| Quality health care is paramount considering the impact of AIDS, the emergence of newer infective agents, the resistance of current organisms to antibiotics, and the morbidity due to chronic illness. Moreover, the increase in growth of the elderly population with their concomitant risks of heart disease, cancer, and stroke mandate extensive medical services such as preventive, primary, long term, hospice and rehabilitation care.;The approach that is most conducive to quality care is one that is designed to view patients from a multifaceted perspective. The biopsychosocial model is one such approach which espouses the conceptualization of disease and treatment from a comprehensive understanding of the patient's biological, psychological and social functioning.;In order for physicians to be able to understand patients from a comprehensive perspective and render quality care, they must develop effective communication skills. This is an essential component of the biopsychosocial approach. It has been demonstrated that communicating effectively not only improves biologic and psychosocial health care outcome but has also been shown to reduce morbidity, mortality, and risk behaviors. Despite this, the literature suggests that patients frequently complain of not receiving adequate information and of a lack of understanding or recall of what they are told by their physicians. Consequently, this lack of communication results in limited patient compliance. Other areas of deficiency have been found in physician's listening skills, their ability to empathize, and their interaction with terminally ill patients and their families.;The purpose of this dissertation is to develop a communication skills manual for medical students and physicians in training from a biopsychosocial approach. A comprehensive manual of this sort would afford them the opportunity to learn skills, techniques, and gain an understanding of patient dynamics in conjunction with their school course work. The literature review provides a summary of current research on this topic. The accompanying manual discusses the psychosocial aspects of disease. Included is a description of techniques on how to build trust with patients and communicate understanding; strategies to facilitate communication; methods to improve patient understanding, recall, satisfaction, and compliance; techniques to communicate with cultural sensitivity; a description of the emotional sequelae of incurable diseases; and ways to convey a terminal diagnosis and interact with the terminally ill and their families. Also incorporated into this manual are the psychological reactions to illness and a review of personality styles as they pertain to medical practice. |
