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Language in particular and communication in general, permeates every aspect of people’s lives. It is important in everything that a person does, in whatever profession an individual might be in. It fosters greater understanding as well the possibility of establishing better relationships between the parties which are communicating. This paper seeks to address the issue by the provision of the theories of communication which are applicable in health and social care, how to use effective communication skills in such a context, methods of dealing with inappropriate communication practices, strategies for effective communication, and the benefits and need to be engaged in effective and efficient communication practices, especially in the context of the said profession.
The author will stipulate significant factors which are assumed to be highly influential in the process of communication include culture, values, legislations, and other regulations which govern the practice of the profession. The author will also provide suggestions on how the communication process can be improved so that it can be more useful in the field of health and social care.
Furthermore, the author will discuss the standard software which are used by the health and social workers in their profession, an analysis of the benefits which were brought about by such applications, provide an analysis of how such technology enhances activities in the profession, and evaluate the legal considerations which are critical to be understood in the application of the information and communication technology.
The author will further discuss the nature of the workplace where the author is working. The organization provides care services for clients with physical and mental disabilities and for clients with dementia.
USE OF COMMUNICATION SKILLS IN HEALTH CARE
THEORIES OF COMMUNICATION
Four theoretical approaches in the practice of health and social care will be highlighted in this section: psychodynamic, behaviourist, humanistic and cognitive. The main foundation of the psychodynamic theory to communication is grounded on the works of Sigmund Freud. This does not involve only a single theory but stems to a number of other theories which were all grounded on the foundations of the work of Freud. This theory combines those which are associated to “psyche” which includes not only the mind but the entire inner feelings, thoughts and experiences and “dynamics” which refer to the notion that psyche is not stable, rather active. According to this theory, communication with the individual’s self is very critical as it is the foundation of that person’s communication practices to others. One of the basic assumptions on this theory is that the individual is the author of his own history; therefore, the individual’s earliest experiences form the foundations of how that person deals with others. Such can be modified along the process. Another basic assumption is that the individual lives in two worlds at the same time, internal and external. The internal world is unconscious while the external is controlled. The theory also assumes that all behaviour is logical and acted upon with purpose. These factors are highly influential with how the individual communicates in health and social care setting (Ellis et al., 2003).
Another theory which can be noted is the behaviourist theory. The main foundation of this theory is the notion that all behaviour is largely based on learnt responses about specific stimuli. This can be able to explain the method of language acquisition such as that of the echoic response wherein the infant imitates the sound which is made by the health or social professional, who, on the other hand, reinforces the behaviour of the infant. This theory focuses on behaviour and highlights the present and the future (Ellis et al., 2003).
The third theory which will be considered in this paper is the humanistic approach. Under this theory, the person is the highlight of interest rejecting the significance of behaviour and the unconscious impulses which result from the past. Two of the theories which are under this approach are the person-centred theory and the transactional analysis. The former highlights the importance of childhood and current experiences in life while the latter reiterates the significance of personality, child development, social psychology, and psychopathology (Sully & Dallas, 2005). According to Carl Rogers (1902-1987), “People are essentially trustworthy, that they have a vast potential for understanding themselves and resolving their own problems without direct intervention on the therapist’s part, and that they are capable of self-directed growth if they are involved in a specific kind of therapeutic relationship.” In relation to health care context, the goal of this theory is to make the clients become more open in their own personal experience, to accept themselves in all aspect, and to minimize things that might challenge their concept of self. To achieve this, there must be a good relationship between the therapist and the client. The therapist must be realistic but not offensive, accepting but critical to the misconduct of the client. Trust between the therapist and the client is important so the client will not feel social distance scale. It is basically understanding and accepting the client as a whole being, not judging the client’s impurities.
The fourth is the social cognitive theory. According to Bandura (1986), individuals obtain more information through observational learning. At home, how a parent would nurture their child can be an environmental factor that influences the child the way he behaves. Learning starts from the home whereby a child imitates the people around him. Behaviour then is being shaped and as the child grows; his natural curiosity is reinforced by his motivation to learn. The social cognitive theory explains the interaction between the person and the environment which involves cognitive competencies such as achievement that are developed and modified by social influences and structures within the environment such as parents and society.
