CONTENTS
Preface
Introduction: Managing Care: Implications for Health Care Communications
PART I: Health Care Communications: Foundations for Understanding Communications in Health Care Settings
Chapter 1: Health Communications and Quality Care
Quality Care
Operational Definitions of Quality Care
Adverse Drug Events
Treatment Adherence
Trust and Patient Satisfaction
Effective Self-Management
Symptom Severity
Morbidity and Morality
Health Care Utilization
Conclusion
Chapter 2: Principles of Human Communication
Sensory Awareness and Sensory Receptivity
Processing Stimuli and the Brain
Interpersonal Foundations for Human Communication
Conclusion
Chapter 3: The Nature of Therapeutic Communications
Therapeutic Communication Defined
Therapeutic Interviewing Skills
Avoiding the Traps of Dysfunctional Communication
Conclusion
Chapter 4: Cultural Similarities and Differences and Communication
Disparities in Health Care and the Role of Provider-Patient Communications
Culture and the Influence of Culture on
Communication
Definitions of Minority and Majority
Cultural Competence—A Developmental Process
Understanding Your Own Cultural Programming
Conclusion
PART II. Professional Skills in Managing Care: Critical Competencies in Therapeutic Communications
Chapter 5: The Pervasive Role of Confirmation and Empathy
Definitions of Empathy and Empathic Response
The Therapeutic Value of Empathy
The Empathic Process—Steps to Arriving at Empathy and the Capacity for Empathy
Barriers to Empathy in the Provider-Patient
Relationship
Conclusion
Chapter 6: Communications That Contribute to Trust and Mistrust of the Providers
Definitions of Trust and Trust-Based Relationship
The Process of Establishing Trust
Trust and Confirmation: An Important Connection
Conclusion
Chapter 7: The Art and Skillful Use of Questions
Therapeutic Use of Questions
Non-therapeutic Use of Questions
Types of Question Formats
Choice of Question Format and Response Burden
Conclusion
Chapter 8: Therapeutic Use of Silence and Pauses
Definitions of Silence
In the Absence of Silence
Therapeutic Purposes of Silence in the Provider
Patient Relationship
Analysis of Silence in Patients’ Responses
Negative Effects of Using Silence
Conclusion
Chapter 9: The Impact and Limitations of Self-Disclosure
Definitions of Self-Disclosure
The Therapeutic Effects of Self-Disclosure
Types of Nontherapeutic Self-Disclosure
Criteria To Judge the Benefits of Self-Disclosure
Deflecting Requests for Self-Disclosure
Conclusion
Chapter 10: The Proper Placement of Advisement
Definitions of Advisement
The Misuse of Advisement and Opinion Giving
Principles Behind the Therapeutic Use of Advisement
Conclusion
Chapter 11: Reflections and Interpretations
Definitions of Reflection
Therapeutic Uses of Reflection
Kinds of Reflections
Reflections and Interpretations
Guidelines in the Use of Reflection
Interpretations Used in Social and Therapeutic Contexts
Guidelines for the Therapeutic Use of Interpretations
Conclusion
Chapter 12: The Judicious Use of Confrontations, Orders, and Commands
Confrontations: Definitions, Levels, Types
Orders and Commands as Explicit Directives
Conclusion
PART III: Communications to Assure Comprehensive and Continuous Patient-Centered Care Under Challenging Circumstances
Chapter 13: Communicating with Patients with Low Literacy
The Problem of Literacy in the United States
Functional Health Literacy
Barriers to Health Literacy
Communication Interventions to Improve Health Literacy
Assessing Health Literacy
Documenting Health Literacy Problems
Practice Approaches to Improving Health Literacy
Improving Health Literacy with Patients with Chronic Illness
Importance of Using "Plain Language"
Conclusion
Chapter 14: Communicating with Patients with Chronic and/or Life-Threatening Illness
The Process of Dealing with Illness and Injury
Provider Responses to the Chronic and Terminally Ill
Conclusion
Chapter 15: Communicating with Patients in Crisis
Definitions of Crisis
Stress Theories and Understanding Crisis
Types of Crisis
Managing Crisis Behaviors
Conclusion
Chapter 16: Communicating Effectively with Patients Displaying Significant Negative or Resistive Coping Responses
Difficult Patients, Difficult Tasks, and Difficult Care
Contexts
Monitoring and Mastering Reactions to Difficult
Patient Behaviors
Selected Patient Encounters and Therapeutic Response
Communication responses related to emotional states
Communication in end-of-life care
Conclusion
PART IV: Beyond Patient-Provider Encounters: Managing Communications Within And Across Relevant Constituencies
Chapter 17: Communications within and across Health Care Provider Groups
The Pervasive Nature of Groups
Diagnosing Group Communication Problems
Improving Communication in Groups
Inter-group Problems
Conclusion
Chapter 18: Conflict in the Health Care System: Understanding Communications and Resolving Dispute
Conflicts and Communication
The Process of Resolution
Conclusion
Chapter 19: Family Dynamics and Communications with Patients’ Significant Others
The Family—A Major Dynamic Constituency
Families, Illness, and Providers
Conclusion
PART V: ETHICS AND COMMUNICATION IN HEALTH CARE
Chapter 20: The Privileged Nature of Patient and Provider Communications: The Issue of Patients’ Rights
Issues of Professional-Patient Privilege
The Legal Status of the Patient-Provider Relationship
The Problems with Informed Consent and
Informed Choice
Conclusion
Chapter 21: The Privileged Nature of Patient and Provider Communications: Issues of Confidentiality, Anonymity, and Privacy
The Sacrosanctity of Provider-Patient
Communications
Common Dilemmas and Alternative Responses
Conclusion
PART VI: TRANSFORMING THE ROLE OF COMMUNICATIONS IN HEALTH CARE
Chapter 22: Health Communications to Enhance Behavioral Change
Theoretical Frameworks and Models for Behavior Change
Social Learning and Social Cognitive Theory
The Theory of Reasoned Action (TRA) and Theory of Planned Behavior (TPB)
The Health Belief Model (HBM)
Transtheoretical Model of Change
Behavioral or Social Ecological Model
Conclusion
Chapter 23: Internet Use and Communications of Patients and Providers
Uses of the Internet for Health Related Information and Support
Health Care Information Internet Users Seek
Effects of the Internet on Patient-Providers Relationships
Conclusion
Chapter 24: Altering Systems of Care to Enhance Health
Care Communications
Overview: Systems of Care
System Characteristics to Enhance Patient-Provider and Provider-Provider Communications
Coordination of Care
Continuity of Care
Comprehensiveness
Accessibility
Studies of System Changes and Their Potential Outcomes
Conclusion
Appendix A—Glossary
Appendix B—References
Index
