COMMUNICATION AND COUNSELING
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Transcript of COMMUNICATION AND COUNSELING
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COMMUNICATION AND COUNSELING
Anna Wahyuni W., S.Farm., MPH., Apt.
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References :• Rantucci, M.J., 1997, Pharmacist Talking with Patients,
A Guide to Patient Counseling, 1th Ed, Williams & Winkins, Baltimore, Maryland.
• Rickles, N.M., Wertheimer, A.I., Smith, M.C., Social and Behavioral Aspect of Pharmaceutical Care, 2010, 2nd Ed., Jones and Bartlett Publisher, MA.
• Beardsley, R.S., Kimberlin, C.L., Tindall, W.N., 2007, Communication Skills in Pharmacy Practice, 5th Ed., Lippincott Williams & Wilkins, Baltimore.
• Glanz, K., Rimer, B.K., Viswanath, K., 2008, Health Behavior and Health Education : theory, research and practice, 4th Ed., John Wiley and Sons Inc., San Francisco.
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Counseling
counseling
Good communicat
ion skills
Educational process
Psychological approach
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COMMUNICATION• Definition : A process of transmission of
information, in which occur the emission, reception and comprehension of messages, both verbal (written and spoken) and nonverbal.
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INTERPERSONAL COMMUNICATION
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THE MODEL
S = SenderR = receiver
= messages/feedback loop= barriers
S
RS
R
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Component• The sender• The messages• The receiver• The feedback• The barriers
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Responsibility of pharmacist in the model• As sender : assuring that the messages is
transmitted in the clearest form, in terminology understood, in an environment condusive to clear transmission need ask feedback and clarify misunderstanding
• Speaking clearly, speaking slowly, using appropriate language, checking understanding.
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Responsibility of pharmacist in the model• As receiver : listening provide feedback
to assured accurate communication• Listen carefully, ask for clarification, write
it down, repeat the message back in order to check the message received is the one given.
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The messagesIncluding thoughts, ideas, emotions,
information, or other factors.Consists of :• Factual information transmitted verbally,
in written form or some combination.• Feeling information transmitted
nonverbally.
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The critical componentThe receiver assign the same meanings to messages as intended by sender :•Words and their context•Congruence between verbal and nonverbal•Preventing misunderstanding•Using feedback to check the meaning of messages
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Perception and communication• Perceptions : perception of meaning
messages and perception of individuals• Sharing the same perception : prevent
misunderstanding use lay language• Using feedback to check perceptions• Perception, credibility and persuation
trustworthiness, competence and personal dynamism
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Barriers includes :• Environmental• Personal• Patient• Administrative and financial• Time
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Environmental barriers• Crowded, noisy area• Privacy• The counter separating the sender and
receiver messages
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Personal barriers(pharmacist’s perspective)• Lack of confidence• Personal shyness• Internal monologue prejudging • Tendency to transfer problems to another
person• Cross cultural factors• Fear of being in situation that is sensitive
or difficult to handle
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Patient barriers• Patient perceptions of pharmacist as not
being knowledgeable.• Patient belief that health care system is
impersonal• Perception of their medical condition
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Administrative and financial• Pharmacist are not paid directly• The mechanism of dispensing
prescriptions
TIME BARRIERS• Inappropriate time
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NONVERBAL COMMUNICATION
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• Nonverbal communication involves a complete mix of behaviors, psychological responses and environmental interactions through which consciously and unconciously related to another person
• Concentrate on our own nonverbal communications and the various nonverbal cues provided by others.
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Element • Kinesics (body movement)• Proxemics (distance between persons
when they communicate)• The physical environment• Paralanguage • Potential distracting nonverbal element.
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Kinesics Open posture :• varied eye contact (consistent but not stare)• Relaxed posture : how people sit, stand or lie• Appropriate, comfortable gestures• Frontal appearance• Slight lean toward other person• Erect body position (head up, shoulders back)
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Proxemics • The distance between two interacting
persons• Approximate distance of the proxemity we
generally accept in our day to day life :distance Appropriate relationship
and activities
< 46 cm Intimate contactPersonal distance : 46 cm – 1.22 m
Close friends or acquaintances
Social distance :1.22 m – 3.66 m
Impersonal, businesslike contact
Public distance : > 3.66 m Formal contact
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Environmental nonverbal factors• Private area consultation• The color used in pharmacy’s décor• The lighting• The use of space• The general appearance
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Paralanguage • Tone • Volume• Inflection
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Concept of health and illness
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Health
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Illness as social concept
If you feel any symptoms of illness,
what will you do?
???
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Illness as social concept
Illness :Individual
responses to symptoms
Disease :Pathological or
biological condition
It is possible to feel ill without suffering a disease and to suffer a disease without feeling ill.
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Individual and interpersonal models of health and illness
behavior
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• “ dokter memberi tahu saya bahwa saya membutuhkan obat ini, tetapi saya merasa baik-baik saja. Bapak dan ibu saya hidup sampai usia 90 tahun dan tidak pernah menggunakan obat ini. Mungkin saya juga tidak memerlukannya”.
• “ saya tahu bahwa tekanan darah saya tinggi dan saya harus meminum obat dengan teratur tetapi saya sangat sibuk dan seringkali terlupa meminum obatnya”.
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Theories? What for?Help in designing intervention to address
problem by identifying :• Why people are experiencing the health
problem• What information is needed before developing
intervention to address the health problem• How best to develop interventions to address
the health problem• What to measure to determine whether the
intervention is effective
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Theories in individual HB• The Health Belief Model• Theory of Reasoned Action, Theory of
Planned Behavior• Transtheoretical Model of change
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Interpersonal model of HBHow individual, environment and health
behavior interaction with others within their social circles
• Social cognitive theory• Theory clinician-patient communication
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The Health Belief Model
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Theory of reasoned action and theory of planned behavior
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Transtheoretical Model of Change
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Komunikasi dan Konseling 2010/2011
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The stage of change (transtheoretical) model (Prochaska and DiClemente, 1984)
Relapse:
Return to previous pattern of behavior
Precontemplation:
Client sees no problem but others disapprove
Contemplation:
Weighing up pros and cons of changing
Active changes:
Putting decision into practice
Maintenance:
Actively maintaining change
Optimal recovery Change conslidated
Premature way-out
start
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Social Cognitive Theory
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Patient-centered communication function