PHARMACEUTICAL CARE 2

INTERPERSONAL AND COMMUNICATION SKILLS FOR PHARMACISTS

COURSE DESCRIPTION• This course deals with the study of basic concepts of

interpersonal relationships and effective communication.

• It covers a variety of areas of learning interpersonal communications and acquiring skills needed by pharmacists to meet responsibilities of patient-centered pharmaceutical care services.

OBJECTIVE• Explain the various assumptions, basic concepts, theoretical perspectives and

contemporary issues surrounding professional pharmacists-client relationships.• Discuss the communication process• Demonstrate the effective listening, writing and speaking skills with special

attention to the application of these to patient interaction and relationships with other health care professionals.

• Define and describe characteristics of therapeutic communication• Identify the purposes of therapeutic communication• Demonstrate the ability to establish patient relationships that create true

“partnerships” with patients in helping them reach their therapeutic goal.• Apply assertiveness skills when needed when pharmacists take and active role

in patient care.

PHARMACEUTICAL CARE• The responsible provision of drug therapy for the

purpose of achieving definite outcomes that improve quality of life

• Involves professional care decision beyond enhanced therapeutic outcomes.

• A clear emphasis on the patient’s welfare, a patient advocacy role with a clear ethical mandate to protect the patient from the harmful effects of “drug misadventuring”

PROFESSION..• Specialized practitioners that develop and provide and array of

significant, unstandardized personal services that were central to human values.

• Means to “testify on behalf of” or “to stand for” something.• Members of a profession pledge or profess their fundamental

commitment to serving society.• People who are professionals stand for something and vow not

only to provide their clients with knowledge but also to use a particular body of learning to solve a specific range of human problems.

PHARMACY AS A PROFESSION..• Procurement, storage, and compounding of drug products.• Dispensing drug products and managing the supply of medicines• Justifiable pride in being responsible and accountable for

controlling drug distribution.• Focus on assuring safe, effective and cost-efficient therapeutic

outcomes for their patients.• Providing pharmaceutical care, which requires accepting

responsibilities for providing drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life.

ROLE OF A PHARMACIST• Centered upon the knowledge and skills needed to

compound drug products.• Advanced role in quality assurance ensuring that the

drugs provided to patients are safe and accurately dispensed.

• Disease and patient oriented approach to pharmaceutical decision-making.

PHARMACIST• Medical professionals are beginning to realize that te

success of their medical interventions with their patients depends as much upon interpersonal, value-based relationship.

• In practice, pharmacists assign priorities to these values as they encounter their patients or when the engage in specific decision making situations.

VALUES ATTITUDES PROFESSIONAL BEHAVIOR

ALTRUISM – concern for the welfare of others

CommitmentCompassionGenerosity

Perseverance

Gives full attention on patientsAssists other health care personnelSensitive to social issues

EQUALITY – having the same rights, privileges or status

FairnessSelf-esteem

tolerance

Provides services based on needs Relates to others without discriminating

ESTHETICS – qualities of objects, events, and persons

that provide satisfaction

AppreciationCreativitySensitivity

Creates supportive patient care environment

FREEDOM - Capacity to exercise choice

OpennessSelf-directionSelf-Discipline

Respects each individual’s autonomy

VALUES ATTITUDES PROFESSIONAL BEHAVIOR

HUMAN DIGNITY - inherent worth and uniqueness of an individual

EmpathyKindness

Trust

Respects the right of privacyMaintains confidentiality

JUSTICE - Upholding moral and legal principle

IntegrityMorality

Acts as a health care advocateAllocates resources fairlyReports incompetent, unethical and illegal practices

TRUTH – Faithfulness to fact or reality AccountabilityHonesty

Documents actions accuratelyProtects the public from misinformation about pharmacy

CARING AS A PROFESSIONAL RESPONSIBILTY• Care often appears to be a more important regulative

notion for determining the basis and direction of health-related activities that might be morally justified.

