DQ 2-1

5. The Change Theory was a three-stage model of change developed by Kurt Lewin. This model was also known as the unfreezing-change-refreezing model that can be used by health care professionals when making discussing treatment for patients (Manchester, et al, 2014). The unfreezing process involves making it possible for people to change their mind. This can be done by helping them overcome a resistance or introducing new information. It is a way to increase the driving forces away from the current situation, such as encouraging a patient to have a diagnostic heart catheter after they have had several episodes of chest discomfort, but is afraid of going to the hospital for a procedure. Change is when there is a change of thought, behavior, or something that moves one from their current or frozen situation. This can be described as the patient agreeing to proceed with the heart catherization, getting on appropriate medication, and following a healthier lifestyle. The Refreezing is established after then change has happened and there is a new habit. For example, after the patient has the heart catheterization, he or she adopts a healthier lifestyle by being compliant with medication and the physician’s treatment recommendations, eating a heart-healthy diet, and exercising.

Communication is more than sending a message from one person to another. Communication involves nonverbal communication such as tone, body language, dialect, paralanguage, proximity, touch, eye contact, gestures, posture, and more. Nonverbal communication between a physician and patient influences patient perception, such as patient satisfaction (Montague, Chen, Xu, Chewning, & Barrett, 2013). Verbal and nonverbal communication barriers such as healthcare jargon, language barriers, emotional barriers, differences in perception and view point, and physical disabilities. Environmental barriers can also disrupt and distort messages. To minimize disruptions and distortions in communication, health care professionals should eliminate noise distractions by taking the patient to a quiet room or closing the door to the exam room or hospital room for privacy. One should speak clearly and slowly, checking for understanding before moving on to the next part of the message. Health care professionals should use a medical certified translator when there is a language barrier or hearing impairment. Reading the patient’s body language can also suggest if the patient is understanding and following along. Cell phones ringers should be turned off to not interrupt the communication. Eye contact demonstrates listening and understanding for both parties. Touch can be clinical and social (Montague, Chen, Xu, Chewning, & Barrett, 2013). A clinician must touch to the patient to assess, diagnose, and treat. However, touching through a handshake, hug, or pat on the back, can be social, therapeutic, and healing. The important part of communication is to make sure one’s message is received and understood. In a clinical setting, this can be confirmed by asking the patient to paraphrase the message. One method used by health care professionals is the Teach-back Method (AHRQ, 2015). This method is used to check the understanding by asking patients to repeat the instruction they were given by using their own words. This method has been shown to improve patient understanding, adherence, and health literacy.

Maxia

References

Agency for Healthcare Research and Quality (AHRQ). (2015). Use the teach-back method: Tool #5. Retrieved from https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2-tool5.html.

Manchester, J., Gray-Miceli, D. L., Metcalf, J. A., Paolini, C. A., Napier, A. H., Coogle, C. L., & Owens, M. G. (2014). Facilitating Lewin's change model with collaborative evaluation in promoting evidence based practices of health professionals. Evaluation and Program Planning, 4782-90. doi:10.1016/j.evalprogplan.2014.08.007

Montague, E., Chen, P., Xu, J., Chewning, B., & Barrett B. (2013). Nonverbal interpersonal interactions in clinical encounters and patient perceptions of empathy. Journal of Participatory Medicine. 5(33). Retrieved from https://participatorymedicine.org/journal/evidence/research/2013/08/14/nonverbal-interpersonal-interactions-in-clinical-encounters-and-patient-perceptions-of-empathy.