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FAM. & COMM. MEDICINE (1ST Shifting) | (Dr. Rouema B. Peralta-Perez) | (9 August 2018)
• Attending “Doctor, a month ago, I had this sore throat, so I went to a doctor
→ “Attention” and “paying attention” and he gave me penicillin for it. So, I took for 7 days and it went
→ Paying attention to the needs of our patients to be away. But a week later, I had the sore throat again.”
understood and cared for emotionally
→ Refers to the way we use our bodies to communicate the “The doctor gave me Amoxicillin this time and took it and the sore
message throat went away. But a few days ago…” (Patient takes his
→ Attending skills handkerchief and crumples it and pulls at it repeatedly.)
▪ L – leaning forward
▪ O – open stance “…the sore throat came back.” (Voice becomes softer, patient
▪ V – voice of compassion shakes his head)
▪ E – eye contact
▪ R – relaxed position “I just can understand what is happening.”
▪ S – sitting at an angle
• Reflecting Content
• Bracketing → Paraphrasing
→ Setting aside our own feelings, thoughts, and judgments ▪ Gets the essential content of the patient’s message
temporarily so that there will be space in our minds and in and restates it in a more summarized and organized
our hearts for what the patient is really saying manner
• Leading ▪ e.g. “This is the third time that you have had a sore
→ Indirect Leading throat within a month and you can’t understand why it
▪ Open invitations made by the doctor-counselor for the keeps coming back.”
patient to talk about anything that s/he wishes → Perception Check
▪ Allows the patient to go wherever topic he chooses ▪ In interrogative form, reorients the doctor if he was
and the doctor-counselor encourages him to do so mistaken, gives the patient the chance to re-explain
− ✓ “What would you like to talk about?” himself in a clearer manner
▪ e.g. “This is the third time you have had a sore throat
− ✓ “What can I do for you?”
within a month and you can’t understand why it keeps
− ✗ “What is your problem?” (too direct and may be
coming back, is that it?”
threatening)
• Can also take the form of words of phrases like: • Reflecting Feeling
− “Yes” → The doctor-counselor articulates the feelings of the patient
− “Go on” by making an observation
− “And then?” → e.g. “You seem to be quite anxious about your sore throat.”
− “Uh-hmm” • Reflecting Experience
→ Direct Leading → Reflecting the non-verbal cues to the patient
▪ The doctor-counselor makes a judgment call as to → e.g. “I noticed that your lips quivered when I talked about
where the patient should go and asks the patient to go blood.”
to that direction
• Focusing
▪ Pick up from what the patient has already brought out
→ The doctor-counselor stirs the conversation into the topic
into the open.
that is relevant to the patient’s concern
V. REFERENCES
Dr. Peraltas’s PPT and Lecture Notes (10 August 2017)
Batch 2021-B Transcription
Batch 2021-D Transcription
Rakel, R and Rakel D. (2016). Textbook of Family Medicine, 9th
Edition. USA: Elsevier.