Whenever attempting to change patients’ behaviours, healthcare practitioners need to be able to explain the benefits & gains to their patients and contrast it with the losses so that these can be tangibly assessed. For example, outlining the key benefit of reducing the chances of the patient or family members getting ill compared to the disadvantages of not getting the vaccination such as days off work or worse.
The way choices and options are presented to individuals effect the way they make decisions.
It is not TELLING it is EXPLAINING.
Instead of tussling with the patient when they are hesitant or even reject the offer of vaccination, using a motivational interviewing approach will increase the likelihood of the patient reconsidering their stance.
The key to making the above effective is having a conversation that is open-ended, with non-judgemental listening and in a positive communication style. That is MOTIVATIONAL INTERVIEWING.
The most important aspect of any Motivational Interview/ Brief Intervention is
Raise the issue or look/listen for ‘triggers,’ allowing you to capitalise on the opportunistic moments to discuss the flu jab is the key at your appointments. Stick to open questions that will allow you to create a discussion.
Remember it is how the information is provided, not what information is given, that is key to creating a positive outcome.
If you are finding it difficult to engage with your patient on the topic then using affirmations might be of an advantage. e.g.’ I can tell you’re busy and you’ve got to get home, but thank you for coming to your appointment today…’
‘Thank you for attending your appointment, apologies for the wait and I appreciate that you need to get going… but can I discuss…’
‘I can tell you’re not sure about the vaccine, and you’re not alone in that, but I’d like to give you some information and hopefully remove the concern or myths you might have heard.’
‘I really appreciate your honesty’
‘Thank you for sharing your concerns’
Affirmations are recognitions of strength, quality, effort, and ability. It is an appreciation of what the individual’s views/barriers are and shows that you care and are genuine when it comes to the patient’s health.
If you are developing a rapport with the patient and the open questions are providing an effective and engaging discussion then take the opportunity to provide advice and some relevant background information/recent research on the vaccine. Making sure that you are using a key skill here and an important element of MI/BI, reflective listening
Here you should use words that emphasise that you’re listening… ‘So what you’re saying is... that you’ve heard about?’, ‘Can I just check that what you’re saying is?’, ‘You mentioned that..?’
Listening well and reflecting back what you’ve heard helps to clarify information and leads to greater exploration.
The final piece to the MI/BI jigsaw is summarising. Summarising in a nutshell is an opportunity for you to relay back what you’ve heard over the course of the appointment.
‘I remember what you told me and I just wanted to relay it back so that it all fits together’
‘So here’s what you’ve told me so far...’
‘Can I just check that I’ve captured everything?’
Summarising allows you to complete an appointment effectively. It is an important tool to use, regardless of what the topic of discussion is in your appointments. It will provide yourself and the patient a chance to ensure that you haven’t missed anything out and fulfil a comprehensive and positive conversation.
Gaining permission from the beginning helps patients feel at ease, gives them equal status in the consultation and the opportunity to say no.
- “Is it ok if we talk about…?”
- “Do you mind if I ask…?”
- “Would it be ok to discuss…?”
RAISING THE ISSUE
Advice given by health professionals is important but how it is “given” is even more crucial. Asking open questions will give you more information and allow for conversation;
- “What has made you want to have the vaccination?”
- “It sounds like you’re interested in hearing a bit more. How do you feel about us doing that?”
- “You mentioned that you’re a carer for a relative, let’s have a chat about the effect of influenza on them, shall we?”
Or more direct;
- “How do you feel about the vaccination today?”
- “What do you know about the vaccine?”
- “What concerns do you have?”
Closed questions lead to a yes-no response, open questions will give you more information.
- “How do you feel about the flu jab?”
- “What concerns do you have with the vaccine?”
- “What are the reasons for you to receive the vaccine today?”
Listening well and reflecting back what you’ve heard helps to clarify information and leads to greater exploration/
- “So what you’re saying is…”
- “Can I just check…?”
Empathy is not sympathy, pity, warmth, acceptance or identification.
Empathy is showing an active interest in and effort to see the world through their eyes. It is exploring opinions and ideas about the behaviour with accurate reflection.
- “I understand that you have some concerns about the vaccine…”
- “It seems to me that you are feeling unconvinced about whether the vaccine is for you…”