Communication
Compassionate Communication
When discussing emotional issues and worries:
- Think about the environment, is there privacy?
- Build rapport – ask about skills & strengths as well as problems.
- Respect and validate the patient’s experience.
- Avoid confrontation and resistance.
- Reflective – check understanding.
- Be non-judgemental, ask open questions.
- Containing distress, overcoming the pressure to ‘fix things’ for the person can be difficult.
Questions to ask
- It sounds like you are worried about your breathing…is that right ?
- You say you feel panicky, how does this affect you ?
- It sounds like you have been having a difficult time…what has helped you manage?
- Let me check I’ve understood what you’ve said?
What does having a respiratory condition mean for the individual?
Patients can respond to their diagnosis in many ways, sometimes all of these ways at the same time. There is no right or wrong way. *Greer & Watson 1987
Challenge (Showing fighting spirit – ‘I’ll beat this).
Threat (Anxious preoccupation – ‘I’m so worried about my health’).
Fatalism (It’s just one of those things you have to live with, what will be will be).
Harm, loss or defect (Helplessness, hopelessness – ‘what’s the point, there’s nothing I can do’).
Denial (Avoidance – ‘there’s nothing wrong, it’ll all be fine’).
Individuals generally know what they are worried about. They might not feel comfortable about raising these worries with you. For example they might be embarrassed to voice worries about their finances or scared to say they are worried about dying. Compassionate and sensitive questioning can help identify what these worries are. There are tools available which can help structure these conversations:
- SWIFT a tool to help build up a picture of how someone is coping. Produced by NES NHS Education for Scotland:
- The SWIFT Check Up [.pdf]
Listening and trying to understand what the persons respiratory condition means to them can help give us insight into how it may be affecting their mental wellbeing and what resources and support they have to deal with their condition. Obviously not all people respond in the same way to a diagnosis of a respiratory condition and you may see a range of reactions as they adjust to what their respiratory condition means for them.
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Click on the links below for additional resources to help with conversations about mental wellbeing.
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