basic Patient communication lecture.pptx

patient communication

1. Communication with Children Behavior Change

2. Objectives Dental fear and anxiety in pediatric patients Possible causes Behavior types of the child patient and his/her family Developmental stages and behavior types according to age Behavior modification techniques in pediatric patients

3. Dental Fear and Anxiety often originate from childhood many children develop fear responses and behavior guidance problems during dental treatment. These emotional reactions should be considered a normal response to threatening situations. All children go through different stages of emotional development

4. Definition Dental fear: is a normal emotional reaction to frightening stimuli that occur during dental procedures. Dental anxiety: is defined as the worry that scary events will occur during dental treatment and also the fear of loss of control.

5. Why do children afraid of the dentists? They fear the unknown, A new environment is frightening They are afraid of pain They lose self-confidence and self-control in unfamiliar environments, large spaces, strange people

6. Dental Fear/anxiety related to… Child Related: Growth and development IQ of the child Past dental experience Social and adaptation skills The parenting style child is exposed to Parents Related: Parent’s adult attitude? Family’s influence on child Parent-child relationship Maternal anxiety Parents' attitudes towards the dentist

7. Dentist Related Factors Ambience of the dental office Persona of the dentist Dentist’s skill (speed) Time and duration of the appointment Use of fearful words Use of praise and reward

8. The First Step In Getting To Know The Child: Getting To Know The Family Pre-interview with the family (best face-face/phone) to obtain info about child’s approach Can be asked to family Past dental experience? How you expect your child will behave during treatment? How do you feel now? (anxious/fearful?) Is the child aware of his/her dental problems? What about the learning abilities at school? How his/her relationships with friends? (compatible or not) The child's tastes and preferences (best color/cartoon/superhero/name of friend/pet)

9. Remind the parent Not to mention their OWN FEARS when with the child Never to use the dentist as punishment or threat. Encourage to talk with the kid about the treatment to prepare Don’t deep dive, keep short and clear If necessary say: I also don’t know, let’s discover together

10. Remind the parents To say: “It’s very normal to afraid, it’s okay to feel anxious” Forbidden words: needle, pain, fear Deal with the child: “ I will be with you if you need” “The dentist will decide, will do the best for you” ”The boss there is the dentist”

11. Pre appointment with child + family Aim: Observe the child and parent’s attitude (to each other) Aim: Get to know and adapt the kid to the clinic, and the staff No intervention should be done on that day (NO pain) If possible, a nice day ( ex.birthday ) should be chosen Child should be encouraged to investigate the tools Keep it fancy Should observe other children being treated

12. TYPES OF CHILDREN ENCOUNTERED DURING TREATMENT Compliant Patient: Understands what needs to be done, follows what is asked, is calm and does not resist the procedures. Patient with Lack of Cooperation: Does not understand the procedures to be performed. Very young children, patients with mental or physical disabilities. They should never be insisted on in the first session. Behavioral types of maladjusted children: Stubborn Shy Angry/agitated- Whiny (crying) Spoiled Indifferent, ignorant

13. How to treat to non cooperative child Spoiled, stubborn, arrogant  determined tone of voice, authoritarian attitude Tense behavior  Soft and light tone of voice, eye contact Indifferent Behavior  caring and patient (Child abuse?) Whiny behavior, whining  Determined behavior, disregard, short and clear orders Shy Behavior  Gentle and affectionate attitude, repeated commands

14. Behavior Management Methods Nonverbal communication-Body Language: using posture and facial expressions. The aim: increase the child's attention and to maintain the authority. The best posture is forward and downward posture. (caring and lovable) Key: Encouraging and reassuring touches to the child from time to time. To make the child feel more comfortable and safe. Intermittent eye contact with the child will increase the sense of trust and reduce the feeling of loneliness.

15. 2. Tone of voice Controlling the tone of voice to ensure effective communication is an important way to ensure authority. physician can warn the child with sudden and emphatic changes in the tone of voice, indicate his/her displeasure and draw the child's attention/interest to him/her. A determined tone of voice can break the child's stubborn behavior. If the child behaves compliant, the physician's thanking the child with a soft tone of voice might encourage the child for the upcoming sessions.

16. 3. Distraction Aim: to focus the patient's attention elsewhere during the treatment. The patient may be told to hold his/her nose during local anesthesia to lift his/her foot to prevent nausea during radiography to make the current procedure easier to carry out. Watching cartoons or listening to music with headphones during the treatment Simply chat with the kid continuously during the treatment.

17. 4.Presence/absence of the parents Positive effect is discussable If the parent is highly anxious, it is possible to influence the child  avoid presence! Some children have separation anxiety (might disturb cooperation)Let the parent in! Some parents are cooperative with the dentist and ease the process Decision should be tailored!

18. 5. Sharing Control It is a deal between dentist and the child The dentist let the child the control the flow of the theraphy at some point Ex: During the local anesthesia injection child is allowed to raise hand to express the pain Note: This should be rehearsed before to avoid any interruption

19. 6. Explain-Show-Apply Method Frequently applied by practioners Whole process is explained to the patient adjusted to his age/mental state The process is fully demonstrated step by step (on a toy/object) The procedure is completed on the patient it self

20. 7. Verbal Communication Aim: To relieve the child’s anxiety by using effective verbal communication methods by Explaining the reason she/he needs this procedure Explaining each step of the procedure Showing empathy that is normal to have some negative emotions throughout the procedure Talk kindly, ask permission, use magic words (please, could you, is that ok for you…) Talk fancy, compassionate and be playful!

21. 8. Behavior Management and Encouraging Positively encouraging is to award cooperation Giving gifts and diploma of courage is a good way to build connection with the child This motivates the child for future sessions Being angry or very dictative generally not beneficial!

22. 9. Hand Over Mouth Technique Old school but effective method When a uncooperative child is crying restlessly and disturbing other children at the clinical setting It is covering of the mouth by the dentist’s hand (without applying any pressure) to give the child an impression of authority Keeping eye contact is essential and explaining the child the reason of performing this!

23. 10. Physical Barriers It is generally applied when the child is inconsolable due to mental state or some disorders. Mostly patient relatives are also invited to help stabilize the child by using force. This method is used if other methods do not work for the patient Consent of the parents is essential!