COMMUNICATION STYLES

INTRODUCTORY:
-Words are not the only way by which pharmacists communicate. Interpersonal
communication involves both VERBAL and NONVERBAL expression.
-WORDS normally express ideas,whereas
-NONVERBAL expressions convey attitudes and emotions.
-In this chapter we will discuss the different communication styles and its important role
in effective patient-centered-communication.

COMMUNICATION STYLES
1.META-COMMUNICATION- main focus
2.VERBAL COMMUNICATION- very common way of communicating

1.META COMMUNICATION
-“What I said Isn’t what I meant”
-a.k.a“NON-VERBAL COMMUNICATION”
-55% to 95% of all communication can be attributed to non-verbal sources
-can be portraited through Cue clusters(combination of non-verbal acts)

Example of Cues:
1.Nod of head 5.Tone of voice
2.Hand Gesture 6.Eye movement(shows interest)
3.Facial Expressions 7.etc.
4.Body language

Example of Cue cluster.

1. A patient who gives you a friendly handshake, a pleasant-sounding “thank you,” and a
warm smile at the end of your interaction is probably more pleased with the interaction
than a patient who abruptly turns around and quickly walks away mumbling something
under his breath.

* When analyzing nonverbal communication, avoid focusing on just one cue. Look
at all the nonverbal cues that you are receiving and use verbal communication to
fully understand the meaning of the nonverbal behavior

Nonverbal communications are unique for three reasons:

1. First, they mirror innermost thoughts and feelings. This mirror effect is constantly at
work, whether or not you are conscious of it.
2. Second, nonverbal communication is difficult, if not impossible, to “fake” during an
interpersonal interaction.
3. Third, your nonverbal ommunication must be consistent with your verbal
communication(or people will be suspicious of the intended meaning of your message.)
ELEMENTS OF NON-VERBAL COMMUNICAITON
1. Kinesics
2. Proxemics
3. Environment
4. Distracting factors

1.KINESICS((body movement)
-The manner in which you use your arms, legs, hands, head, face, and torso may
have a dramatic impact on the messages that you send.
*Some communities uses the ff:
1.Handshake- as a sign of friendship ,but some uses Bow

The Open Stance

-Is a must for health care professionals
-Shows empathy,respect and commitment
Example:
1.Standing/Sitting with a full frontal appearance to the other person
2.Arms and Legs not crossed
3.Facial expressions that expresses interest and a desire to listen and as well as speak.

The Close stance

-results to shortening/breaking of interaction
1.Arms and Legs Crossed
2.Head facing downwards
3.Eye looking away from patient
NOTE: It is appropriate to use a closed posture, for example, when you want to
limit the interaction with an overly talkative person.

Key Components of Kinesics

• Varied eye contact (consistent, but not a stare)
• Relaxed posture
• Appropriate comfortable gestures
• Frontal appearance
• Slight lean toward the other person
• Erect body position (head up, shoulders back)

2.Proxemics(distance between two interacting persons)

-the structure and use of space
-consideration of distance factor
-distance factor may cause anxiety and perhaps anger at the trespass of their intimate
zone

*Behavioral scientists have found that the quality of interactions can vary depending
upon the distances between the communicators (Keltner, 1970).

-Intimate distance for embracing, touching or whispering(6-18 inches)

-Personal distance for interactions among good friends or family(1.5ft-4ft)
-Social distance for interactions among acquaintances(4 -12 ft)
-Public distance used for public speaking(12-25ft)

*The type of instructions that you need to give to the patient will also affect the distance.
Example:
1.For sensitive issues, such as explaining the use of a rectal or vaginal medication, you
may need to enter the patient’s private zone(1.5-4ft), especially if others are around.
HANDLING SENSITIVE ISSUES
-In 1997 , Harris Survey found that embarrassment was the most common reason why
consumers did not approach their health care provider.
Example of embarassing issues:
1. Incontinence 5. Hemorrhoids
2. Sexual dysfunction 6. Contraception
3. Depression 7. Breast or prostate cancer.
4. Menopause

*As a pharmacist!
1. You should be prepared to recognize situations that may be sensitive areas for
patients.
2. You should be comfortable discussing such matters in a nonthreatening way and in a
nonverbal environment that conveys confidentiality and privacy.

TACTICS AND TECHNIQUES IN HANDLING SENSITIVE ISSUES

1.Watch your patient

-Before engaging in a conversation, watch their behavior to get a clue about their
feelings.
-They may appear to be embarrassed before they reach the prescription counter.

2. Discuss sensitive issues with clarity and avoid potentially frightening scenarios
-Example, you may bring up the subject of incontinence by saying, “Miss Smith, we have
many women who get their prescriptions from us here for bladder control problems.
While this problem is potentially embarrassing, there are several effective means to deal
with it. Would you like to step away to a quieter area and we can discuss it?”

3. Be cognizant for the potential of non-adherence

-Observe patient behavior when they are describing how they take their medications.
If you suspect nonadherence to medication regimens, ask open-ended questions to
assess patient attitudes and feelings.

3.ENVIRONMENTAL FACTOR
-The general appearance within the pharmacy setting conveys nonverbal messages to
patients.
EXAMPLES:
1.Dirt,Clutter and Untidiness carry negative non-verbal messages
2.Color,Decor’s and lightning used in pharmacy plays an important nonverbal role.
3.Prescription/Counseling counter is a very important environmental factor.
4.Physical characteristics of pharmacy employees(dress code)

4.DISTRACTING FACTORS
Examples:
1. Eye contact
-It is frustrating to talk to somebody who is not looking at you
-Pharmacists uncociously focuses on the prescription and the computer screen or others.
-Lack of eye contact limits your ability to receive feedback from the patient about the
messages that you are giving.

For example,
-if you say, “Go ahead I am listening, tell me about it!” but your eyes are distracted by
something else in the pharmacy, you may be communicating mixed messages.
The patient hears you say that you are interested, but your nonverbal behavior
communicates otherwise.
2. Facial expressions
-may send a message that you did not intend to transmit

For example, if you roll your eyes as a patient explains something to you, you may
be communicating a feeling of disinterest or lack of concern toward the patient.

3.Body position
-dictates willingnes to listen

For example, a closed stance with folded arms or a

body position that is slouched forward or tilted to one side may be communicat-
ing reluctance on your part to talk with them

4.Tone of Voice
-People interpret the message not only by the words you use, but also by the tone
of voice you use

For example, a comment in a sarcastic or threatening tone of voice will produce a

different effect than the same phrase spoken with an empathic tone