Interpersonal Dynamics and Communications

Chapter 2


Interpersonal Dynamics and Communications



Learning Objectives



image Define at least 10 words relating to the health care worker’s characteristics and abilities.


image Describe the relationship among values, attitudes, and behavior.


image Describe the hierarchy of needs established by Abraham Maslow.


image Identify at least five methods of maintaining good personal health and professional appearance.


image Use a problem-solving system to make a decision that involves identification of alternatives, risks, and evaluation of the outcome.


image Identify the elements of effective communication and at least three factors that might interfere with it.


image Describe at least one example of assertive communication that requests a change in behavior.



Key Terms















Interpersonal Dynamics


To provide adequate care, the health care worker must be able to recognize and accept the values, attitudes, and beliefs unique to each person. The health care worker must consider the diverse cultural and religious background and special needs of individual patients. Some populations may need special care because of their diversity or differences. Examples of populations that need special care include pediatric, geriatric, obstetric, emergency, and disabled patients, and those with chronic or terminal illness. The health care worker also needs to be aware of the differences in culture and religion and how they affect the patient’s view of health care.


Different beliefs about health care may result from cultural diversity. Factors that influence these beliefs include the age, gender, education, religion, ethnicity, and national origin. In Western culture, certain beliefs relate to health care. People generally believe health care can make an illness or injury better. They believe they can control nature and that it is better to do something as soon as possible rather than waiting. They also believe that something that is stronger or newer is better than something weaker or older. Most people of Western culture believe that authority figures are to be respected and trusted with health care decisions. People of other cultures of the world might not share these beliefs. The health care worker must be aware of and sensitive to differences in culture.


When working with a patient from a different culture, the health care worker should follow guidelines that are sensitive to diverse beliefs (Box 2-1). If an interpreter is necessary, the health care worker watches the patient, not the interpreter, when speaking. The health care worker should avoid the phrases “you must” or “you should” and offer reasonable options instead. Important information is repeated more than once.



BOX 2-1   Guidelines for Cultural Awareness





image Brain Byte


In 2008 health care was the largest U.S. industry, employing more than 14.3 million workers.


The health care worker must be able to communicate effectively, provide leadership when necessary, and use technological equipment. The health care worker also must maintain the ethical code of the profession and be aware of the legal considerations of health care. More than any other single characteristic, the health care professional of the future must be flexible to adapt to the changing industry. The industry is changing daily because of new medical discoveries, technological advances, and evolving health concerns.


Interpersonal skills allow an individual to relate with friends, family, co-workers, and patients. Some skills helpful in interpersonal relationships include the ability to communicate well, to act independently by making decisions, and to demonstrate sincere compassion for others.





Self-Awareness


Understanding and accepting the differences that exist among people of different backgrounds rely on an understanding of one’s own values and motives. Understanding and accepting the self leads to development of high self-esteem. Psychologists believe that how a person thinks about an experience determines the feelings and behaviors that result from the event. Each mentally healthy person can choose the feelings that result from events that occur in life.


Personality is the sum of the traits, characteristics, and behaviors that make each individual unique. Behavior is the action of an individual that can be seen by others. Society prefers some behaviors to others. Habits are acts that are performed voluntarily but without conscious thought. Habits can be changed by repetitive behavior changes. Many behaviors result from habit and can be changed by the individual.


The behavior that an individual displays in a situation is seen as a reflection of an attitude. Attitudes are the mental views or feelings formed by an individual or group. With new information and experience, individuals can change their attitudes.


Attitudes are formed from personal values. Values make up the system each individual uses to measure or evaluate the worth of ideas, people, and things in the world. They are formed early in life as a result of the environment and experience. Values are difficult to change. An undesirable value such as prejudice might not even be recognized by the individual who holds it (Fig. 2-1). The sum of the behavior, attitudes, and values that a person exhibits to others is called character.


image
FIGURE 2-1 Values form the basis on which attitudes are formed. Attitudes are reflected by behavior. Behavior is made up of the actions seen by others.

The patient and other caregivers expect certain characteristics, attitudes, and behaviors in the health care worker (Box 2-2). Undesirable behavior can be changed if it is recognized and the desired behavior is practiced.



BOX 2-2   Characteristics of the Health Care Worker




image Communicates concisely and accurately in a clear, well-modulated voice


image Dresses neatly and appropriately


image Maintains controlled and upright posture


image Promotes good health through lifestyle


image Shows patience and poise under pressure


image Remains tactful and courteous at all times


image Has sincere interest in and tries to understand others


image Takes responsibility for own actions


image Exhibits reliability, perseveres to accomplish tasks


image Is able and willing to follow directions


image Is flexible when changes in routine are necessary


image Displays humor but not at the expense of others


image Accepts criticism and makes an effort to improve


image Maintains ethical conduct including promptness, honesty, care of equipment, and respect for the organization’s policies


image Shows initiative in tasks but knows the limits of practice and does not exceed them



image Brain Byte


Most jobs in the health care industry require less than 4 years of college.



