Building Emphaty

Giving Information

A simple way to be an amazing Communicator

Film Patch Adams

What is Empathy ?

Empathy is the
capability to share
another being's
emotions and
feelings

Building Emphaty (1)

The Basic Formula
Basic empathic understanding can
be expressed in the following stylized
formula:
You feel[name the correct
emotion expressed by the patient)
Because[indicate the correct
experiences and behaviors that give
rise to the feelings].

Building Empathy (2)

Two Stages Process :

Understanding & sensitive

appreciation of another persons
predicament or feeling
Communicate of the understanding
back to patient in a supportive way

Building Empathy (3)

Respond Accurately to patients
Feelings, Emotions and Moods
Respond Accurately to the Key
Experiences and Behaviors in
Patients Stories verbal & non verbal
by
Encouragement
Silence
Repetition
Interpretation

Verbal vs Non Verbal

Verbal
Using open
& close
question
appropriately
Paraphrasing
clarifying

Non Verbal
responses:
Listen attentively
Eye Contact &
smile
Lean forward
Nod your head
Serious mimic
Mirroring

The Empathy Communication

Coding System (ECCS)
Level 0 : Dokter Menolak Sudut
Pandang Pasien
Contoh : Ya, kalau gitu operasi saja
sekarang

Level 1 :Dokter mengenali sudut

pandang pasien secara sambil lalu
Contoh : Dokter sambil menulis,
menyiapkan alat, membalikkan badan

Bylund & Makoul (2005)

Level 2 : Dokter mengenali sudut
pandang pasien secara implisit
Level 3 : Dokter menghargai
pendapat pasien
Contoh : O jadi bapak merasa sedih ya,
bisa diceritakan lebih jauh pak keadaan di
rumah yang membuat bapak sedih

Bylund & Makoul (2005)

Level 4 : Dokter menkonfirmasi
kepada pasien
Contoh : Bapak sepertinya jarang di rumah
ya, apa ada kesempatan olahraga pak?

Level 5 : Dokter berbagi perasaan

dan pengalaman
Contoh : Ya saya mengerti anda berdua
khawatir dengan pengalaman aborsi
anda yang pertama

Other Way of Empathy

Some Things that Should be

Avoided

No response
Distracting questions
Clichs
Interpretations
Advice
Parroting
Sympathy

Giving Information

Giving Information (1)

Describe what information you plan
to give
Results of the physical examination
Results of tests
Diagnosis
Cause of the problems
Treatment Modality planned
Prognosis
Advice about lifestyle

Giving Information (2)

Summarize patients problem
Contoh : Jadi bapak ada keluhan
nyeri di ulu hati dan kadang dada
terasa panas. Bapak sering
mendapatkan serangan ini di malam
hari. Betul begitu pak ?
Find out the patients understanding
of their condition
Contoh : Barangkali bapak sudah
pernah membaca atau mengetahui

Giving Information (3)

Outline structure of interview
Contoh : Baik, pak sekarang saya akan
menjelaskan tentang gejala bapak,
pertama tentang kemungkinan
penyakitnya, kedua tentang
penyebabnya, ketiga tentang
pemeriksaan lanjutan yang bapak
butuhkan dan terakhir tentang
penangananya

Use appropriate language

Give the most important information
first

Giving Information (4)

Use Drawings
Gunakan gambar, model, foto dll

Explore patients view & check

understanding
Contoh : Bagaimana bapak sudah
memahami tentang masalah bapak, atau
ada yang perlu bapak tanyakan ?

Negotiate Management
Berikan advis gaya hidup (Ajari
caranya !!!)

Tips from NLP approach

(1)
(Hypnotic
Language Patterns)
Tag Questions
Saya yakin bapak bisa, bukan begitu pak
?

Metaphors
Pak, luka di lambung bapak seperti juga luka
di kulit jika terkena sesuatu yang kecut aka
terasa nyeri. Karen itu bapak harus membatasi
makanan yang terlalu kecut dan pedas

Qoutes
Memang dari penelitian tentang autis, penderita
disarankan diet GF/CF Glucose free Casein free
Atau anak ibu harus membatasi gula dan

Tips from NLP approach

(2)
(Hypnotic
Language
Patterns)
Testimony
(Gunakan
Pihak Ketiga)
Contoh : Saya juga pernah punya pasien seperti
bapak, dan dia dapat meninggalkan kebiasaan
makan kecutnya

Single banding (Moreand more)

Contoh : Semakin bapak menunda untuk
memeriksakan anak bapak, semakin besar
kemungkinan komplikasi dan biayanya

Double banding
Contoh : Kira-kira bapak akan ke periksa
laboratorium sore ini atau besok pagi ?

Delivering Bad News

Bad News
Why is it difficult to give bad
news ?
The messenger may feel
responsible and fears being blamed
Not knowing how best to do it
Fear of the patients emotional
reaction
Fear of the implications for the
patient. E.g. disfigurement, pain,

The Process of Giving Bad

News
Give Information

Check the patients

understanding of the
information

Identify the patient main

concern

Elicit the patients coping

strategies, personal resources
and give realistic hope

Breaking Bad News (1)

Personal preparation
The physical setting:
Shouldnt do:
Give bad news at the end of a
physical
examination
Give bad news in corridors & over the
telephone
Looking out of the window

Breaking Bad News (2)

Talking to the patient & responding to
concerns.
Requires:
-empathy
-starting with what patient
knows/understands
-find what they want to know
-active listening/give info
-eliciting the patient own resources for

Breaking Bad News (3)

Arranging for follow up or referral
Feedback & handover to colleagues

Calibrating Emotion
RUMUS WAKAT

Wa Wajar
Ka Karena
T Tetapi
Contoh :
Saya mengerti ibu khawatir, beberapa
orang yang akan operasi juga
merasakan kekhawatiran seperti ibu.
Masalahnya, kalau kekhawatiran itu
berlebihan, justru kurang baik bagi
kesehatan ibu.

Giving Lifestyle Advice

(1)

Enquire about the patients attitudes

to health
Using Health Belief Model : a Predictive
model used to predict what a person is going to do

Perceived of Susceptibility
Perceived of Seriousness
Perceived of Benefits
Perceived of Barriers

HEALTH BELIEF MODEL

(Detailed)

Giving Lifestyle Advice

(2)
Giving Information
Negotiating
Supporting patient (motivate
patient)