COMMUNICATION REVIEW FINAL EXAM
沟通复习期末考试
Noise that can block communication in any form can be:
任何形式阻碍通信的噪音包括：
Static on a phone line, the actual sound or noise
电话线上的静电噪音，实际的声音或噪音
an improperly printing fax machine
打印不正确的传真机
Bad grammar in an email message
电子邮件中的语法错误
Wrong word use
用词不当
Environmental noises
环境噪音
Religion beliefs
宗教信仰
Different cultural background
不同的文化背景
Language barriers, prevents the receiver from understanding
语言障碍，阻碍接收者理解
Mental or Physical state of the receiver, the receiver may have some sort of physical pain or discomfort that prevent them from effectively listening
接收者的精神或身体状况，接收者可能会有某种身体疼痛或不适，阻碍他们有效地倾听
The receiver may be distracted by fear or anxiety about themselves or a family member or friend and cannot effectively concentrate
接收者可能会因对自己或家人或朋友的恐惧或焦虑而分心，无法有效地集中注意力
Receiver may have lack of interest what the sender has to say
接收者可能对发送者所说的内容不感兴趣
The receiver may be hearing or sight impaired.
接收者可能有听力或视力障碍。
Studies show an estimated 70% of communication is nonverbal, 23% involves the tone of voice, and only 7% of communication occurs by the chosen words
研究表明 ， 大约 70 % 的交流是非语言的 ， 23 % 涉及语调 ， 只有 7 % 的交流是通过选择的词语进行的
One of the most valuable gestures that a HCP can learn to recognize is seated readiness. The readiness gestures that signal a desire to end a conversation or encounter are leaning forward with both hands on both knees, or leaning forward with both hands gripping the chair that signal ready to go. Should either of these occur during a conversation it would be wise for you to take the lead and terminate it.
医护人员可以学会识别的最有价值的姿势之一就是坐下准备姿势。这些准备姿势表示想要结束对话或会面，例如身体前倾，双手扶住双膝，或者身体前倾，双手紧握椅子，表示准备结束。如果在对话中出现这两种情况，明智的做法是你主动结束对话。
There are four generally accepted distance zones to be considered when interacting with others:
与他人互动时需要考虑四个普遍接受的距离区域 ：
• Intimate distance = up to 1.5 feet apart. This distance allows the individuals to touch each other. Clinicians often need to enter this zone to examine and care for the patient. HCPs are members of one of the professions where it is not only legitimate, but necessary, to enter this zone.
• 亲密距离 = 最多相距1.5英尺。此距离允许人员相互接触。临床医生通常需要进入此区域进行检查和护理。医护人员属于此类职业，因此进入此区域不仅是合法的，而且是必要的。
• Personal distance - 1.5 to 4 feet apart (about an arm's length). This is the distance at which personal conversations with soft or moderate voices may take place. The personal distance is commonly used in healthcare settings where a clinical procedure is being explained or a patient is discussing a personal matter.
• 个人距离 - 相距 1.5 至 4 英尺（约一臂之长）。 此距离可用于轻声或中等音量的私人对话。 个人距离通常用于医疗保健场所，例如解释临床程序或患者讨论个人问题。
• Social distance = 4 to 12 feet apart. This distance is common in business or social settings. Many HCPs may maintain a social distance during a consultation.
• 社交距离 = 4 至 12 英尺（约 1.2 至 3.6 米）。此距离在商务或社交场合很常见。许多医疗保健专业人员在咨询期间可能会保持社交距离。
• Public distance = more than 12 feet apart. Used in larger events, this distance is intended to separate the speaker from the listener.
• 公共距离 = 相距超过 12 英尺。此距离用于大型活动，旨在将演讲者与听众区分开来。
As MT’s we are definitely treating in at a closer distance than this. Therefore, we are often within the intimate distance during a massage.
作为按摩师，我们进行治疗的距离肯定比这更近。因此，按摩时我们通常都在亲密的距离内。
Touch also has many other important functions in health care as it may serve to:
触摸在医疗保健中还具有许多其他重要作用 ， 它可以起到以下作用 ：
• Ease a patient's sense of isolation;
• 减轻患者的孤独感 ；
• Decrease patient anxiety;
• 减少患者的焦虑；
• Demonstrate caring, empathy, and sincerity;
• 表现出关怀 、 同理心和真诚 ；
• Offer reassurance, warmth, or comfort;
• 给予保证 、 温暖或安慰 ；
• Enhance the rapport between the HCP and the patient;
• 增强 HCP 与患者之间的关系 ；
• Supplement to verbal communication.
