Health Communications

Communication

Skills

for the

Health Care

Professional

Concepts, Practice, and Evidence

Gwen van Servellen

CHAPTER 15

Chapter 15
Communicating with Patients in Crisis

Objectives

Define crisis response
Individuals and groups in crisis
Dysfunctional communication in times of crisis
Relevance of stress and adaptation in periods of crisis
Adaptive and maladaptive coping responses

Objectives Continued

Stressors, coping resources, and stress resistance resources
Differentiate between situational and developmental crisis
Stages of crisis resolution
Interventions to manage highly anxious patients
Interventions to manage agitated and/or confused patients

Definition of Crisis and Crisis Responses

More change is required of an individual than capable to deal with at the time
Assumptions
Not all crises are incapacitating
Persons experience crisis in isolation of others
Persons can worsen each others responses through further excitation
Crisis is not the same as the stressor itself

Dysfunctional Aspects of Crisis Communication

Difficulty in perceiving accurately
Abilities of processing information may be impaired
Ability to express ideas, thoughts, and emotions may be limited
Perceived state of disorganization can increase these deficits

Impact: Over Stimulation and Under Stimulation

Over stimulation
Rapid bombardment or excessive stimuli
Not too much but stimuli are noxious
Exceed tolerance level
Inability to hear, speak, and if they do hear, unable to move

Stress Theories and Understanding Crisis

Levels of anxiety and effects on patients; mild to severe and panic
Stress and adaptation
Lazarus and Folkman (1984) coping always discussed when stress effects are analyzed
Studies of stress of different kinds; and stress of the same kind across several groups of individuals

Adaptive Coping Responses

Seek information
Seek comfort/support from friends or family
Search for solutions to the problem(s)
Self-talk that will help them feel better
Seek professional counseling or advice

Types of Crisis

Developmental Crises: interruption or unsatisfactory passing from one psychosocial task and developmental phase that correspond also to physical developmental growth

Situational: Crisis emanates from precipitating events that occur and are typically out of the person’s realm of expectancy.

Caring for Patients in Crisis

Do not re-victimize in the process of helping
Establish an emotional or psychological connection with the patient and family
Do not challenge the validity of the crisis situation or underestimate its effect
Practice active listening skills, direct straightforward approach, become aware of personal responses and their impact

Summary

Crisis is unavoidable; many illness or injury events can be perceived as a crisis to the patient and family. More needs to be known about the unique expression of crisis across individuals and communities.

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