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AMANY R. ABO-EL-SEOUD
Prof. of Community Medicine
Zagazig University, EGYPT
Define communication, health
attitudes, belief and behavior.
Describe the communication
Plan a session of health
Communication: It is a requirement for life
in any society. It is the process in which
feelings or ideas are expressed as messages:
sent, received and comprehended.
The process of communication is dynamic,
continuous, irreversible and transactional.
Health education: To raise awareness of
people to prevent disease and to improve
knowledge, attitude and practice of
individuals for healthy living.
Knowledge: confident understanding of a
subject with the ability to use it for a
specific purpose. المعرفة
Attitude: positive, negative or
neutral view of a person, behavior
or event. موقف
Belief: a subjective mental
interpretation derived from
perception, reasoning or
Behavior: actions or reaction of a
person in relation to certain
Human communication is the process of
creating meaning between two or more
It is to transfer Ideas - Information - Norms
-نماذج Values - Attitudes through message to
another party so that it can be understood
and acted upon.
The importance of communication:
To make people understand us and to
To make us accepted.
To undertake something.
To strengthen the human relationships and
To spread the human spirit of friendship and
To improve patient compliance
To improve patient satisfaction
To improve health outcomes for patients
To improve the accuracy and efficiency of
the consultation and hence is more
rewarding for the doctor
Elements of communication
The Sender Who Sends the message: doctor, nurse,
parents, actor, teacher
The Message What Ideas, Information, Feelings,
Emotions. Can be at personal
hygiene, nutrition guide, safe
motherhood, risk factors etc
The Channel How Means of message transmission.
Face-face, group discussion, radio,
newspaper, conference, T.V,internet.
The Receptor To whom The person to whom we talk or the
one who receives the message.
Illiterate or highly educated, culture,
habits, traditions, language.
The Feedback With What
The information or the reaction
given to the receptor
1- At the source or sender level
Does not know or convinced with others
cannot communicate the message.
Does not formulate clearly the objectives or the
Does not choose the suitable language of the
Does not change the tone.
The communicator must :
CLEAR= C: Clarify L: Listen E: Encourage A:
Appreciate R: Reassure
Do not give orders. Do not attack. Do not be
aggressive or ridiculous.
2- At the message level
Is not of interest to the receiver.
Is not related to the stated objectives.
3- At the channel level
Not adapted to the message transmission.
Not accessible to the receptor.
4- At the receptor level
Indifferent to the message.
Could not decode (understand) the message.
Cannot receive the message.
Poor listening conditions.
5- At the feedback level
Feedback not well prepared.
Selection of those who respond.
Question poorly formulated.
Verbal: By saying or writing words e.g. talk,
discussion, conferences, or Presentation,
Intentional (signs and movements).
Unconscious (Feelings) as way of client’s
walking, sitting, hand movements, facial
(pitch, volume, rate).
(1) Skills of history taking
Welcome the patient, stand up, shack hands.
Call him/her with his/her name
Asking in voice tone showing your care
Asking one question every time.
Giving open questions.
During the client's answer, help him/her to
Asking the question in different ways to be sure
that the client is understanding.
(2) Skills of communication in Counseling
Definition: Counseling is not guiding,
recommending, persuading, instructing
and advising. Counseling is helping one
person at one time or several together in
a group or family to live in more satisfying
and resourceful way i.e. counseling is
helping a person (or a group) to develop
self-help and self-care abilities.
Counseling is valuable at any age, in
health and in illness, whenever
adaptation to physical psychological
changes is required. It is helpful to the
elderly and their care giver, as well as to
children and their parents, to women at
all their life stages, e.g. puberty and
child bearing, motherhood and
menopause. It is also helpful for women
undergoing hysterectomy, mastectomy, or
seeking treatment for infertility.
I- Preparing For a Counseling Session
The ideal context is a quiet, calm, setting
in which there is little chance of being
Timing: The maximum time allowed for
each session ranges between 45-60
minutes. The best timing is when the
counselee is more likely attentive not
sleepy or in pain.
II- During the Interaction:
To be able to help the counselee to talk,
disclose, reflect, think and take decisions.
The counselor should master the following
Ability to build trust
Any crisis situation- breaking bad news.
Bereavement or grief.
Terminal illness / palliative care.
Marital problems. Family problems.
Sexual dysfunction. Infertility.
Anxiety and stress. Depression.
Intellectual handicap in child.
Any disease or illness, especially severe illness.
Sexual abuse/ child abuse. Domestic violence.
Insomnia and other sleep disturbances.
H.E.is translation of what is known about
health to desirable behavior by means of
H.E. is the process by which people learn to
behave in healthy manner
H.E. is subject concerned with methods, that
facilitate voluntary adaptation of behavior
that are conductive to health.
Is planned opportunities for people
to learn about health and
make changes in their behavior
Steps: to know (knowledge)
to feel importance to health(attitude)
to change (practice)
Improvement of quality of life
Restore state of good health
Make the best of remaining health
i.e. in health promotion, prevention of
hazards, control of disease and complications
and in rehabilitation.
i.e. in physical, mental, social health
it is life long process.
Either to give new information (unknown before) or change
old wrong knowledge.
Health education covers all the levels of community
medicine, in health promotion (to give information to
people how to be healthy) in prevention of health hazards
(give information about vaccination, smoking hazards) in
control of disease (to take treatment according to doctor
advice) and in rehabilitation (to use the remaining health
Health education is concerned with physical, mental and
It is life long process
It can be directed to individual, family or community
Health education improves the health status of
individuals, families, communities, states, and
Health education enhances the quality of life for all
Health education reduces premature deaths.
By focusing on prevention, health education reduces the
costs (both financial and human) that individuals,
employers, families, insurance companies, medical
facilities, communities, the state and the nation would
spend on medical treatment.
Some people specialize in health education
(trained and/or certified health education
Others perform selected health education
functions as part of what they consider their
primary responsibility (medical treatment,
nursing, social work, physical therapy, oral
Lay workers learn on the job to do specific,
limited educational tasks to encourage healthy
The target group
"who says what and when to whom by which
therefore we should consider the following:
the message, sender, recipient, method,
* Pre and post testing: for the same group or
for 2 groups
Every thing should be evaluated (the
educator, message, method and the persons
who are educated)
* Increased number of good behaviors
* Change in the morbidity & mortality rates
Brief introduction, aim and gentle asking for
Simple language, direct questions
Not ask for 2 things in the same q.
Don’t use negative negative q.
Short answers, closed q.
Not too long questionnaire
It must be reliable, valid
2 types of questions:
Qualitative (Likert’s scale) for attitude or
Quantitative: giving % or number
Multiple choices are easier