UNIT 4 PATIENT-CENTRED COMMUNICATION

A IN THE PATIENT’S SHOES

1 You are going to watch two clinical consultation videos. 16, 17 Make notes based on the questions below.

Consultation 1
Is there anything the doctor could improve on?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

What do you notice about his verbal and non-verbal communication?

……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

How do you think the patient felt?

……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

Consultation 2
What does the doctor do differently?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

What do you notice about his verbal and non-verbal communication?

……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

How do you think the patient felt?

……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

2 More often than not, people are not overly excited to visit doctors. Try to put yourself in the patients' shoes
and think why that is so. The questions below will guide you.18

1 What things can consciously or unconsciously affect the doctor-patient relationship?

…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
2 Why might some patients feel nervous or anxious before seeing a GP?
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
3 Why might they feel even more anxious if they are in hospital?
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………

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 UNIT 4 PATIENT-CENTRED COMMUNICATION

4 How might hospital staff (doctors, nurses, administrators etc) or the hospital
environment increase patient anxiety?
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………

B PATIENT CENTRED-COMMUNICATION

1 The table below contrasts two healthcare models – the patient-

centred model (generally promoted in healthcare training and
practice) and the medical model (more traditional, also referred to as
disease focused or paternalistic).
Read the five points of the patient-centred model. Then consider the
medical model and complete the five points. Number 1 is done as an
example.5

MEDICAL MODEL1 PATIENT-CENTRED MODEL

Patient's role is passive. Patient's role is active.

1
Patient is quiet. Patient asks questions.

Patient is a partner in the treatment plan.

2
Patient asks about treatment options.

Doctor collaborates with the patient.

3
Offers opinions, discusses pros and cons.

Care is quality-of-life centred.

4 Patient focuses on patient's family and other activities and not
just their illness.

Patient is more likely to adhere to the treatment plan.

5
The treatment accommodates the patient's culture and values.

2 A patient-centred approach to care is based on three goals2:

- eliciting the patient’s perspective of their illness

- understanding the patient’s psychosocial context, which looks at how
the patient’s environment affects their physical and mental well-being
- reaching shared treatment goals based on the patient’s values

1 The medical model may also be referred to as disease-centred, disease-focused, doctor-centred etc.
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3 You are going to read an article which offers practical suggestions to help doctors remain patient-centred
during their consultations and develop their core communication skills.14
a) Before you read it in detail, first skim read the article and choose the correct heading for each section.

Active listening Effective questioning Efficient explaining Building rapport

A opportunity to tell their story. Open questions such

It is important to create a positive impression and
connection with your patient. If this doesn't come
naturally as you're talking with the patient, you can
demonstrate a positive sense of connection by
noticing the patient's tone of voice, their speed of
speech and the words they use and then subtly
mirroring your responses in order to give them a
sense of familiarity. The same goes for gestures and
body language – if they are sitting in a certain
position, perhaps move yourself into a similar
posture. Appropriate smiling and eye contact can
also go a long way to building a positive, friendly,
interested impression which then encourages the
patient to relax and builds trust with them.
B the back of a patient's mind may be some concerns
You can demonstrate that you are concentrating on
what the patient is saying by giving them time to
finish their sentences and not interrupting early on.
There is evidence to show that there is a 'golden
minute' at the start of the consultation that, if we
allow it to unfold, will elicit a lot of useful
information from the patient and also give them
the sense of being respected and listened to. It also
means listening not just to the content of what
they are saying, by repeating back and
summarising, but also listening to the feelings and
meaning behind what they are saying. For example,
if the patient talks about an elderly relative who
they are caring for, whilst at the same time trying
to cope with worsening back pain. An empathic
statement such as "It must be a strain caring for
your mother and coping with your pain" lets the
patient know that you are both listening and
attempting to understand their perspective. By
reflecting back to the patient, we demonstrate
empathy.
C received and whether the patient has any
Depending on the stage of the consultation, or the
particular piece of information you want to elicit,
different types of questions can be used. At the
start it is important to give the patient the
as "How can I help you today?" offer an invitation
for them to do so. Once you have uncovered the
presenting complaint and the background, you can
then funnel down to more disease-specific closed
questions in order to aid your diagnosis and rule
out certain conditions e.g. "Do your hands shake?"
Avoid asking multiple questions at the same time as
information may be missed and using tag questions
as these can have an influence on the patient's
response.
Exploring the patient's perspective of their illness
by asking them about their thoughts, e.g. "What
are your thoughts about what is happening?" may
provide some useful background and insight into
their health beliefs relating to their symptoms. At
or worries, which when elicited, may mean that you
can provide more effective reassurance. You could
ask them "Is there anything, in particular, that’s
worrying you?”
D
Most patients want to be more involved in
decisions about their care and the management of
their condition. By discussing treatment options
and their pros and cons doctors can help patients
make more informed choices. This part of the
consultation is vitally important in terms of
encouraging responsibility and imparting
information, as well as facilitating shared decision-
making. However, research has shown that most
patients immediately forget between 40%–80% of
the medical information given to them. We can
improve this by tailoring our explanations more
carefully to what the patient wants to know. It is
also important to give bite-size pieces of
information, rather than a long speech, and to
pause at regular intervals to see how it has been
questions. It is often useful to provide additional
written information in the form of leaflets, or
signpost them to available internet resources.

