Public Health Visiting Essay Sample
Health visiting is one of the aspects of the healthcare industry. The concept of health visiting began long ago during the time of Florence Nightingale in the 1800s (Adams, 2012). Health visitors have different roles compared to nurses. Their primary responsibilities include providing health education to promote health among infants, their families, and in the communities. Over the past century, the role of health visitors has evolved from addressing matters concerning sanitation and infectious diseases to addressing chronic illness concerns in people's homes and communities (Adams, 2012). Health visiting focuses on four main principles, which include influencing laws that affect people's health needs, stimulating their awareness of and search for health needs, and facilitating activities that enhance people's health (Adams, 2012). This essay focuses on how a health visitor can employ interpersonal and communication skills during a health visit to try and educate Sophia on her health needs and those of her child.
The Development of a Therapeutic Relationship through Communication and Interpersonal Skills
According to Lunenberg (2010), communication is a process that involves passing on information from a sender to a receiver. Communication requires a common understanding for it to be successful. In health visiting, communication occurs between the health visitor and the client.Shyam and Elizabeth Joy (2016) claim that people require interpersonal skills to communicate and interact with each other effectively. Interpersonal skills are vital while communicating with patients and clients. Interpersonal skills include being polite, steering clear of gossip, being empathetic, generating solutions calmly, translating information and conveying it accordingly, and possessing the ability to interpret other people's emotions and feelings during a conversation (Shyam& Elizabeth Joy, 2016). A health visitor requires interpersonal skills to enhance his/her success while communicating with patients.
Effective interpersonal communication enables a health visitor to establish a relationship born of trust with individuals (Chichirez&Purcărea, 2018). In health visiting, the communication quality between health visitors and their clients has a great impact on both parties. Proper and effective communication can lead to better outcomes for a patient and his/her family (Sibiya, 2018). In Sophia's case, effective communication will enable her to learn the importance of immunizing her child and the effects that may arise from failing to agree to the immunization. Communication with a health visitor can also help allay Sophia's fears and misgivings concerning her child's immunization (Adams, 2012). Thus, health visitors should possess the necessary interpersonal skills to assist them in promoting healthy practices among patients and the public.
According to Sibiya (2018), there are two main types of communication that human beings apply when exchanging information. These include verbal and non-verbal communication. Verbal communication relies on the spoken word and is essential for health visitors as they communicate verbally with their hosts and patients (Lunenberg, 2010). On the other hand, non-verbal communication relies on one's body signals and facial expressions to communicate. Nonverbal communication depends on the signals that a person's body releases while communicating (Sibiya, 2018). This type of communication portrays a lot and can be very confusing for a person. In most cases, communication between two people usually involves some non-verbal communication (Shyam& Elizabeth Joy, 2016). Therefore, health visitors need to learn some of the forms of non-verbal communication as it sends out more meaning compared to verbal or written messages.
In Sophia's case, a health visitor can focus on utilizing verbal and non-verbal communication skills to inform her about her and her child's health needs. According to Redsell, Bedford, Siriwardena, Collier, and Atkinson (2010), a health visitor with expert communication skills knows when to approach a parent about immunization. He/she is supposed to be sensitive to the priorities and needs of the parent while informing them about their health needs (Shyam& Elizabeth Joy, 2016). Effective verbal communication, in this case, involves reflection, summarizing, and providing empathic responses (Redsell et al., 2010). Applying these skills will help Sophia understand the importance of immunizing her child and let go of her fears concerning the process.
Sibiya (2018) claims that in most cases, non-verbal communication elicits and sends stronger signals compared to verbal messages. Nonverbal communication is made up of different signals, including body posture, gestures, facial expressions, proximity, and the tone of the speech, speech errors, the accent, and bodily contact (Sibiya, 2018). Communicating with Sophia will require the health visitor to monitor her body language and facial expressions to prevent projecting mixed messages, thus, avoiding confusion. Some of the non-verbal communication skills that the health visitor can apply include the use of body language and facial expressions such as frowns, smiles, and eye contact, among others (Lunenberg, 2010). The body posture will also help to communicate most of the information required to develop a therapeutic relationship with Sophia.
Using different types of communication skills will enable thehealth visitor to establish a therapeutic relationship with Sophia. The health visitor can do this by actively listening and concentrating. The health visitor should focus on total, active, receptive, and empathic listening while communicating with Sophia (Chichirez&Purcărea, 2018). The visitor can also adopt a calm, open, and patient attitude while discussing immunization with Sophia. The body posture is also essential. The visitor can maintain eye contact and monitor her other facial expressions to avoid making Sophia feel unmotivated or frustrated. Lastly, the health visitor should be responsive to Sophia's questions and fears (Redsell et al., 2010). The visitor can offer objective solutions for Sophia and offer some criticisms of Sophia's choices to maintain an honest relationship.
A Critical Justification of Interventions that address Health Needs
In some instances, some patients resist certain health care requirements that are necessary for their well-being. Sophia's case is a fitting example of such instances. A health visitor can apply the Health Belief Model (HBM) to help Sophia address her health needs and those of her son (Jones et al., 2015). The visitor can use some interventions to help in the success of the HBM.
