Body Language by VIJAYA KUMAR
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The patient should be placed in a comfortable position. Present condition of the patient can be enquired through open questions. Most of the patients will be aware of the seriousness of the condition, and some may even know their diagnosis. The physician is then in a position of confirming bad news rather than breaking it.
The history, the investigations, the difficulties met in the process etc need to be explored. The dynamics of the family and the coping reservoir of the patient are very important in delivering the bad news.
Try to involve the significant other people of the patient in the decision-making process, if allowed by the patient. At least few patients may respond in a bizarre way to the bad news. Hence, a careful exploration of all these points should be carried out.
A common tendency from the physicians is that they jump into premature re assurances. Premature reassurance occurs when a physician responds to a patient concern with reassurance before exploring and understanding the concerns. The prognosis can be explained in detail; with all available data. A reasonable conclusion based on the facts can be presented. A warning shot is desirable, so that the news will not explode like a bomb.
Euphemisms are welcome, but they should not create confusion. The patient has the right to know the diagnosis, at the same time he has the right to refrain from knowing it. Hence, announcement of diagnosis has to be made after getting consent. The body language of both the physician and patient is very important, and the physician is supposedly a mirror image of the patient.
The embarrassment, agony, and fear of the patient should be reflected in the physician mirroring the emotions , so that the patient will identify the physician as one close to himself.
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Announcement of the bad news must be in straightforward terms, avoiding the medical jargon completely. Lengthy monolog, elaborate explanations, and stories of patients who had similar plight are not desirable. Information should be given in short, easily comprehensible sentences. A useful rule of thumb is not to give more than three pieces of information at a time. People listen to their diagnosis differently. They may break down in tears. Some may remain completely silent, some of them try to get up and pace round the room.
Sometimes the response will be a denial of reality, as it protects the ego from a potential shatter.
A gallows humor is also an expected behavior. Adequate space for the free flow of emotions has to be given. Most of the time, patients will not actively listen to what the physician say after the pronouncement of the status. It involves asking the patient to recount what they have understood. Be clear that the patient did not misunderstand the nature of disease, the gravity of situation, or the realistic course of disease with or without treatment options.
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While trying to kindle the emotions, care has to be taken not to utter any unrealistic treatment options. The patient and their relatives will cling on to it, and subsequently feel embarrassed because of its unrealistic nature. Answers have to be tailored to the question, and physician should stay away from lecturing to the patient.
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Lecturing occurs when a physician delivers a large chunk of information without giving the patient a chance to respond or ask questions. Dealing with denial is another difficult task.
It may be necessary to challenge denial because the patient may have some important unfinished business to conduct, or because the patient is refusing treatment that might alleviate symptoms. In such situations, attempts to break the defense without mutilating the ego should be attempted. The physician has to summarize the session and the concerns expressed by the patient during the session.
It essentially highlights the main points of their transaction. Madhu's recital was embedded with gamakams that amazed the audience. The performance was organised by Ernakulam Kathakali Club and Ernakulam Karayogam in connection with the Navaratri celebrations. Already have an account? Sign in. Sign up for a day free trial. Sign Up.
Kochi Startup Village chief Sanjay Vijayakumar appointed USISTEF member
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We brief you on the latest and most important developments, three times a day. Our plans enhance your reading experience. Support quality journalism - Subscribe to The Hindu Digital. Kalamandalam Balasubramaniam and Margi Vijayakumar shone in their roles of Bahuka and Damayanti respectively. Do you wish you could understand the communicative signals of others better?
This book is a comprehensive guide to the language of body postures and gestures.
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It makes interesting reading, and has pictures detailing the gestures and the meanings they convey. It enables you to interpret the body language of yourself and others.
Sagar Vijay Kumar Agrawal - Trainer in Koti, Hyderabad
A must for success in effective communication. Table of Content What is Body Language? Limb Barriers 7. Eye Signals 8. Other Popular Gestures 9. Kindle Edition , pages. More Details Friend Reviews. To see what your friends thought of this book, please sign up. Lists with This Book. This book is not yet featured on Listopia.