Kelly (2010) defines communication as an “interactive process that occurs when a person (the sender) sends a verbal or nonverbal message to another person (the receiver) and receives feedback” (p.125). There are various levels of communication that are important in the healthcare profession. Each level will be described along with the importance of each level. The first level to be described is interpersonal communication, which is one-on-one communication between human beings and can be written, oral, and nonverbal. Interpersonal communication is the most fundamental level of health care communication because the individual affects their own health. The importance of interpersonal communication is that it allows for a relationship to be formed between the parties that are involved. The second level to be described is intra-personal communication, which is a person communicating with one’s self (the thought process), and it allows thoughts to become feelings and eventually actions, which allows the healthcare professional to devise the best possible plan of care for each individual patient. Intra-personal communication impacts people’s personalities and influences how people communicate with others, both of which can be summed up as negative in, negative out and positive in, positive out. The third and last level to be described is public communication, which is shared communication between the communicator and a group of people. The importance of public communication is that it allows the communicator to send out information to a vast number of people, which can influence behaviors by affecting values, attitudes, opinions, laws, and policies (Kelly, 2010).
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Communication is affected by many factors, such as emotions, needs, individual perceptions, each party’s values, cultural diversity, individual goals, literacy, cognitive ability, the education level of all parties involved, the mode in which the communication is administered, and the environment in which the communication takes place. Communication requires honesty and openness from all parties involved. Communication is used to synchronize patient care in healthcare. Ineffective synchronization and communication contributes to adverse measures of patient care. Teamwork among healthcare professionals is so crucial in patient safety and effective outcomes that it is considered a priority among healthcare management; therefore, effective interpersonal communication is a necessity for creating a safe environment for patients (Kelly, 2010).
With the age of technology, healthcare providers are using a variety of technologies to communicate with patients and each other. Special care must be taken when using these forms of technology for communication. Patient privacy is of the upmost importance when using any form of communication, but methods such as telephone, fax, e-mail, and voice mail require the healthcare professional to be even more diligent in patient privacy. The nurse in such a care giving role must be proficient in the writing skills required to communicate in one of these advanced communication methods, and the response should be done in a timely manner. Special attention should be given to spelling, grammar, and the organization of the thought process since greater importance is given to these aspects when face-to-face contact is not achieved (Kelly, 2010).
Communication alone can increase knowledge and awareness of a health problem or a solution of the intended audience, sway preconceived notions, beliefs, and attitudes that may modify social norms, promote action, demonstrate or illustrate healthy lifestyle choices, reinforce healthy decisions, show the advantages of beneficial changes, advocate for a health issue or policy, amplify the demand or support for health care, disprove myths and misconceptions about health care, and reinforce relationships, whether interpersonal or organizational (National Cancer Institute, 2008).
Communication coupled with other strategies can bring about change in which the client adopts and maintains a new health action or an organization adopts and maintains a new policy or procedure, and conquer barriers or problems (National Cancer Institute, 2008).
Communication cannot balance inadequate care or access to health care, generate change that is successful in multifaceted health issues without support of a larger program for change, or be effective in addressing all issues or relaying all communication uniformly due to the wide range of topics or behaviors (National Cancer Institute, 2008).
Communication in healthcare “encompasses the study and use of communication strategies to inform and influence individual and community decisions that enhance health. It links the domains of communication and health and is increasingly recognized as a necessary element of efforts to improve personal and public health” (Healthy People 2010). Communication in health care contributes to all aspects of prevention of disease and promotion of health and is relevant to (1) healthcare professional-patient relations, (2) individuals’ use of, search for, and exposure to health information, (3) individuals’ compliance with recommendations and treatment, (4) production of public health campaigns and messages, (5) distribution of health risk information for individuals and populations, (6) health images in all areas of media, (7) consumer education on access to health care, and (8) advancement of telehealth applications (Healthy People 2010). Individual consumers gain awareness of health risks and prevention from effective health communication. It also provides motivation and knowledge needed to reduce the risks, find support from individuals in similar situations, and affect or strengthen attitudes. Health communication also demands appropriate health services and eradication of unsuitable health services. Health communication can make information available to help individuals make complicated choices. Health communication can also be used to persuade the agenda of the public, promote policies and programs, advocate for positive changes in the socioeconomic and physical environments, advance the delivery of health care services, and support social values that promote health and quality of life (Healthy People 2010).
There are many barriers to communication in the healthcare environment, but the barrier that warrants visitation is listening. According to Shipley (2010), “Listening is likely the most ancient of healthcare skills; it is a critical component of all aspects of nursing care and is necessary for meaningful interactions with patients” (p.125). For communication to be effective, patients must perceive that they are being heard and understood and that the person listening is actually interested in what is being conveyed.
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Research shows that people long to be heard by their healthcare professionals above any other aspect of their experience. Active listening by healthcare professionals contributes to the patient’s overall feeling of well-being and patient satisfaction. Research also shows that poor communication between the patient and the healthcare team is reported more often than any other dissatisfaction of care. Therefore, therapeutic listening is essential for quality care of the patient (Shipley, 2010).
Active empathetic listening is an advanced form of communication and increases patient satisfaction. The major elements of active listening include sensing, processing, and responding. Sensing includes evocation of feelings, the use of non-verbal cues, conveying concerns, tone, and being aware of implications. Processing during listening addresses memory, summarization, clarification, and prioritizing. To respond, one must have assurance, must question, use body language, paraphrase, and make use of verbal probes. Active listening improves mutual understanding between both the patient and the healthcare professional. There are two components of active listening: listening attitude and listening skill. Attitude is patient-centered and is based on empathy, congruence, and unrestricted positive regard. Skill includes responses and techniques to promote conversation (Shipley, 2010).
Listening demands a conscious effort and involves being able to be silent, nonjudgmental, respectful, and conveying empathy and compassion. It also requires the ability to identify verbal and non-verbal cues in order to be able to read between the lines so that understanding can be established. Effective communication can only occur when a safe environment is created for the patient to communicate. In order to listen non-judgmentally and in an accepting manner, the healthcare professional must do away with all preconceived beliefs, prejudices, and negative thoughts or actions. Listening involves perceiving the person holistically and remembering that each patient is unique and that each individual has different beliefs and values. Being non-judgmental during communication conveys respect for the individual and creates an atmosphere in which the patient can trust and feel free to open up without fear of rejection. The commitment of effective listening requires that the healthcare professional give their full and undivided attention to the patient. Healthcare professionals tend to be action-driven, and automatically think that they must do something, but learning to remain silent and refrain from action will allow the patient the time and freedom for uninterrupted communication (Shipley, 2010).
Doctors and nurses talk themselves through diagnoses, interventions, and patient goals before ever talking to each other or the patient. Doctors, nurses, and other healthcare professionals communicate with each other to devise the best plan of care for each individual and all healthcare professionals communicate with patients concerning their diagnoses, their treatment options, treatment goals, the expected outcomes, treatment compliance, and education about their illness as well as prevention of future illness.
So, whether written or spoken words, sign language, body language, facial expressions, or even silence, communication plays a vital role in everyday life and within the healthcare profession. Healthcare without communication, whether it is intra-personal, interpersonal, or public would prove disastrous, causing extended hospital stays, rising healthcare costs, even loss of life.
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