Professionals in the health sector have constantly applied the HBM to help people adopt a more effective health behavior (Jones et al., 2015). The Health Belief Model is made up of six constructs, which include perceived susceptibility, perceived severity, perceived benefit, perceived barriers (Jones et al., 2015), cue to action, and self-efficacy. Different scholars have suggested the use of HBM with other models to increase its effectiveness in realizing health behavior change. In Sophia’s case, we will consider the use of motivational interviewing, stages of change model, cognitive behavioral therapy, and solution focus therapy.
Motivational interviewing is a counseling style that centers on the client and adopts a direct approach to eliciting behavior change (Miller &Rollnick, 2012). Such an interview enables a client to explore and resolve his/her state of indecisiveness towards a particular health behavior. Motivational interviewing is more beneficial, more goal-oriented, and more focused, and elicits better results compared to other approaches (Miller &Rollnick, 2012). This method is appropriate for Sophia's case as it centers more on her willingness compared to other confrontational methods.
While applying the method in Sophia's case, a health visitor can use the OARS to communicate with her. The health visitor can try to understand Sophia's frame of reference by asking her open-ended questions and via reflective listening. The health visitor should also express affirmation and acceptance of Sophia's views (Miller &Rollnick, 2012). He/she should also help elicit and reinforce Sophia's statements, her desires and concerns, her expressions regarding problem recognition, and her willingness and intention to change (Miller &Rollnick, 2012). Lastly, the health visitor should monitor Sophia's readiness to change by summarizing her statements and affirm the choices that she makes and the direction she decides to take concerning Jack's immunization.
The Stages of Change Model
The Stages of Change Model (SCM) focuses on the body and mind stages that one goes through during the process of change. The model guarantees that change does not occur in one major move, but progresses systematically from one step to another. The stages of change that a person goes through based on this model include pre-contemplation, contemplation, preparation, action, and maintenance (Prochaska, Norcross &DiClemente, 2013). The process aims at improving a person's need to change. In the pre-contemplation stage, the patient does not acknowledge the existence of problem behavior and the need to change it. During contemplation, the patient acknowledges the existence of problem behavior but is unsure about changing it (Prochaska et al., 2013). The preparation stage refers to the patient’s readiness to change his/her behavior. The action stage involves the patient taking the big step and changing his/her behavior. The last step involves maintenance whereby the patient maintains the new behavior and exits from practicing the problem behavior.
A health visitor can apply this model in Sophia's case by constantly assessingher stage of change to apply the correct interventions and avoid treating her as though she is in action (Prochaskaet al., 2013). The constant assessment will enable the health visitor to assist Sophia in moving from one stage to another, which could improve her chances of success and maintenance. Applying this model will enable the health visitor to gauge Sophia's understanding concerning her conflict on immunization and her need to change (Prochaska et al., 2013). The visitor can assist Sophia in the process by raising her consciousness on the problem and leaving a pamphlet or leaflet that talks about immunization.
Cognitive Behavioral Therapy
Cognitive-behavioral therapy (CBT) is a psychotherapy treatment that integrates a practical approach to problem-solving. CBT is goal-oriented and does not take long to produce results. This type of therapy centers on changing the behavior and thinking patterns of a person behind a particular problem (Martin, 2019). CBT helps to change patients' behavior or attitude by concentrating on their situations, thoughts, emotions, feelings, and taking action. CBT is an advantageous process as it only takes a short while though not short enough for Sophia's case(Martin, 2019). CBT combines behavioral therapy and psychotherapy that enable a patient to understand his/her problems and collaborate with the therapist to find solutions.
Applying this process in Sophia's case requires breaking it down into five main areas. First of all, the therapist should discuss the problem or situation. Secondly, the therapist should help Sophia explore her thoughts, emotions, and feelings (Davis &Saripalli, 2018; Martin, 2019). After discussing Sophia's thoughts and feelings concerning immunizations, the therapist should take action and develop a strategy that will help Sophia look at the situation in a more positive perspective (Davis &Saripalli, 2018). CBT will assist Sophia in learning better ways of behaving and thinking and equip her with coping strategies that will help her deal with any challenges concerning her son's health.
Solution-focused therapy is a form of therapy treatment that centers on coming up with solutions to a problem instead of dealing with the causes of the problem. The method focuses on effective solutions to a particular problem (Lightfoot, 2014). The therapist and the client come up with multiple solutions depending on the problem, and the client explores these solutions to find the most suitable method. In this therapy, the therapist learns from the client about what method of treatment is best suited for them. The therapist focuses on the client's strengths and encourages him/her to utilize those strengths while working on a solution. In solution-focused therapy, the client has all the power to fix his/her problems instead of always relying on the therapist. The client sets goals that he/she wishes to accomplish and uses the therapist's assistance to come up with multiple solutions that will help him/her accomplish the set goals (Lightfoot, 2014). Solution-focused therapy is brief; client-focused has a high success rate and focuses on the client's present and future instead of the past. The problem associated with the method is that some people tend to focus on their problems and look to the therapist to provide the solutions.