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b) Match these words and phrases (highlighted in the text) with their definitions.1

to tailor to funnel down informed to worsen to facilitate reassurance

gestures perspective connection insight to mirror to elicit

1 ________________ the relationship of a person, thing, or behaviour to someone or something else

2 ________________
3 ________________
4 ________________
5 ________________
6 ________________
7 ________________
8 ________________
9 ________________
10 ________________
11 ________________
12 ________________
words of advice and comfort intended to make someone feel less worried
to get or produce something, especially information or a reaction
to move on to more specific aspects of something
the ability to have a clear, deep and sometimes sudden understanding of
a complicated problem or situation
to make something possible or easier
movements of the hands, arms, or head, etc. to express an idea or feeling
a particular way of considering something
to copy something; be similar to something
to adjust something to suit a particular need or situation
having a lot of knowledge or information about something
to become more unpleasant, difficult, or severe than before

c) Now read the article more carefully and answer the following questions.

1 What 3 ‘building rapport‘ tips could you use during a consultation?

…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
2 What shouldn’t doctors do during the ‘golden minute‘? Why not?
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
3 Write an empathic statement for a patient who can’t sleep at night because
of a cough which disturbs their sleep.
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………

4 What four different types of questions does the article mention?

Why are/aren‘t they used?
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
5 Why should doctors help patients make informed choices about their treatment?
What are your own ideas?
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………

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4 A doctor's initial contact with their patient is extremely important. It can affect not only the doctor-patient
relationship but also the patient's willingness to adhere to any future treatment plan. The initial contact with
a patient should fulfil the following four objectives. Give each set an appropriate heading. 18

1 2

I'm a medical student (US) / student doctor (UK) working

Good morning, [Jenny], come in, take a seat …
Good afternoon, Mr [Hanks], isn't it?
Hello, can I just check it's [Mr Wang]. We've not met before…
[William Delby]? What would you prefer me to call you?
Hello, Ms [Kavanagh] … Am I pronouncing it correctly?
with Mr [Donaldson].
My name is Dr [da Silva], I'm one of the registrars (UK) /
residents (US) on the ward this evening.
I'm Dr Janowicz. My colleague, Dr [Taylor] …
Dr [Murad] has referred you to me for further investigations. My
name is Dr Lozano and I'm …
Hello, I'm Dr [May], the locum (UK) / doctor covering for (US) with
this practice.

3 4

Your GP asked you to come and see me about your pain. Is that
right?
I've come to have a little chat with you about…
I'd like to spend five minutes with you to ask some questions if
that's OK.
I wonder if we can chat for a few minutes about …
If you don't mind, I'd like to take some notes as we talk.
Do you mind if our medical student (UK)/ student doctor (US) is
present during our chat?
If it's all right with you, I'd like to have a listen to your heart.

5 In the UK the National Health Service encourages patients to play an active role in healthcare consultations
and provides them with a checklist of questions to ask their doctor or healthcare professional. Example
questions, which you might find useful to use during class simulations or in real-life situations, can be found
in SUPPLEMENT at the end of this unit.

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C HISTORY TAKING

1 Healthcare professionals need to be able to take a full and comprehensive history from a patient in
a systematic and professional way. The following history taking sequence is generally used:

- presenting complaint
- history of the presenting complaint
- past medical history including mental health
- medication history
- family history
- social history

The presenting (chief, US) complaint is the problem that brings the patient to the doctor´s surgery or hospital
emergency department. There can be more than one presenting complaint, in particular with elderly patients.

