Unit 6: Overcoming Communication Boundaries

Communication Barriers

A communication barrier is an obstacle that prevents the exchange of information or effective communication. Messages may become unclear, which can cause uncertainty and confusion. Common communication barriers can develop because of: environmental or physical barriers. semantic or language differences. cultural differences. emotional barriers. differences in perception or viewpoint. Communication barriers can affect the patient's ability and motivation to communicate, which affects their health care. For example, a patient who cannot understand the medical jargon that a doctor uses may not understand how to complete aftercare tasks at home, and may not be motivated to do so.

Therapeutic Relationships

A therapeutic relationship is a relationship between a caregiver and a patient that is built over time and focuses on meeting the wellness needs of the patient. If this does not exist, it can become a barrier. How care is delivered and how communication is handled is important. The caregiver works to handle communication properly to foster a therapeutic relationship. For example, a patient who goes to the same doctor for treatment for five years may develop a therapeutic relationship. A long term therapeutic relationship usually means the doctor will know the patient's medical and family history. The patient will usually feel that the doctor's office is familiar and safe. The communication will usually be relaxed, and the patient will feel comfortable communicating medical issues with the doctor.

Behavioral Considerations

Behavioral considerations are considerations that are nonverbal in nature and can include body language, eye contact, physical contact, and use of personal space. When taking into account behavioral considerations, a healthcare professional can ensure that messages come across as intended. For example, a healthcare professional may need to come down to a child's level to talk. This behavior shows that the healthcare professional is interested in what the child has to say. Children will be more willing to share symptoms or information if they feel they are being listened to. Communicating nonverbally may include frowning and crossing the arms to show disapproval, or nodding and smiling to show approval. In a healthcare setting, it helps to nod and say "yes" to indicate that a patient is being heard. It also encourages the patient to speak openly. This open dialogue facilitates effective health care.

Special Considerations in Communication

Building relationships is a key component to patient care. Good communication skills are essential for building great relationships and ensuring effective health care. Physical, behavioral, or emotional barriers can impair communication in health care. Healthcare workers may make various changes to improve communication when faced with these barriers. For example, a nurse may eliminate a communication barrier by using the aid of an interpreter to help communicate with a patient.

Barriers to Therapeutic Relationships for Patients

Communication barriers are obstacles that interrupt the flow of information between caregivers and patients. Patients can create communication barriers and hinder therapeutic relationships when they: do not want to talk about symptoms. do not listen to or understand care instructions. Patients might create these barriers by not wishing to talk to a practitioner who is not empathetic to what they are feeling. Also, patients may not share information if they do not feel that the provider is interested in listening to their concerns.

Emotional Barriers to Communication

Emotional barriers are feelings that negatively affect communication. These barriers may include feelings of helplessness and fear, which can come across as shyness, fright, or suspicion. A healthcare professional's lack of empathy or not being able to "put one's self in someone else's shoes" is another form of an emotional barrier. An example of an emotional barrier could be a case in which a patient is very upset about an injury. Because the patient is upset, he may struggle to understand the nurse's instructions.

Emotional Considerations

Emotional considerations are considerations related to the emotional state or needs of a patient. These considerations can help ensure that the patient is ready to listen to the message. Emotional considerations include giving a patient adequate time to process questions and to respond. They can include taking a break when someone gets frustrated or reassuring a patient that his or her needs are going to be met. An example of an emotional consideration in a healthcare setting is a nurse asking a patient what is bothering him, and then taking the time to listen and respond to his requests.

Developing Therapeutic Relationships

Methods for developing therapeutic relationships include showing empathy, using active listening, and displaying professionalism. Empathy is the ability to identify and understand another's feelings. Active listening is the ability to hear and understand what someone is saying. Professionalism in health care is the ability to remain both caring and objective.

Consequences of Poor Therapeutic Relationships

One consequence of a poor therapeutic relationship can be an uncomfortable visit to the doctor's office. However, poor therapeutic relationships can also have dangerous consequences. They can lead to: medical errors due to inaccurate or incomplete patient history. complications from patients not following aftercare instructions. inaccurate diagnoses that can arise because a patient does not feel comfortable talking to a healthcare provider and does not give the correct information.

