In this assignment the writer is going to focus on how communication is important in health and social care settings. In the first section of the assignment the writer will explore in detail what communication is, the methods of communication that are used in health and social care settings and a communication theory that is relevant to health and social care. The writer will also identify potential barriers to effective communication that may arise within a health and social care setting and explore how these barriers may be overcome. Following this section of the assignment the writer will review at least one strategy that is used to support people with specific communication needs and analyse the benefits to service users of using these strategies and make recommendations for health care workers. In the final section of the assignment the writer will analyse key ethical and cultural consideration’s that need to be taken into consideration for a health and social care worker to communicate effectively with service users.
1.1 – Apply relevant theories of communication to Health and Social Care contexts In this section the writer will define the meaning of communication. The writer will describe a range of communication methods that are used in the Health and Social Care sector using examples and describe a communication theory that is relevant to Health and Social Care. Define Communication:
Communication is the passing of information between people or organisations. It is a basic human need that allows people to interact and establish a closer relationship and contact with one another. The purpose of communication is to send messages in a quick and effective way to the person that is receiving it. Communication brings people together who believe in a certain goal with a view to strengthen relationships. Communication allows information to be transferred through exchanging ideas, feelings, and facts so that a better understanding of a subject or conversation is made. For example: in normal day to day conversations, we communicate to: gain information from other people, develop social relationships, and provide feedback to other people.
However when we communicate in a health and social care setting we as care professionals communicate to: explain policies and procedures to both the employees and service users, exchange information with service users and their families as well as with other health care professionals and outside agencies, promote relationships and offer support, to get to know the service user so that all of their needs are met, and to negotiate and liaise with the service users, their family and other health care professionals. Describe methods of communication used in Health and Social Care: There are a range of communication methods that are used within the Health and Social Care sector. The main methods of communication that the writer is going to focus on are: Verbal, Non-verbal, Written and Listening.
The first method to discuss Verbal Communication, which is expressed through spoken word and is used in many different ways throughout health and social care settings. It is used by the patient to inform the care professional how they are feeling, and what concerns they may have. This can be done through face to face or by phone. Verbal communication is also needed to communicate regularly with the patients about their medical procedures, daily care tasks and the patient’s overall health. Before any of these professionals performs any medical procedure or care task with a patient, it is important that they use verbal communication to inform the patient of what they are going to do. This allows the patient to know what to expect when they come into the care setting. The second method is Non Verbal Communication, which occurs through body language, facial expressions, and gestures. It is used in many different ways throughout health and social care settings. Touching a person can send messages of care and affection.
However, as a care professional it is important to consider the surrounding environment and what message you are trying to pass on to the service user before touching them, for example: an arm around a parent who has been told sensitive news about another family member in an hospital setting can make the person feel better however a teenager or young child in the same situation may feel intimidated by this contact from an older person. It is also important to consider sensitive issues such as Child Protection guidance. The third method is Written Communication, by means of written symbols (either printed or handwritten). It is used in many different ways throughout health and social care settings in the form of E-mail, letters, memos, and medical records. Many hospital based settings use Emails to communicate with both their staff and their patients. Emails can be both formal and informal.
The nurses/doctors in a specific department or ward in a hospital can contact the recipient(s) immediately by using an email service. Many other health and social care settings such as a doctor surgery may use letters as a form of communication. Letters are often addressed as formal and they are used widely to contact patients with regards to appointments, test results & collections of medication. Memos are also used within departments of a hospital or residential care homes. They are used to advise staff on latest employee news or policy changes and to keep them updated on any changes within the department and within the hospital/residential care home as a whole, but would not usually be accessible to the service users. The fourth method is Listening Communication which is expressed through listening and paying attention to the person conveying the message and is used in many different ways throughout health and social care settings.
Having good listening skills will help care givers to ascertain if patients/service users have any worries, fears or preferences about their care, for example: a patient in a residential care home setting may tell their nurse that they are being abused. Therefore it is the nurse’s job to listen to the patient and take appropriate action about the information being disclosed. When nurses are handing over care to other nurses at the change of shifts listening communication is also vital the correct information about medication etc. is passed on. Also at ward rounds with doctors the nurses must listen to what the doctor is requesting for the patient, for example: this may be a change in medication or results from a blood test. Therefore it is the nurse in charges duty to report this information back to the other nursing staff.
Explain a communication theory relevant to Health and Social Care: There are a range of different communication theories that are relevant to Health and Social Care. The main communication theory that the writer is going to focus on is the Johari Window Model. 1“The word “Johari” is taken from two people named Joseph Luft and Harry Ingham who made the Johari Window model in 1955. This communication model was developed to help individuals to understand the meaning of self-disclosure and gently encourage people to give and accept feedback. There are two main ideas behind the model. The first idea of the model is that you can build trust with other individuals by disclosing information about yourself. The second idea is that with the help of receiving feedback from others you can learn more about yourself as a person, and come to terms with personal issues.
