
Contents
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Introduction to communication with the patient and family Introduction to communication with the patient and family
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What is ‘good communication’? What is ‘good communication’?
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What are the outcomes of ‘good communication?’ What are the outcomes of ‘good communication?’
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Current communication practice Current communication practice
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Communication skills can be learned Communication skills can be learned
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Areas of uncertainty Areas of uncertainty
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Putting theory into practice: a communication skills overview Putting theory into practice: a communication skills overview
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Prepare in advance Prepare in advance
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Whenever possible, communicate face-to-face Whenever possible, communicate face-to-face
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Use open-ended techniques Use open-ended techniques
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Solicit the patient’s agenda Solicit the patient’s agenda
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Ask permission Ask permission
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Ask–tell–ask Ask–tell–ask
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Empathize Empathize
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Praise Praise
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Use ‘wish statements’ Use ‘wish statements’
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‘Hope for the best . . . ’ ‘Hope for the best . . . ’
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‘Are you at peace?’ ‘Are you at peace?’
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Use interpreters Use interpreters
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Putting it all together Putting it all together
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Conclusion Conclusion
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References References
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Online references Online references
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6.1 Communication with the patient and family
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Published:March 2015
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Abstract
High-quality palliative medicine depends upon communication that is patient-centred, clear, and attends to the central role of emotion in the medical encounter. Good communication leads to a number of improved outcomes including greater adherence to therapy, higher patient satisfaction, decreased anxiety and depression, and care that is more consistent with patients’ goals. Unfortunately, in practice, communication frequently does not meet these standards and opportunities are lost to meet patients’ most basic needs. That said, good communication can be deconstructed and conceptualized as a series of discrete behaviours and skills including assessing patient understanding before entering into difficult conversations, asking permission to discuss tough topics, delivering information in small manageable chunks while checking for understanding, responding to patients’ emotions, eliciting patients’ values, and aligning treatment preferences to their goals. Specific techniques and cognitive roadmaps exist to help navigate these conversations and ought to be in the toolbox of every palliative care clinician.
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