Interpersonal Communication Between Medical Personnel In Persuasing Prospective Patients To Conducting Mcu In The Medical Check Up Unit

Interpersonal Communication between Medical Personnel in Persuasing Prospective Patients to Conducting MCU in the Medical Check Up Unit (Case Study at Moh Ridwan Meuraksa Class II Hospital)

Devi Wijayanti ^*1, Gloria Angelita ^2*

¹Postgraduate, Sahid University

²Postdoctorate, Sahid University 

DOI: https://dx.doi.org/10.47772/IJRISS.2024.8120194

^*Corresponding Author

Received: 05 December 2024; Accepted: 13 December 2024; Published: 11 January 2025

ABSTRACT

This study aims to reveal the importance of closeness through interpersonal communication interactions between a medical worker and a prospective patient to obtain openness in an effort to provide in-depth explanations regarding medical check-ups to find out early about the health condition of a prospective patient. A person’s health data is a very personal document, so the task of a medical worker to obtain data on a patient’s health complaints plays a role in the sustainability of a patient conducting regular and routine health checks. Openness, empathy and equality are the main points of revealing a person’s identity like an old friend. Intimate openness in social space, better known as social penetration, is a bridge for a medical worker to interact interpersonally with prospective patients. Persuading, and providing transparent information is very much needed by a prospective patient. This study uses a descriptive qualitative approach with a post-positivity paradigm. The data collection method is by conducting in-depth interviews equipped with structured interview guides in order to obtain accurate and factual data supported by literature which is then triangulated by data sources.

Keywords: Interpersonal Communication, Social Penetration, Medical Check Up, Medical Personnel, Prospective Patients

INTRODUCTION

In today’s health world, Medical Check Up are a special concern for the government, because, healty people support a healthy government, healthy people are one of the supporters of a good economy for a country, but unfortunately, there are still many people who do not know the importance of carrying out a Medical Check Up, the reason for ignorance, cost factors and worry about the findings after carrying out a Medical Check Up are factors that cause people to be reluctant to carry out a Medical Check Up. The factor of ignorance about Medical Check Up may be a way out, depending on the situation and conditions, the worry about facing the results of a Medical Check Up is felt like a phenomenon that occurs in society, and also occurs in some medical personnel, where they seem healthy, but some time later it is reported that they have “passed away”, This may happen because the medical officer has never carried out a Medical Check Up before. The Indonesian Medical Code of Ethics article 20, 2012 states that doctors are required to maintain their health and maintain their health in order to work well. It can be said that a doctor must maintain his health in order to work optimally, but in reality many doctors ignore the implementation of Medical Check Up. In terms of cost, people are reluctant to carry out a Medical Check Up because to carry out the Medical Check Up procedure they still have to pay for it themselves. The Medical Check Up procedure is not covered by the Social Security Administering Body or BPJS Kesehatan. However, active participants can receive screening services if they have complaints in certain parts of the body, not a complete examination for prevention purposes. Screening services for BPJS Kesehatan participants are provided based on capitation rates.

The capitation rate itself is the amount of per capita payment per month paid in advance by BPJS Kesehatan to first-level health facilities or FKTP based on the number of registered participants without taking into account the number and type of services provided. Medical Check Up or commonly abbreviated as MCU, is an examination procedure carried out to determine overall health conditions, in which there are a series of medical examinations consisting of consultations with medical personnel, laboratory examinations, heart examinations with EKG and Treadmills, Radiology or X-rays, Audiometry (inner ear examination), Spirometry (pulmonary function examination), Mental Health examination and many more examinations carried out at the Medical Check Up.

The purpose of a Medical Check Up is: 1) to detect disease, diagnose early diseases or conditions that may not be physically visible and provide immediate information about a person’s health. This will help in the prevention, management and treatment of diseases early on, as well as taking appropriate, quick action if any health problems are found. Medical Check Ups should be carried out regularly, according to the Indonesian Medical Code of Ethics article 20 of 2012, MCU should be carried out at least once a year, 2) the purpose of a Medical Check Up is used for certain purposes, for example, the requirements for filing ASN / TNI-Polri / BUMN, as a requirement for applying for jobs in domestic and foreign companies, completeness of school entry documents so that physical health and internal organs can be assessed which are associated with activities as needed later. In Law No.

