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Communication

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Communication & counselling

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Communication

  1. 1. Health education Communication IEC (Information Education Communication) BCC (Behaviour change Communication) Counselling Advocacy: Act of pleading or arguing with a view to influence decision or policy in a stated direction
  2. 2. Communication Two way process of exchanging ideas, feelings and information Two aspects: Content & Relationship Communication can take place if there is Common interest / purpose Mutual benefit Mutual understanding(relationship of trust)
  3. 3. The Communication Process Receiver Feedback ChannelMessageSource
  4. 4. Sender Objective: SMART Abilities and limitation Message, channel, audience & utilize feedback
  5. 5. Message Content: ideas, information Code: Verbal, nonverbal Treatment: Arrangement, Sequencing, Tone and tenor(emotion)
  6. 6. Channel – means by which the message travels between the source and the receiver; – a mode of coding and decoding – can be in the form of interpersonal or mass media
  7. 7. IPC • Better interaction provides scope for clarifying doubts, immediate feedback and building rapport • Personalised attention is more effective for motivation and guiding into action • Useful for people with lower IQ & laggards
  8. 8. Mass media • Useful for rapid dissemination • Quick public attention / sensitization • Effective for elite section
  9. 9. Group discussion • Effective to arrive at a decision not possible to attain by individual effort alone e.g. refuse disposal • Long term compliance: cessation of smoking
  10. 10. Receiver Decoding (listening): attention,comprehension,absorption Mental filtering Change of behaviour Change in Knowledge (Recall) Change in Opinion (Agreement) Change in Attitude (Approval) Change in practice
  11. 11. Change in behaviour Awareness Motivation a) Interest (stage of initiation) b) Evaluation (direction) c) Decision making (attempt) Action: transition from attempt into action, needs guidance / social intervention
  12. 12. What Are the BarriersWhat Are the Barriers To Communication?To Communication? Physiological: Impaired vision/hearing/ speech Psychological: Low IQ, Anxiety, tension Environmental: Noise, illumination Cultural: Language, illiteracy, level of knowledge & understanding
  13. 13. Barriers to communication Noise, Distractions Inappropriate medium Assumptions/Misconceptions Emotions Language differences Poor listening skills Inconsistency Human failings (tiredness, stress)
  14. 14. Utilities of communication 1. Dissemination of information 2. Education 3. Behaviour change (BCC) 4. Counselling 5. Advocacy 6. Informed participation 7. Management decision
  15. 15. Communication skills Effective speaking skills Verbal & nonverbal skills Listening skill Questioning Skill
  16. 16. Effective speaking skills 1. Make the receiver comfortable 2. Personal touch 3. Friendly tone of voice 4. Give complete information 5. Invite clarification
  17. 17. Verbal skills Pitch of voice Pace Tone
  18. 18. Nonverbal skills: ROLES 1. Relax 2. Open & approachable 3. Lean towards clients 4. Eye contact 5. Sit squarely and smile
  19. 19. Listening skill Attention Comprehension Absorption
  20. 20. Questioning skill • Rapport building • Privacy • Confidentiality/Beneficence • Sensitivity towards the condition/situation • Non-threatening and non-judgemental • Probing but no leading question
  21. 21. Seven ‘C’s and Behavior change process Clarify the message command attention knowledge Cater to the heart and head Create trust Approval Convey a benefit Intention Practice Advocacy Call to action Consistency counts Create confidence to speak out
  22. 22. Counselling • Helping process aimed at problem solving Help in identification and understanding the problem Help in identifying alternative solutions Help in chosing the best possible alternative
  23. 23. Counselling techniques 1. Focus of attention 2. Acceptance 3. Empathy 4. Probing 5. Paraphrasing 6. Summarising 7. Advising
  24. 24. Do doctors need communication? Historically the emphasis was on the biomedical model in medical training which places more value on technical proficiency than on communication skills. Poor communication causes a lot of medico-legal and ethical problems.
  25. 25. Communication: With whom? Patients & care-givers Nurses & auxiliary staff Colleagues Administrators Evidence in court Reporting research findings Talking to the media Public & legislature
  26. 26. Communication: How? The medical interview is the usual communication encounter between the doctor and the patient. It can be classified according to the purpose of the interview into 4 types: History taking Breaking bad news Consultations Obtaining informed consent
  27. 27. Questions to ask yourself after each consultation Was I curious? Do I know significantly more about this person as a human being than before they came through the door? Did I listen? Did I make an acceptable working diagnosis? Did I explore their beliefs?
  28. 28. Questions to ask yourself after each consultation/2 Did I use their beliefs when I started explaining? Did I share options for investigations or treatment? Did I share in decision-making? Did I make some attempt to see that my patient understood? Did I develop the relationship?
  29. 29. Dealing with emotional Patients Set an example: don’t ask patients to calm down. Get patients’ attention: lower your voice. encourage them to sit down but let them control their emotions at their pace. Listen not just to the patients needs, but also for underlying issues/concerns and unexpressed expectations.
  30. 30. Dealing with emotional Patients/2 Avoid arguments, use disarming statements. Consider rolling with the resistance and agreeing with the patient if possible. Take a step back from the demand and ask probing questions to find underlying concerns. This may change a rant into a conversation.
  31. 31. Dealing with emotional Patients/3 Don’t assume things, ask to find out Don’t get emotionally involved, keep your professional attitude. Don’t give false reassuring comments. Say no in a tactful manner to the patient’s unrealistic wishes & demands.
  32. 32. Breaking Bad News Clinicians are responsible for delivering bad news, this skill is rarely taught in medical schools, clinicians are generally poor at it. Medical education typically offers little formal preparation for this task.
  33. 33. THE PAST AND THE PRESENT  Hippocrates advised concealing most things from the patient.  Older physicians, who trained during the 1950s and 60s, were taught to "protect" patients from disheartening news.  In the past decades traditional models of patient care have given way to an emphasis on patient autonomy.
  34. 34. BREAKING BAD NEWS/2  Many health care professionals tend to define 'bad news' as worst case scenarios (eg. telling a patient they have cancer or that their loved one has died), But a knee cartilage problem requiring rest for a waitress may mean no pay
  35. 35. BREAKING BAD NEWS/3  Any news that drastically and negatively alters the patient’s view of his or her future.  It results in a cognitive, behavioral, or emotional deficit in the person.  Receiving the news that persists for some time after the news is received.
  36. 36. Principles of effective communication  Requires planning and thinking in terms of outcomes. Follows the helical model (what one person says influences what the other says in a spiral fashion so that communication gradually evolves through interaction). Demonstrates dynamism (what is appropriate for one situation is inappropriate for another).
  37. 37. Barriers to effective communication Personal attitudes Language Time management Working environment Ignorance Human failings (tiredness, stress) Inconsistency in providing information
  38. 38. Questions

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  • ravailhaq

    Sep. 27, 2016
  • NadineKnowles

    Oct. 17, 2016
  • RaziaMohammadi1

    Mar. 26, 2018

Communication & counselling

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