Communication skills and patient counselling مهارات الاتصال وإرشاد المريض

 Communication skills  and  patient counselling

-          It is necessary to use communication skills that convey the correct information to the patient and encourage discussion  of health-related problems.

-          Patient counselling is undertaken by pharmacists:

• during dispensing

• in disease management

• in providing advice on self-care: advice on product selection and use, non-drug self-care, referral and health assessment.

Pharmacist actions and communication with patients :-

• Ensuring safe and correct use of medicines

• Responding to symptoms

• Discussing patient health-related and social problems that impact on health status .

• Empowering individuals to be active in health promotion التوعيةand preservation .

Steps of Communication process :-

• Understanding perception of individual

• Rapport building skills .

• Non-verbal communication and body language .

• Questioning and listening skills .

• Responding and explaining skills .

1-   Understanding perception of individual

Through the communication process, anticipate different perceptions according to the individual’s needs (e.g. social problem associated with occurrence of acne may impact differently on individuals).

2- Rapport building skills

• Convey friendliness and warmth

      • Express genuine interest and concern

              • Refer to previous encounters when relevant

                                  • Provide reassurance

                                  • Preserve confidentiality .

3-      Non-verbal communication and body language

• Close conversational distance

                       • Direct eye contact

      • Direct body and facial orientation

• Open, forward leaning posture

                    • Smiling and using pleasant facial expressions

                 • Voice intonation denoting interest and appropriate speech speed.

4-      Questioning and listening skills

• Use effective questions by adopting open questions to obtain information that is necessary.

• Ask only one question at a time.

• Structure the flow of questions to follow a logical pattern.

• Use probing questions to follow up patient’s response. Patients may not be aware that certain information must be known by the pharmacist to suggest appropriate line of action.

• Encourage patient participation by pausing both after asking a question and after the initial response.

• Practise active listening.

5-      Responding and explaining skills

• Place the most important points at the beginning of the communication session.

• Emphasise key issues.

• Give specific, concrete instructions.

• Limit the information to the essentials to prevent cognitive overload.

• Simplify complicated messages.

Barriers to communication

1-    Environmental factors such as lack of privacy, lack of space in the pharmacy .

2-    Time available for pharmacist to dedicate to the patient for listening .

3-    Patient characteristics such as speech defect, inability to communicate.

Dont’s in communicating with patients

                  • Don’t ask ‘why’ questions

• Don’t use ‘should’ and ‘ought’

                   • Don’t blame the patient

                 • Don’t automatically compare the patient’s

experience with your own

           • Don’t invalidate the patient’s feelings.

Pharmacist skills needed

the pharmacist also needs the ability to:-

1-    explain information clearly and in terms that are understandable to patients of different backgrounds.

2-    pose the right questions to patients without putting them off .

3-    listen to the patient.

Counselling in the community pharmacy setting:-

• This should be an integral part during dispensing of medicines.

• Pharmacists should be visible and accessible for patients to request advice.

Counselling in the hospital pharmacy setting:-

• On admission

• During hospitalization: needs assessment

• On discharge

• At outpatient clinics

• In rehabilitation settings.

Objectives of patient counselling by pharmacists:-

• To ensure that patients are adequately informed about their medication.

• To predict any problems which might cause loss of efficacy of the drug or be detrimental to health of patient.

• To identify any drug-related or health-related problems.

Counselling process during dispensing of medicines

• How and when to take or use a medicine

• How much to take or use

• How long to continue treatment

• What to do if a dose is missed

• How to recognize side-effects and minimize their occurrence

• Lifestyle and dietary changes

• Drug–drug and drug–nutrient interactions.