44 of 2009 concerning Hospitals, states that a hospital is a health service institution that provides comprehensive individual health services covering Promotive, Preventive, Curative, and Rehabilitative Services, by providing Inpatient, Outpatient and Emergency services. One of the core points to be emphasized here is in terms of the implementation of preventive health services. Like the motto that says “prevention is better than cure”, the motto is applied to the services at the Moh Ridwan Meuraksa Class II Hospital, especially in the service called the Medical Check Up (MCU) Service, but the motto has a different meaning at the MCU of the Moh Ridwan Meuraksa Class II Hospital where the MCU of the Moh Ridwan Meuraksa Class II Hospital is one of the service places for the Admissions Committee for Candidates for TNI members and the Education Selection or Domestic and Foreign Service for TNI members. Most patients registered at the MCU of Moh Ridwan Meuraksa Hospital Class II are only at a certain age, on average between 15 – 35 years old. The results of the Medical Check Up that has been carried out, if there is anything that needs to be fixed, then of course it will be fixed immediately, This is what is meant to be different in meaning from the Medical Check Up which has a general meaning where MCU is for prevention and not treatment. MCU data with the age of the MCU Unit of Moh Ridwan Meuraksa Hospital Class II in 2024. Description Table 2. Aged 15 – 25 years there is an increase in MCU patients who carry out MCU for Education Tests, Age 26 – 35 years there is a decrease in the number of MCU patients for the purposes of Military promotion, while the age of 36-75 years some of the patients who carry out MCU for the Hajj Pilgrimage In 2024, the age criteria for carrying out MCU at Moh Ridwan Meuraksa Hospital were mostly patients aged between 15 – 35 years, this is a question for researchers to analyze and create strategies to overcome this.

Table 1.1 MCU data with the age of the MCU Unit of Moh Ridwan Meuraksa Class II Hospital in 2024

The need for a healthy life is very important, and this must be understood by the community. Providing education related to the importance of regular health checks through the MCU program requires a strategic approach, namely personal communication. In everyday human activities, communication is a very important thing. Communication can occur when two people take action and reaction. These actions and reactions are called communication actions. Almost every moment we act and learn through communication. Most of the communication activities we do take place in interpersonal communication situations. We can find this interpersonal communication situation in the context of the lives of two people, families, groups or organizations (Mulyana, Deddy: 2005: 39).

Communication between two people can occur, this is stated by Little John and Foss in Interpersonal communication is communication between one individual and another involving face-to-face meetings between two or more people, where the sender can convey messages directly and the recipient of the message can receive or respond directly as well (LittleJohn, 2009: 280). Communication between medical personnel and patients can also be referred to as interpersonal communication, as can be referred to as Therapeutic Communication, which is a process used by using a consciously planned approach, purposeful and its activities are centred on the patient. Therapeutic communication does not occur by itself without being planned, and considered, but is carried out professionally, help patients carried out by professional groups through a personal approach based on feelings and emotions and based on mutual trust between the two parties involved in the communication and reducing doubts and helping to take effective action, strengthening the interaction of the two parties, namely between patients and medical personnel professionally and proportionally in order to help solve patient problems (Agnena and Kharisma, 2015)

LITERATURE REVIEW

Thesis of Andi Rahadi, a student at the Faculty of Social and Political Sciences at Hasanuddin University in 2022, entitled “Interpersonal Communication in Managing Anxiety and Reducing Uncertainty of Tax Bailiffs and Taxpayers

On KPP Primary Maros. Results this research is in the form a of description of the pattern. Characteristics of interpersonal communication and patterns of communication uncertainty between Tax Bailiffs at Maros KPP Pratama and Taxpayers at Maros KPP Pratama. Researchers hope to be able to fill the gaps in Science academics regarding the formation connection /initial interaction through interpersonal in tax collection. Thesis written by Andi Khaidir as a student of the Faculty of Public Health in 2023 at Hasanuddin University Makasar, with the research title “The Influence of Interpersonal Communication on the Behavior of Hypertension Patient Treatment Compliance at the Cempe Health Center, Parepare City”. The research method used in the study       This is a qualitative research for analyzing the influence of interpersonal communication on the behaviour of compliance with the treatment of hypertension patients at the Cempae Health Center, Parepare City.

DISCUSSION

Communication is a routine activity carried out by humans, such as by speaking humans can relate to each other both in everyday life at home, at work, in the market, between residents or wherever humans are. Any activity carried out by humans cannot be separated from communication. Communication is very important for human life in everyday life. The process of increasing knowledge possessed by humans from time to time is due to communication. Communication is a form of social system that needs each other, so that communication cannot be separated. According to DeVito, based on a brief understanding of interpersonal communication, it can be concluded that interpersonal communication has several elements, including the following:

1. Source Receiver (Receiver),

Interpersonal communication involves at least two people. Each individual performs the source function (formulating and sending messages) and also performs the receiver function (understanding and comprehending messages). The term source-receiver emphasizes that both functions are performed by each individual in communication.