USE OF COMMUNICATION SKILLS
There are many ways to communicate; it could be verbal, non-verbal, writing and listening. Verbal communication is used when giving information or doing trainings, on the telephone, hand over and when talking face to face with a client. For verbal communication, there are things to consider like the tone of voice, pitch and talk on the same level, never talk with your back on your client. Non-verbal communication is used for clients who have difficulty hearing, deaf and mute. Factors to bear in mind are facial expression, hand gestures, physical appearance and body posture. Aids that might help communication are the use of symbols, picture cards and communication board or writing pad. The art of good listening is practiced by letting the clients talk in their own pace and giving them time to express themselves. Transmission of information becomes effective by getting the message across clearly and reflects on how the message was conveyed.
The benefits of effective and efficient communication skills in the practice of health and social care can be highlighted by how it is used in the profession. One of the uses of communication in this field is to foster the growth and development of the practice. It must be noted that communication does not only exist between the health professional and the client. It is also evident between health professionals themselves. Communication can be used in this field to be assured that innovative ideas, trends, and best practices are shared amongst the healthcare professionals and social workers for the betterment of their profession (Santy & Smith, 2007).
Communication can also be used in the context of health and social care to be able to promote an advocacy. This kind of communication is often utilized in mediums like advertisements on print and other channels. The use of media for health promotion campaigns is very convincing that people understand healthy living and what is best for them.
Lastly, it has also been noted that communication can be used in the health and social care setting to be able to foster partnership with clients or patients, treat them with respect, provide patients with self-esteem, provision of practical help and advice regarding their condition, stimulate their intellectual development, improve the client’s sense of self-being or self-worth, satisfy the physical, emotional, and social needs of the patients and to be responsive of their needs (Haworth & Forshaw, 2002).
DEALING WITH INAPPROPRIATE INTERPERSONAL COMMUNICATION
To be able to reap the benefits of a good communication practice, health and social workers must be able to properly deal with any inappropriate communication practices. For instance, any barrier to communication should be resolved as such can result into misunderstanding in the professional practice. An example of a factor which can be a hindrance to good communication practice would be culture and language itself. Professionals in the field of health and social care should see to it that both parties understand each other, especially when decision making is involved. The use of jargons should be limited as it can lead into inappropriate communication leading into misunderstanding. Another factor which can be considered as an inappropriate practice in communication in the context of health and social care is privacy. Patients are private individuals, their records should therefore be held with confidentiality and there should be no presence of breach of contract as well between practitioners or professionals. Health and social workers have the inherent duty to not disclose any information without the knowledge of all the parties which are concerned. The lack of trust of the patient to the medical worker can also be a barrier to effective communication. Lastly, the lack of knowledge can also serve as another barrier to communication (King & Wheeler, 2007).
STRATEGIES TO SUPPORT USERS
To be able to be potentially engaged in efficient and effective communication practices, as a carer
VARIOUS FACTORS THAT INFLUENCE COMMUNICATION PROCESS IN HEALTH AND SOCIAL CARE
VALUES AND CULTURE
Two of the factors which are assumed to be highly influential in the communication process, specifically in the field of health and social care, are values and culture. These may include factors which are related in demographics such as age, gender, race, educational and economic status, and also beliefs, among others. Culture, which can be defined as the “identifiable integrated pattern of human behaviour that includes customs, beliefs, values, behaviours, and communications” (Servellen, 1997), is said to be highly influential in this field basically because they arise from almost every group that are involved in the communication process. In tackling the issue of culture and its influence in the communication process, one of the factors which should be understood are the sub-groups, for instance, Asian. Among the Asian cultures, people from different countries have various approaches to communicating. For instance, in the Vietnamese culture, talking is customary. Professionals who are working with people who are accustomed to the Vietnamese culture must be able to take such cultural factor into account so that the communication process can be carried out more efficiently and more conveniently. Another factor which should be understood on this note is cultural identity. One of the inclusions in this identity is the fact that all people are influenced by cultural programming which makes it essential to have an understanding of that culture so that communication can be carried out better (Servellen, 1997).
