Thursday, December 31, 2020

Expert Offers Guidance on How to Talk With Patients About Getting Vaccinated for COVID-19

To end the COVID-19 pandemic, it is essential that citizens are willing to receive a vaccine. Yet vaccine hesitancy is becoming a growing problem. In an article in Psychiatric News, Joshua Morganstein, M.D., chair of the APA Committee on Psychiatric Dimensions of Disasters, outlined actions psychiatrists can take to prepare for and have conversations about COVID-19 vaccines with patients.

Check your pulse: After the challenges that 2020 has brought, health care professionals are increasingly tired and frustrated. Yet burnout and extreme stress will make it only more difficult to start tough conversations with patients about vaccinations. Psychiatrists must address their own physiologic needs—including those as basic as getting adequate sleep, nutrition, and hydration—to engage effectively with patients. “A brief check-in with a trusted family member, friend, or colleague can provide helpful feedback on the extent to which we are prepared to effectively navigate vaccination conversations with patients,” Morganstein wrote.

Know your audience: It is vital that psychiatrists understand their patients' perspectives on COVID-19 vaccines and adjust their approaches accordingly. Additionally, psychiatrists should ensure they understand cultural factors within their communities to help improve trust. Patients who are ready to receive a vaccine should be encouraged and have any questions answered. For patients who are hesitant, psychiatrists can employ motivational interviewing, in which they explore  patients’ concerns and discuss potential benefits and risks to receiving or not receiving a vaccine.

Psychiatrists should respect the perspectives of those patients who express a refusal to receive a vaccine, while informing them that receiving a vaccine is recommended and offering to speak more on the topic later, if the patient should so desire. Efforts to change the behavior of those who have already refused to get a vaccine are rarely successful, Morganstein wrote. In fact, those conversations may have the unintended consequence of deepening mistrust and reducing the chance that a common ground may be reached in the future.

Find the words: Morganstein recommended staying away from medical jargon when talking with patients, noting that “more understandable and down-to-earth language often serves to enhance trust and build rapport.” He also suggested using language that normalizes feelings, such as talking about concerns, rather than using clinical terms like anxiety.

Appealing to emotions rather than relying on data and statistics can also be effective, as can talking about universal values, such as family safety, rather than controversial topics like politics or religion. Sharing personal stories can humanize psychiatrists and strengthen the therapeutic bond, as well. “The use of guilt, shame, or criticism rarely motivates behavior change, may further entrench patients in or move them toward vaccine refusal, and should be avoided,” he wrote.

“Health care professionals and patients may not come to an agreement,” Morganstein wrote. “Ultimately, it is an individual’s choice whether or not to receive a vaccine, and it is essential that health care professionals respect patient autonomy.” But the actions he outlined, he continued, will help “move the needle” and encourage patients to get vaccinated during this crucial point in the global pandemic.

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