J \ P rh — — | DONOR COUNSELLING |Background Roles and responsibilities of a counsellor Counselling skills Stages of counselling + Pre-donation information Pre-donation counselling * Counselling during donation + Post-donation counselling Elements of blood donor counselling Donor retention and motivation WELCOME!Sy COUNSELLING: THE TALKING CURE The means by which one person helps another to clarify his or her life situation and to decide further lines of action” - Philip Burnard WHO defines blood donor counselling as “a confidential dialogue between a blood donor and a trained counsellor about issues related to the donor's health and the donation process” (WHO, 2005) The counsellor's job is to reassure and provide suitable information after listening to the concerns of the counsellee — in this case the donor erred ‘Am healthy enough to donate blood? idea ‘Amina position todonate blood right now?ay COUNSELLING: THE TALKING CURE The means by which one person helps another to clarify his or her life situation and to decide further lines of action” - Philip Burnard WHO defines blood donor counselling as “a confidential dialogue between a blood donor and a trained counsellor about issues related to the donor's health and the donation process” (WHO, 2005) The counsellor's job is to reassure and provide suitable information after listening to the concerns of the counsellee — in this case the donor erred ‘Am healthy enough to donate Blood? Slatted ‘Amina position todonate blood right now? willichurt? willl experience any weakness after the donation?|ROLES & RESPONSIBILITIES OF COUNSELLOR * Donor education regarding: } > blood donation process > TTl reactivity and referral > deferral and preventive health education |* Donor identification * Reporting and record keeping + Motivation and monitoring PHbire reerNYV aN EN) COUNSELLING SKILLS Special ways of talking to help counsellees These special ways of talking are “counselling skills” Deliberate Use of particular statements and sentences with the planned aim ofa certain effect on the counselleeReflection of ‘content+ Acounsellor must listen carefully to avoid missing key facts * To show counsellees that they are listening >» Pay attention > Use statements and gestures to reflect they are listening1. a] Using minimal encouragers + “Mmhmm’, “OK’, “Tell me some more”, head nods 1 I * Away to continue the conversation without interrupting the speaker | * Keeps the conversation ticking and shows that the listener is interested in the conversationMy father died of a heart attack... He was 73 years old. He had been suffering from diabetes for some years.PANY) ANY) Sy | 1. b] Open body posture [ 4 Closed body postures with crossed arms listener is not interested/ uncomfortable/ bored Deliberate use of this knowledge to mould our bodies accordinglyPANY) Repeating * Repeat some of the last words to encourage them to speak/ elaborate + Used when there is a pause in the conversation Yes. He died of a heart attack. It was very sudden. He never had any real problems before that other than diabetes.PANY * Paraphrasing Repeat facts shared by the counsellee, in their own words To highlight relevant points before moving on to a new topic To check your own understanding Do not add some assumptions of our own So far you have shared that your father died suddenly of a heart attack at the age of 73. Before that his only problem was diabetes. ahlZ 41. d] Reflection Throwing back at the counsellee what they said or feeling they showed * Reflection of content: Use of counsellee’s words as much as possible Reflection of feelings: Observations about emotional state of the client Do not assume that your personal reaction would be their emotional response | A\|My father was 73 years old. He died of a heart attack. It was Reflection very sudden. He never had any real problems before that other than diabetes. He was 48 when he discovered he had a diabetes. My current age is 48. Hmm... You are 48 years old. At 48 your father found out he had diabetes. It seems like you might be concerned about diabetes yourself. Is this right? Fimm... From your question, | get the feeling you might bi scared. Would this be a correct guess?2. INFORMATION GATHERING Counsellor initiates the interaction * In blood bank, counsellor wants to know about medical history and personal habits of the donor + Judicious use of open-ended and closed questionsProduce a simple Yes / No answer. Do not permit elaboration Blood Donor Questionnaire has closed questions to rule out that a person does not have certain medical conditions or personal habits To get direct answers to specific questionsnN NYY} 2. b] Open-ended ques! Generate answers with more details Yes-No answer is not appropriate Nothing major. Coughs, colds. Once | had dengue fever.Questions should be well planned and appropriate Do not use leading questions Make it difficult for the person answering the question to reply freely without contradicting the person asking the question Eg. “You're not sexually active, are you?”