Chapter 8 Communication

Question 1

Ineffective listening

Answer 1

-creates misunderstandings, waste time, hurts relationships, causes errors
-listening on and off (typically listener thinks four times faster than speaker)
-pre-judging message
-not listening to the end, interrupting
-absorbed in their own thoughts,
daydreaming
-defensive
-leads to poor treatment, weaker relationships, poor documentation (leading to denied payment) less satisfaction leading to decreased reputation and referrals
-good listening skills need to be practice as with any PT skill

Question 2

Communication through body language and facial expression?

Answer 2

-can convey acceptance or rejection of ideas

=== also it includes clothing, grooming which has cultural connotations===

Question 3

Body language?

Answer 3

Includes posture and gestures it reveals inner feelings

Question 4

Open postures?

Answer 4

Conveys the willingness to receive a message

• uncrossed arms/legs
• standing/sitting at patients eye level
• facing person speaking

Question 5

Closed postures?

Answer 5

-conveys an unwillingness to receive message

Question 6

Nonverbal communication displaying acceptance:

Answer 6

• smiling /nodding
• Direct eye contact (without staring)
• getting at eye level with the patient

Question 7

Nonverbal communication displaying rejection/superiority:

Answer 7

• eye rolling/Staring
• looking down or away/Shaking head
• frowning
• standing while talking to seated patient

Question 8

Nonverbal communication touch:

Answer 8

-can be taken positively or negatively depending on the situation and culture

=== emotional intelligence-being able to recognize emotions in self and others and then being able to address appropriately

Question 9

PT written communication

Answer 9

• written evaluations, progress notes, discharge summaries, home exercise programs, informed consent, surveys
• write the information as if I was talking to the patient
• use active voice
• use short sentences, common words

Question 10

Home EX program handouts (HEP)

Answer 10

Organize, concise, and in layman’s terms
-be specific about exercise details
-Number of reps/sets/ many times
daily/ how many times weekly/ the position
-include diagrams when able
-write at fifth grade reading level
-order exercises so patient doesn’t have to change positions repeatedly
-keep it simple and low numbers of exercises
-involve caregiver when possible

Question 11

Listening?

Answer 11

1•Effective listening involves reflecting on the patient’s message and summarizing it to clarify meaning
2•Builds rapport, Saves time, Builds trust, Reduces errors

Question 12

Effective Listening Methods-

Answer 12

a skill that can be learned
•Focus on patient, smile and look at them
•Watch nonverbal communication- gestures, facial expressions, tone of voice, posture
•Ask for clarification, Repeat/summarize
•Take notes
•Use positive body language (nodding, eye contact)
•Don’t interrupt

Question 13

Effective Communication?

Answer 13

1•Ask patients to repeat or return demonstration to ascertain if they truly understand
2•Don’t be fake in any of your communication
3•Open vs Closed Questions
4•Open questions: don’t limit responses; for example: “Describe the pain you are feeling”
5•Closed questions: lead to short, specific responses; for example, “Are you in pain?”

Question 14

Effective Verbal Communication more tips?

Answer 14

-Vocabulary should be simple, precise and accurate and in terms the patient can understand
1•Speak clearly and concisely in a normal tone of voice
2•Accompany education with written instructions using pictures or diagrams when possible
3•Don’t call the patient by their pathology (say the patient with the heart condition, not the heart condition patient)
4•ALWAYS describe (and demonstrate when possible) the treatment prior to performing it
5•Ask questions to build rapport and get feedback
6•Pause after giving instructions to allow time to process
7•Respond with patience and smiling to requests to repeat

Question 15

•Verbal Communication is used to:

Answer 15

1•Establish rapport with patient & caregiver
2•Obtain information regarding patient/progress
3•Transmit information to other healthcare providers
4•Provide education & instruction to the patient/caregiver
5•Increase patient HEP compliance & decrease their health risks

Question 16

•Cultural Diversity & Communication

Answer 16

1•Be knowledgeable- certain cultures appreciate periods of silence (African Americans, Navajo Indians, Asians
2•Limitations in English does not indicate cognitive level/status
3•Linguistic competence- learn & use key words and expressions

Question 17

Consider the following when communicating with other cultures:

