This assignment discusses communication skills, and the various factors that influence the communication process. It looks at learning theories, strategies to improve interpersonal behaviour, charters and codes of practice, the usage of information technology, and the effectiveness of such systems, together with legislation, across the health and social care environment.
Communication is a process of passing information from one person to the other and between employees, agencies, service users and their relatives in health and social care through verbal and non-verbal communication.
Non-verbal communication is a form of communication (e.g. body language, signs and symbols). Verbal communication is communicating with words (e.g. conversation). In order to improve relationships with service users, their families, colleagues, managers and others who worked within health and social care environment, care workers need to have good communication skills. Good, supportive relationships are built on effective communication (Michie, 2006).
Communicating effectively performs a significant role in health and social care workplace, therefore understanding learning theories can improve the quality of communication process.
In health and social care, learning theories have been effectively applied. For example, social learning theory, is learning by imitating the behaviour of others – either consciously or unconsciously. It is applied in health and social care by offering the positive things learnt from others into health and social care workplace to improve staff-patients interpersonal relationships. The woman who decided to stop drinking after being aware of the risk of having liver disease or felt proud after she quit drinking completely is an example of social learning theory (Bandura, 1977).
The importance of communicating effectively is shown in the hospital appointment scenario where the doctor was devoid of good communication skills. He is an example of a poor communicator who appears to have used his position of power in his ‘closed’ questioning style. Shukla et al. (2010) that ‘good doctor-patient communication has a positive impact’ on patients reactions to consultations. For example, it improves patient satisfaction, physician satisfaction. In fact, doctors who are patient-focused have a been reported by patients to have a good quality of care (op.cit). The present scenario shows that interpersonal skills are lacking resulting in the patient’s apparent dissatisfaction with treatment. In the scenario the doctor did not recap to the patient, and there was no active listening and relationship between them (Moss, 2012).
Classical conditioning theory is also used to change and improve peoples’ behaviour. This can be used in setting with the mentor and mentee. It is learning by association. For example learning to feel upset at the sight of flashing police lights in your rearview mirror. It is applied in health and social care, by making sure service users, their relatives, visitors etc. receive quality care and services so that they can respond positively regarding the kind of care and services that was render to them by health and social care workers. Classical conditioning process remains significant today for various applications, including transformation and mental health treatment. Classical conditioning is often used to treat anxiety, panic disorder and phobias (Pavlov, 1927).
Skinner’s (1938) model of operant conditioning often is a effective way of changing behaviour by reinforcement. For example when a child is rewarded for achieving a higher grade at school or when a baby is crying and chocolate is given to the baby and the baby stop crying. And any time the baby cries and chocolate is given to the baby, the baby will d stop crying. It is applied in health and social care workplace, whereby a mentor will give a mentee a constructive and encouraging feedback and advice e.g. a general practitioner (GP) giving a patient a constructive feedback and advice from the patient medical condition enquiries (Nevid, 2008).
Michie (2006) stated that different skills can be used to promote effective communication in health and social care. Therefore, health and social care workers must be able to communicate effectively with patients, there is need for them to understand how patients feel and the things they want and need. They need to be able to respond to patients concerns and questions in ways that can be understood and they need to be able to communicate effectively with their managers, colleagues, visitor and other professionals. For example, they need to be able to pass on information which others can understood and to understand instructions by communicating clearly, slowly, concisely and avoid using jargons when giving instructions of medication intake to service users. For example, in the hospital scenario when there was no personal relationship between the doctor and the patient (Bastable, 2008).
According Moonie (2005) health and social care workers must understand the importance of verbal and non-verbal communication in order to communicate with service users. Non-verbal communication comprises the use of signs and pictures, body language such as facial expressions, posture, eye contact, and gestures. Health and social care workers need to be an active listeners, and let service users have their right to communicate their needs and preference and to make decisions and choices to improve the quality of their life. There may be obstacles to effective doctor-patient relationship, when a doctor does not aid open communication with a patient. For example, when a patient does not understand medical terminology, or believe the doctor has not really listened and therefore, does not have the information to make good treatment decisions. The doctor should sit down, maintain eye contact, listen without interrupting and explain and restore confidence during test (Hill, 2011).
