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Assessment  Reading

 Explanation and planning

Providing the correct amount and type of information

 Aims: to give comprehensive and appropriate information

           to assess each individual patientís information needs

           to neither restrict or overload

          Chunks and checks: gives information in assimilable chunks, checks for understanding, uses patientís response as a guide to how to proceed

         Assesses patientís starting point: asks for patientís prior knowledge early on when giving information, discovers extent of patientís wish for information

         Asks patients what other information would be helpful e.g. aetiology, prognosis

         Gives explanation at appropriate times: avoids giving advice, information or reassurance prematurely

 Aiding accurate recall and understanding

 Aims: to make information easier for the patient to remember and understand

         Organises explanation: divides into discrete sections, develops a logical sequence

         Uses explicit categorisation or signposting (e.g. ďThere are three important things that I would like to discuss. 1st...Ē ďNow, shall we move on to..Ē)

         Uses repetition and summarising: to reinforce information

         Use of language: uses concise, easily understood statements, avoids or explains jargon

         Uses visual methods of conveying information: diagrams, models, written information and instructions

         Checks patientís understanding of information given (or plans made): e.g. by asking patient to restate in own words; clarifies as necessary

 

Achieving a shared understanding: incorporating the patientís illness framework 

Aims:   to provide explanations/plans that relate to the patientís perspective of the problem

           to discover the patientís thoughts and feelings about the information given

           to encourage an interaction rather than one-way transmission

 

         Relates explanations to patientís illness framework: to previously elicited ideas, concerns and expectations

         Provides opportunities and encourages patient to contribute: to ask questions, seek clarification or express doubts; responds appropriately

         Picks up verbal and non-verbal cues e.g. patientís need to contribute information or ask questions, information overload, distress

         Elicits patient's beliefs, reactions and feelings: re information given, terms used; acknowledges and addresses where necessary  

 

Planning: shared decision making

 Aims:   to allow patients to understand the decision making process

           to involve patients in decision making to the level they wish

           to increase patientsí commitment to plans made

         Shares own thoughts: ideas, thought processes and dilemmas

         Involves patient by making suggestions rather than directives

         Encourages patient to contribute their thoughts: ideas, suggestions and preferences

         Negotiates: negotiates a mutually acceptable plan

         Offers choices: encourages patient to make choices and decisions to the level they wish

         Checks with patient: if accepts plans, if concerns have been addressed

 

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