Communication skills in patient counseling

 Communication is the transfer of information meaningful to those involved. It is the process in which messages are generated and sent by one person and received and translated by another person. However, the meaning generated by the receiver can be different from the sender’s intended message.

Patient counseling is a key competency element of the Pharmaceutical Care process. Communication, plays a vital part in the health sector, the counselor needs to be skilled in analyzing and evaluating the human behavior. They need to know about human behavior and development, relationships, different techniques, social and cultural issues. Communication is the exchange of information, ideas, thoughts and feelings. It involves not just the spoken words, but also what is conveyed through inflexion, vocal quality, facial expression, body posture and other behavioral processes.

Effective communication with patients depends greatly on the degree of empathy demonstrated in the course of conversation. Pharmacist should use proper verbal and non-verbal communication skills during the counseling session. Studies repeatedly show that effective patient counseling can significantly reduce patient non-adherence, treatment failure, and wasted health resources. Effective, open-ended questioning and active listening are essential skills for obtaining information from and sharing information with patients.

To be good communicators, pharmacist must be attuned to the types of questions asked, the manners in which questions are asked, and the avoidance of repetition. The counseling pharmacist should be well dressed so that the patient feels the pharmacist is a professional. The nature of the counseling should be tailored to the patient population. A good counselor is one who listens to the patient carefully and shares the problems intimately so that the patient expresses the emotions underlying the disease. During counseling pharmacist should be totally involved in the counseling and should not be half minded. Even attending a telephone call while counseling may affect the quality of counseling. An effective counseling will end up with several questions being asked by the patient. Throughout the counseling process, the pharmacist should avoid jargons and slang expressions.

Communication with special patients

Elderly Patients:

As a group, sometimes the aging process affects certain elements of the communication process in some older adults. In certain individuals, the aging process affects the learning process, but not the ability to learn. Some older adults learn at a slower rate than younger persons. They have the ability to learn but they process information at a different rate. The elderly might also have problems such as poor vision, speech or hearing. Therefore, it is very important to set reasonable short-term goals, and break down learning tasks into smaller components. It is also important to encourage feedback as to whether they understand the intended message.

Terminally Ill patients:

Terminally ill patients are usually intimidating to work with because people do not want to say the “wrong” things that would upset them. Before interacting with them, be aware of your own feelings about death and about interacting with terminally ill patients. Simply being honest with them can improve their interaction with them. It will also open them up to voice out their concerns as well. Many terminally ill patients know that they can make others feel uncomfortable. You should not avoid talking to them unless you sense that they do not want to talk. Not interacting with them only contributes further to their isolation and may reaffirm that talking about death is uncomfortable.

Patients with AIDS:

Patients with AIDS are not only dealing with life threatening diseases, but also the social stigmas that often accompany their conditions. The key is not to treat them as different from others. Due to the advent of highly effective antiretroviral therapy, health professionals should adjust their thinking to perceive HIV infections as a chronic condition rather than a terminal disease.

Mentally Ill Patients:

Patients who are mentally ill can be difficult to communicate with. Open-ended questions would be more effective as they can be used to determine the patient’s cognitive abilities. Ethical considerations include whether they require consent from the patient for treatment. Mentally Ill Patients might not always understand their treatments or medication purposes.

Communication with Children

- Attempt to communicate at the child’s developmental level

- Ask open-ended questions rather than questions requiring only a yes or no response

- Use simple declarative sentences for all children

- Ask the child whether he or she has questions for you

- Augment verbal communication with written communication

- Nonverbal communication is very important with children therefore be aware of your facial expressions, tone of voice, gestures, and so on. Children want to know. Healthcare professionals should communicate directly with children about medicines and treatment.

References:

1. Harvey M. Rappaport et al. The Guidebook for Patient Counselling. Lancaster, Pennsylvania: Technomic Publishing Company, 1994.

2. Tindall, William N, Robert S. Beardsley, Carole L. Kimberlin. Communication Skills in  Pharmacy Practice (fourth edition). Baltimore, Maryland and Philadelphia, Pennsylvania:  Lippincott Williams & Wilkins, 2003.

Regards,

THE PHARMACY CARES