There are 4 types of factors that could result in possible barriers to communication during holistic assessment:
Prior to the holistic health assessment, you should account for such barriers, as they could impact the quality of the information that you gather.
The environment in which a holistic health assessment takes place is very important. Environmental factors that could pose as possible barriers could be:
· Noise: When children accompany parents, it is important, when possible, to keep the children engaged in some form of play or activity in a way to minimize disruptions. In addition, noise from the bells, telephones, etc in the department could be avoided by using an admissions room for the health assessment.
· Temperature: A room that is either too cold or too hot could pose a barrier with communication during the health assessment.
· Privacy: Allowing for privacy, by having an admissions room available, is always a good option.
· Uniform: The white coats of staff (doctors, nurses) could possibly intimidate patients.
The main method of communication between the staff and the patient is through language; therefore, it is essential for you to understand your patients language and vice versa.
Some tips for avoiding this barrier are:
· Avoid jargon.
· Speak clearly and slowly.
· Use trained interpreters or translators, when necessary.
· Have a bilingual liaison service accessible.
Other cultural factors to overcome are health beliefs and values. It is important to understand your patients cultural differences. For example, Vietnamese don’t generally encourage expression of strong emotion).
Some physical disorders exhibited by patients can be connected to communication difficulties. Examples may include:
· Stroke: A patient may have difficulty speaking; you may want a close relative to assist in gathering information regarding the patient.
· Heart/Lung Conditions: A patient may produce breathlessness; veer toward asking open-ended questions to the patient.
· Deafness/Blindness: Use Braille when necessary for patients who have a combination of deafness/blindness. Don’t assume all patients exhibit both physical disorders.
There are several other physical conditions that may impede communication between a health care professional and the patient during the health assessment. These may include:
Age: When talking to an elderly patient, face the patient to allow for lip reading; speak slightly louder than normal and in good lighting conditions; when a patient has a hearing aid, ensure he/she is wearing it and it’s turned on; be sensitive to the needs of the elderly. Avoid discrimination and communicate respect, acceptance, warmth, and empathy to aid in the information-gathering process.
Mental State: Emotions, which can be displayed differently by patients, can impede communication during a health assessment. Tips for dealing with this barrier are:
· Explore how the client is feeling through open-ended questions.
· Use close up observation to elicit any pent-up emotions.
· Use active listening skills to help allay fears and enhance the communication process during the health assessment.
Learning Disability: Another barrier to communication during a health assessment could involve a patient with a learning disability. Tips for dealing with this barrier are:
· Use diagrams, videos and special communication techniques such as Makaton.
· Demonstrate patience, respect and warmth.
Subject: Sometimes the subject being discussed by the healthcare professional is uncomfortable for the patient. Tips for dealing with this barrier are:
· Be sensitive during the assessment process.
Patient Unable to Ask Questions: Sometimes patients have questions to ask, but do not do so. Tips for dealing with this barrier:
· Create an atmosphere which encourages questions.
Use of Computer-Mediated Communication: The use of computers is common in healthcare today. Some patients are concerned about confidentiality. Tips for dealing with this barrier are:
· Be sensitive in the use of computers.
· Ensure maintenance of confidentiality.