How knowledge, skills and attributes improve the effectiveness of health results and health literacy
Dealing effectively with human relationships (Moscovici, 1981), through adaptation to situational needs and demands (Wiemann, 1977, p. 17). This is a permanent challenge, above all, and nowadays, and particularly in the health area, it requires a herculean effort from health professionals.
In this context, competence is an important factor in the way individuals help to shape the world and not just how they deal with it (OECD, 2005, p. 5).
And in the health area, it is the competencies that allow the effectiveness of health results.
In the domain of information exchanged in the health relationship, it is necessary to “know how to question” (Hargie & Dickson 2004), with the communicative competences central in the interaction between professional and patient, such as:
1) asking questions (question-asking);
2) provide information (information provision) and encourage the patient to express concerns or report symptoms clearly and completely; and
3) verify that the information (verifying) received is understood, which implies clarifying issues, increasing understanding and remembering the information (Cegala (2003, p. 92).
The understanding of what “competence” is described in the literature as a complex concept and as a multidimensional construct (Flynn, 2014, p. 364), in which communication skills are also integrated, based on the functionality of communication, adequacy and sufficient knowledge, judgment and skills (Light & McNaughton, 2014).
Communicative competence allows the (interacting) individual to function effectively in society using language and non-linguistic behavior (Wiemann & Backlund, 1980, p. 186).
SKILLS: HEALTHCARE PROFESSIONALS MUST BE HOLISTIC TODAY.
Competence thus means using knowledge, skills and attributes to act in society. And the more complex the society is, the more demands are placed on health professionals. Adopting a holistic view makes the health professional a “transformative” human being, as many health professionals said during an investigation carried out in Portuguese hospitals in 2019 by the researcher.
The OECD (2005) stresses that key competences are determined by the nature of the goals of individuals and society and must relate to the main resources and requirements in life (p. 5). Thus, the skills of individuals cannot be determined only by arbitrary decisions, about what are the personal qualities and cognitive skills of individuals (OECD, 2005, p. 5).
An individual with interpersonal competence has an open (available) posture to receive messages from other people, does not cause anxiety in others (Wiemann, 1977, p. 196), is empathetic, affective, supportive and calm while interacting, adapting his behavior to situation within an encounter and changes as it moves between encounters (p. 197).
Interpersonal communication skills integrate the ability to:
1) formulate and achieve goals.
2) collaborate effectively with others in an interdependent manner; and
3) adapt to situations (Wiemann, 1977, p. 197).
Figure 1. Interpersonal communication skills
Competence is thus a combination of skills, knowledge and personal attributes that lead to a superior performance of professionals (Tench & Konczos, 2013, p. 5).
In professional-patient interaction, different skills (acquired and learned) are used (Hulsman, 2009), which allow continuity of care (Wonca, 2002) and include clinical and communicative skills. In the therapeutic relationship, interpersonal, strategic communication is used, with previous information and knowledge, empathy, commitment to balance of powers, assertive and clear language and behavior, whose focuses in the patient’s life involve a conversation of healing and care (Greenhalgh & Heath, 2010).
Communication skills include (Epstein et al., 2005, p. 1) creating a sustainable relationship with the patient; 2) explore the patient’s perspective and help him verbalize his emotional experiences; 3) use empathy; 4) encourage the sharing of tasks and the joint development of strategies that aim to improve health outcomes (Epstein et al., 2005, p. 415) In Table 1, we summarize some of the main competences of health professionals integrated respectively in knowledge, skills and personal attributes.
Table 1: Some competencies of health professionals
| Examples of competencies: Knowledge, skills and attributes |
| Knowledge
• Understanding duties and limits • Understand the other determinants of health (social, cultural, economic, political) • Find health information on the Internet or in periodicals and books • Understand the implications of health-related initiatives • Understand and defend patients’ rights • Understand patients’ rights and responsibilities • Understand, interpret and analyze health information • Understand and know the effects of good communication on health |
| Skills
• Support the patient in solving their problem • Help the patient to navigate the Health System • Determine the use of medical records as an act of patient privacy • Determine which health sites contain accurate information and which do not • Disseminate patients’ good practices through testimonies to other professionals and patients • Understand the patient and support him / her in informed consent • Asking questions and providing appropriate responses • Make summaries of quality reports • Read and apply health information • Read, understand and make decisions based on labels • Participate actively in health care meetings • Ask for clarification and ask questions to the patient • Fill out an application with a health insurance or form • Have a key question and answer checklist for your patients |
| Attributes
• Therapeutic empathy to understand the patient’s good practices • Leadership to manage the therapeutic relationship with good results • Realize what can put the patient at risk due to lack of understanding • Know how to make the appropriate decisions based on the information received • Verbal and non-verbal sensitivity • Be honest in the interaction • Be organized to promote and protect the health and prevent diseases of patients • Pay attention to the analysis of risk factors in advertisements for prescription drugs • Have confidence to act • Have courage when needed • Have humility in dealing with the patient • Willingness to work as a health partner |
Fonte: A autora, baseada em Gazmararian et al, 2005; Tench e Konczos (2013); Sørensen et al, (2012).
REFERENCES
Cegala, D.J. (2003). Patient communication skills training: a review with implications for cancer patients. Patient Education and Counseling, 50, 91-94.
Flynn, T. (2014). Do They Have What It Takes? A review of the literature on knowledge, competencies, and skills necessary for twenty-first-century public relations practitioners in Canada. Canadian Journal of Communication, 39, 361–384.
Leonard, M., Graham, S., & Bonacum, D. (2004). The human factor: the critical importance of effective teamwork and communication in providing safe care. Quality Safe health, 13(1), i85-i90. Doi: 10.1136/qshc.2004.0110033
Leape, L. L. (1994). Error in medicine. JAMA: The Journal of the American Medical Association, 272(23), 1851-1857. doi:10.1001/jama.1994.03520230061039
Light, J., & McNaughton, D. (2014). Communicative competence for individuals who require augmentative and alternative communication: A new definition for a new era of communication? Augmentative and Alternative Communication, 30, 1- 18. doi:10.3109/07434618.2014.885080
Moscovici, F. (1981). Competência interpessoal no desenvolvimento de gerentes. Revista Administração Empresarial, 21(2), 17-25.
OCDE (2005). The definition and selection of key competencies. Executive summary. Author. 1-20.
Tench, R., & Konczos, M. (2013). Mapping European communication practitioners’ competencies: A review of the European communication professional skills and innovation program. UK: ECOPSI.
Wiemann, J.M., & Backlund, P. (1980). Current Theory and Research In Communicative Competence. Review of Educational Research. 50(1).185-199.
Wiemann, J. W. (1977). Explication and test of a model of communicative competence. Human Communication Research, 3(3), 195-213.
Vaz de Almeida, C. (2019). Capacitação dos profissionais de saúde. Literacia em saúde e competências de comunicação dos profissionais de saúde. O modelo de comunicação em saúde ACP. Revista Nephros, 21(1), 25-28.
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