• 补充口头交流。
We can use touch as a form of communication and the touch should be appropriate for the situation. For example, placing your hand on the arm or shoulder to ease a distressed patient or family member may be comforting. However, touching an angry patient may be less helpful than simply letting them vent their feelings, therefore we do not generally use touch to calm an angry person. When dealing with an angry client we would remain calm, and speak gently using our problem-solving tone
我们可以用触碰作为一种沟通方式，并且触碰的方式应该与当时的情况相符。例如， 将手放在病人或家属的手臂或肩膀上，可能会起到安慰的作用。然而，触碰愤怒的病人可能不如让他们发泄情绪那么有效，因此我们通常不会用触碰来安抚愤怒的人。面对愤怒的病人时，我们应该保持冷静，用解决问题的语气温和地说话。
Speaking Tones
说话的语调
Expressive Tone (Not a tone HCP should use)
富有表现力的语气（HCP 不应使用这种语气）
We use this tone to express our feelings, tell jokes, talk about what we like or do not like or complain when we socialize
我们在社交时用这种语气来表达我们的感受、讲笑话、谈论我们喜欢或不喜欢的事情或抱怨
Directive Tone: (not a tone for HCP)
指令语气：（不是针对 HCP 的语气）
Is used as an authoritative and judgmental tone. This is the tone used to give orders, exert leadership or pass judgment
用作权威和评判的语气。这种语气用于下达命令、发挥领导作用或做出判断
Problem-Solving Tone: (used frequently by HCP)
解决问题的语气：（HCP 经常使用）
Is used to have a rational, objective and unbiased conversation. This is the tone we use to indicate to the listener that we are using the analytical portion of our brains to come to the correct answer about a certain set of circumstances.
用于进行理性、客观、公正的对话。我们用这种语气向听众表明，我们正在运用大脑的分析能力，针对特定情况得出正确的答案。
HCP do not use slang to help us connect with clients and we avoid the use of medical jargon (we would use laymen’s terms).
HCP 不使用俚语来帮助我们与客户沟通，我们也避免使用医学术语（我们会使用外行人的术语）。
Empathy: when you are able to put yourself into the other person’s shoes. Understand how they may feel about a situation. To show empathy to the client is to show that you understand how the patient feels to the point of being able to put yourself (or think of yourself) in their place.
同理心： 指你能够设身处地为他人着想。理解他们对某种情况的感受。向来访者表达同理心，意味着你理解患者的感受，甚至能够设身处地为他们着想。
Sympathy: is to have an awareness of what another person is feeling, and to feel sadness, sorry or pity with regards to the other person’s suffering.
同情： 就是意识到别人的感受，并对别人的痛苦感到悲伤、遗憾或怜悯。
A HCP needs to have good interpersonal skills. These are the skills one relies on the most in order to have a successful interaction with the patients. These skills include: tactfulness
医护人员需要具备良好的人际交往能力。这些技能是与患者成功互动的关键。这些技能包括：得体
Courtesy - genuineness
礼貌 ——真诚
Respect - appropriate self-disclosure
尊重 ——适当的自我披露
Empathy - assertiveness
同理心 ——自信
Potential roadblocks to care from the patient include: ineffective coping behaviours
患者护理的潜在障碍包括：无效的应对行为
Compensation - Denial
赔偿 - 拒绝
Displacement - Dissociation
位移 -解离
Identification - Projection
识别 -投影
Rationalization - Regression
合理化 - 回归
Repression - Anger
压抑 ——愤怒
Anxious
焦虑的
During the interview a caring facial expression, an honest and genuine demeanor, and empathy will decrease the patient’s feelings of anxiety and helplessness.
在访谈过程中，关怀的面部表情、诚实真诚的举止和同理心会减少患者的焦虑和无助感。
During the interview you will use closed (direct questions, yes/no answers), open-ended questions (client can elaborate) or indirect statement questions. We use layman’s terms (easy to understand, not medical terms) when communicating with clients.