Another area to be examined in health and social care is interpersonal communication, which is the process by which people exchange information, feelings, and meaning through verbal and non-verbal messages; it is face-to-face communication. Interpersonal communication is not what is actually said or the language used, but how it is convey and the non-verbal messages pass through tone of facial expressions, body language, gestures and voice. Discrimination can cause inappropriate interpersonal communication in health and social care environment, because people often feel that they belong to certain types of group whom they share same view, look similar and who m they think alike. Health and social care workers must have to be interested in learning about other people, they should not divide service users into group, and must not exclude them from receiving quality care services because they belong to a different ethnic group, religion, culture, gender or age group or because of their sexuality.
Stereotype is another factor that can cause inappropriate interpersonal communication. carers may make assumptions about their patients based on stereotyped thinking, this may be barriers to effective communication in health and social care workplace. For example, health and social care worker, working with elderly people, may decided to wash and dress an older service user without asking her what she want or need because the carer feel she is old and she can remember anything “old people do not remember” (Downs and Adrian, 2004).
In health and social care sector, there are different strategies healthcare professionals can use to support service users with particular communication needs (e.g. SOLER technique, and Braille) have been put in place to help those with mental and physical disabilities to overcome communication barriers. Braille is a system of communication based on raised marks that can be read by the visual impair people. SOLER is a non-verbal listening technique used in communication; face the other squarely, adopt an open posture, lean towards other, maintain eye contact and relax. Health and social professionals may come across a number of patients at workplace who speak different language rather than English, have disabilities which may affect their speech.
These service users may need respective approach and specific needs, service users can be complemented by communication skills and technological aids. For example, when a carer is communicating with a patient with visual impairment, closed personal space is required so that health care professionals and service users, can develop closer relationships in order to convey accurate message. Health care professionals have to use technological support (e.g. screen enlarger and text-to-speech devices). And also pictures, diagrams, written information printed in big characters with illustrations can be use to assist service users with communication difficulties (Weiten et al., 2011).
It is imperative for health and social care workers to have a knowledge base of cultural diversity. Differences can occur in attitudes, norms of behaviour; high (Chinese, Thai and Japanese), medium (English, French, Italian, Spanish) and low (North Americans, Germans, Swiss) context cultures can influence how health and social care professionals interact with service users to achieve good communication relations and quality care services. High context cultures convey a limited portion of the meaning of words, which must be interpreted in terms of how it is being said, where it is being said, and the body language of the speaker. Medium context cultures convey a fair portion of the meaning of words. It depends the context in which the message is delivered. Low context cultures convey most of the meaning of words in the communication. Understanding differences and similarities within and between cultures can also improve staff relationship in health and social care sector.
People learn the values, customs and norms of their culture through communication, the cultural values are impacted in the way that people speak, perceive and interpret the words. In order to prevent misunderstanding in health and social care sector, cultural diversity must be understood and accepted (Rasheed et al., 2010). Culture has specific symbols consisting of verbal symbols, non-verbal symbols, language, symbols and signs. We know that we are product of many cultures and traditions, that mutual respect allows us to learn from other cultures, culture can become clearest in well-meaning clashes e.g. interacting with people from different backgrounds. Each may behave ‘normally’ as far as their own culture is concerned, but not as judged by the other culture (Bastable, 2008).
Working in the health care sector, it is fundamental that facets of confidentiality are understood and applied by employers and employees. By understanding legislation and Code of Practice averts misuse of confidential objects by professionals working in the health care sector. Therefore it is the duty of employees to stick to these rules in order to encourage good practice. Not abiding to these principles can lead to patient disappointment and lack of trust in health care services. The Health and Social Care Act 2012 (DH, 2012) outlines the changes of NHS system which is the replacement of Primary Care Trusts (PCTs) and the responsibilities of the clinical commissioning groups, who are GPs and other clinicians, to allow greater liability for using local resources economically under the support of NHS Commissioning Board.
This Act aims at incorporated and more available service provision placing the need of local people and patient in the middle, which would reduce pointless costs and time devoted during the administration work. Equality Act 2010 protects people who have different characteristic on the ground of disability, race, marriage status, religion or belief, sex and sexual orientation from being discriminated in the case of employment, perception, association, payment, access to health care and social services and so on (Walsh et at. 2011).
This legislation and code of practice are implemented as guidelines for the professionals to produce effective work-relationship. Also, health and social care provider should respect religious and cultural diversity of the service users and implement an equal advance towards the disabled people as a good organisational practice. The Charter for Communication place the right of people with a communication impairment in terms of information, support and training, time to speak, right of entry to services, addition in social networks, and services from employers. Due to this Charter, health and social care service providers and general public have been able to adopt and develop suitable method of communication, such as providing choices of booking a GP visits, allocating experienced staff with balancing communication tools in reception area, or offering additional time to value the needs of people with communication complexities (Walsh et al., 2011).