Some of the popular techniques that a therapist can apply with Sophia using this model include asking scaling and miracle questions (Ackerman, 2019). Miracle questions will help Sophia to set goals and objectives of what she wishes to achieve and also help her to imagine an existence without the problems she is currently facing. For instance, the therapist can ask Sophia to imagine how her life could be if she did not have to fear about vaccinating her son. The scaling questions will help Sophia to rate her problems or the progress of her treatment (Ackerman, 2019). For example, the therapist can ask Sophia to rate the progress they have made on tackling her fears towards immunization on a scale of 0 to 10. The therapist should focus on Sophia's strengths and use them to reinforce the behaviors that help produce positive outcomes.
Maintaining Professionalism during Health Visits
A health visitor should maintain his/her professionalism during client visits. Professionalism is a crucial aspect of every industry involved with the provision of social services. Professionalism reflects a person's competence in his/her field of profession. The key elements that measure professional competence include clinical reasoning, knowledge, communication, and technical skills (Zafiropoulos, 2017). It further involves a person's ability to solve problems within his/her profession and to provide definitive and clear solutions for any problems that may arise. Maintaining professionalism is important during health visits. It enables the health visitor to remain non-biased towards clients and to maintain his/her integrity throughout the visit.
There are different ways in which a health visitor can maintain integrity. According to Chichirez and Purcărea (2018), a health visitor demonstrates his/her professional competence through in-depth practical and theoretical knowledge and his/her ability to apply creative solutions while visiting clients. One way of maintaining professionalism is through exhibiting and applying proper communication skills (Chichirez&Purcărea, 2018; Zafiropoulos, 2017). The health visitor should be able to apply the proper verbal and non-verbal cues while communicating with Sophia. Proper communication will enable the health visitor to establish a professional relationship based on trust with Sophia.
The health visitor can maintain professionalism by communicating with Sophia in a way that suits her insights and status and in a way that shows her support and solidifies their relationship. The health visitor should avoid misinforming Sophia or judging her according to the choices she makes. A health visitor can exercise their professionalism by maintaining boundaries between herself and Sophia. The health visitor can do this by exercising work ethics which prevent misconduct and help protect client confidentiality (Chichirez&Purcărea, 2018; Zafiropoulos, 2017). The health visitor should show self-respect and regard Sophia with gratitude while giving her all the attention she requires. She should also remain objective to Sophia's need, but be empathic to portray an understanding of her problems. Applying work ethics and proper communication skills are the key methods of maintaining professionalism during a health visit. Maintaining professionalism will help the health visitor to build and maintain a therapeutic relationship with Sophia based on trust and honesty. Such a relationship will benefit Sophia as she will learn to adopt the proper health behaviors that will meet her health needs and her son’s health needs.
Areas of Personal Development and Action Plan
There are different areas in communication in which a health visitor can develop him/herself personally. As mentioned by Chichirez and Purcărea (2018), communication is one of the key functions in the healthcare sector. Thus, a health visitor should endeavor to improve and perfect his/her communication skills constantly. In previous research, scholars have discovered that the listening, empathizing, and explaining skills that a health visitor possesses have a profound effect on the client's outcome and his/her willingness to change or adopt a particular health behavior. Therefore, a health visitor should endeavor to improve his/her listening and communicating skills. According to Chichirez and Purcărea (2018), for listening to be effective and efficient, several rules should be met. The listening should be total, receptive, active, empathic, and have a certain criticism. This means that while communicating and listening, a health visitor should pay attention to what the client says, coordinate his/her body language, empathize with the client, provide objective solutions and offer criticisms where they are due. The health visitor should also learn to control her body language and facial expressions to prevent confusing the client and portraying the wrong information.
A health visitor can apply different approaches to help in their personal development. A health visitor can apply reflective practices to help develop his/her communication skills (Burton, 2017). The health visitor can do this through constant training on emerging communication trends, shadowing senior health visitors, and observing how they perform their tasks and communicate with their clients. The health visitor can also seek the help of senior visitors and their insight on approaching clients and communicating with them. Lastly, a health visitor can use patient feedback to rate his/her performance concerning their visits and on areas that he/she needs to improve on for better outcomes.
Health visitors are key to ensuring the well-being and safety of the public. They help educate the public on important health issues and encourage them to adopt healthy behaviors that promote their health and safety. The role of health visitors has evolved over the years. However, the visitors still play an essential role in improving sanitation and encouraging parents to adopt behaviors such as child immunization.
From the discussion above, it is clear that communication and interpersonal skills are essential for a health visitor. Health visitors adopt different approaches and interventions to convince a client to realize the need to adopt a particular health behavior. The interventions discussed above are all client-focused and center on the need to assist the client in realizing his/her problems and motivating them to adopt changes to their behaviors and attitudes. Exercising proper communication skills while applying the two models is crucial for their success and the client's health outcomes. Therefore, health visitors should constantly improve their interpersonal communication skills to ensure the effective and efficient provision of services.
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