Hierarchy of Needs


Psychologist Abraham Maslow created a hierarchy of human needs that is still widely used to understand behavior and motivation (Fig. 2-2). Maslow stated that a person strives to meet the most basic needs first.


image
FIGURE 2-2 Maslow’s hierarchy of needs.

If the needs at the lower levels are not met, the higher needs cannot be reached. The first level describes the most basic needs, including phraseological concerns such as air, shelter, sleep, food, and water. The second level includes safety needs such as protection, order, security, and stability. Family, affection, relationships, and groups are included in the next level, described as “love or belongingness” needs. Esteem needs of the fourth level include achievement, status, responsibility, and reputation.


The fifth level of Maslow’s hierarchy is called self-actualization and includes personal growth and fulfillment. Other people might describe a self-actualized person as self-motivated. Maslow later added three new levels. Between self-esteem and self-actualization, he added “understanding” and “aesthetic beauty.” Understanding includes the need to know and learn. The need for aesthetic beauty describes the emotional need of the artist. Self-actualization was divided into two parts called “self-actualization” (self-potential) and “transcendence”, or the ability to help other people reach their potential.



Task Achievement


Erik Erikson describes eight stages of psychosocial development with tasks that must be completed throughout life to develop an identity (Table 2-1). His theory of personality development states that achievement of a task, or crisis, may be complete, partial, or unsuccessful. The more the task is mastered or completed, the healthier the personality of the individual. A favorable resolution of the task is called a “virtue.” Erikson states that the person must find a balance between the parts of a task. For example, a child who can get dressed independently demonstrates a balance between trust and guilt.




Personal Health


Good personal health is basic for an individual to establish high self-esteem. The World Health Organization defines health as a state of physical, mental, and social well-being. It is not just the absence of illness or injury. The foundation of good personal health, cleanliness, is maintained by a daily routine that includes bathing, using a deodorant, shampooing the hair, and cleaning the teeth (Table 2-2). Nutrition, exercise, sleep, posture, eye care, and good personal habits are also necessary to maintain good health. Some specific daily behaviors that indicate good personal grooming include the use of mouthwash, shaving, nail care, change of undergarments, and clean clothing that fits properly. Health care workers wear minimal jewelry to prevent both its loss and the spread of microorganisms.



First impressions are often based on personal appearance. This impression is then modified by the behavior that is observed. Patients notice the personal appearance of the health care worker’s face, hair, nails, dress, odor, skin, posture, and teeth. Appearance reflects self-esteem and how workers view themselves. The appearance of the health care worker is doubly important because it represents the employer and the worker.



Stress and Time Management


Health care is one of the most stressful occupations. The work affects the most fundamental part of the patient’s and health care worker’s lives. One of the first psychologists who studied stress-related disease was Claude Bernard. He proposed that the body has an “internal milieu,” or need to maintain a consistent internal environment. Canon used the term homeostasis to describe the self-regulating processes of the body, including the “fight or flight” reaction to stress. Hans Seyle noted that many diseases share similar signs and symptoms, such as fatigue, weight loss, aches, and gastrointestinal problems. He stated that these result from a general stress reaction from increased adrenal gland secretions, shrinkage of lymphatic tissues, and increased secretion of hydrochloric acid in the stomach. Seyle proposed that illness results from too small or too large of a reaction by the body’s stress adaptation mechanism (Table 2-3).



Some methods used to manage stress include proper nutrition, exercise, relaxation techniques, and personal behavior changes (Box 2-3). Stress is not the result of events that occur, but rather it is the result of attitudes that are formed about the events. Another stress management technique includes a method of time management.



BOX 2-3   Stress Management Techniques




Time management uses organization of a schedule to maximize effectiveness and productivity. The key to effective time management is planning. The basic tool for planning is a calendar. Learning and meeting the behavioral expectations of the setting help the worker concentrate on the task at hand.



image Brain Byte


Analysts of the U.S. Department of Health & Human Services predict a shortage of 100,000 physicians, 1,000,000 nurses and 250,000 public health workers by 2020.


Setting both short-term and long-term goals increases the probability of accomplishing them. Goals allow a person to establish step-by-step actions toward accomplishing something. Keeping focused on the goal helps one to complete the action steps necessary to reach it. Reaching a goal creates pride and self-confidence. Goals should be clearly defined, measurable, and tangible (Box 2-4).



BOX 2-4   Setting Goals



Tags:
Apr 15, 2017 | Posted by in MEDICAL ASSISSTANT | Comments Off on Interpersonal Dynamics and Communications

Full access? Get Clinical Tree
Get Clinical Tree app for offline access