June 10, 2008
2 min read
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Are you listening to your patients?

Better understanding of patients may result in improved treatment adherence and success with diabetes self-management goals.

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In today’s rushed, numbers-driven health care system, it is often difficult to take the time to really listen to our patients.

Diabetes is a complex and difficult disease that affects every area of a person’s life. When diagnosed, patients often feel shocked, depressed, guilty and overwhelmed. It takes time to adjust to the demands of the disease and to make the necessary changes to one’s lifestyle. One of the most important things we can do for our patients as health care providers is to actively listen to them when they talk about life with diabetes and work to incorporate their needs, feelings and lifestyle requirements into treatment recommendations and management plans.

 Amparo Gonzalez, RN, BSN, CDE
Amparo Gonzalez

In my 16 years as a diabetes educator, I have assessed hundreds of patients. Together, my patients and I have created individualized educational plans, set self-management goals, lowered risk factors, prevented complications and successfully improved health outcomes. The key to this beneficial relationship is active listening.

Diabetes educators and other health care professionals have a duty to identify solutions to the problems patients present and find ways to support them. However, it is essential that we fully explore and understand the circumstances of the problems our patients identify before we offer advice and develop a plan. A successful education and management plan is tailored for the patient based on the information that the provider obtains by asking the right questions and actively listening to the patient’s response.

This seems simple, right?

Well, ask yourself this: When your patients are talking, are you really listening to what they’re saying, or are you just waiting for your turn to speak?

There are four main types of communication: speaking, listening, reading and writing. Most of us have spent a considerable amount of time learning skills for speaking, reading and writing. But how much time have you dedicated to learning how to listen? Listening is a skill and it takes time and effort to learn how to do it effectively.

Active listening helps providers or counselors improve their understanding of a patient’s needs or situation and ensures that the patient feels comfortable, safe and validated. Instead of just “zoning out” when patients are talking, the provider must pay attention to the actual words that are said, body language and the feelings that are being communicated.

It is also essential that providers remain nonjudgmental and open when discussing problems, issues or needs with a patient. When you are actively listening, it is good to check that you have understood what the patient is communicating. This can be done by paraphrasing the patient’s comments or describing an emotion the patient seems to feel about a situation. For example, an active listener might start off paraphrasing the situation by saying, “So, you are having a hard time following your meal plan because…” If the patient is upset or angry, an active listener might point it out and ask for more clarification: “You seem frustrated with this situation. Is that because…?”

When you have asked a question, continue listening until you have obtained enough information to know and understand your patient’s perspective of the problem or situation. Do not offer solutions until you have had adequate time to listen to your patient, understand where he/she is coming from, and can keep their perspective and needs in mind when designing a diabetes self-management plan.

Our patients want to be understood, affirmed, validated and appreciated, just like we do. We owe it to them to actively listen when they are communicating their feelings and struggles with diabetes. Ultimately, our better understanding of patients will result in their increased adherence with treatment recommendations and their success in meeting diabetes self- management goals

Amparo Gonzalez, RN, BSN, CDE, is President of the American Association of Diabetes Educators, Director of the Emory Latino Diabetes Education Program and an Adjunct Professor at the Emory University School of Nursing.