Joseph Luft and Harry Ingham designed the model that if done effectively it will help people build and strengthen their relationship with one another as well as helping them to solve issues and work more effectively as a team”. The Johari window model is made up of four quadrants. The four quadrants consist of: the Open area, the Blind area, the Hidden area and the Unknown area. The Open Area – This quadrant is the most important quadrant of the Johari Window model. The open area includes things that are known to you and things that are also known to others, for example – the more open you are and the more people you know, the more productive, cooperative, and effective your group will be when working together. In terms of health and social care when communicating with a patient it is important that the care professional that is delivering the care knows who they are delivering the care to.
For example when a patient with cancer is admitted to hospital for chemotherapy it is important that when they arrive they tell the care professional their name and medical history. This allows the care professional to know about them and their health and provide the best quality of care. The Blind Area- This quadrant includes the things that others know about you but you might not be aware of. This can include simple information that you don’t know or it can involve deeper issues such as feelings of unworthiness or rejection that we keep within ourselves and that which we retain out of fear. In terms of health and social care an example of this could be that you don’t maintain eye contact when talking to a patient in a one to one interaction. The patient may notice that you are not maintaining eye contact with them and may think that you are interested, however you may not know this as you cannot see the facial expressions that you are making.
The Hidden Area- This quadrant represents the things that others don’t know about you but you know. This can include our insecurities and shyness. In terms of health and social care an example of this could be that a patient who is experiencing bladder problems may not disclose this type of information to others as they may feel embarrassed to share it, therefore it is hidden. Another example of this may be a nurse who is hiding that she is looking for a job only until a better job comes along because with the salary that she is earning in the job that she is in she is not able to provide for her children. The Unknown Area- This quadrant represents the things that are unknown by you and are unknown to others. This includes the information, feelings, capabilities, talents etc. This can be due to traumatic past experiences or events which can be unknown for a lifetime.
The person will be unaware till he/she discovers his/her hidden qualities and capabilities or through observation of others. In terms of health and social care an example of this may be that a service user being unaware of a hereditary disease that runs in his/her family, for example- a nurse may not be aware that her mother’s grandmother had breast cancer. Due to being unaware this information will be unknown until the nurse has the hereditary disease in later life. In conclusion the ultimate outcome of the Johari Window model is openness which allows for an open dialogue, trust and respect to be shown. 2“The process of enlarging the Open Area quadrant is called “self-disclosure,” and it’s a give-and-take process that takes place between yourself and the people that you’re interacting with. As you share information, your Open Area expands vertically and your Hidden Area gets smaller.
As people on your team provide feedback to you about what they know or see about you, your Open Area expands horizontally, and your Blind Area gets smaller. Done well, the process of give and take, sharing, and open communication builds trust within the group”. 1.3 – Review methods of dealing with inappropriate interpersonal communication between individuals in Health and Social Care settings In this section the writer will identify potential barriers to good communication in Health and Social Care settings as well as exploring how these barriers may be overcome. One of the main potential barriers to good communication in a health and social care setting is Physiological barriers, for example: ill health – a patient in a residential mental hospital who is suffering from Alzheimer’s disease, presenting with confusion and poor memory. This can lead to misinterpretation and will affect communication between the patient and carer.
For example – the patient may be in pain and be in an agitated state, however nurse not realize this and may think their agitated behavior is coming from being in an unusual environment. To overcome this barrier the nurse may provide reassurance to the patient by using calming phrases such as calling the patient by his/her name and letting them know that they are there to help. The nurse may settle the patient into a familiar area where they know the patient feels calm and safe. If the agitation continues the nurse will realise there is more to the unsettling behaviour and this will lead to further investigation in order to get to the root of the problem. Another main potential barrier is Language, for example: a patient who is from the Philippines may have limited English and their care givers do not speak any other languages. The patient will struggle to communicate their medical issue clearly, and the nurses will struggle to communicate the treatment plan.
To overcome this, interpreters can sometimes be used, however this is not always appropriate. Instead many health care providers invest in training staff in non-verbal communication, using basic sign language or creating picture flash cards which demonstrate a range of illnesses and treatments. The physical environment can act as a barrier to communication. Visual factors include lighting, noise, body language, viewing angle and vision. Bad lighting conditions in a face-to-face interactions can affect a nurse’s ability to notice nonverbal communication, obscuring visual clues and body language and could reduce a hearing-impaired person’s ability to lip read. To overcome this the nurse in a hospital could find a room within a ward which has a perfect lighting suiting the service user’s needs. The room was not too bright and not to dim, so the patient could communicate properly and feel comfortable in the environment which she is in.