在访谈过程中，您将使用封闭式问题（直接提问，用“是”或“否”作答）、开放式问题（客户可以详细说明）或间接陈述式问题。我们与客户沟通时使用外行术语（通俗易懂，而非医学术语）。
There are three primary functions of the medical interview:
医疗访谈有三个主要功能：
Information gathering
信息收集
Relationship building
建立关系
Patient education
患者教育
Pinpointing is used in the interview to identify the client’s chief or primary compliant.
在访谈中采用精确定位来确定客户的主要或主要的投诉人。
Health Literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions. Low health literacy leads to poorer health outcomes and higher healthcare costs.
健康素养是指个人获取、处理和理解做出适当健康决策所需的基本健康信息和服务的能力程度。健康素养低会导致健康状况较差，医疗成本也较高。
When clients are educated about their health care, they are more likely to comply with the HCP’s recommendations.
当客户了解了自己的医疗保健知识后，他们就更有可能遵守 HCP 的建议。
Strategies for Communicating with Patients who are visually impaired:
与视障患者沟通的策略：
Greet the client as you approach them
接近客户时向他们打招呼
Speak directly to the client
直接与客户交谈
Tell the client before touching them and when leaving the room
在触摸客户之前以及离开房间时告知客户
Be verbally descriptive
用语言描述
Use the words “look” and “see” normally
正常使用“看”和“看见”这两个词
Do not attempt to guide the patient without asking first
未经询问，请勿尝试引导患者
Never touch or distract the patient’s service dog
切勿触碰或分散患者的服务犬的注意力
Walk with the patient between you and the service dog
陪同患者在您和服务犬之间行走
Provide reasonable accommodations
提供合理的住宿
Strategies for dealing with a patient who is hearing impaired:
应对听力障碍患者的策略：
Be sure they see you approach
确保他们看到你接近
Speak directly with the patient
直接与患者交谈
Record and respect the patient’s preferred method of communication
记录并尊重患者偏好的沟通方式
If your patient hears better in one ear and speak to that ear
如果你的病人一只耳朵听得更好，并且对着那只耳朵说话
Gain the patient’s attention before you speak
说话前先引起病人的注意
Speak clearly, in a normal tone of voice, a little more loudly, and at a moderate pace. Pause between phrases.
说话清晰，语调正常，音量稍大，语速适中。每句话之间要停顿。
Optimize conditions for speech reading
优化朗读条件
Minimize the use of medical terminology
尽量减少使用医学术语
Maintain eye contact with the patient
与患者保持目光接触
Include the use and observation of nonverbal communication
包括非语言交流的使用和观察
Rephrase or write the message
重新措辞或写下信息
Indicate a change in topic
表明话题发生变化
Supplement the conversation with visual aids
用视觉辅助工具补充对话
Have patient repeat the information
让病人重复信息
Elderly Patient Strategies:
老年患者策略：
Schedule earlier in the day and allot extra time
提前安排并留出额外的时间
Speak slowly, clearly and loudly if required
如果需要的话，慢慢地、清晰地、大声地说话
Repeat important information and write down instructions
重复重要信息并写下说明
Focus on one topic at a time and minimize distractions
一次专注于一个主题，尽量减少干扰
Face the patient and maintain eye contact
面对病人并保持目光接触
Use visual aids
使用视觉辅助工具
Delirium: (acute confusion) occurs when a patient undergoes a temporary or reversible period of disorientation, hallucinations or delusions.
谵妄：（ 急性精神错乱）发生在患者经历暂时或可逆的方向迷失、幻觉或妄想时。
Dementia: (chronic confusion) occurs when a patient undergoes a progressive, irreversible decline in mental function, characterized by memory impairment, deficits in reasoning and judgement
痴呆症：（ 慢性精神错乱）是指患者的精神功能逐渐、不可逆转地衰退，其特征是记忆力受损、推理和判断能力下降
Strategies for dealing with decreasing cognitive (reasoning) abilities:
应对认知（推理）能力下降的策略：
Expect an increase in confusion upon waking and as the sun goes down
预计醒来时和日落时困惑会加剧
Approach the patient from the front and call them by name
从正面接近病人并叫出他们的名字
Respect the patient’s personal space and observe their reaction as you move closer
尊重患者的个人空间，并在靠近时观察他们的反应
Avoid sudden movements
避免突然动作
Speak slowly and distinctly in a low, pitched voice
用低沉、尖锐的声音缓慢而清晰地说话
Ask one question at a time
一次问一个问题
Give one step directions and instructions
提供一步指示和说明
Remain mindful of your nonverbal messages
注意你的非语言信息
Do not disagree or argue with the patient
不要与患者意见相左或争论
Three important objectives of patient education:
患者教育的三个重要目标：
Changing health behaviours
改变健康行为
Improving health status
改善健康状况
Improving patient compliance
提高患者依从性
3 learning styles: visual, auditory and kinaesthetic
三种学习风格：视觉型、听觉型和动觉型
Patient education may result in better compliance with treatment programs
患者教育可能会提高患者对治疗方案的依从性
Cultural barriers to health care:
医疗保健的文化障碍：
There is significant, documented evidence to indicate that racial and ethnic minorities receive lower quality and poorer access to health care.
