Pharmacy Practice

Pharmacy practice 222Disclosing personal informationSelf-disclosure is the act of verbally and/or nonverbally communicating to otherspersonal information (Tardy and Dindia 1997). It can be nonverbal, in that we can eitherhide feelings such as worry, happiness etc., or openly express them in our facialexpressions, posture, and so on. However, most research on self-disclosure focuses uponthe verbal component, and here the key defining feature is the use of a personal selfreferencepronoun such as ‘I’, ‘me’, ‘mine’ etc. (Hargie et al. 1994). Thus, the differencebetween the statements ‘diabetes is very worrying’ and ‘I am very worried aboutdiabetes’ is that the former may or may not be a self-disclosure, whereas the latterdefinitely is.A knowledge and skilled use of self-disclosure is important in pharmacy for two mainreasons (Hargie and Morrow 1991). First, to effect an accurate diagnosis, patients mustopenly and honestly disclose personal details about their condition. Pharmacists thereforemust use tactics that encourage patients to fully explain their situation. They can increasethe level of self-disclosure from patients by:• Establishing a relationship of trust, confidence, acceptance and empathy• Having a professional personal appearance• Providing a private environment in which personal matters can be discussed freely• Dealing with patients in a receptive, caring, and unhurried styleSecond, pharmacists have to decide what, and when, it is appropriate to self-disclose topatients. Here, self-disclosure can be divided into two main types—the pharmacist’s ownpersonal experiences, and the pharmacist’s personal reactions to the patient’s disclosures.Both are appropriate, but must be used judiciously. The first type can help to reassurepatients that what they are experiencing is not unusual (a technique known as‘normalising’), and also help to develop rapport by demonstrating shared experiences(e.g. ‘I know what you’re going through. When we had our first child, she kept usawake…’). However, patients do not expect a great deal of disclosure from pharmacists,and so the second type is more common. Here, the focus of attention stays firmly uponthe patient, and the pharmacist shows a willingness to become involved in their‘world’ (‘I really am determined to help you stop smoking…’).PersuadingGiven the wealth of evidence indicating that patients often fail to follow advice abouttreatment regimes, a knowledge of the influencing tactics that can serve to increasepatient compliance is important. A range of effective persuading strategies has beenidentified (Allen and Preiss 1998). To influence patients the pharmacist should:Capitalise on their professional relationship with patients: we are more likely to beinfluenced by people we like, and for whom we have high regard. A positive pharmacistpatientrelationship is the key to successful persuasion. In fact, the forceful delivery ofnegative messages within a positive relationship often leads to increased acceptance by apatient of the health threatening nature of their condition.