2 Finding out about the history of the presenting complaint involves asking a series of questions in a particular
order. SOCRATES4 is a mnemonic acronym used by health professionals during this stage of the consultation
to evaluate the nature of the symptom(s) that the patient is experiencing using different types of open and
closed questions. It was developed to use with pain symptoms but can also be adapted to use with other
symptoms. Look at the letter and the questions and complete the missing words of the acronym.

LETTER QUESTIONS

S Where does it occur? Where exactly is the pain? Can you point to it?

When did it start? Did it start gradually or suddenly? What were you doing?
Onset
Have you had anything similar before?
What does it feel like? What do you mean by X?
C
Can you describe it to me?

R Does the pain spread/move elsewhere?

When it happens, does anything else happen with it? Any nausea or headache?
A
Have you noticed any other systems?
How long does it last? Minutes, days, weeks? How often does it occur?
T
Does it come and go?

Exacerbating/relieving factors Is there anything that makes it better? Is there anything that makes it worse?

On a scale of 1–10 how bad is the pain if 10 is the worst pain you have ever
S
experienced and 0 is pain free?

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3 Patients often present with pain. Eliciting the nature of the pain is a crucial part of the assessment and helps to
establish the right diagnosis. Match the conditions below with the type of pain they are typically accompanied
by.18

1 migraine A shooting pain

2 period pain B burning pain

3 heart attack /angina C blinding headache

4 sciatica / toothache D crushing pain

5 pins and needles E throbbing pain

6 urinary infection F pounding pain

7 chest pain G stabbing pain

8 headache H cramping pain

9 indigestion I tingling sensation

10 tension headache J gripping pain

4 When describing symptoms, patients and doctors use a variety of expressions including phrasal verbs. Here is
a choice of phrasal verbs, all formed with the particle up. Use their correct forms to complete the sentences
below. (Non-phrasal verb equivalents in the infinitive form in italics have been provided to help you.)
Number 1 is done as an example.18

1 My little girl was coughing so much, she brought up

clog
some yellowish phlegm. vomit, be sick, expel build flare
2 I’ve been having these headaches, the tension
___________, my head is going to explode! increase clear throw

3 You say your stomach ___________ after meal – you

have a bloating feeling, is that right? swell cough dry

4 The eczema seems to have ___________, the UP

hydrocortisone must have done the trick. heal
bring ease
5 His ears are a little _______________ with wax, that’s
why he is having problems with hearing. block
tighten shoot
6 You’ll probably find the pain will ___________ when you
lie down and relax. improve play blow
puff
7 Doctor, the rash has ___________ again. Could I have
a prescription for the cream again? erupt
8 Ms Singh says her chest has ___________, she’s also having difficulty breathing.
become tighter
9 He ___________ last night, he must have eaten something that disagreed with him.
vomit, be sick
10 The pain just ___________ my arm, I don’t know what I’ve done. rise dramatically

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 UNIT 4 PATIENT-CENTRED COMMUNICATION

11 Kieran’s eyes keep ___________, I think he’s got conjunctivitis again. swell
12 Dad says his arthritis is ___________ again, he’s had a lot of pain in his joints.
cause a problem
13 Every winter, my face really seems to ___________, the skin is all flaky. dehydrate
14 The patient ___________ a little bit of blood this morning but seems fine now.
eject from the lungs by coughing

5 Look at the general framework for history taking below and come up with three sample questions for each
stage. The first one has been done.

GENERAL FRAMEWORK FOR HISTORY TAKING

1 Presenting complaint
How can I help you today?
What’s brought you to see me today?
What seems to be the problem?
2 History of presenting complaint (ask questions to get more information about
the presenting complaint and any other symptoms the patient has)
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
3 ‘Past’ medical history (now and past; significant diseases/illnesses; hospital admissions;
surgical procedures/operations; childhood diseases: allergies)
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
4 Medication history (now and past; prescribed and over-the-counter
medications, alternative therapy/medicine; immunisation; reactions to medication)
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
5 Family history (grandparents, parents, siblings and children)
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
6 Social history (diet, exercise, smoking, alcohol, recreational drugs, stress, anxiety, pets,
free time activities, accommodation and living arrangements, marital status, occupation)
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………

