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FNP 350 > Midterm > Flashcards

Midterm Flashcards

1
Q

What is the KASH model ? What does it stand for?

A

4 skills needed to communicate effectively:

  1. KNOWLEDGE - gaining knowledge and remaining current in practice
  2. AWARENESS - increasing awareness of how one communicates
  3. SKILLS - practicing new skills
  4. HABIT - practicing until it becomes habitual
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2
Q

What are 5 integral qualities a dietitian/helping a professional should have?

A
  1. trustworthy
  2. honest
  3. reliable
  4. good listener
  5. caring
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3
Q

Give 5 points about a prescriptive approach.

Give 5 points about a patient-centred approach

A

Prescriptive approach:
- RD advises, teaches, informs, instructs
- Expectation of compliance
- its based on authority and expertise
- RD in control of the session
- CAN BE EFFECTIVE FOR SOME, BUT HAS LIMITS

Patient-centred approach
- takes patient into account
- attempts to understand whole person
- works alongside the patient
- flexible

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4
Q

What are 5 methods of RD helping a client?

A
  1. Instructing
  2. Teaching
  3. Advising
  4. Discussing
  5. Counselling
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5
Q

Instructing:
purpose?
skiils needed?
Approach?

A

Purpose: get RD msg across
Skills: ordering
Approach: practioner-led

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6
Q

Teaching:
purpose?
skills needed?
Approach?

A

Purpose: to ensure client understands the material
Skills: explaining/demonstrating
Approach: practitioner-led

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7
Q

Advising:
purpose?
skills needed?
Approach?

A

Purpose: to tell client what to do
Skills: persuading
Approach: practioner-led

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8
Q

Discussing:
purpose?
skills needed?
Approach?

A

Purpose: to exchange points of view
Skills: express oneself
Approach: Combined approach

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9
Q

Counselling:
purpose?
skills needed?
Approach?

A

Purpose: to understand/help clients make changes
Skills: listening/responding helpfully
Approach: patient-led

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10
Q

what is the difference between psychotherapy and psychological counselling?

A

psychotherapy: the purpose is to treat the psych disorder, applying a specific technique. it is a controlled act

Psychological counselling: an interaction where the helper offers another person time, attention, respect

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11
Q

what are the 5 stages of change?

A
  1. pre-contemplation
  2. contemplation
  3. preparation
  4. action
  5. maintenance
    (relapse)
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12
Q

_____ is fostered when using a prescriptive approach.

A

dependency

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13
Q

If a patient feels helpless and expects the dietitian to solve their problem, this is an example of:

A

transference

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14
Q

when a dietitian says something like “its for your own good” that is an example of

A

countertransferance

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15
Q

what are 3 ways to keep biases in check?

A
  1. practice self-awareness
  2. acknowledge and accept that I have biases
  3. re-focus on empathy and patient-centredness
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16
Q

What are the core conditions of a helping relationship? explain?

A
  1. Empathy
    - are sensitive to otherpeoples experiences while maintaining own sense of identity
    - caring in an accepting and genuine way
    -outcome: client feels heard
    - outcome - client is more likely to experiment
  2. Acceptance
    - involves having respect and warmth for another person. Relates to acceptance of ourselves
    - outcome: client feels accepted
    -outcome: client is more likely to take risks
  3. Genuineness
    - being who we truly are, without facade
    - outcome: client feels valued
    - outcome: client is more likely to change behaviour to achieve goals
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17
Q

empathy is effective at reducing barriers in relationships through ______ and ______

A

active listening
reflective responding

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18
Q

what is the difference between empathy and sympathy?

A

empathy = connecting with the other person instread of trying to find approproiate response
sympathy = you take on another’s experience as your own

Empathy = “i can see that you feel ____ because”

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19
Q

What are 3 ways we can demonstrate acceptance (a core condition for a helping relationship) in practice?

A
  1. consider the value of self-awareness
  2. consider the value of self-acceptance
  3. consider the value of being honest with yourself
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20
Q

what are 5 features of a competent communicator?

A
  1. large repertoir of comms skills
  2. flexibility
  3. empathy/perspective taking
  4. cognitive complexity
  5. self monitoring/self awareness
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21
Q

what are 6 different reactions to change?

A
  1. talking
  2. feeling ambivalent
  3. bargaining
  4. feelings of doubt
  5. blaming
  6. distancing
22
Q

What are the developing stages of the helping process?

A
  1. listening and identifying
    - listen to patient’s history
    - help person identify and understand their problems
    - skills of active listening and building report
    - TRY: ATTENDING (FELOR), LISTENING, CONVEYING EMPATHY
  2. clarifying what the client wants
    - clarify meanings
    - includes active listening and building rapport
    includes open-ended questions as a way to clarify
  3. planning ways to achieve realistic goals
    - review, encourage, support
23
Q

active listening requires:

A
  1. awareness of feelings, thoughts, non-verbal comms, discrepancies
  2. knowledge of empathy, acceptance and helpful responding
  3. skill in observation, mirroring, attending
24
Q

What is attending?

A

FELOR - helps us be aware of our nonverbal comms as we attempt to acitvely listen

FACING the person
EYE contact
LEANING in
OPEN posture
RELAXING

25
Q

What are some barriers to communication?

