GROUP 7

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• ATTITUDE AND BEHAVIOR
• PATIENT AND FAMILY ATTITUDE TOWORDS ILLNESS AND HEALTH
• NURSES’ ATTITUDE TOWARDS PATIENT AND FAMILY
• COUNSELING
• DEFINITION
• PURPOSES
• PROCESS
• TYPES
• PRINCIPLES
• CHALLENGES

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ATTITUDE

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• Social life is complex, but consistent pattern can be found in our attitude as well as in our positive and negative interactions with others effects.

QUESTION

• What is your attitude toward the affirmative action, environmental group, the death penalty etc.

ANSWER

• The answer can have far reaching effect on their behavior (our tastes) friendships, votes, preferences, and goal.
• Attitude: An attitude is a mixture of belief and emotions that predisposes a person to respond to other people, object or institutions in positive or negative way. Attitude summarizes your evaluation of objects. (Petty Wegener and Fabrigar, 1997)

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NB: Attitudes are expressed in three ways.

They are;

BELIEF COMPONENT: This is what a person beliefs about 'the attitudinal objects'

EMOTIONAL COMPONENT: It’s the feeling expressed towards attitudinal objects.

ACTION COMPONENT: This refers to one’s action towards various people objects or institutions.

FORMATION OF ATTITUDE

Direct contact: This deals with the personal experience one has. Example, opposing pollution when a nearby factory ruins your favorite river.

Child rearing: Influence from parents whiles bringing their children up may show the children’s attitude, as in their beliefs. Example, if both parent belong to the same political party, chances are 2 out of 3 that their children will belong to one or same party.

Interaction with others: For instance, if three of your friends are volunteer at a local recycling center and you talk to them about their beliefs you will probably come to favor recycling

Mass media :( Marshall McLuhan) he says we are 'massaged by the mass media. This means wed are coaxed, persuaded and skillfully manipulated. Example, a person who is so much into Korea movies would at a point want to adopt some of their behaviors.

Group membership: Where a person finds him/herself often have impact in their attitude. Example a person who joins max international would begin to act like the members of the group

HOW TO MEASURE ATTITUDE

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• Attitude can be measured in several ways. Examples, in a opened ended interview, individuals are simple asked to freely express attitude towards a particular issue.
• Attitude scale: Consist of statements expressing various possible views on issues. Example socialized medicines would destroy the quality of healthcare in this country.
• Attitude change: It is a deliberate attempt to change attitude of beliefs through information and argument. (Persuasion)

FORCED ATTITUDE CHANGES

• Brain washing
• Cult

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BEHAVIOR

• Behavior is the range of action and mannerism made by individuals in conjunction with themselves (WIKIPIDEA)
• The way in which one acts or conducts himself especially toward others. (OXFORD)
• Examples of good behavior: caring, desire to help people, charming, etc.
• Examples of bad behavior; Manipulation, jealousy, gossiping, and poor listening etc.

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• TYPES OF BEHAVIOUR
• Overt and covert behavior
• Overt is a behavior that can be manifested and covert is not observable
• Conscious and unconscious
• Conscious actions are reading ones awareness and unconscious action is reading ones unawareness.
• Voluntary and involuntary
• Voluntary is done with man’s free will and discretion done intentionally. Involuntary, these actions are automatically or unintentionally

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PATIENT AND FAMILY ATTITUDE TOWARDS ILLNESS AND HEALTH

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• Patient and family attitude towards illness can be in the positive or negative way.
• Relating to the component of attitude, it can be classified in three ways such as beliefs, emotions and action.
• Most families become emotionally when their relatives are sick. Hence they show all sort of concern towards their relative who is the patient.
• Also some family members prevent their sick relative who is a patient from receiving treatment due to their beliefs. Example the witnesses who don’t believe in blood transfusion would prevent a sick person from accepting the blood transfusion even at the point of death
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CONT’D

• Families are mostly the first contact of patient before doctors. As a result, they tend to give the sick person first aid treatment before sent to the hospital.
• Patient with chronic diseases such as cancer, HIV/AIDS, asthma etc. are sometimes scared to inform their families about it since some relative would isolate themselves from them.
• Some patient is slow to treatment. If such a person tends to be a bread winner, then there is a problem since there would be crisis at home, so the family members show more concern to the person in order to enhance speedy recovery

NURSING ATTITUDE TOWARDS PATIENT AND FAMILY

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• Nurses are noted to be the right hand of the doctors. Some nurses have good attitude others have bad attitude. However the nurse is to assure the patient recovery. For some time now in Ghana, nurses has been on the media with bad remark on how they treat their patient .Nursing activities include protection, promotion, improving health and abilities, prevention of illness/injuries, alleviation of suffering diagnosis, treatment and advocacy for care of individuals, families and communities. Below are the nurse’s attitude towards patient and families;

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CONT’D

• Sensitivity and intimate relationship: Nursing involves both technical medical and emotional aspect to caring, listing attribute to caring as attitude, actions, relationship, acceptance and variability providing high quality care involve doing the right thing at the right time and improving health outcome for patient families and community. Unfortunately this does not always happen; patient complains about dissatisfaction about the quality of care they receive from nurses. Also poor care provided for specific illness such as HIV, hepatitis was related to the poor health worker attitude by the nurses. Nurses needs to have a positive attitude towards patient and family

CONT’D

• Confidentiality: Information of patient should be kept between the nurse and the patient. Nurses are expected to refrain from divulging confidential information based on the nurses code of professional ethic.
• Advocate: Nurses act as advocate and intervene on behalf of the patient making them safe. Particularly, nurses communicate with physicians when patient do not wish to continue certain medications.
• Nurses should avoid making their personal beliefs affect patient. Example a patient who is HIV /AIDS positive should not be discouraged by the nurse even though he /she won’t survive.
• Teaching: Nurses are to educate both patient and families on how to go about their health and healthcare procedure which would maintain and restore their health

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COUNSELING

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• The provision of personal assistance and guidance in resolving personal and psychological problems.