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D REFLECTION
Feeling
Before you put your knowledge of history taking and
patient-centred communication to use in a simulation, we
are going to look at how to reflect on and make explicit the
learning that takes place during simulated (and real life) Description Evaluation

experiences. Reflection is used extensively in healthcare

training and professional practice in the UK. One of the
most famous models of reflection is Gibbs' Reflective Cycle
which provides a framework for examining experiences
using six distinct stages. The table below presents the stages
and also provides helpful questions to guide you through Action plan Analysis
the reflective process.3
Read the stages and the questions. An example answer for
the description stage has been provided. Conclusion

STAGE HELPFUL QUESTIONS EXAMPLE ANSWERS

Myself and _________ took part in a role play during my

English lesson to practise taking a patient history using the
What was your task/objective?
Description history-taking framework questions and using patient-centred
Who was present? communication skills.
I was the doctor and __________ was the patient.

Feelings What were you feeling or thinking before,

during and after the role play?

What went well?

Evaluation
What didn’t go so well?

Why did things go well?

Analysis
Why didn’t it go well?

Conclusions What skills do I need to develop for me to

do this role play better?

Action plan If I had to do the role play again, what

would I do differently?

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 UNIT 4 PATIENT-CENTRED COMMUNICATION

E SIMULATION

You are now going to put your knowledge of patient-centred

communication and history taking to use in a simulation. One of you
will be a GP and the other a patient. The activity will end when you
complete the ‘social history’ questions. You do not need to diagnose
or offer a treatment plan. You have 20 minutes for the activity which
includes 5 minutes to prepare your character, 10 minutes for the
consultation and 5 minutes for reflection and feedback. After that you
will swap roles and roleplay a new scenario.
After the simulation the ‘doctor‘ will spend a few minutes reflecting on their experience using the questions to
guide them. While the ‘doctor’ is reflecting, the ‘patient’ will be answering questions which will help them give
the ‘doctor’ feedback on their history taking and patient-centred communication skills which they will then share
with the doctor. If the ‘doctor’ feels comfortable they can also share any aspect of their reflection with their
‘patient’ – though it is not a requirement as this is a personal rather than public reflection activity.

LANGUAGE PRACTICE

1 Complete the gaps with appropriate expressions from the box. There are two words you are not going to use.

disposal heart only lack rely secondary red

symptoms order long-term mistaken representas absence interchangeably

The consultation is at the 1 _____________ of general practice. It is the central setting through which primary care
is delivered. As a general practitioner, if you 2 _____________ a clear understanding of what the consultation is,
and how the successful consultation is achieved, you will fail your patients.
Consulting and communication skills are often used 3 _____________, but effective communication skills, while
essential, are only a subset of the knowledge, skills and attitudes required to consult effectively. Within the
consultation your patients 4 _____________ on your skills as a doctor not 5 _____________ to identify any
significant illness, but also its probable 6 _____________. Understanding the epidemiology of illness presenting in
general practice requires a normality-orientated approach, 7 _____________ opposed to the disease-orientated
approach in 8 _____________ care. This approach requires the recognition of 9 ‘_____________ flag’ elements in the
patient narrative which may 10 _____________ a significant illness in its early and undifferentiated stage, where
urgent intervention is needed in 11 _____________ to minimise risk. Physical examination and investigations
should be appropriate, timely and should follow the best available evidence. As a GP, one of the most effective
tools at your 12 _____________ is the use of time, watching and waiting when it is safe to do so, and also using the
continuity of contact with individual patients and their families. The 13 _____________ relationship between you
and your patient acts as a repository for mutual trust and understanding, which enables high-quality care.

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 UNIT 4 PATIENT-CENTRED COMMUNICATION

2 Complete the gaps with the correct forms of the verbs in the box.

delay jog recognize remain visit

An accurate family history is a well-established method for 1 _____________ genetic disorders and susceptibilities
that may present risks for future health problems. It 2 _____________ one the most powerful 'genetic tests' to
identify individuals at risk from inheritable diseases when laboratory tests are not available. Early identification of
families with increased risk of chronic diseases such as heart disease, diabetes and certain cancers can often
improve, 3 _____________ or even prevent adverse health outcomes to individual members.
However, patients are only human, and many people have bad memories. Unless patients 4 _____________ the
doctor regularly, they are unlikely to have all the information about their past medical history at their fingertips.
Doctors are advised to encourage by 5 _____________ their memory: What about injuries [when you were at school]?
What about [sports / DIY injuries]?

