social behavior lecture 1,2,3,4

what are nonverbal cues

posture, facial expression, eye contact, gestures, time, paralanguage, touch, distance

if someone is sitting in with their hands and legs crossed that is

closed posture

if someone is sitting in with their hands and legs open that is

open posture

which is more welcoming open or closed posture

open posture

what do hands on hips indicate

dominant/confidence, disrespect, insecure/discomfort

what does slouching indicate

shy, low self esteem, lazy, lethargy

what does crossed arms indicate

defensive/introverted, uncomfrotable, uncertain

should we welcome or avoid crossed arms, slouch, hands on hips

avoid

optimal posture to faciliatate conversation while sitting

face patient, lean in to show interest, open posture

optimal posture to faciliatate conversation while standing

face listener, open/relax arms, stand with legs slightly apart, display palm for openness

illustrators, adapters, emblems are examples of

gestures

what are gestures meant to do

enhance nonverbal communication

illustrators

have no meaning on their own, further illustrate verbal communication

do illustrators support or interfere with effective patient communication

supports

adapters

behavior/movement related to anxiety, can also relieve excess energy, have no meaning on their own

do adapters support or interfere with effective patient communciation

interfere

fidgeting, play with hair, tap finger/foot, click pen are examples of

adapters

emblems

movements that have specific agreed on meaning (ex. thumbs up means good), can replace verbal communication, can be culture specific

can emblems replace verbal communication

yes

can emblems be culture specific

yes

what is useful for initiation/regulation of communication

eye contact

what is the optimal amount of eye contact

50-75% majority

what can avoiding eye contact imply

deception, low confidence, inanttention, cultural dependent

is it best to communicate at patients eye level or above/below them

at patients eye level

average rate of speed

125-150 wpm

speaking too slow

can cause impatience

speaking too fast

can make it hard for patient to understand

paralanguage

vocalized but nonverbal parts of a message

pitch, volume, rate, verbal filler, and accenting are components of

paralanguage

what helps convey meaning

pitch

what helps convey intensity

volume

what helps emphasize parts of message to help with meaning

accenting

benefits of touch

reduce tension, provide comfort, improve rapport

ways to touch for professional communication

handshake, hand on shoulder, pat on back, high five

distance account for

2 feet of personal space for one on one encounters

in distance look for attempts to establish

intimacy equilibrium

intimacy equilibrium

gets too close and patient back up to establish equilibrium

nonverbal cues when using translator

face patient when speaking, observe patient to confirm understanding, asses patient openess to information

nonverbal cues to demonstrate listening

stop talking, take notes, nod head, avoid action that inhibit conversation

actions that inhibit conversation

showing distraction, yawn/stretch, shake head, backing away

S in SOLER means

squarely face the patient

O in SOLER means

open posture

L in SOLER means

lean toward patient to show interest

E in SOLER means

eye contact at eye level (50-75% of time)

R in SOLER means

relax

C in CLOSER means

control distractions

L in CLOSER means

lean toward patient to show interest

O in CLOSER means

open posture/squarely face the patient

S in CLOSER means

smile

E in CLOSER means

eye contact (50-75%) of interaction time

R in CLOSER means

relax

nonadherence to medication causes

high hospitalizattion, suboptimal outcome, increase health care costs and mortality

benefit of patient counseling is to

reduce med error, improve med adherence, increase patient understanding, minimize adverse drug reaction, improve patient outcome

3 objectives to patient counseling

assess, improve, motivate

assessing

assess patients understnading of the therapy

improving

improve patient adherence

motivate

motivating patient to take active role in health management

essential component of counsel session

establish trust, communicate verbally/nonverbally

open ended questions

requires more than yes/no answer, detailed response, allows gathering of more info and more complete assessment

what can be used for open ended questions

who, what, how, where, when

closed ended questions

limit response to yes/no, ineffective to assess patient level of knowledge, used to elicit specific details or get info you want to collect

leading questions

suggest particular answer, lead patient to give answer that they think interviewer wants to hear, doesnt assess patient level of understanding

what kind of questions should be avoided

leading questions and why questions

why questions

make patient feel like they have to defend their actions, patient may feel judged

clarifying questions

allows reflection and rephrasing of what you heard from other person, demonstrates active listening, reassure patient that they heard what you said

what kind of question is this “are you taking all of your medications”

closed

how to make this open ended “are you taking all of your medications”

what medications are you taking

what kind of question is this “do you understand how to take your medications”

closed

how to make this open ended “do you understand how to take your medications”

what questions do you have about your medications

what kind of question is this “you are not having any low blood sugars, are you”

leading

how to make this open ended “you are not having any low blood sugars, are you”

since the last visit have you had any low blood sugars

what kind of question is this “why didnt you take your blood pressue medications for 3 days”

why

how to make this open ended “why didnt you take your blood pressue medications for 3 days”

is there something that hinders you from taking your medication for 3 days

it is optional for pharmacists to counsel

false, it is mandatory by law

taking patient history chart

start by introducing yourself, explain your role, give purpose of session, verify info, update allergy/medical list

list the 3 prime questions

what did the doctor tell you the medication is for?

how did the doctor tell you to take the medication?

what did the doctor tell you to expect?

after 3 prime questions how do you finish the session

do final verification then farewell

when counseling on refills make sure to

show patient their medication bottles and tablets and review medication

what are some environmental barriers regarding the counseling area

computer placement, organization of consult area, drive thru, front of store

what are some environmental barriers regarding the counseling area but towards the patient

phones or children

what are some environmental barriers regarding approachability

privacy, perceived accessibility of health care provider

patient counseling in private area with decreased environmental barriers show

more adherence towards their medication, retain more info, have greater patient satisfaction

environmental barriers in regard to distractions

ringing phone, children, other patient/pharmacy employee, technology

what should you never do when counseling a patient

multitask

pharmacists should not look at what unless necessary

phone or computer

what are some pharmacist centered barriers

lack of confidence to counsel, nonverbal communication, attitude towards counsel and open communication

what are some pharmacist centered barriers to avoid in regards to listening

internal convo, interruption, make assumption, finishing patient sentence

what are some pharmacist centered barriers road blocks

interrupting, express judgement, right/expert trap, probing question before patient explanation complete/express concern

how can a pharmacist be a better listener

pay attention, listen, take notes, read between lines, remain open minded, stop talking

what can increase risk of misinformation or inacurate information

accept vague info, not verifying info heard, leading questions, interal convo, assumption, finish sentences, road blocks

‘what you should have done is’ an example of

antagonistic message delivery

‘its not that hard to keep up with your meds, just use a pillbox’ is an example of

judgemental message delivery

‘this deivce is better bc i dont think you can handle the other one’ is an example of

condescending message delivery

‘well ive gone to school for 6 years so i know what med is best for you’ is an example of

expert role message delivery

listen to an example is a

enthusiasm message delivery

how can you build raport

AIDET, improve patient satifaction, decrease anxiety, build patient loyalty, increase adherence to improve clinical outcome

patient centered barriers

halth literacy, visual/hearing/physical challenges, aging, language barrier, disinterest/rush, alternative health belief/personal

health literacy

degree to which individuals have capacity to obtain process, understand basic health info and services needed to make appropriate health decisions, associated with med nonadherence

is health literacy the same as literacy level

NO

whats universal precaution of health literacy

assume everyone has low heatlh literact until proven otherwise