EKARINA RATNA HIMAWATIDEPARTEMEN FARMASI KOMUNITAS

FAKULTAS FARMASI UNAIR

Membina hubungan yang sedang berlangsung antara farmasis dan pasien

Memberi pertukaran informasi yg diperlukan untuk:

- menilai kondisi kesehatan pasien - mencapai keputusan2 pd. rencana terapi - menerapkan rencana terapi - mengevaluasi dampak pengobatan thd. kualitas hidup pasien

INTERVIEW (HISTORY TAKING) PATIENT COUNCELING PATIENT EDUCATION

Tujuan pembelajaran mhs. mampu:- memilih pasien yg. plg. memerlukan history taking- mengetahui perlunya dilakukan history taking- mengetahui pertanyaan2 yg. tepat utk. melakukan history taking- mengetahui tipe2 respon verbal yg tepat & yg tidak tepat utk. merespon pernyataan pasien- memilih teknik yg tepat utk memotivasi pasien agar berkomunikasi- mengetahui penemuan2 bermakna yg sebaiknya dikomunikasikan kpd. dokter, perawat, & pasien.

ListeningProbingAsking sensitive questionsUse of silenceEstablishing rapport

saat menginterview sebaiknya kita: 1. Berhenti berbicara. 2. Menghilangkan gangguan2 yg. memecah konsentrasi. 3. Gunakan tatapan mata yg. baik mem-

bantu konsentrasi. 4. Bereaksi thd. ide, bukan thd. orangnya. 5. Baca pesan2 nonverbal. 6. Dengarkan bgmn. sesuatu diucapkan (nada suara & kecepatan berbicara). 7. Berikan umpan balik utk. mengklarifikasi

perhatikan bentuk/susunan kalimat pertanyaan. hindari jenis pertanyaan “mengapa” ganti dg. “apa” atau “bagaimana” hindari pertanyaan yg. mengarahkan gunakan pertanyaan terbuka & tertutup dg. tepat

gunakan keheningan dg. tepat kadang pasien tidak berbicara, bisa karena: - butuh waktu utk. berpikir/bereaksi thd.

informasi kita - tidak memahami pertanyaannya dg.

lengkap - merasa takut atau tertekan - sedang mencari-cari jenis respon yg. kita

berikan semakin besar “rasio berbicara” di pihak yg.

diinterview semakin berhasil proses interviewnya.

caranya: - memberi sambutan yg. tulus &

ramah - berperilaku sopan - tidak bersikap stereotyping &

prejudging - mendorong pasien utk. datang ke

satu apotek saja

Interview considerationsType of informationType of environmentStarting the interviewEnding the interview

What exactly do you want to accomplish? - specific pieces of information directed interview approach - the outcome is unknown or ambiguous non directed approach the interview becomes more free flowing open-ended questions more frequently

Provide as much privacy as possible The privacy of the setting improves the amount of information retained by the patient increases.

Privacy also allows the pharmacist and the patient to express personal concerns, to ask difficult questions, tolisten more effectively, and to share honest opinions.

HUMOR SELINGAN

KECELAKAAN

Pada suatu sore di ruang praktek masuklah seorang bapak dengan muka gelisah dan tergesa-gesa.Pasien : “Tolong Dok dikeluarkan, anak saya kece- lakaan!”Dokter : “Di mana anak Bapak?”Pasien : “Masih di mobil, tak mau keluar!”Dokter : (Wah, gawat. Beratkah kecelakaannya?) “Ayo cepat kita keluarkan!”Pasien : (Dengan air muka senang segera berlari menjemput anaknya di luar yaitu di dalam mobil).Dokter : “??? (Melihat seorang gadis keluar dari mobil bersama seorang ibu). “Kecelakaan??? Oooh, dosa siapa ya?”

A. Pemilihan pasien yg akan diinterview dahulukan pasien yg:- punya gejala mengarah ke DRP.- penyakitnya akut & parah- punya riwayat kurang mematuhi pengobat-

an, respon terapetik tdk. mencukupi, atau reaksi alergi

- menerima obat dg. indeks terapi sempit- mendpt. multiple drug regimen atau dg.

Multiple disease state- pasien psikiatri dan manula.

∗ Lihat catatan pasien, surat rujukan, riwayat pengobatan & pemeriksaan dokter, data lab., catatan kemajuan kesehatan, dll.∗ buat catatan khusus ttg. pasien∗ siapkan formulir PMR yg minimal berisi: • pengobatan dg. resep & non resep • alergi & manifestasinya • reaksi samping obat selain alergi • obat2 yg. dipakai di rumah • diet/pola makan • asupan cairan • pola hidup

Start by greeting patients by name and by introducing yourself to patients.

State the purpose of the interview should be stated in terms of the benefit to the patient.

State the amount of time needed State the subject to be covered and the final outcome

“Selamat siang, Pak Doni, saya Ratih, apoteker di sini (perkenalan diri). Karena Bapak baru pertama kali ke apotik kami, saya ingin menanyakan beberapa pertanyaan singkat tentang obat-obat yang Bapak terima ini (subyek yang ditanyakan). Ini akan membutuhkan sekitar 5-10 menit (waktu yang dibutuhkan) dan akan memungkinkan saya bisa membuat gambaran tentang semua pengobatan yang Bapak terima. Hal ini akan membantu kita mengenali masalah2 yang mungkin akan terjadi dengan obat baru yang diresepkan dokter untuk Bapak (tujuan/outcome).”

