Communications 2

Question 1

What happens in an eye examination?

Answer 1

Initial meeting
History and symptoms
Clinical investigation
Conclusion and summery

Question 2

How many % are asymptomatic referrals?

Answer 2

> 15%

Question 3

What type of asymptomatic referrals do you get?

Answer 3

POAG >50%
Diabetic retinopathy
Amblyopia
Naevi

Question 4

What is good communication?

Answer 4

Increase patient understanding
Encourage good rapport with practitioner
Improves compliance
Enhances patient satisfaction

Question 5

What is bad communication?

Answer 5

Leads to gross dissatisfaction
Going to another practice
Litigation

Question 6

What may influence the interactions?

Answer 6

Patients health beliefs

• Family and friends
• school or workplace
• prev healthcare experience
• culture and religious beliefs
• internet
• verbal or non verbal behaviour
• prev experience of practitioner

Question 7

What are pre conceived myths?

Answer 7

Does not understand instructions

Question 8

What type of information are there?

Answer 8

Cognitive

Affective

Question 9

What is cognitive information?

Answer 9

The stuff you need to know, ie patient wearing glasses, is there a family history of something

Question 10

What is affective information?

Answer 10

Unspoken information- how nervous patient looks

Question 11

What are common problems in interview?

Answer 11

failure to control the interview, 
premature and restricted focus
lack of clarification 
lack of systemic interview procedure 
lack of precision 
failure to prepare patient 
lack of self awareness 
deficiencies in question style

Question 12

What is the relevant information needed to be obtained?

Answer 12

Open V closed 
Direct V indirect 
Compound
Leading 
Questionnaire 
Probing 
Facilitative 
Clarification 
Validation 
Confrontation

Question 13

What is Open question?

Answer 13

More than one answer

Question 14

What is closed Question ?

Answer 14

One answer

Question 15

What is direct Open?

Answer 15

Why did the elephant cross the road?

Question 16

What is direct closed?

Answer 16

Find X

Question 17

What is indirect question?

Answer 17

Dont really sound like a question

Question 18

What is compound question?

Answer 18

Can be quite confusing for the patient

Question 19

What is leading question?

Answer 19

This lens makes it blurry doesnt it?

Question 20

What is a questionnaire question?

Answer 20

Offers range of possibilities

Question 21

Probing question?

Answer 21

To elicit precise information about symptoms

Question 22

What is funnel question?

Answer 22

Start with open question

Narrow question down

Response

Question 23

What is facilitative question?

Answer 23

Encourage remarks eg please continue

Question 24

What is clarifying question?

Answer 24

Summarise history and symptoms

Question 25

What is validating question ?

Answer 25

Normally an assumption from the effective information

Question 26

What is confronting questions?

Answer 26

Occasionally may need to confront patient before continue eg you seem quite angry about your glasses why is this?

Question 27

What are the measuring and investing type of techniques?

Answer 27

Memory Ability to generalise understanding of concepts Ability to communicate

Question 28

What complication can you find?

Answer 28

``` Concise and clear Specific to what you found Non verbal reinforcement Categorisation Primacy and recency effects Call for commitment Summary Body language ```

Question 29

What if patient cant respond well?

Answer 29

Then direct questions to carer but ensure you include the patient

Question 30

What disabilities can px have?

Answer 30

Cerebral palsy Downs syndrome Autism

Question 31

How many people have learning disabilities?

Answer 31

``` 1.2 million in UK Third are children 40% have eye problems 37% have hearing problems 50% receive no regular eyecare figure increases with age ```

Question 32

What do you avoid at all cost?>

Answer 32

Sympathy, fear and hostility Pathos or hopelessness Over identification with patient or carer Do not assume patient responses are wrong Do not mistrust their state of mind

Question 33

Orientation?

Answer 33

Pre arranged visit Staff awareness pre exam questionnaire

Question 34

How many have hearing disabilities?

Answer 34

14% of population 8.7 million people vast majority over 65 years

Question 35

What do you do with elderly patients?

Answer 35

Consider memory problems, check mobility consideration | establish attitude

Question 36

What tip do you consider for a silent patient ?

Answer 36

Warm, friendly manner | inverted funnel approach-initialy closed question

Question 37

What tip do you consider for a talkative person?

Answer 37

Closed question polite interruption Be aware on non verbal behaviour and ensure you look like your listening

Question 38

What tip would you consider for a nervous patient?

Answer 38

Warm, friendly manner avoid jargon closed question

Question 39

What tip do you consider for a aggressive or angry patient?

Answer 39

``` Remain calm maintain good eye contact Open body posture acknowledge their feelings Direct address the problem if patient very aggressive leave door open ```

Question 40

What tips do you consider for know all patients?

Answer 40

Directly acknowledge the situation in non confrontational manner consider using more technical terms in this scenario

Question 41

How do you tell someone the bad new?

Answer 41

Ensure privacy Respect confidentiality Good open body language Good eye contact

Question 42

What should you not do with a patient when telling them bad news?

Answer 42

Do not sympathise | Do not patronise

Question 43

What should you do about a patient that will hear the bad news?

Answer 43

Ask what patient already knows | listen to how patient tells you

Question 44

What is aligning ?

Answer 44

Start at the level of the patient understanding and use same vocabulary

Question 45

What is educating?

Answer 45

Give info in small chunks. keep language clear and simple. check that the patient understands what you are telling them

Question 46

How do you respond to the patients reaction?

Answer 46

Acknowledge all reactions and feelings Be empathic Deal with crying and other strong emotions

Question 47

How do you close?

Answer 47

Summarise the main points | Ask if the patient has any questions