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DOMAIN 1-Communicating
with the Patient
Identifying
the Problem
- Bring relevant
medical and psychosocial knowledge to the encounter
- Elicit complete
and accurate information
- Perceive essential
data
- Form and test
hypotheses (problem-solving)
- Identify psychosocial
and other contextual variables-Role of family members and significant
others, support systems, psycho-emotional states, developmental states,
altered cognitive states, stigmatizing conditions, socio-economic problems,
language and culture, sexual orientation, spiritual/religious, other
limitations in ability to communicate
Developing
and Maintaining Relationships
- Elicit the patient's
perspective
- Respect the patient
as a unique individual
- Demonstrate professionalism
Education and
Counseling
- Assess health
literacy, using the psychosocial and contextual variables identified
above.
- Use non-technical
language while explaining the recommended course of action
- Elicit and address
questions
- Confirm patient's/family
member's understanding
- Negotiate a mutually
agreeable treatment plan
- Educate patient
about the implementation of treatment plan
- Facilitate behavioral
change
Specific Applications
Settings
New patient interview, established patient interview, Chronic condition,
Non-adherent patient, health maintenance visits, problem-focused interview
(acute), family interview, patient interview utilizing medical interpreter,
telephone interview, e-mail communication with patient.
Situations
Advance Directives, Bad News (diagnosis, errors, sub-optimal results,
etc.), Informed Consent, Limitation of Treatment (DNR, DNI, etc.), Organ
and Tissue Donation, HMO/Insurance Limitations, abusive relationships,
substance abuse, genetic counseling.
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