سال انتشار: ۱۳۸۶

محل انتشار: دومین همایش سراسری طب اورژانس

تعداد صفحات: ۲

نویسنده(ها):

MORAD ALI AHANGAR – ARTESH UNIVERSITY OF MEDIALSCIENCE BEAST (AIR FORCE) GENERAL OSPITAL

چکیده:

Patient-physician communication is an integral par1 of clinical practice. When done well, such conmunication produces a therapeutic effect for the patient.
To address the area of clinician-patient communication, the 4 Es (Engage, Empathize, educate, and Enlist) are clinician communication tasks that are associated with positive outcomes, including improved clinician and patient ,reduced . reduceice malpractice clain~s,i ncreased patient adherence, and improvement in patient health outcomes. When coinbil~ccl wirh the communication tusks of "opening" and "closing" the encounterand the
clinical task? of diagnostic reasoning and treatment planning. the 4 Es contribute to a contributemodel of clinical care
the opening segment:
Introduce self: role, name.
Greet the patient by name.
Welcome the patient .
Maintain eye contact.
Engagement:
Join.
Orient to role
Orient to process
Elicit the agenda.
Elicit the patient’s story of illness
Reflective listening.
Empathy:
Acknowledgefacial and bodily expressions.
Eliminate physical barriers.
Reflect feeling, concerns ,values.
Normalize and express understandability.
Self – disclose ,when appropriate .
Avoid judgmental statements of responses.
Educate:
Aesces baseline knowledge, understanding and self-diagnosis .
Tell – Provide information that is matched topatient’s neess.
Address the following common areas of concern:
AJdress the following common orals of Lollcern:
Mysteries of health .
-What has happened to me (diagnosis)?
– Why has it happened to me (etiology)?
– What is going to happen to me (prognosis)’?
Mysteries of the medical world .
-What are you (they) doing for me (to me)?
– Why are you (they) doing this rather than that?
-Will it hurtme or harm me? How much? How long?
– When and how will you know what this all means’?
– When and how w111 I know what this means?
Assure understanding :
Ask about understanding
Clarify, correct, and reinforces
The closing segment:
-Anticipate and forecast discharge .
– Summarize diagnosis , treatment, prognosis.
Review next steps:
-Follow-up: who, when, where ?
– Role of family and other caretakers
What to do if problems arise?
Say goodbye and express hope.