| 3. SUPPORTIVE TECHNIQUES | Try to deliberately provide an appropriate supportive response to the counsellee’s specific concernSome situations produce identical reactions. Eg. Before donation, people are concerned about pain Appropriate counselling response is to acknowledge this by saying that many people feel the same way and moving on to how to manage it “It is normal to feel” “It is common for people to feel” “most people normally feel like you do”Actually though I have come forward to give blood, am slightly worried. It is common for people to feel a bit worried when they face the prospect of a needle, Let me tell you how we manage this process so you might feel less anxious. Oh. Everybody feels a bit worried when they face the prospect of a needle. You should not worry so much about a little pin prick. * Use normalisation as a skill only when the reaction is normal * Use normalisation for feelings not actionsPy) wayyy) wayyy Wy) 3. b] Identifying strengths and resources Help the counsellee remember strengths and resources they have used in the past Strengths and resources could include people who have given emotional support in the past, prayer and spirituality, positive coping mechanisms, ability to reason and use logicSTAGES OF BLOOD DONOR COUNSELLINGNY SN NY SEN PRE-DONATION INFORMATION Inform and educate donors about the process of blood donation General information, similar for all donors, simple and clear format Verbally or printed, graphic, audio-visual and online materials Provided individually or in a group Opportunity for self deferralPRE-DONATION INFORMATION: OBJECTIVESClarify any misunderstanding about donor selection, blood donation and blood screening Review the donor's answers on the donor questionnaire Explain that it is okay to self-defer (“giving permission”) Obtain the donor's informed consent to give blood Use a non-judgmental or neutral tone of voice when asking questions , w ~~ wa “|PRE-DONATION COUNSELLING: OBJECTIVES Ensure the donor understands the donor questionnaire and responds accurately to all questions Ensure the donor understands that his/her blood will be tested for blood group serology and markers of TTI and the test results will be given to the donor Ensure the donor is in a position to give informed consent to donate and recognizes that his/her signature affirms that responses provided to the questionnaire are accurate Ensure the donor is willing to be informed of his/her test resultsNY Viel NYY) a4 DIFFERENCE BETWEEN PRE-DONATION INFORMATION AND COUNSELLING Counselling focuses on the donor and must be done one-on-one Information focuses on delivery of a common set of messages and may be delivered in a group Counsellor must always direct personal issues towards counselling sessionDonor's experience during this time will shape their overall experience and willingness to donate blood Maintain a warm and polite environment: behavior and pictures Respond courteously to any questions asked, and professionally to any adverse donor reactions Alertness to donor's words and bodily cues to pick up any discomfort Messages: introduction of staff, ask previous history, gentle reassurance, venepuncture, skin disinfection, volume and time, CUENy= Nye EN Nv as 3 CONFIDENTIAL UNIT EXCLUSION (CUE) Opportunity to inform immediately after donation or subsequently if they consider that their blood may be unsuitable for transfusion Useful if donors have been persuaded or coerced to donate Donors should be given information to enable them to contact the Blood Bank and to communicate that their blood should not be used for transfusion {COUNSELLING DURING DONATION: OBJECTIVES Ensure that donors feel comfortable during blood donation, including the venepuncture Reduce donor anxiety and minimize the risk of any adverse donor reactions, suchas fainting Give post-donation advice, including care of the venepuncture site Secure donor’s cooperation in the confidential unit exclusion or post donation information process Foster donor trust and confidence for donor retentionNY aN ew aN ENV) D POST-DONATION COUNSELLING + Need-based Immediately after donation, donors are given self-care instructions for next 48 hours and information about adverse after-effects Brief message on healthy lifestyle and encourage regular donation Thank the donor Counselling for unusual red cell serologyPOST. Explain the test results, the need for confirmation of the results, the S health implications for the donor and the donated