1. FAMEFAMEFAMEFAME Communication& Patient Interviewing

2. FAMEFAMEFAMEFAME Aim & objectives Objectives: Knows basic principles of communication Knows the place of verbal and nonverbal communication in patient interview Is aware of the importance of nonverbal clues Know the importance of hidden agenda Can explain the interview process

3. FAMEFAMEFAMEFAME What is Communication? A process of production and submission of knowledge / symbols, which are received and interpreted by the other party.

4. FAMEFAMEFAMEFAME Signal SourceSenderChannelReceiver Target Noise The communication Model

5. FAMEFAMEFAMEFAME Signal حدث (7+-2Chunks 134 BPS) الحالة الشعورية الحالة الفسيولوجية Action تصرف D D G الحذ ف تشو ية تعميم التمثيل الداخلي

6. FAMEFAMEFAMEFAME Patient Communication 70% of the patients can be diagnosed by only communication. Doctors who are good communicators are less suited by their patients. Patient satisfaction increases when he/she can have a good communication with the doctor.

7. FAMEFAMEFAMEFAME However …… 69 % Doctors interrupting patients speech within the first 18 seconds 77% Patients didn’t even express their reason for encounter:

8. FAMEFAMEFAMEFAME Moreover 50% of patients leaving doctors office who do not have enough information on their illness: 50% 50% of patients who do not know how to use their medication 22-70% of patients not adhering to the suggestions of their doctor

9. FAMEFAMEFAMEFAME Components of face to face communication Verbal (% 7) Paralanguage (% 38) Body language (% 55)

10. FAMEFAMEFAMEFAME Components of face to face communication

11. FAMEFAMEFAMEFAME Reference: (McCaskey 1979 )

12. FAMEFAMEFAMEFAME Non-Verbal Communication S (smile) O (open posture) F (forward lean) T (touch) E (eye contact) N (nod)

13. FAMEFAMEFAMEFAME Hand Shaking

14. FAMEFAMEFAMEFAME Forward Lean

15. FAMEFAMEFAMEFAME Facial Communication

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19. FAMEFAMEFAMEFAME Hand Communication

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21. FAMEFAMEFAMEFAME Body space

22. FAMEFAMEFAMEFAME Social zone Private zone Intima te zone Public zone 15 - 46 cm 46 cm - 1.2 m 1.2 m - 3.6 m > 3.6

23. FAMEFAMEFAMEFAME The Environment Dr. Pt. Couch

24. FAMEFAMEFAMEFAME The Environment Couch Dr. Pt.

25. FAMEFAMEFAMEFAME The Environment

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29. FAMEFAMEFAMEFAME Hands & body posture

30. FAMEFAMEFAMEFAME Sitting Position

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32. FAMEFAMEFAMEFAME Hand Movements حركات راحة اليد

33. FAMEFAMEFAMEFAME Hand Movements حركات راحة اليد حركات راحة اليد لغة التهديد التوسل لغة الامر

34. FAMEFAMEFAMEFAME Hand Movements حركات الذراعين

35. FAMEFAMEFAMEFAME Hand Movements حركات الذراعين دفاعي سلبي موقف متعالي موقف عدائي

36. FAMEFAMEFAMEFAME Legs Movements حواجز الرجلين

37. FAMEFAMEFAMEFAME Legs Movements حواجز الرجلين واقعي وعنيد اظهار الاستياء مجادلة ومنافسة متعال

38. FAMEFAMEFAMEFAME Hand & Face Movements مخادعترديد كذبةغير متأكدخائف

39. FAMEFAMEFAMEFAME Negative communication

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43. FAMEFAMEFAMEFAME Mirroring

44. FAMEFAMEFAMEFAME The body Language

45. FAMEFAMEFAMEFAME Hand On doorknob Syndrome Sometimes what patient says at the door is his/her real reason for coming. The door is safe; patient can leave easily if refused. Ask at the end: “Is there anything we have not covered or anything else you would like to ask me?”

46. FAMEFAMEFAMEFAME Patients Interview Summary sentences Recognize deviations in perception/expectations Patient empowerment Patient participation Attentive listening

47. FAMEFAMEFAMEFAME Traps in the Interview Direct questions “Why” questions Guiding questions Yes-No questions Sudden topic changes Loss of eye contact Loss of feedback

48. FAMEFAMEFAMEFAME Defensive patient Anxious patient Angry patient Selfish and demanding patient Problem patients

49. FAMEFAMEFAMEFAME Changing Reactions It is possible to change the process and initiate a new behavior How did I interpret the patient’s statements or behavior to make myself angry? Is there another way to interpret the patient’s behavior?

50. FAMEFAMEFAMEFAME Summary What is communication? What models of communication do you know? 1/3rd of communication is by body language. The best doctor-patient interview is by sitting on both sides of the table. Nonverbal messages are produced intentionally. In which body position is the patient most receiving if you give some kind of education?

51. FAMEFAMEFAMEFAMEThanks