Lost (and found) in translation: Effective communication with patients

By Zuzana Dankulincova, Pavol Jozef Safarik University, Slovakia

While most researchers are aware that disseminating study results is part of their ethical responsibility to research participants (and wish for their research findings to have clear, practical implications), the transition from awareness of evidence to widespread implementation can take a long time. Scientific knowledge is not always applied to everyday practice; when it is, it is usually not done consistently or systematically.

Why does it happen? The sheer number of research studies, interventions, and recommendations to follow can be overwhelming for healthcare providers. When reviewing evidence and recommendations, think about how relevant the evidence is for your local setting. Is the context described in the recommendations from research studies comparable with yours? Do you have what you need to implement recommendations, or do you lack the resources and skills needed? Do your patients have what they need to implement recommendations? Even the most well designed and most promising      intervention will not be effective if there is no “fit” with your patients and setting. For example, it could be problematic to recommend an e-health intervention for those without smartphones or computers, or those with low digital literacy.

Another crucial aspect in the translation of knowledge is the interaction between those who use the knowledge (e.g., patients) and those who own and share the knowledge (e.g., health care practitioners). No matter how well we communicate our recommendations, it will not lead to the desired impact      if it is not relevant or useful for the patient.  Listening is a core component of knowledge translation. A person who is listened to can tap into their wisdom and see things from a new perspective. The better we listen to patients and clients, the better we’ll be able to meet their needs, and the more our messages will be believed, liked, and ultimately acted upon. To achieve this, listen actively to what your patient has to say without imposing your expectations and provide enough time for your patient without interruptions. Use open questions if possible, adapt to your patient´s level of health literacy, and avoid using medical terminology. If medical jargon needs to be used, make sure to check if it is understood and if not, make sure to explain the terms used. 

In addition, you should also ask yourself and your patient or client about factors that might prevent you from successfully providing a particular intervention or might prevent the patient from successfully implementing the intervention. To successfully implement a change, measure, or intervention, you should consider potential barriers beforehand. Even though you will probably not be able to list all of them, make sure you have enough time with your patient to think about what might go wrong, why, and how it could be prevented or solved. For example, if your patient decides to make dietary changes, it might be relevant to talk about whether the patient will prepare their food or if they are going to eat at restaurants or canteens. If food prepared at home, is there enough time for that? If there is little time, how can this be resolved?? If the person is planning to eat at restaurants or canteens, do they have a variety of appropriate food? It is always good to consider different scenarios together, purposefully assessing potential problems or encouraging your patient to do it on their own as a part of the planning.

Once the relevant intervention is chosen and tailored to fit your patient and the context, taking into account potential barriers, it is time to implement it. Keep your intervention as clear and as concise as possible. For instance, if you want to encourage the patient to form action plans to exercise, encourage them to specify when, where, and how to do it. Evidence suggests that change is more likely to happen in the case of more planned and focused interventions

Implementation is not the end, you need to know whether the intervention is working. An important last step is getting your feedback along with the evaluation so you can take those into account in the future. Make sure to follow up with your patients, ask them about their progress, what works for them, and if they have problems following recommendations or sticking with interventions, discuss with them what could cause the problems and what solutions they could implement.  

Practical Recommendations:

  1. Find knowledge relevant to your local setting – find your source of relevant and valid information and assess the relevance and suitability of the evidence for your patients and your context.
  2. Communicate effectively – open an effective interaction and communication channel with your patients and listen without imposing your ideas on what your patients need. 
  3. Think about and ask about barriers – together with your patient, think about what might go wrong, why, and how it can be prevented.
  4. Plan your intervention clearly and concisely – change is more likely to happen if the intervention is planned and focused.
  5. Get feedback – gather information about how the intervention is going and make sure to use it to improve it in the future.