It is the responsibility of employers and staffs working in the health care sector to be familiar with policies and procedures. It is also important that they know who to report to in situations of improbability. Health and social care workers must be able to direct those in their care to professional organisations who can offer advice and support to people experiencing various difficulties. When employees adhere to the policy and system of an organisation, this will enhance the safety of employees and service users within the health care organisation. For example, the confidentiality policy which stated that people personal information should be protected and process fairly at all time, service users personal details must be protected by health and social care workers (Moss, 2012).
The Care Quality Commission (CQC) controls all health and adult social care services in England including those provided by the NHS, local authorities, private companies or voluntary organisation. The CQC makes sure that necessary standards of quality of care and safety are being met where care is provided, from hospitals to private care homes. The CQC make sure better care is provided for everyone in the hospital, care homes, own homes or elsewhere. When communication is supported through organisational policies and staff training, this will create a safe working environment for service provider and service users, and it will also improve the communication skills of health care professionals and service users fulfilment (Hill, 2011).
In health and social care sector, there are different techniques that have been put in place to develop the communication process in the health and social care sector. Communication can be blocked if people differences are not understood. For example when people don’t get the message, include visual disabilities, hearing disabilities, environments, and speaking from too far away and when people cannot make sense of their messages e.g. the use of different languages, the use of different terms, such as jargons (technical language) and slang (using different terms) in health and social care workplace.
Health and social care workers need to be trained in the areas of identifying barriers and how to improve the communication processes in health and social care in order to be able to provide quality care service for the service users. For example, health and social care workers should avoid using jargons and slang to communicate in health and social care organisation in order to avoid communication barriers (Moonie, 2005).
Since I started health and social care management course, I have developed new uses for information communication technology (ICT) and the benefits are worth the effort and has resulted in major improvement in my area of work, not just for providing quality service for the service users, but also for the benefit of me and my work team. With the use of information communication technology (ICT), I can now check information about patient care by assessing the modern email system which is the fastest and secured way of exchanging information, and to support a patient-centred care approach for older people and people with long term condition by electronically enabling single assessment process (e-SAP). I also use information communication technology (ICT) to improve, more consistent monitor and record service users conditions. For example, by using electronic mat to monitor the movement of a confuse patient, that will immediately alert me when the patient stood on. The electronic mat is always spread by the side of the patient bed, and the buzzer will sound when the patient stood on it.
I use information communication technology (ICT) to get better information to support and improved my performances (Moonie, 2010). Over the last three decades in health and social care settings, huge benefits has been achieved by the use of information communication technology (ICT) by users of services care workers and care organisations. Service users can benefit from information communication technology (ICT) by the use of Electronic Health Record that will give them information about their health record held by their General Practitioner (GP) or their health care professionals, in order for them to be able to take control and participate in their care, so that they can receive treatment at the right time.
Service users can also benefit from the use of information communication technology (ICT) by using e-prescribing that will help service users to collect their medication straight from the pharmacy without waste of time, errors in dispensing (such as wrong drug or contraindicated drug) and it eliminate hard-to-read handwritten prescriptions. Care workers and care organisations can benefit from the enhance performance of quality services delivered by the use of information communication technology (ICT). For example, the breakdown to barriers to communication and information exchange between health care workers and the organisation through electronic systems, and the use of Clinical Decision Support System also help clinicians to support the decisions of other professionals (Rafferty and Steyaet, 2007).
However, there are legal consideration in the use of information communication technology (ICT) in relating to Data Protection Act 1998, which stated that service users information must be confidential and should not be disclosed, and can only be disclose to certain people e.g. Social worker, General Practitioner (GP), Police etc. The employers have a legal duty under Health and Safety at work Act etc 1974 to safeguard, so far as is ‘reasonably practicable’, the health, safety and welfare of their employees and others who may be affected by the work activity, and provide and maintain safe equipment and safe systems of work. Employers must also carry out risk assessment and have a written health and safety policy ( if there are five or more staff), display health and safety poster etc. The employees must take care of themselves and other and follow safety advice and instructions. Workers who use computers for long periods of time are prone to health problems, this is why it is important to understand health and safety at work because it can lead to mental disorder, nausea, fatigue etc (Lash, 2002).
This assignment explored communication skills and how different factors influence the communication process, and theories of communication have been applied to health and social care together with the use of information technology in health and social care.
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