Health Counselling in Nursing

Definition

Interaction between nurse and and the client in solving the patients' problem by using the resources available to the client.

Qualities of a good counsellor

  1. Personal ability
  1. Immediacy
  1. Genuineness
  1. Warmth and empathy
  1. Positive regards and Respect

Ethical consideration involved

  1. Confidentiality
  1. Professional boundaries

Basic principles of Counselling

  1. Being reliable and professional
  1. Being respectful
  1. Creating relaxed atmosphere
  1. Be flexible and patient
  1. Sharing the experiences at right time
  1. Listen

Problems and Solution of counselling

Problem

Solution

Co-counselling

Burn Out

Counselling Process

  1. Relationship building
  1. Assessment
  1. Goal setting
  1. Counselling Intervention
  1. Evaluation and termination

Key to Successful counselling

  1. Willingness
  1. Motivation
  1. Commitment
  1. Faith

Counselling Theory

  1. Reality therapy by William Glaser
  1. Rational- Emotive Approach by Albert Allis
  1. Field theory or Gestalt theory by Christian von Ehrenfels
  1. Client-centered Approach by Carl Roger
  1. Psychoanalytic Theory by Sigmund Freud

Goals of Health Education

  1. Focus on the behavior to be changed
  1. Address the influences on the behavior to be changed
  1. Check the level of influences and continue to address them
  1. Plan health counselling using the appropriate theores

Behavior and health counselling

Causation and determinants of Behavior

  1. Perceived Benefits
  1. Environment
  1. Knowledge
  1. Social Support

Theories for Behavior Change

  1. Cognitive Behavioral Theory
  1. Transtheoretical Model

Stages Of Transtheoretical Model

  1. Preparation
  1. Precontemplation
  1. Contemplation
  1. Action
  1. Maintenance

Readiness

Definition

Combination of factors in the person such as their past experiences with the behavior they want to change, the degree of knowledge and skills they have to change the behavior

Readiness Scale

  1. Low readiness (1-3)
  1. Moderate readiness (4-7)
  1. High readiness (8-10)

Effective counselling skills

OARS

  1. Open ended question
  1. Affirmation
  1. Rolling with resistance
  1. Summary

Screening tool for Sensitive Topic

  1. Alcohol and drug use screening

CAGE

Have you ever felt you should Cut down your drinking

Have people Annoyed you by criticizing you for drinking

Have you ever felt Guilty for drinking?

Do you drink as soon as you wake up to overcome the hangover? (Eye opener)

  1. Intimate Partner Violence

SAFE

Safety- Do you feel safe in your relationship

Afraid or Abused- Has your partner ever abused you and your children

Family or friends- If you were hurt, will you call your family or friends?

Emergency plan- Do you have a place to go in emergency?

  1. Sex and sexual practices

Factors that affects the Reliability of information

  1. Nurse's anxiety
  1. Patient's Anxiety
  1. Method of asking question

Techniques to reduce anxiety

  1. Normalizing
  1. Transparency
  1. asking Permission
  1. Option of not answering the question
  1. Addressing confidentiality

Communication in Counselling

Therapeutic communication

Non-Therapeutic Communication

Non-verbal Communication

  1. Intentional
  1. Accidental
  1. SOLER
  1. Reflective listening 2. Shifting focus 3. Agreement with a twist 4. Reframing 4. Emphasizing the personal choice and control

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