As mentioned earlier, one of the dimensions of culture and values which influence the communication process is gender. Men and women are naturally equipped with differences and such can be reflected in the way they engage themselves into the process of communication. Having different communication styles base on gender, interpretation may also vary in both sexes. Health and social workers should be aware of these differences so that they will be sensitive on how to deal with each patient or client. One of the key to understand these differences is to be an active listener so that the professional can be able to better understand the patient. The same is true with age and ethnicity. Communication with elderly should be done on a different approach wherein the health or social worker should demonstrate more respect. A different approach is also given when communicating with the younger ones. Furthermore, each nationality also has different approaches to communication. Some verbal and non-verbal communication techniques might be appropriate for other cultures while it may prove to be rude for some. These should be understood clearly so that there will be no misinterpretation and confusion with regards to the transmission of the message (Basavanthappa, 2004).
LEGISLATION, CHARTERS, AND CODES OF PRACTICE
Despite the fact that communication in the field of health and social care is highly influenced by culture and values, it has also influenced the existence and stipulations which are provided by legislations, charters, and codes of practice. The institution is often left with no option but to follow such stipulations as it is a legal requirement in the context of their practice.
One of the most important factors by which legislations and charters influence communication techniques can be demonstrated by the fact that such allows the provision of equality. The existing laws which govern the practice of health and social care are based on the principle of equality which does not allow discrimination of any party, be it a patient or a health or social worker. For instance, legislations such as those which provide fair employment, sex discrimination acts, race relations, and others are some of the laws which demonstrate and influence in professional practice. These laws serve as the foundation of the behaviour of the healthcare professional and form the basis of how they act and how they communicate. The serious consequences of going against such legislations will be undeniably a critical factor in the observance of a good communication practice (Cambridge Training & Development, 2000).
The Data Protection Act 1984 is a good example which demonstrates legislations in good communication practice in the field of health and social care. This can be able to provide protection to information which are assumed confidential and should be used solely for the purposes known by the persons involved. Service users could possibly demonstrate loss of trust from the service providers if confidential information are leaked making it important for laws to provide protection for such. Certain legislations are also made available to provide equality and anti-discrimination in the workplace. These factors are highly influential in shaping the communication practice and activities of people in health and social care (Moonie, 2005).
Furthermore, the stipulations in the code of practice and ethics in a certain institution are also highly influential in communication practices especially in consideration of the fact that they can affect confidentiality and privacy of information. For instance, the use and access to the internet for health and social workers are often limited and defined by codes of conduct, depending upon the institution, to be assured of good communication practices and work ethics. The use of other technological aids can also be regulated by existing rules and regulations to be able to protect the rights of the institution, the workers, the patients, and the public in general (Martin, 2003).
ORGANIZATIONAL SYSTEMS AND POLICIES
For all concerned parties to be engaged in effective and efficient communication practices, one factor which can be considered as essential would be effective organizational systems and policies. These systems and policies will be able to shape the communication activities and will make it more appropriate and meaningful. Health and social care institutions need to develop systems and policies which can foster good communication. This can include factors which are related to documentation, information systems, establishment of procedures and practices. For instance, the development of a dynamic and advanced information system can demonstrate effectiveness and efficiencies in the various activities which are undertaken. In the absence of such systems, it will be highly impossible to transmit and share information which might prove to be significant in the profession. For instance, at Ashleigh Court Rest Home, policies are strictly implemented. Stated below are some of the policies that the home adheres with:
Whistle Blowing Policy – this document has been written to comply with the Public Interest Disclosure Act 1998, which was introduced to protect employees who “blow the whistle” about any wrongdoing. The policy gives clear guidance to all members of staff regarding the correct procedure for bringing to attention any wrongdoing or suspected wrongdoing which they feel could affect the reputation of the home, other members of staff, visitors, residents or any other organization or persons connected with the home. The policy outlines commitment to openness and good communications.
