Personal and Professional Health Care Communication

The field of healthcare communication began to emerge in the mid-1970s as an interdisciplinary area of professional concern. It is essentially a holistic field and combines elements of a variety of other disciplines. These include both micro-level and macro-level areas of concern. The former includes issues of effective communication between nurses and other healthcare professionals, their patients, and others to whom they have a professional responsibility. The latter area deals with issues of healthcare on a wider societal level. These include the organization of healthcare systems, public health, community health programs, health education, and healthcare on a wider, global level (Schiavo, 2007). Healthcare communication also serves slightly different purposes on the micro-level and macro-level. On the micro-level, effective healthcare communication serves to enhance the quality of care being administered to the patient and increases the patient’s prognosis for full recovery. On the macro-level, healthcare communication has the effect of influencing both public opinion and public policy in ways that enhance the overall quality of health in the wider society.

The primary element of micro-level healthcare communication is the relationship between health care professionals and their patients. The nurse-patient relationship is normally the starting point and primary building block of a wider network of such relationships. While recognition of the need for effective communication between patients and their nurses is uncontroversial, the evidence also indicates that many nurses and other healthcare professionals overestimate their own communication skills, often egregiously so. The relationship between a patient and their nurse can often become rather complicated. A patient must be able to feel their nurse is trustworthy, competent, and is concerned with their best interests. A patient who does not have this level of trust will be considerably lesser inclined to follow the suggestions of their nurse concerning care for their own health (Longnecker & Fong Ha, 2010). Indeed, the nurse-patient relationship often forms during times when the patient is under great stress not only physically, but also due to the emotional devastation that serious illnesses and injuries can inflict on patients.

A patient who comes to depend on their nurse for medical guidance and treatment for serious healthcare crises will often also come to regard the nurse as a trusted friend (Parvis, 2002). Indeed, it can be extraordinarily detrimental to a patient to lose their confidence in their nurse. Not only will the patient be less inclined to heed the nurse’s advice, but a patient may also suffer emotional damage due to a sense of betrayal if they begin to feel their nurse lacks the highest level of concern for their well-being. It is therefore essential that nurse’s develop optimal communication skills within the context of their professional relationships with their patients. This is a skill set that some nurse’s naturally have a greater aptitude for.

It is of the utmost importance that healthcare professionals recognize their own limitations in this area and seek to constantly improve their skills. This is true of all categories of healthcare professionals. Longnecker and Fong Ha (2010) indicate that the perceptions of physicians and nurses alike concerning their skills in this area often differ dramatically from those of their patients. For example, they cite a study that indicated that while seventy five percent of healthcare professionals felt their skills at communicating with their patients were accurate, only twenty percent of patients shared such a perception of their doctor. Clearly, this is an area where the consciousness-raising of nurses and other healthcare professionals is in desperate need of advancement. Longnecker and Fong Ha also observe that the nature of the healthcare professional and patient relationship has undergone an alteration in the past half century.

In the mid-twentieth century, doctors and nurses tended to maintain an authoritarian’s relationship with their clients. The physician even became something of a father figure in many instances, and the nurse a mother figure. That was also an era when gender roles were much more rigid and segregated in the healthcare professions. However, subsequent decades have seen a shift from an authoritarian relationship to an individualistic one. The result has been a more participatory relationship between healthcare professionals and clients. Patients now take a much more active role in the decision-making process concerning care for their own health. In past times, the patient was often treated as a de facto subordinate to the nurse or physician (Longnecker & Fong Ha, 2010). In the present era, a patient often assumes the role of a consumer of the healthcare professional’s services.

An enhanced nurse-patient relationship made possible through more effective communication has many benefits. The first and most significant of these is the increase in the quality and effectiveness of the healthcare being provided to the patient. Effective levels of communication between the nurse and patient help to more adequately manage the emotional difficulties being experienced by the patient during a crisis in their own health. A higher level of trust in the nurse on the part of the patient will strengthen the patient’s willingness to divulge personal information, habits, issues of self-care, and the like that may impact the outcome of whatever treatment regimen the nurse provides for the patient. Effective communication also enhances the ability of the healthcare professional to determine the degree of responsiveness to the prescribed treatment on the part of the patient. A patient who trusts and highly regards their healthcare provides, whether nurses or physicians, will be more honest in their communication (Longnecker & Fong Ha, 2010). The nurse will be more properly informed concerning the degree to which the patient is heeding the doctor’s directive, and what ongoing symptoms or physical difficulties the patient may be experiencing.

