Principles of effective communication

Effective communication

To be effective, communication should be planned.
The notion of agendas is important to understanding communication. An agenda refers to what a person wants to achieve or say during a conversation with another person.
There are always likely to be two agendas: our agenda and the agenda of the person with whom we are in conversation.
Take time at the start of an encounter to find out if there is anything the patient wants to discuss or ask: establish their agenda.
In general, go with the patient’s agenda before your own.
Communication is not just about relaying factual information, but it is also about having the skills and confidence to allow people to disclose how they perceive and understand situations, as well as express their fears, worries and concerns. These are likely to be at the forefront of a person’s mind if he/she is living with a life-threatening or life-limiting illness.
We need to show recognition and understanding of what another person is attempting to communicate to us.
Patients do not always expect problems to be fixed. Many problems cannot be fixed by anyone, regardless of how skilled or experienced they might be.

Facilitation skills

These are verbal and non-verbal skills we use to enable individuals to discuss issues important to them (Thorne et al., 2005).

Pick up cues. Cues are hints we all use at times to guide the person we are talking to about what is really on our mind and what we would like to talk about. By picking up cues, we are able to focus on the other person’s agenda more quickly and make the best use of limited time.

Use open questions. These are questions that require more than a ‘yes’ or ‘no’ response. For example, ‘How did you feel when you came into hospital?’

Use summary during a conversation. Summarise what you understand the person has said. This shows the person you have been listening. Summaries also help to slow the pace of a conversation and allow people to reflect on what they have said.

A screening question, such as ‘Is there anything else?’, follows a summary to establish if there are some additional issues the person would like to discuss. Screening may elicit the most important concern.

Show empathy. Empathy is acknowledging the feelings and emotions you sense in a person’s words and body language. For example, ‘I can see this has been a really upsetting time for you’; ‘I get the feeling that you don’t know what to do at the moment’. Showing empathy helps to build rapport and foster trust as it shows you are truly listening to what is both said and implied.

Summary and empathy are skills that enable you to show rather than claim understanding. Instead of saying, ‘I understand what you’re going through’, show your understanding by summarising effectively and by commenting upon the emotion underpinning a person’s words and behaviour.