艾滋病咨詢培訓(xùn)咨詢技巧優(yōu)秀文檔

CounsellinginHIVandAIDS3:

CounsellingSkills

艾滋病咨詢培訓(xùn)3：咨詢技巧DrPetrakJennyDrYaoBingVSOAims目的Tounderstanddifferentformsofcommunication明白不同類(lèi)型的交流Toconsiderconfidentiality考慮保密Tounderstandhowourvaluescanaffectcounselling

明確我們自己的價(jià)值可以影響咨詢Topracticecounselling實(shí)踐咨詢Isculturallysensitive(i.Gestures 手勢(shì)Listeningskillspractice

傾聽(tīng)技巧練習(xí)AcouplecomeforHIVtestbeforemarriage.自我介紹并詢問(wèn)患者名字Minimisedistractions(e.Groupdemonstrationandfeedback小組展示和反饋Donot‘takeover’andtellhowtheyshouldbehaveoryourownstory

不要反復(fù)討論和告訴他們應(yīng)該怎樣做或你自己的故事Helpspatientsrecognizeandbuildonstrengths

幫助患者認(rèn)識(shí)和建設(shè)能力Askparticipantstoswaprolesandstartagain.談?wù)撋泻玫氖虑椋瑩Q位重新開(kāi)始“Youarealwaysusingcondoms,aren’tyou?”

你一直用安全套，不是么？desks)障礙（如桌子）Thefirstconsultation

第一次咨詢Wheredothesevaluescomefrom?GivingAdvice提供建議respectsthetraditionalorethnicbeliefofthepatient)是否敏感（尊重傳統(tǒng)和民族信仰）Whatiscounselling

什么是咨詢?“HIV/AIDScounselingisaconfidentialdialoguebetweenapersonandacareprovideraimedatenablingtheclienttocopewiththestressandtakepersonaldecisionsrelatingtoHIVandAIDS” (WorldHealthOrganization)世界衛(wèi)生組織對(duì)艾滋病咨詢的定義如下：求詢者和咨詢員之間的在保密情況下的談話，目的是是使求詢者能應(yīng)付HIV感染帶來(lái)的緊張壓力，做出自己的決定。Whatare

thedifferenttypesofcommunication

有哪些不同類(lèi)型的交流?Verbal言語(yǔ)Non-verbal非言語(yǔ)Intra-personal私人內(nèi)部Inter-personal私人之間Massmedia大眾媒體Giveexamplesofeach互相舉例….Non-verbalbehaviour

非言語(yǔ)行為Bodylanguageinclude:

肢體語(yǔ)言包括Gestures 手勢(shì)Facialexpressions

面部表情 Posture姿勢(shì) Bodyorientation/distance

身體方向、距離Eyecontact目光接觸Mirroring 鏡子Barriers(e.g.desks)障礙（如桌子） Paralinguisticinclude:非語(yǔ)言包括Sighs嘆氣Groans呻吟Grunts哼聲Voicevolume音量Giggling咯咯笑Yawning哈欠Speedofspeech

談話速度Counsellingskills

咨詢技巧CounselingIs咨詢是…Establishinghelpingrelationships建立幫助關(guān)系Havingconversationsthathaveapurpose有目的的談話Listeningattentivelytowhatclientshavetosay

認(rèn)真聽(tīng)患者所說(shuō)的話Givingcorrectandappropriateinformation

提供正確、恰當(dāng)?shù)男畔elpingmakeinformeddecisions幫助做決定Helpingrecognizeandbuildstrengths幫助認(rèn)識(shí)并建立力量Helpingdevelopapositiveattitude幫助樹(shù)立積極的態(tài)度CounselingIsNOT咨詢不是….GivingAdvice提供建議Makingdecisionsonbehalfofclients代表患者做決定Judgingorblaming

判斷或者是責(zé)備Interrogatingorlookingforfaults置疑或挑錯(cuò)Preachingorlecturing

說(shuō)教或演講Makingpromisesyoucan’tkeep做不能堅(jiān)持的保證Imposingyourownbeliefs

施加你自己的意見(jiàn)Effectivecounsellingis

有效的咨詢是…Abilitytomaintainconfidentiality,makeclearandunderstandabletopatient

讓患者清楚和理解你會(huì)保密Beinggenuine真誠(chéng)Compassion,

warmthandpositiveregard

熱情、溫暖和主動(dòng)Abilitytomeetatpatient’slevel配合患者的水平Elicitneededinformation–closedandopenquestions引導(dǎo)所需的信息……開(kāi)放和閉合的問(wèn)題Explorefeelings探索感情Giveaccurateinformation,non-judgmental