The hospital would also be periodically conducting risk assessments to ensure the lighting levels in public areas are at a suitable standard. Noise adversely effects communication. Visual noise can be passing traffic at a window can be distracting for a nurse examining a patient and audio noise can be any background noise which could result in a nurse being unable to hear the patient clearly. These can be overcome using a range of different methods, for example the patient can be taken to a private room with closed windows to reduce interior and exterior noise and distractions. Having an appropriate temperature within the wards and consultant rooms will also impact on the patients and staff work because if the temperature is too hot or too cold the nurses may not be as focused on the message that they are trying to send to their colleagues, head nurse, or patients.
This barrier can be overcome by the care home or hospital maintaining a suitable ambient temperature and monitoring it on a regular basis to ensure the comfort of patients. 1.4 – Analyse the use of strategies to support users of health and social care services with specific communication needs In this task the writer is going to review two strategies that are used to support people with specific communication needs. The writer is also going to analyse the benefits of using these strategies for the service user’s as well as making recommendations for the health care workers. Good communication is essential for effective healthcare. However many individuals throughout our society have various different disabilities which affect their communication skills. Disabilities can range from being deaf to the inability to understand or use one’s native language. Examples of these disabilities include: Visual and Hearing impairment’s such as being blind and deaf, learning disabilities of various degrees of severity such as Dyslexia and Autism.
As a health and social care professional it is your duty and responsibility to help overcome any problems of communication that may arise. This can be achieved by supporting the service user by providing them with strategies to overcome communication problems. The two strategies that the writer is going to focus on are: Braille and Sign Language. Braille: Braille is a technique that is used for people who are blind or partially sighted. It is made up of a range of raised dots which makes up the letters of the alphabet, numbers and punctuation marks. Braille is designed to be read by using your fingertips rather than using your eyes and is produced by a machine known as a Braillewriter. In the health and social sector a letter will be sent to a patient to inform them of an appointment. If the patient was blind they would have registered to receive their communication in an accessible form, so the letter would be typed in braille 3“Braille was invented by Louis Braille around 200 years ago, who lost his sight at the age of 15 and became a teacher of the blind. Braille has been adapted to every known language.
Over the years the Royal National Institute of Blind people has continued to fight for braille and the rights of the blind and partially sighted to have access to information and the opportunity to express themselves in written word”. The main benefits of using Braille are that: braille can be self-taught. This allows the blind person to work to their own timetable. It is also less complicated to learn compared to other methods that are used for the blind. Braille provides independence to the individual. Examples of braille being used in the health and social care setting would appointment letters sent in braille, medication packaging and instructions can be labelled in braille, informing them of the correct dosage. Many posters and leaflets displayed around health care settings are produced in braille allowing the service user to receive information relating to their needs.
This material is beneficial to the health care user as they have more knowledge of medical conditions and procedures. This relieves the patient’s anxiety as a result of not having the correct information. Communicating with patients who are visually impaired can be a big challenge for health care professionals. Some recommendations to overcome these barriers may to gain the persons attention before starting to verbally communicate with them. This can be done by simply touching the person’s arm, reassuring them that someone is there to help, as well as introducing yourself to the patient.
It is also important that they feel secure in the environment and this can be done by verbally communicating a description of the surrounds that the find themselves in. Adjustments should be made to fit the individual needs, the room could be cleared of obstacles that may be a trip risk to the patient, the patient can be informed that the room is clear. Reassurance can be given by explaining exactly what will happen in the appointment. In the case of a home visit to the visually impaired patient, the care provider could offer documents in braille giving patient good information on service provided. The service provider could speak in a clear voice, ask the patient if they understand what is being said, repeat important information to make things clearer and conduct the meeting in a quiet environment.
Sign language is a visual way of communicating to people who are hearing impaired and cannot lip-read, using hand gestures, facial expressions and body language. Different sign languages are used in different countries. Having access to a signed language is vital to any deaf person, child or adult for their cognitive, social, emotional and linguistic growth. Sign language is thought to have been used as far back with early man using gestures before language developed. It is also recorded that Juan Pablo de Bonet invented sign language. In the year 1620, he wrote a book that contained the first known manual alphabet system.
The hand shapes in this system represented different speech sounds. Sign language was continually developed over the next 200 years. The benefits of using sign language in a health and social care setting is the service user is able to understand fully the procedures and treatments that they will receive by and interpreter communicate through sign. This will relieve any anxiety or stress they may have due to being properly informed. The patient is able to communicate with a trained health care interpreter if they have any problems or painful symptoms, this allows the proper medical attention to be given.
