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1. Explain how Therapeutic Communication Enables Person-Centred Care

Answer:

Therapeutic communication is the basis of a synergistic relationship between health professionals and patients. It creates a positive relationship with patients by manifesting care, warmth, empathy, and respect. An effective therapeutic communication is a key to patient-centered care in the healthcare system (Younis, Mabrouk and Kamal 2015). Giacco, Anguera, and Salcuni 2020 suggested that verbal and non-verbal aspects of communication and is the fundamental principle for building therapeutic alliance which determines the interactive regulation and convey information between patient and healthcare providers. Verbal communication is linked with spoken words and plays a crucial role in the healthcare context. People associated with a multi-disciplinary healthcare team communicates verbally with patients as well as their family members while non-verbal communication is also effective while communicating with patients who are not amenable to the regular mode of communication such as listening (Sibiya 2018). According to BetterHealth, 2015 patient-centered care is a model of treating a patient with respect, care, and compassion, taking care of their needs and their preferences by involving them in communication and coordinating with them in all the decisions regarding their health.

The elements of person-centered care involve 4 C’s i.e, culture, care, communication, and collaboration with the primary goal to improve patient’s health outcomes. Therapeutic communication relates to patient-centered care as it involves the patient and it’s family in all health-related decisions by communicating with them giving them full transparency of patient’s health information and equally valuing their viewpoints (NEJM Catalyst 2017). Communication is the cornerstone in achieving person-centered care, through verbal and non-verbal communication, the patient will be able to express his symptoms and concerns and listening to patient’s situation carefully, discussing care and treatment alternatives with them, showing care and concern to patient’s needs and preferences, and showing empathy as empathy is the basic competence in any helping relationship, having empathetic communication builds up faith, mutual understanding, support, medication adherence and self-efficacy that will lead to better and positive health outcomes. Mindfulness is another aspect of therapeutic communication, the healthcare providers who score high in mindfulness because of their ability to observe and notice what is happening to their patients and their psychology and act based on what they noticed provide more patient-centered care and have more satisfied patients with better health outcomes (Hafskjold et al 2015).

2. Discuss the Role of Inter/Intra-Professional Communication in The Provision of Clinical Handover

Answer:

Intra-professional communication refers to the teamwork between doctors and nurses which is a crucial thing for optimal patient care. Health professionals are pressurised to work together in collaboration. This type of communication involves working together, sharing, solving problems by communicating with each other regarding patient’s health which will lead to better care and treatment of patients while interprofessional communications refers to the communication between multiple workers with different professionals working together with patients, his family, caregivers, doctors, counsellors and social workers to ensure the best quality of care. Collaboration of intraprofessional workers with interprofessional workers provides a positive work environment as well. Both inter and intra-professional communication plays a major role in order to ensure the best care of patients. Inappropriate or poor communication or ineffective inter-intra communication leads to misinterpretation, medical errors, dissatisfaction within the staff and hinders in the positivity of the work environment which affects the patient adversely. To avoid these, tools like ISOBAR should be consider.

Clinical handover is the transfer of information, transfer of clinical accountability and the responsibilities of the healthcare experts to enable the continuity of patient’s care. ISOBAR is the fundamental framework for all clinical handovers. ISOBAR stands for Identify, Situation, Observation, Background, Agree to a plan, and Readback. The role of frameworks like this ensures that the clinical handover is conducted in the same structured manner by healthcare professionals for patient’s safety and best healthcare facilities. This framework is mandatory policy to be followed under the clinical governance, safety and quality which is supported by the national safety & quality health service standards (Government of Western Australia department of health 2019).

3. Critically Reflect on The Potential Communication Barriers that May Affect Safety and Quality in Healthcare

Answer:

Communication is the most important in providing the best quality of healthcare which leads to satisfactory health outcomes of the patient while providing competent and qualified services, nurses and health providers face communication barriers which hinders the quality of care they provide and patient’s potential healthcare may get affected. These barriers are the usage of medical terminologies by health providers in communication with patients, the difference of culture, colloquial language, and gender differences, lack of privacy, competing demands, the unfamiliarity of the language affects the verbal communication while the culture of the patient and nurses provides hindrance to the non-verbal communication (Norouzinia 2016). Time constraints create a significant hindrance in communicating with patients because hurried communication is never effective. Apart from them, there are psychological complaints such as anxiety and social isolation that creates a communication gap between the patients and the health provider.

Medical terminologies are not easy to understand by the patients, using clear and simple language for communicating will help the patient to understand better. Listening is another factor as it makes the patients to respond more to the treatment. By recording each visit to the patient will provide the value-based healthcare environment and impactful analytics. Another way to overcome the communication barrier is making and giving time to patients for communicating (Medical Memory 2018). Increasing awareness of verbal and non-verbal communication styles by including particular kinesics, proxemics, and paralanguages and appointing a trained interpreter who is fluent in the universal language as well as in patient’s language and culture will help in overcoming this issue. Appointing interpreter physically is not necessary so, online availability of interpreters will also help. Enhancing multicultural competencies for the health providers will also be a way to accomplish this (Li 2017). The most important aspect in overcoming this problem is showing empathy towards patient and understanding his problems because it makes the patient feel safe and builds trust between them. However, increasing patient-nurse cooperation, training nurses for better communication skills first in laboratories and then letting nurses practice in real.

Reference

BetterHealth. 2015. Patient-centered care explained. [Online]. Available at: https://www.betterhealth.vic.gov.au/health/ServicesAndSupport/patient-centered-care-explained [Accessed on: May 28th, 2020].

Giacco, L. D., Anguera, M. T. and Salcuni, S. 2020. The action of verbal and non-verbal communication in the therapeutic alliance construction: A mixed methods approach to assess the initial interactions with depressed patients. Frontiers in Psychology, 11(234), doi: 10.3389/fpsyg.2020.00234

Government of western Australia department of health. 2019. Clinical handover. [Online]. Available at: https://ww2.health.wa.gov.au/Articles/A_E/Clinical-handover [Accessed on: May 28th, 2020].

Hafskjold, L., Sundler, A. J., Holmstrom, I. K., Sundling, V., Dulmen, S. V. and Eide, H. 2015. A cross-sectional study on person-centered communication in the care of older people: the COMHOME study protocol. BMJ Open, 5(4), pp. e007864. http://dx.doi.org/10.1136/bmjopen-2015-007864

Joynes, V. C. T. 2018. Defining and understanding the relationship between professional identity and interprofessional responsibility: Implications for educating health and social care students. Advances in Health Science Education, 23, pp. 133-149.

Li, C. et al. 2017. Overcoming communication barriers to healthcare for culturally and linguistically diverse patients. North American Journal of Medicine and Science, 10(3), pp. 103-109.

Medical Memory. 2018. Overcoming communication barriers in healthcare. [Online]. Available at: https://www.themedicalmemory.com/overcoming-communication-barriers-in-healthcare/ [Accessed on: May 28th, 2020].

NEJM Catalyst. 2017.What is patient-centered care? [Online]. Available at: https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0559 [Accessed on: May 28th, 2020].

Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M., and Samami, E. 2015. Communication barriers perceived by nurses and patients. Global journal of health science, 8(6), pp. 65–74.

Sibiya, M. N. 2018. Effective communication in nursing. London: IntechOpen Publisher.

Younis, J. R., Mabrouk, S. M. and Kamal, F. F. 2015. Effect of the planned therapeutic communication skills of pediatric nurses. Journal of Nursing Education and Practice, 5(8), pp. 109. doi:10.5430/jnep.v5n8p109

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