Figure 1. Devito’s Interpersonal Communication Model, 2014

The ability to communicate effectively (as a source and receiver) is an interpersonal competence, so your competence includes, for example, the knowledge that, in a particular context and with a particular audience, one topic is appropriate and another is not.

2. Encoding-Decoding,

Encoding refers to the act of producing a message. For example, speaking or writing. Decoding is the opposite and refers to the act of understanding messages. Encoding refers to the act of producing a message. For example, listening.

or reading. By sending ideas through sound waves (in the case of speech) or light waves (in the case of writing).

3. Message(Message),

A message is a signal that serves as a stimulus for the recipient and is received by one of our senses auditory, visual (seeing), tactile (touching), olfactory (smelling), gustatory (tasting), or a combination of these senses. You communicate interpersonally with gestures and touch as well as with words and sentences.

4. Channel(Channel),

A communication channel is the medium through which a message passes. It is a kind of bridge connecting the source and the receiver. Communication rarely occurs in just one channel; two, three, or four channels are often used simultaneously. For example, in face-to-face interactions, you speak and listen (vocal-auditory channel), but you also gesture and receive signals visually (gestural-visual channel), and you emit odours and smell them to others (chemical-olfactory channel).

5. Noise(Disturbance),

Technically, noise is anything that distorts any message preventing the receiver from receiving the message. At one extreme, noise can prevent a message from getting from the source to the receiver. A buzzing sound or static line can easily prevent an entire message from getting through to the receiver on your phone. Four types of noise are particularly relevant. It is important to identify the type of noise and, if possible, to reduce its effects: physical noise, physiological noise, psychological noise, semantic noise

6. Context,

Communication always occurs in a context or environment that influences the form and content of your message. Sometimes this context is subtle or distracting; it seems so natural that it is ignored—like background music. Other times the context dominates, and how it constrains or stimulates your message are clear. Compare, for example, the differences between communicating at a home funeral, a football stadium, a formal restaurant, and a rock concert.

7. Ethics(Ethics),

Interpersonal communication also involves questions of ethics, the study of good and bad, right and wrong, moral and immoral. Ethics deals with action, with behaviour; it deals with distinguishing between moral (ethical, good, and right) and immoral (unethical, bad, and wrong) behaviour. (DeVito, ed14th. 31-39)

One of the images of the Communication Pyramid listed in Rutger de Graaf’s theory is:

Figure 2. Communication Pyramid, Retger de Graaf, 2005

 The importance of communication attracts some of us to study it academically so that a discipline called communication science emerged. This pyramid describes the levels of communication, namely society, institutional, group and interpersonal. The sciences of history, politics, and sociology focus on society, and psychology focuses on interpersonal and intrapersonal.

In approaching communication as a science, there are three main perspectives as follows:

1. The view of communication as the transmission of messages and the focused approach to communication
2. The view of communication as the production and exchange of meaning is consistent with the construction of sign messages and the calling of meaning through signification.
3. An approach to the view of how communication is used to construct social reality.

Study This There is on Context Communication Interpersonal

Interpersonal Communication

Interpersonal Communication According to Devito (2014, p. 56), interpersonal communication is the delivery of messages delivered by a person and received by another person or group of people, with various responses and the opportunity to provide feedback. According to Devito (2014, p. 57). Interpersonal Communication like other forms can be very effective and can also be very ineffective. The characteristics of effectiveness are seen from three perspectives, the first is the humanistic perspective, the second is the pragmatic or behavioural perspective that emphasizes the management and freshness of interaction, and in general the qualities that determine the achievement of specific goals, the third is the social perspective and the equality perspective. In this study, researchers took the characteristics of interpersonal communication effectiveness from the humanistic perspective, the humanistic perspective consists of: (Joseph A, DeVito ed.5_page 285). The characteristics of interpersonal communication effectiveness from the humanistic perspective are as follows:

Openness, the willingness to respond to information received in communication. The quality of openness refers to three aspects of interpersonal communication. First, an effective communicator must be open to his/her communicant. Second, the communicator reacts honestly to the stimulus received. Third, the communicator acknowledges that the feelings and thoughts he/she expresses are his/her own and he/she is responsible for them.