Bullying In The Workplace – The home believes that all staff have the right to work in an environment that is free from bullying, harassment or intimidation, from either colleagues or management. The home seeks to enable staff to enjoy their work and fulfil their personal and professional potential, by creating and sustaining a stimulating and supportive work environment. It is recognised that staff who feel powerless, vulnerable or even persecuted will not be able to give of their best work or work successfully.
Prevention of Accidents – The home fully accepts the responsibility to ensure that all reasonable steps and precautions are taken to provide and maintain safe and healthy working conditions, which comply with all statutory requirements and codes of practice. The home fully supports and complies with the relevant National Minimum Standards and Regulations, which relate to the promotion and protection of the health, safety and welfare of service users and staff. It is recognised, however, that even in the safest of working environments, accidents will occur, from time to time. Where and when this does happen, the Registered Providers (employers) will abide by the requirements of The Health and Safety at work Act 1974. As such, employers must, by law, notify certain categories of accidents, specified cases of ill health and specified dangerous occurrences to the Health and Safety Executive or the Local Authority to comply with the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR). By undertaking these notifications, the home will not only be meeting the legal requirements but will be able to determine local patters and causes of accidents, so that preventive measures can be put in place to prevent recurrence. A written record such as Accident/Incident Report will be kept, of any accident, however minor, which occurs in the home.
Policy on Racial Harassment – Every Service User has the right to live and every staff member has the right to work in the home without the threat of racial harassment, discrimination or abuse. Any occurrences of this nature will not be tolerated and perpetrators will be subject to disciplinary procedures. The home fully upholds the principles and guidance of the Race Relations Act 1976 and the Protection from Harassment Act 1997. Racial harassment is any behaviour, deliberate or otherwise, pertaining to race, colour, ethnic or national origin, which is unwanted by the recipient and creates an intimidating, hostile or offensive environment. It may include racist jokes or insults, abusive comments about racial origins and skin colour and ridicule of an individual on cultural and/or religious grounds.
IMPROVING COMMUNICATION PROCESS
Health and social workers must be perpetually engaged in the improvement and development of the communication process to be better in their profession. One of the ways by which such can be improved is through the provision of security of information. In this way, privacy and confidentiality can be achieved and it can to help prevent any misunderstanding and confusion in the communication process. Furthermore, the communication process can also be improved through the provision of dynamic and sustainable rules which relate to documentation, presentation, and use of outputs and reports so that their purpose can be maximized by its users and providers. The provision of technological aids and communication tools can also help improve such process. Furthermore, the following are other ways by which communication can be improved in the health and social care setting: provide communication access to persons with difficulties; be aware of the various communication barriers and develop strategies by which they can be minimized or reduced at an acceptable level; teach workers about ethics and values related to communication practices; and rigorous training and education to enhance workers’ knowledge about effective and efficient communication. There is a need to make service providers understand what are the processes and activities involved in the complex communication process and the need to teach them to be active listeners. By doing the earlier mentioned, the health and social care workers can have an improved communication process and it can foster greater understanding and build better relationships between providers and users (Malone, 2005).
EXPLORING THE USE OF INFORMATION COMMUNICATION TECHNOLOGY IN HEALTH AND SOCIAL CARE
STANDARD I.T. SOFTWARE
The activities in the provision of health and social service would not be possible to carry in the absence of various I.T software and applications. Some of these include: word-processing, spreadsheets, presentations, internet, intranet, and email. These tools are assumed to have critical significance in the profession as it helps in the completion of day-to-day activities in the organization.
Word processing is important because it allows the creation, editing, reading, and amendment of various documents which might prove to be vital with health and social care work. If these documents are handwritten, there is no form of standardization and it will be hard to understand as well as too slow to accomplish. Therefore, word processing is considered as one of the most significant I.T. software package as it allows ease in work and reduces the intensity of labour in the creation of documents. Spreadsheet, on the other hand, allows them to do mathematical calculations with ease as it has formulas which can make their works easier while presentations allow them to prepare and present visual presentations in order to communicate better. The internet and intranet is also a good tool as it allows connectivity between the network of users within the organization and through the globe using the internet. Lastly, emailing would allow them to exchange information within each other and share documents in the workplace (Cook, 2006).
