Standard 5: Communication

Every person’s experience of pain is personal, unique, and often complex. It is recognised that both the experience of pain, and the way that an individual communicates is influenced by their biological, psychosocial, cultural and demographic context. A health practitioner working with a person experiencing pain must have a sound understanding of communication principles and corresponding skills to communicate effectively with each person. 

The intent of this standard is to reinforce the importance of communication when working with a person experiencing pain, and to promote the health practitioner’s development and application of the advanced communication skills required to implement quality pain management.

“Communication is key in every clinical encounter and is often regarded as lower value than the learning and understanding of professional ‘technical skills’." – Stakeholder consultation workshop participant 

“The essence of the framework was captured simply and poignantly by one priority in particular; ‘listen to me, learn from me and hear what I am telling you, so it makes me feel my concerns have been understood.’ This priority articulates how listening carefully, validating, and acknowledging individual pain stories might be one of the most positive, safe, low-cost, and impactful aspects of care.”^{41 p.e1159}  

^{Note: All references supporting this information can be found in the full Australian Standards for Health Practitioner Pain Management Education document.}

Effective communication underpins every aspect of healthcare delivery and practice,^60,61,65,75 leading to better outcomes for individuals experiencing pain and improved health practitioner satisfaction.⁷⁶ Effective communication between health practitioners and individuals experiencing pain is particularly vital because pain management is often complex.^39,43,77  This complexity can be exacerbated if the individual experiences inappropriate or frustrating interactions with the health system or is non-verbal. 

Therefore, health practitioner training requires a major focus on improving skills in effective communication, including listening, hearing, speaking and explaining.^43,78,79 The communication standard seeks to address the importance of ensuring all health practitioners working with individuals experiencing pain develop and maintain an understanding of factors that influence communication and strong interpersonal skills. 

^{Note: All references supporting this information can be found in the full Australian Standards for Health Practitioner Pain Management Education document.}

Individuals experiencing pain are often vulnerable when seeking healthcare, and fears that they will not receive adequate pain management or will be disbelieved or dismissed are not uncommon,^39,43 particularly for those with chronic and/or undifferentiated pain. 

A health practitioner’s communication knowledge and skills are vital in developing a positive therapeutic alliance with the individual and their significant / relevant others³⁹ that will facilitate shared decision making and a holistic and tailored approach to pain management.^42,43 Providing an environment in which individuals feel culturally, psychologically and physically safe to share their lived experience and concerns is important.^43,70,80,81 Empathic and active listening is aided by understanding the diverse ways in which individuals experiencing pain may communicate (for example, verbal, non-verbal, paraverbal) as well as awareness of one’s own communication styles.^43,76 

Being able to adapt communication to the individual’s unique circumstances, skills in acceptance and validation^,42,43,79 use of language that is appropriate to a person’s level of understanding,⁴³ and ability to promote self-confidence⁴³ are all fundamental communication skills for health practitioners working with individuals experiencing pain. The communication standard highlights the importance of ensuring these skills are consistently addressed and reinforced in pain management education. 

^{Note: All references supporting this information can be found in the full Australian Standards for Health Practitioner Pain Management Education document.}

The tailoring of communication skills to meet the needs of a diverse population is a major consideration within the context of pain management. It is well-acknowledged that many diverse individuals express their pain in atypical presentations, often feel misunderstood by their health practitioners, and evidence shows that there are significant gender and racial disparities in pain management.^40,82 

When working with individuals experiencing pain, their social, cultural and demographic circumstances (including but not limited to gender, race, ethnicity, disability, age, geography and other aspects) cannot be considered in isolation. Different aspects of the individual’s identity can expose them to overlapping forms of discrimination and marginalisation or privilege (referred to as “intersectionality”). 

Pain education for health practitioners working with individuals experiencing pain must instil a strong understanding and practical application of communication approaches and frameworks appropriate to individuals from wide backgrounds and identities.^70,83 'Some examples include effective use of interpreter services and telehealth, adapting communication to cognitive and/or intellectual disabilities,^84,85 Clinical Yarning,⁷⁰ appropriate involvement of significant/relevant others,⁸⁰ family-centred care approaches,⁸¹ and trauma-informed approaches to care.⁸⁶

The Australian Standards for Health Practitioner Pain Management Education as a whole recognise the significance of diversity in the experience of pain and the importance of equipping health practitioners with the required skills to effectively work in with the diverse population of Australians who experience pain.

^{Note: All references supporting this information can be found in the full Australian Standards for Health Practitioner Pain Management Education document.}