Communication Skills – ‘Common Factors’

Why is mental health and emotional wellbeing included in the clinical guideline?

The majority of nurses who responded to our survey thought that the mental health and emotional wellbeing needs of patients with COVID-19 were addressed less well than for patients in other settings. Patients told us that they experienced and saw things in hospital that had a powerful negative impact on their mental health. Relatives and significant others were also affected by the isolation, inability to visit and uncertainty about the outcomes for their loved ones in hospital.

Clearly, these issues also affect nurses and other health care workers deeply. We will cover the mental health and emotional wellbeing of nurses in the ‘Actions for Managers’ activity.

What is mental health and emotional wellbeing?

In general, a positive sense of ‘wellbeing’ refers to being comfortable, healthy, or happy. However, when we refer to mental health and emotional wellbeing, we are specifically describing how we are thinking, behaving and feeling emotionally, including our mood and anxiety levels.

Why mental health and emotional wellbeing is important

Mental health problems, particularly common ones such as anxiety and depression, are up there with cancers, cardiovascular, diabetes and musculoskeletal diseases in terms of the impact on what is known as the ‘global burden of disease’. That means that poor mental health has a significant impact on our ability to function at work, socially, at home and in relationships to a similar degree as common long-term physical health conditions.

Good mental health and wellbeing is associated with a range of better outcomes for people including improved physical health and life expectancy. Sadly, health services often keep treatment and care for physical and mental ill health separate. The best way to remember just how important mental health and wellbeing is, is to memorise the phrase, ‘No Health without Mental Health’. Physical and mental trauma such as experienced by many patients with COVID-19 can have very significant effects on people’s mental health. This in turn can lead to poorer physical as well as mental health outcomes.

Read the ‘Do Remember Mental Health and Emotional Wellbeing’ section of the COVID-NURSE clinical guideline to learn more about strategies to support other’s mental health and emotional wellbeing.

Common Factors

‘Common factors’ describes interpersonal communication techniques that are essential for meaningful interactions between patients and healthcare professionals. They contrast with specific skills used by mental health professionals when counselling or treating people’s mental health problems. Common factors can, and should, be used by anyone.

Key common factors skills include:

• Clear introduction consisting of five steps, as described in the ‘Communication’ activity
• Establishment of relevant expertise
• Positive, non-judgemental attitude
• Non-verbal competences: Eye contact Facial expression Posture
• Verbal competences: Reflection (mirroring patient’s words or non-verbal communication back to them) Empathy (demonstrating awareness of a patient’s feelings and providing validation eg. “that sounds like it must have been really difficult”) Summarising (a brief statement pulling together information that the patient has given you) Factually accurate and realistic reassurance (Do not say things like “It will all be fine”, “Don’t worry”)

(Richards and Whyte, 2011)