Demografics and family history (pendidikan, pekerjaan, usia, BB, riwayat penyakit keluarga)

Past medical history Current medical problems Allergies and ADR Lifestyle issues related to health (merokok, olah-raga, pola makan)

Immunization history

Bagaimana penjelasan Dokter tentang obat Anda?

Bagaimana penjelasan Dokter tentang cara pakai obat Anda?

Bagaimana penjelasan Dokter tentang harapan setelah minum /memakai obat Anda?

People seem to remember best what was said last don’t end the interviw abruptly or rush the patient out the door.

To conclude the interview summerize the key information provided by the patient.

A summary also hints to the patient that the interview is ending.

In conjunction with a summary, use nonverbal cues to indicate that the interview is over.

Before terminating interview, you should reflect on wether the goals of the interview were accomplish and what should be done if they were not.

Finally, key information must be documented as part of the patient record.

HUMOR LAGI AAAH….

DIPATUK ULAR

Seorang pelatih Palang Merah Remaja (PMR) sedang menguji salah seorang siswanya.Pelatih : “Seandainya temanmu dipatuk ular di betisnya, apa yg. akan segera kamu lakukan?”Siswa : “Cepat2 ikat pahanya, agar racun ular tdk. menyebar ke seluruh tubuh.”Pelatih : “Kalau yang dipatuk siku tangannya?”Siswa : “Ikat lengannya.”Pelatih : “Kalau yang dipatuk kepalanya.”Siswa : “Ikat lehernya!”Pelatih : ???

DAFTAR PUSTAKADAFTAR PUSTAKA

Berger A.B., Communication Skills for Pharmacists, 2nd Edition, American Pharmacist Association, 2005.

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

Rantucci M.J., Pharmacist talking with Patients: A Guide to Patient Couseling, 2nd Edition, Lippincott Williams & Wilkins, 2007.

Daftar Tugas Kelompok Selasa

Kel.

Judul Pustaka

I Developing the Relationship Comm. Skills for Pharmacist, 2nd Ed.

II Managing the Angry Patient Comm. Skills for Pharmacist, 2nd Ed.

III Conflict Management Comm. Skills for Pharmacist, 2nd Ed.

IV Interacting with Physicians Comm. Skills for Pharmacist, 2nd Ed.

V Supporting Communication Comm. Skills for Pharmacist, 2nd Ed.

VI Persuasive Communication Comm. Skills for Pharmacist, 2nd Ed.

VII Communication Skills and Interprofessional Collaboration

Comm. Skills in Pharmacy Practice 5th Ed.

VIII Ethical Behavior when Communicating with Patients

Comm. Skills in Pharmacy Practice 5th Ed.

Daftar Tugas Kelompok Rabu

Kel.

Judul Pustaka

I Developing the Relationship Comm. Skills for Pharmacist, 2nd Ed.

II Managing the Angry Patient Comm. Skills for Pharmacist, 2nd Ed.

III Conflict Management Comm. Skills for Pharmacist, 2nd Ed.

IV Interacting with Physicians Comm. Skills for Pharmacist, 2nd Ed.

V Supporting Communication Comm. Skills for Pharmacist, 2nd Ed.

VI Persuasive Communication Comm. Skills for Pharmacist, 2nd Ed.

VII Medication Safety and Communication Skills

Comm. Skills in Pharmacy Practice 5th Ed.

VIII Communication Skills and Interprofessional Collaboration

Comm. Skills in Pharmacy Practice 5th Ed.

IX Ethical Behavior when Communicating with Patients

Comm. Skills in Pharmacy Practice 5th Ed.

Daftar Tugas Kelompok Kamis

Kel.

Judul Pustaka

I Developing the Relationship Comm. Skills for Pharmacist, 2nd Ed.

II Managing the Angry Patient Comm. Skills for Pharmacist, 2nd Ed.

III Conflict Management Comm. Skills for Pharmacist, 2nd Ed.

IV Interacting with Physicians Comm. Skills for Pharmacist, 2nd Ed.

V Medication Safety and Communication Skills

Comm. Skills in Pharmacy Practice 5th Ed.

VI Communication Skills and Interprofessional Collaboration

Comm. Skills in Pharmacy Practice 5th Ed.

VII Ethical Behavior when Communicating with Patients

Comm. Skills in Pharmacy Practice 5th Ed.

Daftar Tugas Kelompok Jum’at

Kel.

Judul Pustaka

I Developing the Relationship Comm. Skills for Pharmacist, 2nd Ed.

II Managing the Angry Patient Comm. Skills for Pharmacist, 2nd Ed.

III Conflict Management Comm. Skills for Pharmacist, 2nd Ed.

IV Interacting with Physicians Comm. Skills for Pharmacist, 2nd Ed.

V Supporting Communication Comm. Skills for Pharmacist, 2nd Ed.

VI Persuasive Communication Comm. Skills for Pharmacist, 2nd Ed.

VII Helping Patients Manage Therapeutic Regimens

Comm. Skills in Pharmacy Practice 5th Ed.

VIII Medication Safety and Communication Skills

Comm. Skills in Pharmacy Practice 5th Ed.

IX Communication Skills and Interprofessional Collaboration

Comm. Skills in Pharmacy Practice 5th Ed.

X Ethical Behavior when Communicating with Patients

Comm. Skills in Pharmacy Practice 5th Ed.