • DVT
  • General feeling of tiredness

Integumentary System Changes

  • Loss of skin elasticity
  • Change of skin texture
  • Loss of touch sensation
  • Diminished sensation of heat or cold
  • Loss of subcutaneous fatty layer

Gastrointestinal System Changes

  • Loss of appetite
  • Decreased secretions
  • Decreased GI motility
  • Decreased sphincter muscle control

Dealing with Older Patients

  • Maintain eye contact.
  • Speak clearly and more slowly.
  • Speak to them, not away from them.
  • Keep them warm if needed.
  • Ask permission to touch.
  • Demonstrate compassion.
  • Ask them what makes them more comfortable.
  • Explain thoroughly and keep them informed.
  • Treat them with respect and patience.

Terminal Patients

  • Death is part of the cycle of life.
  • Radiologic sciences professionals often deal with the dying process as part of acute death events.
  • Society’s attitudes toward death and dying have changed to become more open and respectful of the terminal patient’s wishes and rights.
  • Dying patients and their families and loved ones need to work through the grieving process in a natural and individualized timeframe.
  • Advanced directives
  • Patient autonomy

Five Stages of Grieving Process

  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance

Conclusion

  • Communication skills are essential to good medical imaging.
  • A good communication process is a closed loop.
  • Communication strategies need to accommodate the uniqueness of each patient.
  • Patients enter the health care setting feeling vulnerable and outside their comfort zone.
  • Medical professionals recognize these feelings and act with compassion and empathy for the patient’s welfare.
  • Aging and terminal patients present their own set of patient care challenges.