A

internal factors:
- anxiety
- fatigue

External factors
- temp, humidity, degree of privacy
-deck positioning, chair quality
- body positioning

26
Q

What are some positive and negative effects of managing time (boundary)

A

Positive
- helps RD to stay on time
- helps RD to say on track
- patient feels secure and safe
- RD is more relaxed

Negative
- can be interpreted as strict
- RD may feel resentment of boundary is challenged

27
Q

Making a contract includes:

A
  1. summarizing what has been said
  2. accurately identifying patient’s key concerns
  3. formulating and discussing goals/course of action
  4. answering questions
  5. making arrangements for follow up
28
Q

What is hearing vs listening? What does listening include?

A

Hearing: a psych activity that occurs when sound waves hit our eardrums

Listening: an active, complex process that consists of:
1. mindfulness
2. attending (FELOR)
3. hearing
4. selecting and organizing info
5. interpreting communication
6. responding
7. remembering communication

29
Q

what are examples of poor listening habits?

A
  1. pseudo-listening
  2. stage hogging
  3. selective listening
  4. filling the gaps
  5. insulated listening
  6. defensive listening
  7. ambushing
30
Q

What are 5 blocks to listening?

A
  1. comparing
  2. mind reading
  3. rehearsing
  4. filtering
  5. being right
31
Q

active listening involves:

A
  1. asking open ended questions
  2. allowing silences
  3. using FELOR
32
Q

Helpful responding involves:

A
  1. awareness of: feelings and thoughts, nonverbal comms,
  2. knowledge about the power of language, the types of response, reflective responding
  3. skill in repeating word for word, summarizing, paraphrasing
33
Q

Paraphrasing vs Reflective Listening

A

Paraphrasing = summarizing what the victim said

Reflective listening = going beyond summarizing and identify the feelings that the person may not have identified

34
Q

What are different aspects of active listening?

A
  1. asking open ended questions
  2. allowing silences
  3. using FELOR
  4. reflecting vs. paraphrasing
  5. mirroring
  6. hypothesis checking
  7. clarifying
  8. summarizing
35
Q

what are common pitfalls of giving dietary advice?

A
  1. lecturing - a way of giving info to many people in short time, but its not effective on individual basis.
  2. jargon - using scientific language
  3. we vs. i language - using the word we sets dietitians apart from the patient and adds power to their position
  4. advising, informing, instructing
  5. risky responses
  6. reassuring
  7. suggesting
36
Q

what are 3 basic rules of responding?

A
  1. how we respond affects the relationship we have with the client and the subsequent outcome of the interview
  2. helpful responses are concerned with EMPOWERING the other person
  3. a dietitian’s attentive presence in itself is reassuring - you can show it through simlpe acknowledgeemnt of the patient’s difficulty
37
Q

when you are considering self disclosure to a patient, what should you consider?

A
  1. is it helpful to talk about yourself in a patient interview?
  2. what is your motivation to self disclose
  3. what is your ability to be genuine in your self disclosure
  4. consider the info’s relevance to the patient
  5. consider potential outcomes
38
Q

what are the basics of person-centred counselling?

A
  1. attending (active listening)
  2. paraphrasing (summarizing)
  3. reflecting (empathizing)
  4. affirmation (legitimization)
  5. partnership
  6. support
  8. mirroring
  9. clarifying (probing)
  10. allowing silence
39
Q

What are 4 types of helpful interventions?

A
  1. confronting
  2. catalytic
  3. supportive
  4. informative
40
Q

“I’m wondering if you would like to continue to meet with me for your dietetic appt” is an example of this type of intervention

A

confronting intervention

41
Q

“What would it mean to you if you could achieve your goal to reduce bp” is an example of this type of intervention

A

catalytic

42
Q

“you do matter, your health is important” is an example of this type of intervention

A

supportive intervention

43
Q

“Persistent high blood sugars are a sign that something isnt right” is an example of this type of intervention

A

informative

44
Q

what are 4 aspects to consider when choosing an appropriate intervention?

A
  1. time
  2. quality
  3. readiness
  4. the level of intervention
45
Q

What are 5 different ways to intervene?

A
  1. asking questions
    - consider tone, purpose, and effect
    - facilitative vs authoritative
    - open vs close-ended
  2. identifying paradoxes, discrepancies, and inconsistencies
    - on the one hand, i hear you say this. on the other hand
    - gives patients control, opportunity to elaborate
  3. confronting absolutes
  4. choosing a focus
  5. addressing a sensitive issue
46
Q

When preparing what you want to say when you intervene, what should you consider?

A

FEW

  1. state the FACTS (without interpretation)
  2. state the EMOTIONS (i was disappointed)
  3. state the outcome you WANT (request clarification)
47
Q

What are 4 techniques used in reflective responding?

A
  1. repeating word for word
  2. repeating key words
  3. paraphrase
  4. summarize
48
Q

4 times to use reflective responding, 3 times to not

A

use it:
1. if your client expresses a concern or is upset
2. your client has a problem
3. something needs clarifying
4. there is a difference in opinion between you/client

Don’t use it when:
1. you are tired
2. you have too mcuh on your mind
3. you can’t be open, genuine or accepting

49
Q

which comms style is most commonly used in an initial visit?

A

counselling

50
Q
A

FNP 350 (1 decks)

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