Читать книгу The Nursing Associate's Handbook of Clinical Skills - Группа авторов - Страница 127

Closed	Do you have any pain right now?
Leading	You have pain right now, yes?
Open	Tell me about your pain.

Verbal communication is an important part of active listening, and there are two different elements to this. Verbally attending is one of these elements. As discussed earlier, the communication interaction should be a conversation; in order to aid this, the use of open questions is imperative. Closed questions – where a yes or no answer is expected – allow people to give one‐word answers which are a barrier to communication; these types of questions do not encourage patients to communicate. Leading questions – where a patient is given the answer within the question – can result in patients not stating their own feelings but what they are led to agree with. These questions do not encourage communication. Open questions allow the patients to speak from their perspective with no prior expectations from the healthcare professional. Box 5.2 illustrates how the same question can be asked in three different ways to elicit more information.

The other element of verbal communication is referred to as vocally attending by Webb & Mille (2011). It is important to make noises to demonstrate listening at appropriate points. These give the patient reassurance and cue them to continue. These noises may include the use of small words such as ‘a‐ha’, ‘hmm’ and ‘yes’. Another option is using reflective statements including ‘I understand’, ‘I see what you mean’ and ‘that sounds like it was difficult for you’. These demonstrate understanding which also gives reassurance and encouragement to continue. A further element of verbal communication in active listening is paraphrasing what has been said. By repeating back what has been said and paraphrasing it, it is clear that the patient has been heard and that can create a good level of trust between the patient and the healthcare professional. It also shows that the healthcare professional has understood the patient.