The following is a recommended intervention identified by the TP-CKD programme for implementation with both staff and patients, to test the following question:
Can the use of intervention tools help to improve the knowledge, skills and confidence of patients with kidney disease to enable fuller participation in the management of their own health?
To explore other interventions identified by the programme, visit our Interventions Toolkit Home Page
Effective communication between the patient and healthcare team is key to successful outcomes in patient-centered care and in enhancing patient engagement in their own care. Effective communication between individuals involves more than just information exchange. It is a skilled activity consisting of various key skill areas including non-verbal communication, listening, explanation, questioning, negotiation, reinforcement, persuasion, reflecting, opening and closing and self-disclosure (Hargie 2006). It requires clusters of behaviours, values, traits, and attitudes as well as skills to exchange information, feelings and meaning verbally and non-verbally.
What are the benefits?
- Effective communication helps build good rapport between patient and health professionals and ensures a clear understanding of patient concerns and worries
- Good clear communication coupled with an empathetic understanding of patient needs helps build strong relationships and can enhance understanding and patient motivation
- Listening skills are an important part of good communication; being an “active” listener helps avoid misunderstandings. Good listening skills enable health professionals to understand the deeper emotional issues affecting patients and help to contextualise management
- Good writing skills are also an essential part of good communication. A patient’s level of understanding of written information can influence outcomes such as medication adherence or health behaviour change
How can it be used?
- To gain the knowledge skills and confidence to self-manage their condition
- To identify and address issues that impact upon everyday life beyond clinical outcomes
- To explain and clearly identify the reasons for making decisions about treatment and options based on the values and circumstances important to them
- To help build a relationship of equality with clinical teams where the experience and expertise of the patient can contribute to service provision and development
Effective communication helps the healthcare professional focus on the whole person. This includes sharing information and decisions, providing compassionate and empowering care, and being sensitive to patient needs. The following skills help build good relationships with patients.
- Active and attentive listening for both verbal and nonverbal communication
- Understanding patient/family problems and working together to find manageable solutions
- Use of open questions where possible to elicit patient thoughts and ideas. Use closed questions in information giving
- For written communication, use clear wording in plain English and explain medical terminology in lay terms
- Involve patients and explain record keeping
- Learn and understand the barriers to communication
Communication skills training is now assuming a larger role in many undergraduate and postgraduate clinical training programmes. Some aspects are also covered in NHS mandatory training programmes. Effective communication is integral to many of the interventions referred to in this toolkit including Ask 3 Questions, Care Planning, and Use of Decision Aids, Coaching and Motivational Interviewing. Training in advanced communication skills is often focused on particular speciality areas such as palliative care. A basic communications e-learning course can be accessed here.
Useful Links and Resources
Communication, communication, communication: A personal blog on the importance of communication, written by Bill Dickson, Kidney Patient and member of the Nottingham Team for Transforming Participation in Chronic Kidney Disease
Hargie O (ed). (2006). The Handbook of Communication Skills. Third edition. Hove: Routledge
Lewin S, Skea, Entwistle VA, Zwarenstein M & Dick J (2009). Interventions for providers to promote a patient-centred approach in clinical consultations (Review). The Cochrane Collaboration. John Wiley & Sons Ltd
How healthcare professionals in Scotland develop their communication skills, attitudes and behaviours: An independent report for NHS Education for Scotland Steven McCluskey, Susie Heywood, Niamh Fitzgerald Create Consultancy Ltd. www.createconsultancy.com
Institute for Healthcare Communication – Impact of communication in Healthcare http://healthcarecomm.org/about-us/impact-of-communication-in-healthcare/
A wide range of modules and events to assist doctors in their professional development. This includes the following communication skills modules:
The Respect model