3 Complete the gaps with the most suitable option (A–D).

1 When your skin gets too dry, it can easily become brittle, scaly, or rough, which can lead
to an eczema ________.
A flare up B flash C rush D explosion

2 ________ to medical care may affect how a patient knows about his family members' medical history.
A Permission B Admission C Access D Contact

3 Patient may have greater difficulty ________ family history than their own past medical history.
A reminding B restoring C recalling D ringing

4 There may be difficult family issues involved, and patients may be ________ to discuss these.
A unfavourable B reluctant C involuntary D against

5 In patient-centred care the doctor tries to meet the patient’s expectations while ________ clinical evidence.
A respecting B disregarding C ignoring D dismissing

6 Specifying ________ and character of their pain is not always an easy task for patients.
A transmission B production C circulation D radiation

7 ________ the patient´s medical record while the patient is speaking is considered unprofessional
behaviour.
A Reviewing B Noticing C Recollecting D Concerning

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 UNIT 4 PATIENT-CENTRED COMMUNICATION

4 Complete the gaps with the most suitable words from the box.9

goes throbbing like sensations

once spinal no needles

Phantom pain is pain that feels 1 _____________ it's coming from a body part that's 2 _____________ longer there.
Doctors 3 _____________ believed this post-amputation phenomenon was a psychological problem, but experts
now recognize that these real 4 _____________ originate in the 5 _____________ cord and brain.
Characteristics of phantom pain include:
- pain that comes and 6 _____________ or is continuous
- pain that may be described as shooting, stabbing, cramping, pins and 7 _____________, crushing,
8 _____________ or in other words pulsating, or burning.

USEFUL EXPRESSIONS

sb – somebody, sth – something

to affect one´s concentration mít dopad na schopnost to confirm a ~ potvrdit diagnózu; to establish a ~
soustředit se určit / stanovit diagnózu, to receive a ~ obdržet
allergic to dust alergický na prach diagnózu
allergy alergie to die from / of zemřít na
alternative medicine alternativní medicína disease onemocnění, nemoc
angina silná svíravá bolest childhood ~ dětská nemoc; chronic ~ chronické
anxiety úzkost onemocnění; heart ~ srdeční onemocnění;
anxious úzkostný, úzkostlivý inheritable ~ dědičné onemocnění; significant ~
appendix slepé střevo významné onemocnění
to have the ~ removed nechat si odstranit slepé ~-centred/-focused na nemoc zaměřený
střevo disorder porucha
arthritis artritida, zánět kloubů genetic ~ genetická porucha
at one's disposal někomu k dispozici to recognize a ~ rozpoznat poruchu
to build up nashromáždit se, akumulovat se, to do exercise cvičit
zvyšovat se doctor lékař
care péče specialist ~ lékař specionalista; student ~ medik (na
high-quality ~ vysoce kvalitní péče; primary ~ praxi)
primární péče; secondary ~ sekundární péče ~'s surgery ordinace lékaře
approach to ~ přístup k péči ~ covers for (another doctor) lékař zastupuje
communication skills komunikační dovednosti (jiného lékaře)
complaint / concern neduh, nemoc, potíž to make an appointment with a ~ objednat se u
chief / presenting ~ (hlavní) důvod návštěvy lékaře
lékaře to visit a ~ navštívit lékaře
conclusion shrnutí, závěr eczema ekzém
to cough up vykašlávat ~ clears up ekzém se vytrácí, mizí
diagnosis (sg.), diagnoses (pl.) diagnóza empathic empatický
differential ~ diferenční diagnóza evaluation hodnocení
evidence (sg., pl.) poznatky, důkazy
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 UNIT 4 PATIENT-CENTRED COMMUNICATION