blood (discard) and DONATION the suitability of the donor for future blood donation. COUNSELLING OBJECTIVES Encourage donors to provide all relevant information, including the possible source of infection. Clarify doubts or concerns raised by donors. Alleviate donors’ anxiety. Provide information on precautions for preventing the transmission of infection to others. Provide information and refer donors for further investigation, management, treatment and care, if necessary. Reinforce the importance of healthy lifestyles for donors found to be. non-reactive on blood screening and encourage regular blood donationELEMENTS OF EFFECTIVE BLOOD DONOR COUNSELLINGESSENTIAL ELEMENTS OF BLOOD DONOR COUNSELLING IN DIFFERENT SITUATIONSSITUATIONS AND CONDITIONS | ELEMENTS OF COUNSELLING -time blood donor Reassurance to allay anxiety and apprehension A young donor Encouragement to return for future blood donations and become a regular donor Donor deferred temporarily or | Explanation of the reason for deferral permanently Clarification of the nature of the deferral (permanent or temporary) Reassurance to allay anxiety and apprehension Encouragement of temporarily deferred donor to return for future blood donations after the defined deferral period Information on how to maintain a healthy lifestyle Donor with risk for TTI/ Donor | Explanation of the reason for deferral and information on the specific risk for TTI who requests confidential unit |Donor with specific risk for TTI: Refer for treatment, care and support and provide exclusion (CUE) Information on relevant TTI Donor seeking to ascertain infection status: Provide information on voluntary counselling and testing services, Reassurance Donor who has experienced an | Information and advice on preventive steps to reduce the risk of adverse adverse reaction previously _ reactions such as adequate fluid intake before donation Assurance of care for donor well-being Donor with post-donation bruising or haematoma: explain why and how bruising occurred and the actions that the donor can take to reduce the bruising and pain. Peco cbc! Discuss possible preventive measures against bruising during future donation,SITUATIONS AND CONDITIONS ELEMENTS OF COUNSELLING jor showing repeated ive TT! results on screening and negative results on confirmatory testing confirmatory results, where infection cannot be ruled out Donor found to have confirmed positive markers for ™ Explanation of the repeated reactive test results, the need for confirmatory testing and the results of confirmatory testing Information about the donor deferral period: i.e, until screening test is non- reactive on follow-up Reassurance to allay anxiety and apprehension Encouragement to return for future blood donations as the confirmatory test results are non-reactive Explanation of the indeterminate test results, the need for confirmatory testing and the results of confirmatory testing Information about the fate of the blood don: Exploration of all relevant information, including possible TTI risk Explanation of the need for temporary deferral and repeat testing Explanation of the positive TTI test results Information about the health implications of the positive TTI test results for the donor and the donated blood (discard) and the suitability of the donor for future blood donations Exploration of all relevant information, including the possible TTI risk Reassurance to allay anxiety and apprehension Information on how to prevent further transmission Referral for further investigation, management, treatment and care, if necessarySITUATIONS AND CONDITIONS | ELEMENTS OF COUNSELLING or with unusual red Information and explanation of the nature and importance of the unusual red cell 'serology or rare blood serology, such as an atypical red cell antibody, or a rare blood group ‘group Advice to carry this information personally at all times in case the donor ever needs a blood transfusion Encouragement to return for future blood donations and enrolment in the rare blood donor panelWe SN OS St; POTENTIAL DONORS Emphasize the positive aspects of blood donation Would-be donors should know about the safety standards in your blood donation set up and confidentiality Using social motivation techniques and stories Establish and maintain a professional and respectful atmosphere Temporary deferral: speak politely and respectfully and encourage them to returnDONATE BLOODP#0MED cio 1. Elements of counselling include all except:P#0MED cio 1. Counselling should be performed in:P#0MED cio 1. What should be the body posture for counselling?P#0MED cioPs0MED 1. Donor retention can be achieved by:cio 1. What should be included in the elements of counselling for @ donor with confirmed positive markers for TTI? P#0MED