提供準(zhǔn)確的信息，非判斷性的Givepracticalassistance,e.g.referral

提供實(shí)際的幫助Focusoncircumstances,factsandfeelings,ofpatient關(guān)注環(huán)境、事實(shí)和感覺(jué)Effectivecounsellingis

有效的咨詢是…Acceptanceofpatientasanindividual把患者作為個(gè)體接受Isculturallysensitive(i.e.respectsthetraditionalorethnicbeliefofthepatient)是否敏感（尊重傳統(tǒng)和民族信仰）Encouragingforpatientstotalkfreely,totelltheirstory鼓勵(lì)患者自由交談，講出他的故事Demonstraterespectandwillingnesstolisten尊重、愿意傾聽(tīng)Beliefinpatient’scapacitytohelpthemselves

相信患者有能力自助Exploreconsequencesofdecisionsandactions

探求相關(guān)的決定和行動(dòng)Helpspatientsrecognizeandbuildonstrengths

幫助患者認(rèn)識(shí)和建設(shè)能力Awareofownfeelingsandvalues知道自己的感覺(jué)和價(jià)值Expressempathy,be‘intune’or‘walkintheirshoes’表示理解，換位思考Confidentiality

保密Whatisconfidentiality?什么是保密HowisitpracticedinChinamedicalpractice?

在中國(guó)醫(yī)療實(shí)踐中如何施行WhatguidelinesforconfidentialityexistinChinamedicalpractice?在中國(guó)醫(yī)療實(shí)踐中存在的保密指導(dǎo)是什么Whatarethebarrierstoconfidentiality?

保密的障礙是什么？WhyisconfidentialityimportantinHIV/AIDS?

為什么保密很重要？Howdoyouexplainconfidentialitytopatients?

你怎樣向患者解釋保密？Whatis‘sharedconfidentiality’?什么是分享保密Howcanconfidentialitybebroken?保密怎樣能被破壞？Valuesandbeliefs

價(jià)值和信仰WhatarethemainvaluesareinChina?在中國(guó)的主要價(jià)值是什么Wheredothesevaluescomefrom?這些價(jià)值從哪里來(lái)？Whatbeliefsandpracticedosomeofyourpatientshavethatare

differentfromyourown?

你的一些患者有什么樣的與你不同的信仰和行動(dòng)？Whyisitimportanttoconsiderthese?

為什么考慮這些很重要？Howdoyouworkwithapatientiftheyhaveverydifferentbeliefs?

怎樣和不同信仰的患者工作？CounselingIs咨詢是…Thefirstconsultation

第一次咨詢Whatare

thedifferenttypesofcommunication

有哪些不同類(lèi)型的交流?Whatiscounselling

什么是咨詢?Tounderstandhowourvaluescanaffectcounselling

明確我們自己的價(jià)值可以影響咨詢Howcanconfidentialitybebroken?保密怎樣能被破壞？AcouplecomeforHIVtestbeforemarriage.談?wù)撋泻玫氖虑?，換位重新開(kāi)始Thenswitch換組‘Icanseethisismakingyoufeelsad’

承認(rèn)患者的感覺(jué)如我可以看到這讓你感覺(jué)很悲傷Helpspatientsrecognizeandbuildonstrengths

幫助患者認(rèn)識(shí)和建設(shè)能力Payingcloseattentiontowhatpatientissaying

注意傾聽(tīng)患者所說(shuō)Demonstraterespectandwillingnesstolisten尊重、愿意傾聽(tīng)談?wù)撋泻玫氖虑椋瑩Q位重新開(kāi)始Helppatienttotellyoutheirreasonforcoming幫助患者告訴你他們來(lái)此的原因Thefirstconsultation

第一次咨詢Whatisactivelistening?

什么是積極的傾聽(tīng)？Payingcloseattentiontowhatpatientissaying

注意傾聽(tīng)患者所說(shuō)Minimisedistractions(e.g.telephone,noise)

盡量少的干擾（如電話、噪音）Acknowledgepatientfeelings,e.g.‘Icanseethisismakingyoufeelsad’

承認(rèn)患者的感覺(jué)如我可以看到這讓你感覺(jué)很悲傷Donotinterruptthepatientunnecessarily

不會(huì)不必要的打斷患者Askquestionsifyoudonotunderstand如果不懂就提問(wèn)Donot‘takeover’andtellhowtheyshouldbehaveoryourownstory

