Chapter 5:
Compassionate Respectful &
Caring Health Informatics
Professionals
Outlines
 Introduction to the Caring, Respectful and Compassionate
(CRC) Health Professional
 Therapeutic Communication
 Types of Communication
 Proxemics and Personal Space
 Eye Contact
 Body Movements
 Therapeutic Use of Touch
 Factors Influencing Communication
Introduction to the Caring, Respectful
and Compassionate (CRC) Health
Professional
 Compassion is a feeling of deep sympathy and sorrow for
the suffering of others which is is accompanied by a strong
desire to alleviate the suffering and/or being sensitive to the
pain or suffering.
 Compassionate care creates a healing link through
understanding the patient’s context and perspective, meeting
the patient’s intrinsic need, and guiding client decisionmaking.
 Compassion is associated with values including empathy,
sympathy, kindness, and the ability to care for others,
including their information
Introduction to CRC…
 Respectful care is any type of care that supports and
encourages a person’s self-respect, regardless of
differences.
 It has to do with paying attention, honoring, avoiding harm,
not meddling or interrupting, treating others with respect,
and accompanied by effective interventions to alleviate the
suffering.
Introduction to CRC…
 The CRC is more important for person-centered care
 Person-centered care is that healthcare professionals
passionate about their profession and enjoy assisting others,
being ethical, and being a model for young professionals and
students
 A person-centered health system is one that supports people
to make informed decisions about, and to successfully
manage, their own health and care, able to make informed
decisions and choose when to invite others to act on their
behalf.
Introduction to CRC…
 CRC health professional have the following four essential
characteristics:
1. Consider patients human beings with complex
psychological, social and economic needs and provide
person centered care with empathy
2. Effective communication with health care teams and
interactions with patients and other health professionals
over time, and across settings
3. Respect for and facilitation of patients’ and families’
participation in decision and care; and
4. Take pride in the health profession they are in and get
satisfied by serving the people and the country
Introduction to CRC…
 CRC is one of the Ethiopian Federal Ministry of Health’s
four key Health Sector Transformation Plan (HSTP)
transformation agendas
Why is CRC transformation agenda?
 CRC is crucial and foundation of health care system
that provides caring, safe and high quality and equity
care and is described as holistic, non-judgmental,
empathetic, respectful and empowering.
 To create movement and champions that serve as role
models to transform the health care
Therapeutic Communication
 Is an important aspect of CRC.
 Communication: Giving, receiving, and interpreting of
information through any of the five senses by two or
more interacting people
 Therapeutic communication: An interaction that is
helpful and healing for one or more of the participants
 Therapeutic communication techniques are strategies
to encourage clients to express their thoughts and
feelings more effectively
Therapeutic Communication…
 Therapeutic communication
 Is patient-centered communication
 Focuses on the patient
 The goal is to promote a greater understanding of
patient’s needs, concerns and feelings.
 The health care professional helps the patient explore
their own thoughts & feelings, encourages expression of
them, and avoids barriers to communication.
 Therapeutic communication techniques are tools for
building and maintaining rapport with others.
 Some techniques are verbal; others are nonverbal
Therapeutic Communication…
 Non-therapeutic communication is that which stops the
communication process or is perceived as a threat by
the client.
 Examples of non-therapeutic actions include the
healthcare provider who talks too much, uses only
closed-ended questions, or demonstrates impatient or
threatening body language.
Types of Communication
 Verbal communication: Sharing information through the
written or spoken word
 Non-Verbal: Sharing information without using words or
language
 It expresses emotions and attitudes, as well as
enhancing what is being expressed verbally.
Types of Communication…
 Verbal and non-verbal expressions should be
CONGRUENT
 If the body language and verbal cues are not congruent,
confusion occurs.
 When verbal and nonverbal messages conflict (are not
congruent), others are most likely to believe the nonverbal
message
Proxemics and Personal
Space
 Human proxemics or territoriality varies greatly among
individuals and between cultures or ethnic groups.
 This concept is closely related to the concept of personal
space.
 Each person has an area around himself or herself called
personal space.
 This area is reserved for only close friends or intimates.
 This culturally learned behavior varies greatly across
cultures, although it may also vary from person to person
within a culture or ethnic group.
 Other variables include sex and social status.
Proxemics and Personal
Space…
 In traditional Western cultures, the areas of personal
space or communication zones are approximately:
 Intimate (physical contact to 18 inches): behavior with
loved ones, sharing secrets, physical assessment in
healthcare
 Personal (18 inches to 4 feet): general conversation,
interviews, teaching one-on-one, private conversation
 Social (4-12 feet): demonstrations, group interactions,
parties
 Public (>12 feet): lectures, behavior with strangers
Proxemics and Personal
Space…
 It is important for health professionals not to
unnecessarily violate the client’s personal space
boundaries.