Personal Barriers to Communication

Personal barriers are obstacles created by a person's habits, opinions, or other factors under that person's control. Personal barriers can negatively affect communication, such as when two people who do not share the same knowledge and attitudes struggle to communicate. For example, a doctor has a habit of making notes while explaining her treatment to the patient. This makes her patients feel as though they would be interrupting the note-taking if they were to ask questions. The doctor's habit of making notes while explaining treatment is a personal barrier that affects communication.

Physical Barriers to Communication

Physical barriers are components of an environment that negatively affect communication. Environmental components include several factors, such as the ability to quickly communicate and maintain a proper distance during different communication situations. Communicating in congested, cramped, poorly lit, or noisy places can also make it difficult to communicate effectively. The form of communication, such as oral, written, or audio visual, can also be an environmental factor. The scene of an automobile accident may have physical barriers that negatively affect communication. For example, sirens and street noise may make it difficult for a paramedic to clearly hear a patient's vitals given by another paramedic.

Physical Considerations

Physical considerations are considerations related to the patient's physical environment. Sometimes this means making sure they can hear and understand what they are being told. This may include reducing background noise, making sure the patient understands the language spoken, speaking slowly enough to be understood, or making print large enough to be read. For example, considerations might be needed for people who are deaf. A person who knows sign language could be brought in to help communicate. For a patient who is blind, extra-large print forms can be used.

Barriers to Therapeutic Relationships for Healthcare Workers

Therapeutic relationship barriers can be negative for patients. Elliot M. Hirsch, MD reports in his article "The Role of Empathy in Medicine: A Medical Student's Perspective" that empathy helps to reduce anxiety in patients and may also help the healing process. When a doctor does not have empathy, does not use active listening, or is not professional, barriers to therapeutic relationships can form. Active listening and professionalism help to convey empathy and improve the exchange of information. Healthcare providers who are not empathetic or professional can cause communication barriers and hinder therapeutic relationships because patients may not: be inclined to talk to a healthcare provider who is not empathetic to how they are feeling. share information if the provider does not seem to be interested in listening.

Importance of Therapeutic Relationships

Therapeutic relationships are important because they create an environment where the patient feels known and valued. These types of environments can be built by ensuring that a patient understands the caregiver's message by explaining medical jargon and by making a patient feel comfortable by chatting or joking. Patients who are at ease may be more comfortable expressing concerns and more likely to understand their illness. Patients who understand their illness well may be more motivated to follow treatment instructions. In these ways, the therapeutic relationship is also important because it ensures that the wellness needs of a patient are met. Since these types of relationships are built over time, the patient's records remain in one place and are complete. Patients who do not build therapeutic relationships may visit a variety of doctors and have information missing from their records.

Overcoming Emotional Barriers

To overcome emotional barriers, a healthcare provider needs to help patients remain calm. If acceptable, the caregiver needs to allow the patient to have someone in the room with whom he or she feels comfortable. A key to overcoming emotional barriers is showing empathy. Patients who feel that the healthcare professional cares may be more willing to attempt to communicate better in a stressful situation.

Overcoming Personal Barriers

To overcome personal barriers, which include not listening carefully, using unclear vocabulary, or failing to give feedback, healthcare professionals need to remember to remain professional and treat all people with dignity and respect. Healthcare professionals should: learn about the people they are treating so they can understand them and better meet their needs. be mindful of their communication weaknesses so they can improve them and provide better patient care.

Overcoming Physical Barriers

To overcome physical barriers, healthcare professionals need to make sure that the patient is in a place that is free from distractions, where the information can be heard clearly. Caregivers need to make sure that the patient understands the language being used. If a foreign language is a barrier, the healthcare professional may need to bring in a translator. The healthcare provider may also be communicating with patients who are deaf or blind, which means perhaps having a sign language specialist or instructions written in enlarged print.