1. Barriers to Communication
Lecture 4

2. Introduction
Barriers can be defined as the conditions that interfere with effective exchange of ideas or thoughts and disrupt the accurate transmission of information.
Minimizing communication barriers typically requires a two-stage process:
First ; you must be aware that they exist.
Second; you need to take appropriate action to overcome them.

3. Barriers to Effective Communication
Environmental (physical) Barriers
Personal (Psychological) Barriers
Administrative Barriers
Time Barriers

4. Environmental Barriers
Include:
1. The height of the prescription counter :
(Ideally, the pharmacy staff and the patient should both be at eye level to enhance verbal and nonverbal communication).
2. Crowded, noisy prescription areas such as people talking or music playing.
3. Presence of glass partitions or dividers between the pharmacist and the patient.

5. Environmental Barriers
Lack of private area: Even in a busy, noisy environment, privacy can be enhanced by:
moving to the end of the prescription counter.
turning away from a busy prescription area that you can lowering your voice to achieve a more private environment.
5. Others ; like light, temp, ergonomics, distance, voice & visual quality, place or location where a communication process takes place can degenerate into a barrier to effective communication.

6. Personal Barriers Pharmacist - Related Personal Barriers
Patient - Related Personal Barriers

7. Pharmacist-Related Personal Barriers
Low self-confidence : when you believe that you do not have the ability to communicate well.
Shyness : you may avoid talking with others.
Lack of objectivity; you must be assertive about your need to communicate with others, but at the same time be aware of their needs as well.
Cultural differences: for example, in some cultures it is not proper to engage in eye contact during communication.

8. Pharmacist-Related Personal Barriers
Discomfort in sensitive situations.
Negative perceptions about the value of patient interaction.
- Many pharmacists believe that talking with patients is not a high-priority activity.
- They may perceive that patients neither expect nor want to talk with them.

9. Pharmacist-Related Personal Barriers
8. Negative experiences:
if you get into a heated argument with a patient who appears to be unreasonable and rude? Would you be excited to talk to the next patient? Probably not.
The negative experiences may influence your ;
- personal desire to communicate.
- Self-esteem regarding interactions with others.

10. PATIENT-RELATED PERSONAL BARRIERS
patient perceptions of pharmacists:
If patients perceive you as not being knowledgeable or trustworthy, they will tend not to ask questions or listen to the advice being offered.
if patients perceive you as being knowledgeable and have had positive experiences in the past, they will tend to seek out information.
Therefore, you may need to alter the negative perceptions by informing patients that you sincerely want to communicate with them, and by counseling them effectively.

11. PATIENT-RELATED PERSONAL BARRIERS
Patient perception about health care system.
based on past negative experiences, they may have been treated poorly in the past and distrust of the health care system, they may perceive you to be part of this impersonal system.

12. Patient -Related Personal Barriers
3. Patient perceptions of their medical conditions :
Some may believe that their condition is a minor one or may not perceive themselves to be ill, requiring no further discussion with you.
In contrast, some patients may be overly anxious about their condition and therefore will avoid talking about it because they feel so vulnerable.
Some patients may feel that their physicians would have already told them all the important information about their condition and their medication. Therefore, there is no need to talk with you.
In addition, many patients think that all the important information is stated on the prescription label or in the patient education leaflet.
some patients place more reliance on folk medicine.

13. PATIENT-RELATED PERSONAL BARRIERS
Thus, You may need to convince some patients that
they need to learn more about their medications.
the few moments spent with you will be valuable to them later on.

14. Administrative Barriers
1. Counseling services are not included as part of pharmacies’ business plans.
2. Most community practitioners are not paid directly for educating or communicating with patients.

15. Administrative Barriers
3. pharmacies often make policies that discourage pharmacist– patient interaction: - Many pharmacies have reduced the number of staff members who can assist pharmacists. Therefore, It is difficult to type a label, count medications, talk on the phone, and complete other necessary dispensing tasks (checking the expire date) while trying to communicate with the patient.

16. Time Barriers
- The timing of the interaction is critical, since both parties must be ready to communicate at a given time.
- Choosing an inappropriate time to initiate conversation may lead to communication failure.

17. Time Barriers
For example, a woman who just came from a physician’s clinic after waiting for 3 hours with two sick children may not be interested in talking with you or anyone else.
The most important thing on her mind is to go home, get her kids to bed, and then have some rest. She is probably not in the best frame of mind to sit down and have a meaningful conversation about her children’s medications.

18. Time Barriers A possible solution might be
to give the mother basic information to get the therapy started.
Another strategy is to write information (a short message, key points ) that can help during busy situations before the patient leaves the pharmacy.

19. Time Barriers
Or you may not be in the best frame of mind to interact with others since you may be dealing with multiple issues:
a physician is waiting on the phone.
a large number of prescriptions need to be dispensed.
you have not eaten lunch so you are starving.
You may feel that this is not a convenient time to talk to others.

20. Summary You must remember that there are no expert communicators:
no one communicates perfectly 100% of the time. There will always be situations where communication could have gone better; you should not be discouraged when it does not go as well as planned.
- However, you must still strive to improve your communication skills by constant practice and reflection on your strengths and weaknesses.

21. Summary
Messages become helpful to others only when they are accurately received and understood.
In any situation, you should assess nonverbal messages from patients for assurances that communication is well timed:
Do they appear to be listening to you?
Are they comprehending what you are saying?

22. Summery
Barriers, may lead to distortion of messages and misunderstandings between you and others.
you must be aware of situations where people are trying to talk with you, but you are not listening appropriately since Failure to communicate may lead to negative patient outcomes.

23. Thank you