Micro-level healthcare communication does not only involve the healthcare professional-patient relationship. Another equally essential form of healthcare communication involves the relationship between healthcare professionals. Quite often a patient will not be treated by a single healthcare practitioner. Instead, multiple healthcare professionals possibly involving nurses, primary care physicians, specialists, surgeons, technicians and others will involve as part of an ongoing treatment process. Indeed, this will be especially true of patients with the most serious illnesses and injuries. Kirby (2010) indicates that a full seventy percent of sentinel events within the process of patient care result from poor communication among healthcare professionals and their colleagues. It has likewise been determined that improper coordination between members of a treatment team is the principal contributing factor to the diminished quality of care, and also the primary area of concern in the majority of malpractice cases. This is a profoundly disturbing state of affairs and one that highlights the necessity of more effective communication between those involved in the process of healthcare delivery.

Issues of health communication between nurses, physicians and their patients, and between healthcare professionals, significantly impact the quality of the healthcare provided to individual patients (Schiavo, 2007). However, it is also true that health communication is a vital area of concern with regards to matters of public health at the macro-level. Heath communication at the macro-level involves a wide variety of purposes. The first of these is the provision of education concerning a particular health issue. Examples include campaigns to inform the public at large of the dangers of tobacco smoking, or the excessive use of butter and other high cholesterol food products. Another example has been the campaign to increase awareness and prevent the spread of HIV through unprotected sexual relations and the sharing of hypodermic needles.

Communication efforts of this type serve the purpose of not only heightening the awareness of the potential health hazards associated with various products and behaviors, but also help to influence public opinion and attitudes concerning the particular health issue in question. The ambition of such communication is to change behavior through, for instance, dietary modification, the increased use of safety devices such as seatbelts, or the avoidance of unhealthy habits such as smoking, drug abuse, or excessive alcohol consumption. Health communication of this kind may be conveyed in a negative or positive manner. The potential risks and dangers associated with certain health practices may be communicated, or more positive behaviors may be demonstrated. For instance, instead of warning of the hazards of a particular form of food, encouragement towards the consumption of more healthy foodstuffs may be encouraged (Baxter, Egbert, & Ho, 2008). As an illustration, televised efforts of these kinds oriented towards children may include cartoons extolling the benefits of developing healthy dietary habits at an early age and attempt to interest the young viewers in foods which provide proper nutrition and contribute to good health.

Macro-level health communication may also help to communicate the positive benefits of alterations of individual and collective health practices such as greater life expectancy, diminished risk of disease, and reduced expenditures on healthcare (Parvis, 2010). Other such efforts may include promoting legislation or public policy intended to enhance public health, such as stricter food regulation or the prevention of tobacco smoking by underage persons. Health communication may involve attempting to influence public opinion towards recognition of the need for better quality healthcare services, or the expansion of healthcare into communities or areas of care where it was previously lacking. Still another function might be to challenge misperceptions and stereotypes concerning certain public health issues (for instance, the once prevalent view that AIDS is a “lifestyle” disease). Healthcare communication involves the use of an array of mediums, from interpersonal communication to the mass media, for the purpose of enhancing both the health of the individual and of the public at large.

References

Baxter, L., Egbert, N. & Ho, E. (2008). Everyday health communication experiences of college students. Journal of American College Health 56, 4, 427–435.

Kirby, S. G. (2010). Communication among healthcare professionals: An essential component of quality care. North Carolina Medical Board Newsletter, 4. Retrieved from http://www.ncmedboard.org/articles/

Longnecker, N. & Fong Ha, J. (2010). Doctor-patient communication: A review. The Ochsner Journal, 10, 1, 8-43.

Parvis, L. (2002). How to benefit from health communication. Journal of Environmental Health, 65, 1, 41.

Schiavo, R. (2007). Health communication: From theory to practice. San Francisco: Jossey-Bass.