Providing clear and simple instructions reduces patients’ uncertainty and fear when confronted with bad news
As health care providers know, the provider-patient interaction sometimes can be very challenging. Getting individuals to alter their behaviors or attitudes is never easy, especially when it involves asking people to change something that has been habitual for years. This task becomes even more difficult when it’s due to a health crisis.
When dealing with a health crisis, uncertainty is a major roadblock for providers dealing with patients. Uncertainty has been shown to produce a negative impact in humans, especially surrounding crises. Uncertainty, as commonly defined in research, is an inability to predict or explain outcomes. By nature, crises cause an individual’s environment to suddenly become chaotic. Put in this situation, their ability to fully understand what is happening, or to be able to know what will happen in the immediate future is compromised. The uncertainty this causes, and the resulting stress and anxiety that emerges, creates a problematic situation not only for the patient but also the health care provider.
According to work published by the CDC, experiencing a crisis affects how people process information. The emotional impact caused by uncertainty in a crisis can lead them to engage in behaviors where they simplify messages, fall back on “tried and true” beliefs or habits, and often stress the importance of confirmation of information.
Furthermore, patients are less likely to listen, or at least retain, information when given a lengthy medical diagnosis. To their potential detriment, patients will also rely on past practices that worked for prior health issues, even if these actions prove counteractive to their current condition. This means that health providers may find patients who normally accept and follow instruction are actively seeking second or third opinions as confirmation, delaying adoption of diagnoses. Or, in worst case scenarios, an increase in disinformation due to increased information seeking (and less critical analysis) by the patient, which health providers must then counteract.
So how can health providers use communication strategies to reduce the crisis impact? First, understand that the presence of a crisis is not just about the symptoms, but also about the cognitions that go with it. Often, health professionals are concerned with addressing the threat (often physical) presented by a crisis. This is not only to help the victim impacted, but hopefully to stem the tide of the crisis itself.
However, there is also a psychological component to crises that intensifies the impact on the victims, which can impede health professionals’ efforts and make the crisis worse. Health professionals must make sure they are incorporating efforts to explain and provide, to the best of their ability, information to patients about the nature of the crisis and its impact. Efforts, no matter how small, that provide better explanatory and predictive abilities to the patient will help reduce the uncertainty, turning the chaotic nature of their current situation toward a more stable and certain outcome.
Second, health professionals should carefully consider the content of their communication and its format. Patients in a health crisis have trouble processing complex information and can often rush to conclusions that might be counterproductive. Patients in touch with their providers on a “normal” basis, such as walk-in visits and annual check-ups, are even more susceptible. Health professionals should make sure to keep it simple. Refrain from providing diagnoses in a complex fashion, with medical terminology. Utilize short simple sentences, and do not be afraid of repetition. When giving instructions, try to keep it to a maximum of three to five steps. Also, rely heavily on the practice of having the patient repeat back the information.
Third, patients may attempt to fall back on past practices and behaviors to deal with the health crisis. Providers should stress the unique nature of this crisis and highlight how it requires unique treatment.
Finally, understand that a patient’s need for confirmation from multiple sources heightens during a health crisis. Providers must be prepared to incorporate multiple sources in their diagnosis or emphasize that their diagnosis is supported by other professionals or organizations. Showing that the diagnosis is coming from the field/discipline and not solely from the provider themselves will go a long way toward persuading the patient to accept it. Providers also need to be aware of potential misinformation surrounding the crisis and address it with the patient. It is also important to note that just because patients don’t express counternarratives doesn’t mean they are not aware of them.
Health crises are unique situations that must be treated as the special circumstances they are. Individuals impacted by a crisis possess a heightened need for information, unfortunately coinciding with a reduced ability to process it. By increasing awareness of what is happening cognitively, as well as physically to patients, health professionals can better understand the needs of patients and adapt their communication to increase its effectiveness. Doing so will lead to more effective treatment while potentially reducing the impact and duration of the patient’s health crisis.
Christopher Morse, PhD, is professor and chair of the department of communication at Bryant University.