• A significant notion that reminds us that medicine serves as one of the ways we can help others maintain basic physical and psychological integrity.

UNDERSTANDING OUR PATIENT

MASLOW’S HEIRARCHY OF NEEDS• Maslow wanted to understand what motivates people. He

believed that people possess a set of motivation systems unrelated to rewards or unconscious desires.

• Maslow (1943) stated that people are motivated to achieve certain needs. When one need is fulfilled a person seeks to fulfill the next one, and so on.

• One must satisfy lower level basic needs before progressing on to meet higher level growth needs. Once these needs have been reasonably satisfied, one may be able to reach the highest level called self-actualization.

MASLOW’S HEIRARCHY OF NEEDSThe original hierarchy of needs five-stage model includes:1. Biological and Physiological needs - air, food, drink, shelter,

warmth, sex, sleep.

2. Safety needs - protection from elements, security, order, law, stability, freedom from fear.

3. Love and belongingness needs - friendship, intimacy, affection and love, - from work group, family, friends, romantic relationships.

MASLOW’S HEIRARCHY OF NEEDS4. Esteem needs - achievement, mastery,

independence, status, dominance, prestige, self-respect, respect from others.

5. Self-Actualization needs - realizing personal potential, self-fulfillment, seeking personal growth and peak experiences.

MASLOW’S HEIRARCHY OF NEEDS

SIGMUND FREUD’S TRANSFERENCE & COUNTER TRANSFERENCE

• Normal phenomena that may arise during the course of therapeutic relationship.

1. TRANSFERENCE - is the “transference” of old feelings, conflicts and attitudes into present relationships, situations, and circumstances.

- Evolves from unresolved or unsatisfactory childhood experiences in relationships with parents or other important figures.

- people may be considered habit-forming in how they relate and interact with others. These habits involve the development of attitudes and preconceived ideas based on the learning and retention of information from past relationships. This may precipitate behavioral and thought patterns in subsequent relationships, even though certain actions and attitude.

COUNTER TRANSFERENCE• Countertransference involves the same principles,

except the direction of the transference is reversed. • Countertransference, a normal occurrence as well,

involves the medical professional’s reactions, behaviors, thoughts, and feelings toward the patient.

• Unresolved conflicts from the medical professional’s past may evolve as countertransference.

STAGES OF PERSONALITY DEVELOPMENT Sigmund Freud believes that there are 5 stages in the

formation of personality.1. ORAL/DEPENDENCY - Takes place from birth to age 2- Child explores the world using their mouth- If needs are not met during this stage, one goes

through life trying to meet them

STAGES OF PERSONALITY DEVELOPMENT2. ANAL/POTTY TRAINING- The child learns to control their bodily functions- iIf not handled properly or if the child is traumatized at

this stage, then he or she might become anal retentive, controlling, or rigid.

- The child can also develop obsessive compulsive behaviors.

- Dreams of being out of control or trying to keep things in order are common.

STAGES OF PERSONALITY DEVELOPMENT 3. Phallic Stage• Between the ages of 3 to 5, the child becomes aware of male

and female.• Personality is fully developed by this stage.• This stage is also classified by the Oedipus and Electra

Complexes.• The Oedipus represents a male child's love for his mother and

the fear/jealousy towards his father. The Electra is the female version where the female child has anger toward her mother and exhibits "penis envy".

STAGES OF PERSONALITY DEVELOPMENT4. Latency PeriodLittle new development is observable during this stage. 5. Genital• Starting from age 12 to the peak of puberty, this stage is classified by the

reawakening of sexual interest. • Freud believes that the motivating force of a dream is wish fulfillment.• Issues of power, lack of control, or unsatisfactory love may manifest in

dreams as a way of satisfying these needs. Thoughts that are repressed during the day may also find a way into your dream as a way to getting fulfillment.

• Freud believes that every imagery and symbol that appears in a dream have a sexual connotation. For example, anxiety dreams are seen as a sign of repressed sexual impulses.