Factors which make difference to the way we communicate with somebody.
1. Ego
2. age
3. education level
4. culture
5. mental state/mood
6. emergency situation
7. level of consciousness
8. gender
What a doctor might use instead of word “cardiac arrest”?
Chest pain, shortness of breath, heart palpitations (racing heart) and flu like symptoms.
Why do we need to have good communication skills?
● humanistic work environment
● competency in professional skills
● satisfaction at workplace
● patient satisfaction
● healthcare quality and as a result a healthy community
The words you use matter as much as your voice management. Nonverbal communication is
important too.
Non verbal
communication:
●
facial expression
●
tone of voice
●
movement
●
appearance
●
eye contact
●
gestures
●
posture
Doctor Patient Interview:
1. Step: Establishing Rapport/ Initial Contact
● 4 objectives:
○ Objective 1: Great the patient and ask her preferred form of
address. (Good morning Mr. Hanks, isn't it? We have not meet
before)
○ Objective 2: Introduce yourself and clarify your role
○ Objective 3: Explain the purpose of the interview (I’d like to have a
little chat with you to ask some questions if it’s OK?)
○ Objective 4: Obtain permission for special circumstances (Taking
notes/presence of student doctor/ listening her heart)
○
○
Plus showing that you care about them such as bringing a cup of
water for the patients or helping them to change clothes and
asking them “how are you feeling today?”
The communication should be as private as possible.
Involvement of members of family should be avoided as much as
possible. Talking with lying and sitting patient is different and
prefer to talk patients while they are sitting to maximise the
involvement of interview.
2. Step: Opening Questions
● What would you like to discuss today?
● What brings you here today?
● What kind of problems/issues would you like to share with me?
● A follow up visit can start with “Am I right in thinking you have come about
your routine check up?” + “Is there anything else you would like to discuss
today?”
● Use facilitation techniques to encourage patient to talk
○ Silence is key
○ Repeating the last sentence in questioning tone
○ Make observational statements such as “you have stop few min ago
while talking…… can you tell me what you are thinking about?”
○ Occasional nods of head + Yes? Then? Huh,huh?
Hospital round: bedside visits by physicians
3. Step: Opening Statement
4. Step: Setting The Agenda
● Anything else?
● Do you have any other problem?
● Which of these problems concerns you the most?
● Which of your problems did you hope I could help you with today?
● Physician ranks the problems in order of importance?
● Shall we start with…?
● we’ll come back to …….. later.
● If that’s all right?
5. Step: History of Present Illness (HPI)
● Patients past history
● family history
● social history
● Seven dimensions to describe a symptom
○ chronology
○ location
○ quality (Pain can feel sharp, hot, and achy)
○ quantity (intensity of pain, number of times)
○ asking of pain specially
■ nature of pain (dull, sharp)
○
○
○
6.
7.
8.
9.
■ onset of pain (sudden, gradual)
■ severity of pain
■ duration of pain
■ progress (constant, intermittent)
■ aggravating and relieving factors
■ previous occurrence
■ associated symptoms
■ patients notion of what might cause the pain
setting (who was with you, where do you get the pain
aggravating and alleviating factors
manifestation associated
Step: Past Medical History
Step: Social History
Step: Review of Systems
Step: Closing the interview
ENT: ear nose throat
GUS: genitourinary system
Depression: sort of mood have you been in
cardiac failure:shortness of breath
asthma:getting wheezy
prostate: problem with waterworks
coronary thrombosis: chest pain
lung cancer: coughing blood
Paresthesia: pins and needles
anesthesia: numbness
retrosternal chest: pain behind breastbone
orthopnea: inability to breath when lying
dysmenorrhea: painful periods
dyspepsia: indigestion
Intermittent Claudication: cramp in leg which comes and goes
dyspnea: breathlessness
stress incontinence: trouble holding water
m: male
f:female
b:black
w:white
l: left
r:right
reg: regular
yo:years old
ETOH: ethyl Alcohol
ICU: Intensive care unit
NAD: nothing abnormal detected
Abd: abdomen
Hb: Haemoglobin
℅: complain of
?:possible
A&W: Alive and well
P: Pulse
HTN: hypertension
TURP:Transurethral resection of the prostate
FH: family history
CXR: chest X ray
PMH: past med history
HPC: history of past complain
LFTS:liver function test
MSU: mid stream unit
CCF: congestive cardiac failure
HS: Heart sound
MRI: Magnetic resonance imaging
EUA: Examination Under Anaesthetic
AIDS: acquired immune deficiency syndrome
BPD: borderline personality syndrome
ECT: electroconvulsive therapy
N/V: nausea and vomiting
a.c: before meals
cap.: capsule
ggt:drops
ADH: antidiuretic hormone
CBC:complete blood count
I&D: Incision and drainage
LOC:loss of consciousness
ARDS: acute respiratory distress syndrome
CT: chemotherapy
OA: Osteoarthritis
b.i.d: twice a day
OGTT: Overall glucose tolerance test
fuo: fever of unknown origin
SOBOE:Shortness of breath on exertion
HS1. Hematopoietic-Specific Protein 1
D&C: Dilation and curettage
O/E : On examination
JVP:jugular venous pressure