不要反復(fù)討論和告訴他們應(yīng)該怎樣做或你自己的故事Encouragement鼓勵(lì)Repeatbackthediscussioninfewerwordstocheckthatyouhaveunderstood(knownassummarizing,reflectionoffeelings)e.g.‘Youseemtobesaying……’用簡(jiǎn)短的語(yǔ)言復(fù)述討論內(nèi)容，以確認(rèn)你完全理解（可以總結(jié)、情感的反映），例如：你似乎是要說(shuō)……Listeningskillspractice

傾聽(tīng)技巧練習(xí)

Inpairs.Onelistener,onetalker.Thetalkershouldtalkaboutsomethinggoodintheirlives.Askparticipantstoswaprolesandstartagain.分組，一個(gè)聽(tīng)，一個(gè)說(shuō)。談?wù)撋泻玫氖虑?，換位重新開(kāi)始Whatisactivelistening,whatdoesitfeelliketobelistenedtoandnottobelistenedto?什么是主動(dòng)傾聽(tīng)，怎樣感覺(jué)被傾聽(tīng)和不被傾聽(tīng)記錄情緒、承認(rèn)和探求原因Repeatbackthediscussioninfewerwordstocheckthatyouhaveunderstood(knownassummarizing,reflectionoffeelings)e.Payingcloseattentiontowhatpatientissaying

注意傾聽(tīng)患者所說(shuō)Donot‘takeover’andtellhowtheyshouldbehaveoryourownstory

不要反復(fù)討論和告訴他們應(yīng)該怎樣做或你自己的故事‘Youseemtobesaying……’用簡(jiǎn)短的語(yǔ)言復(fù)述討論內(nèi)容，以確認(rèn)你完全理解（可以總結(jié)、情感的反映），例如：你似乎是要說(shuō)……Beginwith‘easy’question以簡(jiǎn)單的問(wèn)題開(kāi)始respectsthetraditionalorethnicbeliefofthepatient)是否敏感（尊重傳統(tǒng)和民族信仰）Wheredothesevaluescomefrom?談?wù)撋泻玫氖虑?，換位重新開(kāi)始Whatare

thedifferenttypesofcommunication

有哪些不同類(lèi)型的交流?Whatarethebarrierstoconfidentiality?

保密的障礙是什么？Thankpatientforcomingandexplainwhatwillhappeninthemeetingincludingconfidentiality感謝患者到來(lái)，解釋包括保密在內(nèi)的會(huì)面內(nèi)容Listeningskillspractice

傾聽(tīng)技巧練習(xí)Whattypeofquestions？

有哪些類(lèi)型的問(wèn)題?Closedquestions閉合問(wèn)題“Doyoualwaysusecondoms?”“Doyoutakeallyourmedication?”你總用安全套么，你吃所有的藥么Openquestions

開(kāi)放的問(wèn)題“HowmightyoureactifyourHIVtestispositive?”如果你HIV檢測(cè)陽(yáng)性會(huì)如何反應(yīng)？

“Whatdifficultieshaveyouexperiencedusingcondoms?”你用安全套時(shí)遇到哪些困難？Leadingquestions

重要問(wèn)題“Youarealwaysusingcondoms,aren’tyou?”

你一直用安全套，不是么？Thefirstconsultation

第一次咨詢Startontime準(zhǔn)時(shí)開(kāi)始Makepatientcomfortable/considerseating

盡量讓患者舒服、就坐Introduceyourselfandaskforpatientsname

自我介紹并詢問(wèn)患者名字Thankpatientforcomingandexplainwhatwillhappeninthemeetingincludingconfidentiality感謝患者到來(lái)，解釋包括保密在內(nèi)的會(huì)面內(nèi)容Beginwith‘easy’question以簡(jiǎn)單的問(wèn)題開(kāi)始Helppatienttotellyoutheirreasonforcoming幫助患者告訴你他們來(lái)此的原因Notemoods,acknowledge,andexplorecause

記錄情緒、承認(rèn)和探求原因Thefirstconsultation

第一次咨詢Letpatientdothetalking,allowsilences

讓患者談話，允許沉默Acknowledgedifficultytalking,canalwayssuggestanothermeeting

承認(rèn)困難的交談需要再安排見(jiàn)面Ifyoudonothavetheanswertoaquestion,saysoandsuggesthowcanbeexploredwithpatient’sagreement如果不知道如何回答，如實(shí)說(shuō)，并在患者同意的情況下，提供解答的建議。Keepreassurancetoaminimum,canbemisleading確保最小程度的誤解