available ~ dostupné poznatky, důkazy lump boule, hrudka

to disregard ~ nebrát v potaz / ignorovat poznatky, marital status (rodinný) stav
důkazy medication lék
examination / investigation vyšetření over-the-counter ~ volně prodejný lék
to facilitate napomoci, umožnit, usnadnit ~ prescribed by a doctor lék předepsaný lékařem
factor factor reaction to ~ reakce na lék
exacerbating ~ přitěžující faktor; relieving ~ migraine migréna
zmírňující factor to mirror odrážet, zrcadlit se, představovat
framework rámec medication lék, léky
to provide a ~ poskytnout rámec to collect ~ from a pharmacist vyzvednout léky v
from the outset “hned od začátku” lékárně
general practitioner (GP) praktický lékař mobility hybnost, mobilita
gesture gesto reduced ~ snížená hybnost
grandparents prarodiče model model
maternal ~ prarodiče z matčiny strany; paternal ~ healthcare ~ model zdravotnictví; medical ~
prarodiče z otcovy strany medicínský model; paternalistic ~ paternalistický
headache bolest hlavy model; patient-centred model zaměřený na
health zdraví pacienta
mental ~ mentální zdraví overweight mající nadváhu
~ literacy zdravotní gramotnost; ~ outcomes pain bolest
zdravotní výsledky back ~ bolest zad; burning ~ pálivá bolest;
to improve ~ zlepšit zdraví cramping ~ křečovitá bolest; crushing ~ drtivá
heart attack srdeční záchvat, infarkt bolest; chest ~ bolest na hrudi; gripping ~ svíravá
to have a sore throat mít bolesti v krku bolest; period ~ menstruační bolest; pounding ~
hospital admission hospitalizace bušivá bolest; phantom ~ fantomová bolest;
history zde: anamnéza shooting ~ vystřelující bolest; ~stabbing ~ bodavá
family ~ rodinná anamnéza; medical ~ anamnéza; bolest; throbbing/pulsating ~ pulzující bolest
medication ~ farmakologická anamnéza; social ~ ~ symptom symptom bolesti
sociální anamnéza nature of ~ povaha bolesti; onset of ~ nástup
neck krk bolesti; radiation of ~ vyzařování bolesti
immunisation očkování ~ in bolest něčeho, v něčem
impression dojem to ease (up) ~ uvolnit bolest; to cope with ~
to create a positive ~ vytvořit pozitivní dojem vypořádat se/vyrovnat se s bolestí
infection infekce ~ eases (up) bolest polevuje; ~ comes and goes
urinary (tract) ~ infekce močových cest bolest je střídavá (přichází a odchází); ~ lasts bolest
information (sg., pl.) informace trvá; ~ moves/spreads bolest se rozšiřuje; ~ occurs
additional ~ dodatečné informace; bite-size piece bolest se vyskytuje; ~ shoots up bolest vystřeluje
of ~ stravitelná informace (z hlediska množství); pancreatic cancer rakovina slinivky břišní
reliable ~ spolehlivé informace; written ~ psané patient pacient
informace elderly ~ starší pacient
to elicit ~ získat informace (obvykle nepřímo); to ~-centred communication komunikace zaměřená
impart ~ předat informace na pacienta; ~consultation konzultace s pacientem;
informed choice informovaná volba ~'s expectations pacientova očekávání; ~'s medical
to make an ~ učinit informovanou volbu record zdravotní karta pacienta; ~'s ; ~'s
insight into vhled do perspective on/of pacientův pohled na; ~'s
illness nemoc response reakce, odezva pacienta; P~ Union svaz
epidemiology of the ~ epidemiologie nemoci pacientů; ~'s values pacientovy (mravní apod.)
locum zastupující lékař hodnoty;
to lose weight ztrácet na váze

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 UNIT 4 PATIENT-CENTRED COMMUNICATION

to greet a ~ pozdravit pacienta; to increase ~ anxiety reluctant to do sth zdráhat se něco udělat
zvýšit úzkost pacienta; to interrogate a ~ výslýchat risk riziko
pacienta; to interview a ~ vést rozhovor increased ~ for zvýšené riziko
s pacientem; to take the ~'s history odebrat to minimize a ~ minimalizovat riziko; to identify a
pacientovi anamnézu ~ identifikovat riziko; to present a ~ představovat
to pee čůrat riziko
performance výkon (pracovní) patient at ~ of chronic diseases pacient s rizikem
the pill antikoncepce chronických onemocnění
to come off the ~ přestat brát antikoncepci sciatica ischias
pins and needles mravenčení sensation fyzický pocit, vnímání
posture držení těla tingling ~ pocit mravenčení
preferred form of address preferovaný způsob sibling sourozenec
oslovení surgical procedure chirurgický zákrok
prescription recept susceptibility (to) náchylnost, choulostivost
to come for a repeat ~ přijít si pro další recept question otázka
to put sth down to sth/sb připisovat něco multiple ~s mnohočetné otázky; open ~ otevřená
někomu/něčemu otázka; tag ~ otázka s tázacím dovětkem
rapport (harmonický) vztah, vzájemné porozumění to tailor sth to sth zde: ušít na míru
to build ~ rapport with a patient navázat vztah tetanus booster shot přeočkování proti tetanu
s pacientem thirsty žíznivý
rash vyrážka toothache bolest zubů
~ erupts / flares up vyrážka propuká treatment léčba
reassurance ujištění, uklidnění ~ options možnosti léčby; ~ plan plán léčby
reflection on sth reflexe, zamyšlení se nad to adhere to a ~ plan dodržovat léčebný plan; to
reflective cycle reflektivní cyklus, cyklus reflexe suggest a ~ navrhnout léčbu
reflective process process reflexe to vomit / throw up zvracet
to guide sb through a ~ provést někoho procesem white coat effect efekt bílého pláště
reflexe white coat syndrome syndrom bílého pláště
registrar (UK) / resident (US) (zhruba odpovídá to wind down relaxovat
českému) lékař před atestací