Sign language is not only useful to the deaf but also to people with other learning disabilities such as cerebral palsy, autism, down syndrome to name a few. Sign language reduces frustration by providing a way to communicate in situations where verbal communication may not be successful. Communication barriers are broken down for these individual and has a positive effect on the service user as it raises their self-esteem. Medical staff are able to treat the individual with the appropriate medical action and eliminate time wasted trying to find out what the problem is through lack of communication.
Communicating with patients who have a hearing impairment can also be a big challenge. Some recommendations to overcome these barriers may be to ensure that the service user can see your face clearly. This could be done by facing the service user in good light with an appropriate posture so that they are able to see your facial expressions and the way your lips move. However if you’re outside, it is important to face the sun so there isn’t a shadow cast in your face and that the sun doesn’t glare in theirs. It is also important that you make your lip patterns clear without over exaggerating. Using gestures and facial expressions to support what you are saying is also recommended in order for a service user with a hearing impairment to fully understand you for example- a care professional may express that she is happy and delighted by smiling when telling the service user that she is pregnant. It is also important that you speak in a clear normal voice.
However if you raise your voice your facial expressions may become distorted, for example a person with a hearing impairment may realise that you are shouting and might assume that you are angry. 2.1 – Explain how the communication process is influenced by values and cultural factors In this task the writer is going to analyse key ethical and cultural considerations that need to be taken into consideration in order for a health care worker to communicate effectively with their service users. An ethical consideration is when you have to judge what is right or wrong with moral duty and obligation. They are impacted by a range of different factors including religion, culture, upbringing and an individual’s own values and beliefs. Health care workers are providing care to a very wide range of service user’s that come from different cultures and ethical backgrounds. This brings with it all sort of challenges.
For example disagreement between service users and their families with health care providers over treatment decisions. These disagreements typically take one of two forms health care professionals might push a treatment option that is unacceptable to service user or service user may request treatment that is unacceptable to health professional. In cases such as this it is important that health care worker communicates the reasons why he feels the treatment is not an option. For example in a case of a pregnant woman who wishes to have a natural birth due to her beliefs. This may not be an option due to problem with the baby lying breech. In this case it is extremely important the health care professional communicates all the risks to baby and mother, as well as informing of alternative action. Another example is refusal of treatment due to religious reasons. Jehovah’s Witnesses’ religious beliefs forbid them from receiving blood transfusions.
In the case of a serious accident, this may be the only course of treatment, but the health care professional must respect the wishes of the patient and their next of kin. Health care professionals cannot “force” someone to follow a course of treatment, only ensure that the patient is in possession of all the facts including the risks, in order to make an informed decision. Effective communication and being informed properly can put health care users at ease and also be the key to the best treatment being accepted by the services user. Another major ethical problem facing our health service today is the waiting time for procedures and operations to be carried out. This waiting time causes great stress and upset to the healthcare user and may even have a detrimental effect on their health. It is important that the health care provider uses communication skills and mediation skills to address these issues. Keeping the patient informed can reduce anxiety and stress.
A major ethical issue is discrimination for any number of factors such as race, age, religion, sexual orientation, disability, or socioeconomic status, and this can happen on an almost unconscious basis. A patient may feel discriminated against or disadvantaged if they are unable to access services in the same way as all other patients. On the other hand any cultural groups, including gay and lesbian individuals to name but a few, receive no medical care or are grossly underserved for multiple reasons. Sensitivity in the treatment of these cases, along with building a trusting relationship with the patient can alleviate these issues, and health care professionals work to a code of practice which removes discrimination and advocates providing the same standard of care to all. Barriers caused by cultural differences in a multi-national society are widespread. Every health care encounter provides an opportunity to have a positive effect on patient health.
Health care providers can maximize this potential by learning more about patients’ cultures. Understanding the cultural background of a particular patient’s health related behaviour can improve patient communication and care. For example an Alzheimer patient from a foreign country being extremely agitated as they are unfamiliar surroundings may be calmed down by a health professional that can communicate in their own language. Many health care settings employ nurses that can translate to service users if there is a large immigrant group within the area. Lack of cultural competence of health care providers is one of the reasons these groups receive inadequate medical care.
Many health and social care settings provide training to staff who deals with patients that have limited English. Although learning a new language can take years, it empowers confidence and trust with the patients and allows the health care providers of health and social care settings to listen in and verify information between the patient and the interpreter. Non-verbal aids such as picture flash cards can also overcome language barriers. Cultural sensitivity in dealing with non-English speaking patients also increases the trust between a patient and their care provider.
Looking at all the different findings and evidence that the writer has gathered the writer feels that good communication is vital in all aspects of health and social care. It allows care professionals to build relationships with the service users and their families as well as developing relationships with fellow care staff, managers and other members of the multi-disciplinary team. Although there is a great need especially in health and social care settings to continually improve the process of communication, communication among healthcare team members the quality of working relationships, job satisfaction and has a profound impact on patient safety.
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