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Dr. Dalia El-Shafei
Assistant professor, Community Medicine Department, Zagazig University
“We are born to see, but have to train ourselves to observe”
WHAT IS COMMUNICATION?
Communication is sending or receiving ideas, thoughts or
feelings from one person to one or more persons in such a way
that, the person receiving it understands it in the same way the
sender wants him/her to understand.
The term ‘Communication’, derived from a Latin term
Also known as “people skills” or “soft skills”.
Ranked in a survey as the most important requirement for
successful job performance.
SENDER MESSAGE CHANNEL RECEIVER
THE COMMUNICATION PROCESS
The specific set of words,
gestures and images that
the sender uses to
convey what he or she
wants to say.
Receivers (or the
audience for the
message) - from whom
the receiver often
expects a response.
The response from the
receiver to the sender.
WHY WE STUDY COMMUNICATION SKILLS?
• 60% to 80% of diagnosis.
• >50% of patients deviate from the doctors’ advice or do not follow it
Good communication provides information to the
• Doctors interrupt patients very early.
• Patients do not understand what the doctor is saying.
• Advice is too difficult to follow.
Poor quality of communication leads to patient’s
Listening (not HEARING)
Observing (non- verbal)
Informing (4 Cs = Clear, Correct, Concise, Complete)
Active process (Not hearing), it involves a conscious effort to listen
to words; to the way they are said, to be aware of the feelings
shown and attempts to hide feelings.
Focus your attention; avoid barriers.
Show that you are listening (verbally & nonverbally).
Understand ideas and pick key words.
Retain information (memory, notes).
Reflect or give your feedback.
- What clients think/know.
Encourage them to talk: tell them that are really listening &
wanting to hear more.
Keep Privacy, listen.
Nonverbal communication through:
Facial expressions Voice tone Body language
In a Clear, Correct, Concise, Complete way.
Consider: Needs, Language, Obstacles.
Check back with the speaker to ensure that the statement is accurate.
Get & give
• Loud sounds
• Activities of
• Values & beliefs
• Not valuing
their health is
• Anger, tiredness,
Barriers to the Communication
SENDER MESSAGE CHANNEL RECEIVER
THE COMMUNICATION PROCESS OR ELEMENTS
MEANS OF COMMUNICATION
Non-verbal communication can Reinforces,
Complements, Contradicts, Regulates, or
Replaces a verbal message.
CATEGORIES OF NONVERBAL COMMUNICATION
Body movement: Way
Posture: Way of sitting,
Gesture: Movements of
hands, legs, arms & feet
Facial expressions &
Space: Place of sitting,
Touch: Shake hands,
patting on the back
Clothes, hair, jeweler
volume, rate & quality),
Smiling Eye contact How you look Shaking hands
+ve Non-Verbal Communications
> 360 cm
120 – 360 cm
45 – 120 cm
15 – 45 cm
WHEN YOU INVADE MY SPACE
Reactions to an invasion of your space
Counselling is a process that uses communication skills to help
client/patient to reach an informed decision/choice
Counselling will provide customized, client-oriented information
and negotiate available alternatives to help take a decision based
on clear information.
Helping a person or a group to develop
self-help & self-care abilities.
CONSULTATION & COUNSELING
• Process of a dialogue that
leads to a decision
• Helping a person or a
group of people to
develop self help
After each consultation session 5 things must be established
Discover the reasons of patient attendance
Define clinical problem (HPT, DM)
Address the patient’s problem (details)
Explain the problem to the patient
Make effective use of the consultation
PRINCIPLES FOR GOOD COUNSELLING
Treat each client
Give the right
Use & provide
satisfy the client’s
Preparing a counseling session
1. Physical setting
Privacy: in a quiet, calm & no interruption
Proper lightening & temperature.
3. Interpersonal space
P D P P
(√) (√) (×)
CONSULTATION, COMMUNICATION PROCESS
Initiating the session
Explanation & Planning
Closing the sessions
THE ELEMENTS OF COUNSELLING
G A T H E R
Give the clients your full attention as soon as you meet them.
Be polite, friendly and respectful.
Introduce your self and offer them seats.
Ask how you can help?
Explain what will happen during the visit.
Conduct counselling privately
Reasons for coming.
Their experience with the health matter that concerns them.
Any information needed to complete client records.
Ask Clients about themselves & their families as appropriate.
-To decide what choices and decisions.
-To express their feelings, needs, wants, & any doubts, concerns or
Keep questions open, simple and brief.
Look at your client as you speak.
Listen actively to what the client says.
Show your interest and understanding all the time.
Tell the clients about their condition or Choices
Help clients understand their possible condition
Information should be: Simple, correct and relevant
HELP CLIENT TO UNDERSTAND
Help the clients think about the results of each possible choice.
Ask if the client wants anything made clearer, repeat and
rephrase information as needed.
Check whether the client has made a clear understanding .
“What have You understood?”
“What have you decided to do?”
Wait for the client to answer.
EXPLAIN WHAT TO DO
Give supplies, if appropriate.
If the service cannot be given at once, tell the client how,
when & where it could be provided.
Describe possible side effects & what to do if they occur.
Ask the client to repeat instructions.
Make sure the client remembers & understands.
If possible give the client printed materials to take home.
Explain when to come back & why.
Check if the client is using the Treatment correctly.
Ask if the client has any Question or anything to discuss.
Consider all concerns seriously.
Ask if the client is Satisfied, has there been any problems
since last visit???
Help the client handle any Problems.
Refer client who need specialized care.