WHO IS A COUNSELOR

• A person trained to give guidance on particular or psychological problems.

TYPES OF COUNSELLING

• Behavioral therapy: It is based on the theory that you can 'unlearn' learnt behavior or change that behavior without focusing on the reason behind the original behavior
• Cognitive analytical therapy: It is a short term structured and directive therapy which explore the client language and thinking and also the link between historical cultural and social factors on how they function

• Cognitive behavior therapy: It seeks to change distressing behavior relatively quickly by challenging unhelpful thoughts, beliefs, and teaching the client to use copying strategies in the future.
• Cognitive therapy: This based on the idea that our thought causes our feeling and behavior not external things like people, situations and events.
• Family therapy: The family therapy explore the family relationships. It works by looking at the family as a whole, rather than working with a single person in the family unit. The focus is on how families interact together and the therapist's aim is to involve the whole family in finding positive solution
• Relationship counseling: It aims to help people recognize and manage differences negative within their relationship. The aim is to help you find ways to change and adopt for a more positive future.

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PRINCIPLES OF COUNSELING

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• Principle of acceptance: There shouldn’t be any discrimination.
• Principle of communication: There should be verbal and nonverbal communication and should be skilled
• Principle of empathy: Putting yourself into the persons shoe
• Principle of no judge: Do not criticize the person
• Principle of confidentiality: Information of patient should be kept secret and not exposed
• Principle of non-emotion: Avoid getting carried away with the patients feelings

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AIMS AND PURPOSES

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• Listen to the patient
• Identifying the need
• Make patient ventilate his emotion properly and help him to be aware of his own emotion and encourage him to be independent.
• Main problems should be focused and sub problems should be focused by the patient
• Make the patient accept himself and adjust until it is over
• Focus on his strength by studying the case and produce positive attitude in him and ultimately help him to reduce negativity.

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DIFFERENCES BETWEEN COUNSELING AND ADVICE

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• Counseling is to be said in other words as the process involved in finding or identifying the root cause of a problem by the counselor and make the counselee in solving it by acting upon the decision arrived on the section whiles Advice is giving a solution or a point of view or someone on such a problem by the experience of self or by general, where this could be taken by the receiver or even ignored.
• Advice is a kind of suggestion on how to handle a particular situation but counseling is instruction given by a certified person telling one how to handle and tackle a particular situation in effective way and to achieve the best outcome

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PROCESS OF COUNSELING

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• Beginning of the counseling session (introduction), greet the patient and welcome the patient to make him or her feel more comfortable.
• Active attending or listening: It is the most important step in counseling because details provided by the client are based on it and it involve listening carefully and paying attention to verbal and nonverbal signals.
• Interpretation: Often people avoid focusing on the real problem and talk around the issue. Interpretation goes beyond expressing feeling and implied meaning of the client's statement. The counselor make the client aware of the core problem, he also help the client to establish what is relevant emphasizing on the important point.

CONT’D

• Repeating: The counselor should not hesitate but repeat the salient point of discussion, state of support or necessary fact
• Summarizing: This is like paraphrasing and help to ensure that each understand the other correctly, summarizing toward the end of counseling provide guidance and direction to both counselor and counselee; to deal with practical matters of the problems and decide the plan of action. It is the combination of reflection on feeling and paraphrasing over a long period of time.

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CONT’D

• Confronting: It involves a direct examination of incongruities and discrepancies in the client's thinking, feeling and/or behavior. The counselor tells the client that their thought affects the behavior of others towards them
• Respecting: As a counselor try to appreciate that people see their problem in unique personal ways determined by culture, social class and personalities. The counselor must respect the client views and beliefs and build on them. The counselor should show respect by asking the client to explain different aspect of the culture and personal belief that are strange.

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CONT’D

• Structuring or prioritization: This means helping the client to see relationship between the fact and the feelings, it helps the client to determine the important aspect for their concern that needs immediate attention and less important ones that can be put off until later.
• Deciding plan of action: Base on scientific knowledge cultural and socio economic aspect of client help the client to explore all the possible solution for the prioritized aspect and choose the most relevant option for action.
• Concluding counseling section: While ending the section summarize the salient point in discussion taken, congratulate client for the effort, wishing them lack and fix the next visit.

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CHALLENGES OF COUNSELING

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• The challenges are some clients were unable to express themselves, maybe in fear, in anxiety and totally dependent on counselor for understanding, support, and accurate answers to their problems.
• In addition to, some client requires more counseling section and besides the clients have many questions which needs to be answered. Some client have more than one problem and sometimes they have difficult questions which may take more counseling section and without readily available answers
• It is also a great challenge to understand the non-verbal and verbal words. The trained counselors are not magician with ready solution to all questions and they to needs time to challenge all questions with an accurate solutions for the client.
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CONT’D

• At times it is quite a challenge to help client who have suicidal intention, deeply emotional client and providing the client with empathetic skills, support and handling them consciously. Some client are delicate we must have patient and understanding when handling the client issue with care
• Client body language movement gives the counselor a great vision to take note and gives the counselor more clues about client problems fear and anxiety. Some clients are very rigid and questioning them very deeply, they will eventually give up and disclose their problems.�

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GROUP MEMBERS

• SEIDU BRIDGET
• ATOTI ABIGAIL
• CECILIA EFUA ASEIDUA
• SUSUANA NELSON
• ESTHER SARKORDIE ADDO
• AMA BAAWAH OFORI-ADARKWAH
• YANKAH DAVID (FOINE

ALL QUESTION TO YANKAH DAVID