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LISTENING andEMPATHIC

RESPONDINGM. Rifqi Rokhman, M.Sc., Apt.

Apakah anda ingin menjadi orang sukses?

Menurut anda?

• Apa makna kesuksesan bagi anda?• Apakah IP selalu berkorelasi dengan

kesuksesan?• Mengapa ada orang yang semasa

kuliah IP biasa tapi saat bekerja bisa menjadi leader bagi orang lain?

Listening

• Trying to understand their thoughts and feelings

• More than understand conveyed back to the patients so they know you understand

• Patient feelings must be accepted without judgment as to be “right” or “wrong”

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Listening well

• Involves understanding both the content of the information being provided and the feeling being conveyed.

• Summarizing the critical pieces of information especially when there are barriers such as language barriers.

• Paraphrasing : convey back the essence of what she has just said

Listening skills

• Passive listening : without interference detect feelings and meaning behind the patient’s words.

• Acknowledgement responses : simple respond : “hmmm..”

• Encouragement : encourage patient to say more : “oh ya” ; “lalu?”

• Active listening : more active participation : “saya mengerti, bapakmerasa…..”

• Non-listening responses :– Excessive verbalization– Premature questioning– Tending to lecture patient (being

evaluative)– Cutting the patient expression of

feelings (ignoring the patients feelings)– Interrupt and monopolize conversation

Emphatic responding

• Empathy : sensitive ability and willingness to understand the client’s thoughts, feelings, and struggles from the clients point of view

• Empathy : understanding in a caring, accepting, nonjudgmental way.

• establish trusting relationship.

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Contoh• I don’t know about my doctor. One

time I go to him and he’s as nice as he can be. The next time he’s so rude Iswear I won’t go back again

• He seems to be very inconsistent• You must feel uncomfortable going to

see him if you never know what to expect.

Contoh

• I’m glad I moved into the retirement village. Every day there is something new to do. There are always lots of things going on, I’m never bored.

• So there a lot of activities to choose from.

• You seem to love living there.

Kasus :

“Saya ini sakit mbak, sama teman sayadisarankan ke dokter A, katanya dokternya bagusdan care sama pasien. Tapi apa nyatanya, sayamenunggu lama sekali padahal saya sudah janjiandengannya, begitu giliran saya diperiksa, dianampak buru-buru sekali sambil bergegas keluarmasuk ruangan jadi saya tidak sempat menjalaskansakit yang saya alami. Dia hanya bertanya apasakitnya sambil menuliskan saja resep ini untuksaya”

Apa respon anda?

Mr. RaymondTypes of response

• Judge response : “shouldn’t”, “wrong”, “bad”

• Advising response• Reassuring response : “don’t worry, I’m

sure..”• Generalizing response : “everyone feels

that way”• Probing response• Distracting response• Understanding response

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Judging response

• Bapak seharusnya tahu kalau dokter A itu memang sibuk sekali. Memangbegitulah beliau.

• Saya tahu dokter A itu dokter yang baik, dan saya yakin dia akan memberikanyang terbaik untuk pasiennya.

• Saya mengerti bapak, saya tidakmenyalahkan bapak jika bapak marah. Seharusnya bapak tidak perlumenunggu lama jika memang sudahada janji.

Advising response

• As pharmacist, we must give advice on their medication regimens, may not be appropriate in helpinh a patients deal with emotional or personal problems.

• Beri tahu sama dokter bapak tentangapa yang bapak rasakan tentangbagaimana seharusnya care denganpasien, atau bapak mencari sajadokter yang lain.

Placating or Falsely reassuring response

• Try to get a patient to stop feeling upset, rather than accepting the feeling upset as they exist.

• Such as terminal illness.• Saya yakin bahwa apa yang bapak

alami hari ini sangat tidakmenyenangkan. Mungkin saat yang lain bapak bertemu dengan dokter A akan berbeda.

Generalizing response

• Others have have had the same experience, may take the focus away from the patient experience, it also can lead you to stop listening

• Saya paham tentang apa yang bapakrasakan dan saya juga tidak sukamenunggu lama untuk periksa dengandokter.

• Tidak ada satu orang pun yang merasabahwa mereka punya banyak waktu untukberbicara dengan dokter

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Quizzing or probing response

• Asking questions when the patient has expressed a feeling can take the focus away

• Berapa lama bapak menunggu dokterA tersebut?

Distracting response

• Many times we get out of situation we don’t know how to respond to by simply changing the subject.

• Baiklah, ijinkan saya berbicaradengan bapak untuk menjelaskantentang obat yang bapak peroleh

Understanding response

• Truly understant the basis of Mr. Raymond’s concern

• Bapak sepertinya merasa adasesuatu hal yang kurang padahubungan bapak dengan dokter A yaitu bahwa ternyata dia tidak care seperti yang bapak harapkan.

• Mechanic & Meyer (2000) identified interpersonal (not technical) competence as the principal component mentioned by patients as key trust in their health provider.

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Problems in establishing helping relationships

• Stereotyping• Depersonalizing• Controlling

STEREOTYPING

• What image come to mind when you think about :

• Pasien yang sudah lanjut usia?• Pasien kaya?• Pasien yang sakit HIV/AIDS?• Pasien dengan penyakit kronis?• Pasien yang tidak patuh dengan

pengobatan?• Pasien dengan gangguan jiwa?

DEPERSONALIZING

• If elderly patient accompanied by an adult, we may direct the communication to the adult and talk about the patient rather than with the patient.

CONTROLLING

• When health care provider do things that reduce the patient’s sense of control over decision that are made regarding treatment , they may actually be reducing the effectiveness of the therapy

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Daftar Pustaka

Beardsley, R.S., Kimberlin, C.L., Tindall, W.N., 2007, Communication Skills in Pharmacy Practice, 5th Ed., Lippincott Williams & Wilkins, Baltimore.

Rantucci, M.J., 2007, Pharmacists Talking with Patients : A Guide to Patient Counselling, 2nd Ed., Lippincott Williams & Wilkins, Baltimore.

Hargie, O., 2006, The Handbook of Communication Skills, Taylor&Francis e-library, NY.

We can not stop the waves,but we can learn to surf

Thank you ..