Answer 17

1•Health beliefs and perceptions
2•Attitudes
3•Level of education
4•Table of verbal and nonverbal communication guidelines for numerous cultures, check it out in text, pp.154-155
5•Avoid using family/friends as an interpreter, as it can break privacy laws and may not be accurate
6•Professional interpreters should be culturally sensitive

Question 18

PT-PTA Relationship depends on:

Answer 18

1•Skills
2•Continuing Ed. Courses
3•State laws
4•APTA resources
5•Personal attributes
6•Expectations made known
7•Communication
8•Department Goals/Policies

Question 19

PTAs may have one or more supervising PTs

Answer 19

•Each pairing has it’s own unique relationship

Question 20

Communication Challenges

•Strategies for dealing with Difficult People:

Answer 20

1•Stay calm and professional and respectful
2•Don’t show irritation or anger
3•Focus on trying to solve the problem
4•Listen carefully
5•Encourage participation and explain consequences, but remember, the patient has a right to choose
6•Remember that people deal with grief, pain, and other emotions differently
7•Treat people with mental illness remembering that they are ill
8•Be friendly, consistent, optimistic and non judgemental
9•Working with patients having cognitive impairments requires patience and repetition
10•Don’t talk too much, allow patient to focus

Question 21

The Therapeutic Relationship

Answer 21

•First Impression is Important

Question 22

• Establish Therapeutic Relationship:

* Punctuality

Answer 22

shows respect

Question 23

• Establish Therapeutic Relationship:

* Friendliness

Answer 23

• Smile, Introduce yourself

* Call patient initially by last name or ask for preferred

Question 24

• Establish Therapeutic Relationship:

* Cultural Sensitivity

Answer 24

It is good to know what is allowed and what is not in a culture

Question 25

• Establish Therapeutic Relationship:

* Good Communication Skills

Answer 25

• Use layman terms, speak to their cognitive level

* Observe hearing limitations

Question 26

• Establish Therapeutic Relationship:

* Patient Focused Behaviors-

Answer 26

shows respect and concern

Question 27

• Establish Therapeutic Relationship:

* Knowledgeable

Answer 27

•PTA should read eval first, ask pertinent questions, answer ?s

Question 28

• Establish Therapeutic Relationship:

* Trustworthy

Answer 28

You have to show the patient that they can trust you

Question 29

• Establish Therapeutic Relationship:

* Helpfulness –

Answer 29

even if it is “not your job”

Question 30

Establish Therapeutic Relationship:

Comfortable-

Answer 30

take a moment to get to know your patient, rapport

Question 31

Empathy empowers the PT/PTA

Answer 31

1•Listen better to the patient
2•Allows the patient to feel “listened to”
3•Form a therapeutic partnership with the patient
4•Facilitate effective interventions by improved understanding
5•Involve the patient/caregiver in decision-making process
6•Encourage motivation & behavioral changes
7•Empathy is NOT the same as Sympathy
8•Feeling as the patient instead of feeling sorry for them

Question 32

Empathy:

Answer 32

the ability to imagine oneself in another person’s place and to understand their feelings, ideas, desires & actions
1•In order to feel empathy, one must have self awareness and the awareness of others feelings, desires, & ideas and ability to imagine
2•Is important in the development of morality, beliefs about what he or she does, think, or feel

Question 33

•The absence of empathy: results in…

Answer 33

1•People exploiting and abusing others
2•Inability to love and relate to others
3•Failure to respect others’ boundaries
4•Inability to accept others’ needs & feelings

Question 34

•3 Stages of Empathy

1•Cognitive stage-

Answer 34

getting into the position of the patient, listening

Question 35

•3 Stages of Empathy

2•Crossing over stage-

Answer 35

for a brief moment, imagining what it feels like to be the patient

Question 36

•3 Stages of Empathy

3•Coming back stage-

Answer 36

return to own feelings

Question 37

Elements of an effective therapeutic relationship:

Answer 37

1•Valuing the patient/client
2•Being attentive to patient needs & focusing on them
3•Acknowledging the patient/client’s needs
4•Listening to the patient objectively without projecting personal beliefs/values
5•Being genuinely empathetic with the patient
6•Having self-awareness to allow communication of inner feelings, emotions, and ideas
7•Desiring to provide the patient/client with the very best care, conveying expertise and confidentiality
8•Placing the patient in a position of equality