Opening Phase Communication
With the OARS model (open questions, affirmations, reflections and summaries), most of the talking is done by the patient rather than the health care professional (HCP). The HCP evokes change talk by asking, encouraging, and active listening.
Open questions
Ask for ideas, insights, feelings, concerns
Open questions cannot be answered with a single word and typically start with "how", "why", "what", or "can you tell me about".
Affirmations
Recognise their strengths
Affirmations are encouraging statements that recognise effort in the direction of positive change. Affirmations must be genuine and congruent.
Reflections
Careful listening and reflective responses
Reflections either repeat or paraphrase what the speaker has just said, often emphasising emotional aspects, using phrases like "So you feel", "It sounds like you", "You're wondering if"
Summaries
Recap to communicate interest, understanding and highlight important points.
Summaries are helpful at transitions in a consultation, to check mutual understanding, using phrasing like "here is what I've heard so far, tell me if I've got it right ..."
Patient Scenario: Chetan
Patient Details
- Name: Chetan Chowdhury
- Age: 35
- Ethnicity: Bangladeshi
- BMI: 29
- Waist circumference: 98 cm
- Occupation: IT worker
- Family Background: Lives with his wife and mother who has type 2 diabetes. Attends for support with smoking cessation.
- Last Appointment: Originally attended his general practice for support with smoking cessation, but arranged a further appoint to discuss his weight after a discussion around his diabetes risk.