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 UNIT 4 CLINICAL COMMUNICATION: PATIENT-CENTRED COMMUNICATION

SUPPLEMENT

PATIENT QUESTIONS TO ASK DOCTORS OR HEALTHCARE PROFESSIONALS

Tests, such as blood tests or scans

What are the tests for?

How and when will I get the results?
Who do I contact if I do not get the results?

Treatment

Are there other ways to treat my condition?

What do you recommend?
Are there any side effects or risks? If so, what are they?
How long will I need treatment for?
How will I know if the treatment is working?
How effective is this treatment?
What will happen if I do not have any treatment?
Is there anything I should stop or avoid doing?
Is there anything I can do to help myself?

What next

What happens next?

Do I need to come back and see you? If so, when?
Who do I contact if things get worse?
Do you have any written information?
Where can I go for more information?
Is there a support group or any other source of help?

During your appointment – if you don´t understand something

Can you say that again? I still don‘t understand.

Can you write it down for me? I don´t understand.

Before you leave your appointment – to check you have understood correctly, to ask further questions

Can I just check I that I have understood what you have said?
Who should I contact if I have any problems or any questions?
Are there any support groups available?
Where should I go for reliable information about my condition?

After your appointment

What happens if I'm not sent my appointment details?

Can I have the results of any tests? Could you tell me what the results mean?

Source
https://www.nhs.uk/nhs-services/gps/what-to-ask-your-doctor/

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 UNIT 4 CLINICAL COMMUNICATION: PATIENT-CENTRED COMMUNICATION

REFERENCES

1 dictionary.cambridge.org
2 Hashim, M.J. (2017). Patient-Centered Communication: Basic Skills. American Family Physician, (95) 1, Jan 1. Retrieved from:
https://www.aafp.org/afp/2017/0101/p29.html
3 http://etec.ctlt.ubc.ca/510wiki/Educational_Blogging_to_Promote_Reflective_Clinical_Practice
4 https://en.wikipedia.org/wiki/SOCRATES_(pain_assessment)
5 https://instructionaldesignfusions.wordpress.com/2011/03/10/patient-centered-care/
6 https://pharmaceutical-journal.com/article/ld/how-to-provide-patients-with-the-right-information-to-make-informed-
decisions
7 https://u.osu.edu/infectiousmononucleosis2/evidence-based-management/
8 https://u.osu.edu/infectiousmononucleosis2/pathophysiology-and-clinical-presentation-correct-diagnosis/
9 https://www.healthline.com/health/white-coat-syndrome
10 https://www.mayoclinic.org/diseases-conditions/phantom-pain/symptoms-causes/syc-20376272
11 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5673148/
12 https://www.nhs.uk/conditions/type-2-diabetes/getting-diagnosed/
13 https://www.rcgp.org.uk/GP-training-and-exams/~/media/Files/GP-training-and-exams/Curriculum-2012/RCGP-Curriculum-
2-01-GP-Consultation-In-Practice.ashx
14 https://www.themdu.com/guidance-and-advice/guides/consultant-pack/staying-patient-focused
15 https://www.verywellhealth.com/reasons-people-dont-go-to-the-doctor-4779661
16 https://www.youtube.com/watch?v=-1Ba9juSMfM
17 https://www.youtube.com/watch?v=-JSxDoNzy0g
18 McCullagh, M., Wright, R. (2007). Good Practice. Communication Skills in English for the Medical Practitioner. Student's Book.
CUP
19 McCullagh, M., Wright, R. (2007). Good Practice. Communication Skills in English for the Medical Practitioner. Teacher's Book.
CUP

Pictures
Google Images

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