One of the most advanced application of information and communication technology in the field of health and social care is through telecare which is a business-to-consumer service provision without personal interaction as it just completed on channels such as telephones and computers. This includes services which are related to health and social care such as automated appointment reminders and client monitoring services at home. Traditionally, these things are done by trained professionals at the client’s home until the inception of technology which defies distance and allows greater interaction between the users and providers (Niman et al., 2006).
BENEFITS OF USING ICT
The use of information and communication technology would have not proliferated in the field of health and social care if it did not bring numerous benefits and advantages to the organization, users, providers, and the general public. One of the benefits is the accuracy of records. Because of the use of the various applications of information and communication technology, it will be easier to have readily available information about the condition of the client and it will be easier for the staff to provide an answer to the concerns of the patients. The health professionals are also able to enjoy the benefits of information and communication technology because such allows them to have safe, modern, and speedy IT systems which can help them in their routine, it allows them to utilize time more efficiently, and it allows the possibility of remote monitoring (Gillies, 2006).
Information and communication technology is also beneficial in the field of health and social care because it allows the possibility of meeting individual needs, it provides ease in the administration of treatment procedures, it makes the administrative practices more efficient, records and documentation can be more accurate, it fosters better communication, and it promotes independence. Information and communication technology also provides collaboration among users and providers which inevitably leads into more efficient service delivery (Leathard, 2003).
ENHANCING ACTIVITIES OF HEALTH AND SOCIAL CARE WORKERS
Information and communication technology demonstrates the possibility of enhancing the activities by which health and social care workers are engaged. This is assumed to be done through the following ways: efficiency in business administration, meeting the needs of the employees, improving the quality of service, accountability, and meeting what is required from them. Because of information and communication technology, the field of health and social work is able to experience increased efficiency. The use of various tools associated to such form of technology has allowed them to be engaged into better practices in their profession. For instance, the internet and the intranet, along with the methods by which documentation has improved, are all seen as highly contributory to the improvement of business administration. Service has also seen a dramatic improvement because of the applications of the said technology. Because of such, it is easier to access records and information, although such has also been limited by existing legislations to protect privacy and to promote confidentiality.
To be assured that the use of information and communication technology is maximized and not detrimental to the society, certain legislations, both internal and external to the company also exist to govern information and communication practices in the field of health and social care. The Data Protection Act provides restrictions and limitations on the use and access of personal information, especially those of the clients or the patients. Some of this information includes personal information, medical records, treatment history, and credit information. Record keeping is very important and should not be underestimated. Disclosing of information is tantamount to breach of confidentiality.
Furthermore, another legislation which is assumed to be significant in the use of information and communication technology is the Access to Personal Files Act 1987 which stipulates general considerations with regards to access to personal information, specifically those data which relate to social services. In addition to these legislations, Access to Medical Reports Act 1988 has also been provided to give right to access into medical reports for the purpose of employment or for insurance. The client, under this legislation, is also endowed with the right to see the information before it is supplied and can also be subject for correction. Lastly, another important legislation is the Access to Health Records Act 1990 which is more concerned about records which could be accessed manually. It gives the client or any other representative the right of access to medical records, in whatever form, electronic or manual (Jones & Jenkins, 2004). Moreover, to keep information within the limits of the workplace, bringing of storage devices are also limited so as the providers cannot transfer any information about the service users which can be leaked and used for purposes which are not under the consent of the parties concerned (Moss, 2008).
RECOMMENDATIONS AND CONCLUSIONS
Technology has brought a number of benefits realized in the health and social care sector such as meeting the individual needs, ease of administration of procedures, making efficient administrative practices, accurate documentation, and fostering a more dynamic communication practice. Information and communication technology also enhances activities of health and social worker such as by improving efficiency of service, accountability, and quality of outputs. To be able to engage in a more meaningful communication practice, there is a need to be aware and to understand the existing differences in culture and values because they will be able to foster better relationships. There is a need for continuous improvement process in communication by being able to identify ways by which such could be improved. The health and social care sector needs to identify, without a halt, ways by which communication can be improved, so that the profession, in general, can also be improved.
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