有大量的记录证据表明，种族和少数民族获得的医疗保健质量较低且较难获得。
Studies show that African North American’s believe that they are more likely to receive lower quality care than whites (non-Hispanic).
研究表明，非裔北美人认为他们比白人（非西班牙裔）更有可能接受质量较低的护理。
Cultural Competence: the knowledge and interpersonal skills that allow providers to understand, appreciate, and work with individuals from cultures other than their own. It involves awareness and acceptance of cultural differences: self-awareness, knowledge of the patient’s culture and adaptation of skills
文化能力： 指帮助医护人员理解、欣赏并与来自不同文化背景的人合作的知识和人际交往技能。它涉及对文化差异的认知和接受：自我认知、对患者文化的了解以及技能的适应。
There are 6 facial expressions that are considered universal:
有 6 种面部表情被认为是通用的：
Happiness
幸福
Sadness
悲伤
Fear
害怕
Anger
愤怒
Disgust
厌恶
Surprise
惊喜
Strategies for improving cross-cultural communication:
改善跨文化交流的策略：
Do not treat the patient in the same manner you would want to be treated
不要以你希望被对待的方式对待病人
Begin by being more formal with patients who were born in another culture
首先要对出生在不同文化背景的患者采取更正式的态度
Do not worry if the patient fails to look you directly in the eye or ask questions about the treatment
如果患者没有直视你的眼睛或询问有关治疗的问题，请不要担心
Do not assume anything about the patient’s ideas about how to maintain good health, what causes illness or ways to prevent or cure illness
不要对患者如何保持健康、疾病原因或预防或治疗疾病的方法做出任何假设
Ask the patient how they prefer to make their medical decisions
询问患者他们希望如何做出医疗决定
Never assume that the patient is familiar with any particular type of medical test or procedure
永远不要假设患者熟悉任何特定类型的医疗测试或程序
Telephone communication:
电话沟通：
Use a voice that is pleasant and professional
使用令人愉快且专业的声音
Use proper inflection
使用适当的语调
Be courteous
要有礼貌
Give the caller your undivided attention
全神贯注地倾听来电者
Paraphrase
释义
Let the caller hang up first
让呼叫者先挂断
Do not repeat confidential information over the telephone if the patients or other unauthorized people are within hearing distance
如果患者或其他未经授权的人员在听力范围内，请勿在电话中重复机密信息
Telephone Triage: a process in which things are ranked in terms of importance or priority
电话分诊： 根据重要性或优先级对事物进行排序的过程
SOAP notes:
SOAP 注释：
S - subjective information – what you are told
S - 主观信息 – 你被告知的内容
O – objective information – what you see
O – 客观信息 – 你所看到的
A – assessment – assessment testing and results
A – 评估 – 评估测试和结果
P – plan – the client’s treatment plan, how often you want to see them, homecare given
P – 计划 – 客户的治疗计划、您希望多久见一次他们、提供的家庭护理
70% of communication is nonverbal, 23% involves the tone of voice and only 7% of communication occurs by chosen words. With telephone communication only 30% of the message may be taken in by the listener (7% verbal and 23% tone of voice). With email/electronic only 7% as it’s all verbal/written.
70%的沟通是非语言的，23%涉及语调，只有7%的沟通是通过精心选择的词语进行的。电话沟通中，听众只能理解30%的信息（7%来自语言，23%来自语调）。电子邮件/电子通讯中，由于全是口头/书面形式，因此只有7%的信息能够被理解。