 If the professional comes too close, it is considered an
invasion.
 If the professional is too far away, the client may feel
isolated or ignored.
 Healthcare professionals, however, are often forced to
invade a client’s personal space to provide care.
 It is important to be sensitive to the discomfort this may
cause.
Proxemics and Personal
Space…
 The health care provider should alert the client before
touching him or her.
 Be careful to touch the client gently on the arm or hand
before further intruding into his or her space; this practice
offers comfort and reassurance so the client feels safer.
 Often, an approach from the side, rather than directly
from the front, is perceived to be less confrontational.
Eye Contact
 Eye contact or eye gaze means looking directly into the
eyes of the other person.
 Lack of direct eye contact has various meanings among
cultures.
 Sometimes indirect eye contact means that a person is
nervous, shy, or lying.
 However, it may also signify respect ins some cultures.
 In these cultures, direct eye contact often signifies
defiance or hostility.
 Staring may be interpreted by many cultures as open
hostility, defiance, rudeness, or as a threat.
Eye Contact…
 Rolling the eyes is often interpreted as disgust or disbelief.
 On the other hand, cultures such as those of the Middle
East, consider a lack of direct eye contact as inattention,
lack of concern, or even rudeness.
 Eye contact also varies between genders in some cultures.
 For example, men can have direct eye contact with each
other, whereas women are expected to avoid direct eye
contact when speaking to men.
 In Western cultures, direct eye contact or a wink between
people is often a part of dating behavior.
Body Movements
 Facial expressions convey messages of many emotions:
joy, sadness, anger, and fear.
 Some people mask their feelings well, which makes
understanding what they are thinking very difficult.
 Healthcare providers have to learn to control facial
expressions if they are experiencing emotions that may
offend the client or block effective communication.
 A twitching or bouncing foot may indicate anger,
impatience, boredom, or nervousness.
 A slouched appearance may indicate depression or pain.
 Wringing hands may indicate fear, pain, or worry.
Body Movements…
 Shrugging the shoulders implies, “I don’t know,” in many
cultures.
 Pacing, rocking, and other repetitive movements may be
a side effect of medications or may indicate fear or
discomfort.
 Avoid making assumptions about these body language
messages, however.
 You can ask the client what he or she is feeling if there is
concern about these or other visual cues.
Body Movements…
 Gestures and Rituals: We use a number of gestures as a
matter of course in daily life.
 Waving may indicate a greeting or “goodbye”
 A wink may indicate a mutual secret or may be seen as
a flirting gesture.
 In some countries, people greet each other by kissing on
both cheeks.
 It is important to realize that some frequently used
gestures in some cultures may be interpreted very
differently in others.
 For example, the traditional Western "thumbs up”
gesture is interpreted as an obscene gesture in
countries such as Iran.
Therapeutic Use of Touch
 Therapeutic use of touch is the most potent non-verbal
communication technique.
 A gentle and reassuring touch tells the client the health care
provider cares and is there to help.
 Be sure to use touch in this manner only if it is non-threatening
to the client.
 Touches can involve such movements as holding hands, a
“high five,” or a pat on the shoulder.
 In some cases, touch by another person makes people
anxious.
 Some people do not like to be touched, feeling that it invades
their personal space.
 Be sensitive to the feelings of all clients.
Factors Influencing
Communication
 Many factors influence the effectiveness of
communication.
 Some factors enhance communication.
 Other seemingly harmless factors create barriers between
people.
Communication barriers include:
 Attention
 Culture & Ethnicity
 Age
 Gender
 Social Factors
Factors Influencing
Communication…
Attention
 A listening or attention barrier can occur because of
lack of concentration.
 Selective listening may also be the culprit.
 In such a case, a person hears only what he or she
wants or expects to hear.
 The healthcare professional may not be paying attention
and may not hear because of emotional responses to
what the client is saying.
 Sometimes, a client is experiencing pain or discomfort
(physical or emotional) so great that he or she cannot
listen or concentrate.
Factors Influencing
Communication…
Attention…
 The client may also be preoccupied with internal stimuli
(e.g., auditory hallucinations).
 If both the sender and the receiver do not give, or are not
able to give, full attention to the current communication,
an effective healthcare provider-patient relationship may
not occur.
 It may be necessary to postpone the interaction.
Factors Influencing
Communication…
Culture & Ethnicity
 Very young or very old clients may be unable to
communicate fully because of physical or intellectual
capacity.
 An older client may prefer to receive care from an older
provider, or a younger client may be more willing to
accept instructions from an older provider.
 An older client may also be energized by the presence
of a young health care professional.