Herni Suprapti
the factors that influence
doctor-patient communication
some bad news
Second
how you feel at the time will
influence what you say, and so
will the attitude of the other
person
The factors (patients) will
influence how communicate
Personality
Upbringing
Social class
Ethnic
Cultural background
Reactions to illness
include
Denial
Anger
Anxiety
Depression
Factors influence doctor-
patient communication
Patient-related factors
Doctor-related factors
Physical symptoms
Psychological factors related to
illness and medical care (e.g.
anxiety, depression, anger, denial)
Previous experience of medical care
Current experience of medical care
Doctor-related factors
Privacy
Comfortable surroundings
An appropriate seating
arrangement
Other factors that must be
taken into account are :
the patients beliefs about
health and illness
the problem they wish to discuss
their expectations of what the
doctor will do (based on previous
experience)
how they perceive the role of the
doctor
Doctor-related factors
medical student
doctor
easier than others to emphathise
and communicate with patients
other factors influence our
behaviour during a consultation
(Table 2.1)
medical student
Tiredness
Anxiety
Privacy is essensial
The setting of the
interview
A patient in a hospital bed
sensitive information
Mrs Smith in the bed next door can
hear every word through the curtains
more informal
4-9 feet
Complex questions
Leading questions
responding appropriately
use of
eye contact
posture (e.g. sitting slightly forward facing the patient)
nodding your head
saying hmm go on
active listening :
asking questions directly related to
following on from the patients last statement.
Facilitation
essential part of effective listening
the aim : to help the patient to talk
as fully as possible about problems
Ex : verbal facilitation :
Please go on and tell me more about
your pain.
Yes, I understand please continue.
give the patient time to respond
after you have spoken.
Non-verbal : adopting an
appropriate posture
lean slightly forward towards the
patient
maintain eye contact
Doctor
That must have been a distressing time
for you
doctor-centred style of
communication
the doctor
has taken the dominant role in a
consultation with a patient
paying little attention to the patients
concerns and understanding of their
illness
not involving the patient in decisions
about their treatment
Patient-centred consultations