‘Other’-centred communication

10. ‘Other’-centred communication



The fundamental nature of the health professions as helping professions mandates ‘other’-centred communication. The skill of placing the ‘other’ at the centre of communicative interactions is one that is also beneficial in everyday relationships (Adler et al 2005, Devito 2007, Lauer 2003). Although achieving ‘other’-centred communication is often challenging, it is essential in the health professions and requires effective listening. Listening is the most widely used communication skill in life. Individuals listen every day – some more actively than others. Studies indicate that individuals who listen effectively tend to assume various roles, some of which are in the health professions. Considering the amount of time people spend listening each day it is amazing that effective listening requires practice and conscious effort.






GROUP DISCUSSION






• What is listening? List the necessary abilities to achieve effective listening.


• How do you know someone is listening to you? What non-verbal and verbal behaviours indicate they are listening? How can you establish whether the listener has understood you?

Effective listening as well as skills in speaking, reading and writing are useful for any person to facilitate communication in general life, but are essential for a health professional (Egan 2007, Giroux et al 2002, Harms 2007, Holli et al 2003, Milliken & Honeycutt 2004, Parker 2006, Stein-Parbury 2006).


Benefits of active listening


Effective listening benefits the health professional, the people they assist, and ultimately the outcomes of intervention. The health professional who listens effectively is able to make appropriate decisions that influence the quality of care (Brown et al 2003). When a health professional is committed to effective listening the person seeking assistance feels valued and is more confident in the health professional because of their demonstrated listening skills (Nyström et al 2003). Thus, the therapeutic relationship develops appropriately because of effective listening skills (Egan 2007, Stein-Parbury 2006). In addition, effective listening increases the probability of the fulfilment of mutually established goals (Lauer 2003, Mohan et al 2004).

Specifically, active listening enables the health professional to Assist, Enjoy, Influence, Observe and Understand (AEIOU; Devito 2007; see Table 10.1).



















TABLE 10.1 AEIOU: Benefits of active listening for the health professional
Adapted from Devito 2007© Devito2007
Assist Listening allows the health professional to gather information that promotes collaboration. The information gathered increases the ability of the health professional to assist the ‘other’ in collaborative problem-solving.
Enjoy Listening enables the health professional to enjoy (if appropriate) the thoughts and feelings of the ‘other’. Listening encourages connection and enhances collaborative and trusting relationships with the person seeking assistance and with colleagues.
Influence Listening indicates the interest and concern of the health professional. This encourages the ‘other’ to impart information that produces insights. These insights, once communicated, can positively influence the ideas and responses of the health professional and the ‘other’.
Observe When effective listening occurs the health professional is able to observe the non-verbal messages of the ‘other’. It is the non-verbal messages that often encapsulate the less-obvious needs of the ‘other’. These observations offer the opportunity to validate and sometimes diffuse emotions that may dominate the observed messages.
Understand It is undeniable that listening in combination with validation unravels the complex needs of the ‘other’. The effective listener uses the information gathered to reduce unnecessary events and the likelihood of difficulties while ultimately increasing the possibility of appropriate outcomes.


Barriers to listening


Awareness of the barriers to effective listening prepares health professionals so they can avoid potential hazards that might negatively affect the listening process. There are various external and internal factors that hinder effective listening (see Chs 6& 8). The external (environmental) factors are important and not always obvious. Consideration of external interferences (Stein-Parbury 2006) – including noise levels, distractions and unrelated activity in the space allocated for the interaction – and adjustments where possible will contribute to the understanding of the listener and enhance their confidence. A health professional who continues listening instead of answering a telephone or pager indicates commitment to the needs of the ‘other’ and encourages the development of a therapeutic relationship.

An effective listener attends to the internal ‘noise’ of their emotions before listening, thereby ensuring they can listen unhindered by their needs (Bergland & Saltman 2002). A listener who is not psychologically prepared to listen because they are preoccupied with their own thoughts may misunderstand messages. Alternatively, a listener who is focused on their own ideas and assumptions may also fail to listen carefully if they attempt to predict what they will hear (Purtilo & Haddad 2002).

Individuals may have habitual internal barriers that affect their ability to listen (Gordon 2004; see Ch 5). These barriers fall into three major categories: i) judging; ii) ignoring the needs; and iii) stipulating the solution. Overcoming these barriers is essential for a health professional because they significantly limit the effectiveness of listening.

The language of the listener may hinder the effectiveness of the communication if their ability in the language of the ‘other’ is poor. Mutual understanding requires both communicators to have some level of competence in a common language. Effective listening is impossible without a common language.


Preparing to listen


Effective listening requires preparation and awareness of the factors that contribute to interested and efficient listening. Systematic preparation of the necessary external and internal factors guarantees positive outcomes for the listening process.


Cultural expectations change the requirements for effective listening


Some skills associated with active listening may not be appropriate in some cultures, for example, eye contact (Higgs et al 2005). In some cultures the age and gender of the speaker will affect the expectations of the listener. A factor considered important for effective communication in one cultural context is often inappropriate or unimportant in another culture. For example, the use of direct questions facilitates sharing of information in many western middle-class contexts, while in some indigenous cultures direct questions are offensive. In such indigenous cultures information may be shared through story-telling while performing activities together.

The principle of SAAFETY (see Table 10.2) reminds the health professional of the necessary factors and stresses the importance of a feeling of safety for the ‘other’ when communicating in the health professions.







TABLE 10.2 SAAFETY: Principles of preparing to listen for the health professional



S


A


A


F


E


T


Y


Schedule an interpreter if required to ensure effective communication.


Arrange your mind to enable complete focus and concentration on the ‘other’.


Arrange the seating in a culturally appropriate way and remove physical barriers.


Familiarise yourself with the history and/or culture of the ‘other’.


Environmental factors affect effective listening. Remove all distractions and reduce noise or activity.


Time alone with the ‘other(s)’ is important to ensure privacy.


Y – Why listen? Clarify and understand the purpose of the interaction.



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Mar 13, 2017 | Posted by in NURSING | Comments Off on ‘Other’-centred communication

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