Empathy, empathy is a person’s ability to feel what other people are experiencing from the perspective of those other people.

Support, effective interpersonal relationships are where individuals show a supportive attitude by being descriptive not evaluative, spontaneous not strategic.

Positive Feeling (Positive), one must have a positive outlook towards themselves, encourage others to participate more actively, and create a conducive communication situation for effective interaction. Equality interpersonal communication will be more effective when the atmosphere is equal, with an implicit recognition that both parties appreciate, are useful, and have something important to give (Novianti, 2017).

Equality in an interpersonal relationship that is characterized by equality, disagreements and conflicts is seen more as an effort to understand the differences that are bound to exist rather than as an opportunity to bring down the other party, equality does not necessarily require us to accept and agree with all of the other party’s verbal and nonverbal behaviour. Equality means that we accept the other party, or in Carl Rogers’ terms, equality asks us to give “unconditional positive regard” to others (Josep A. Devito:2018.285-291).

Interpersonal communication is a form of communication carried out by two individuals which is useful for conveying a message face to face. And is divided into 2 (two) main factors, namely the content of the information and the content of the message that is spoken or tried through verbal or nonverbal. The two main factors are to be observed and tried based on considerations of the atmosphere, circumstances, and conditions of the recipient of the message. Interpersonal communication is an exchange of data and transfer of interpretation between 2 (two) people or from a small group of individuals through various impacts and feedback. From some of these understandings, it can be summarized regarding interpersonal communication, where interpersonal communication activities are generally carried out by 2 (two) or more individuals, through verbal and nonverbal, which aim to obtain the same meaning. Interpersonal communication has a function that greatly supports an interaction to become closer and easier to build trust. The function of interpersonal communication is an effort made to improve relationships between humans, minimize conflict between individuals and carry out knowledge and experience with others. The previous function of interpersonal communication is a way to understand ourselves or others, communication carried out individually can make it easier to gain knowledge directly, and produce and establish interpersonal interactions. The closeness that is built can produce openness between the sender of the message and the recipient of the message to the point of intimacy (disclosure). Altman & Taylor’s non-intimate relationships move into intimate relationships because of self-disclosure. Altman and Taylor’s, found this in their theory: social penetration which has been known since 1973, likens the uniqueness of human personality to be revealed like an onion, namely humans have several layers of personality. The outermost layer of personality is the one that is open to the public, what we usually show to others in general, not covered up. As fellow humans, we become closer more often and faster through interactions from the outermost layer to the deepest layer of ourselves.

Figure 3. Penetration Social Theory, Altman & Taylor, 1973

Medical Check Up MCU is performed by general medical officers or specialist medical officers at   health centers or hospitals. Before undergoing MCU, patients usually have to provide their medical history and information about their family history. This will help medical officers determine what tests and examinations need to be performed. After MCU, medical officers will provide a report of the results explaining a person’s health condition. This report will include the results of the tests and examinations performed, as well as recommendations for further treatment if needed.

Some types of tests and examinations in Medical Check Up to evaluate overall health conditions include;

Physical examination, includes checking blood pressure, pulse, body temperature, height, weight, and examination of body organs such as the heart, lungs, skin, eyes and limbs.

Blood test, blood tests are used to evaluate several examinations including blood sugar levels, cholesterol, and triglycerides in the blood, as well as other tests to evaluate liver, kidney, and thyroid function.

Urine test, urine tests can help medical personnel detect infections, kidney disorders, or metabolic disorders.

Other supporting tests, imaging tests such as X-rays, CT scans, or MRIs to see the condition of internal organs, or reproductive health check-ups, allergy sensitivity checks, and mental health tests.

Lung function test, pulmonary function tests are used to evaluate how a person’s lungs are functioning, and can be done using spirometry or a peak flow meter.

Heart health test, health tests include an electrocardiogram (ECG) to evaluate heart activity, a cardiac HRV test to evaluate stress heart function during physical activity and a treadmill.

Eye examination

This includes eye tests to check vision and eye exams with special instruments to find eye problems such as glaucoma.

In the Medical Check Up Unit, it consists of several personnel, including general medical officers, specialist medical officers, nurses, technicians and computer operators as admin officers, each personnel has duties and responsibilities.

Patient first came from Indonesian, the word patient is English. The patient is explained through Latin, namely patient which has the same meaning as the word pati itself has the meaning of “sick” people who feel unwell in their limbs due to illness. Previously, the understanding in the Big Indonesian Dictionary No. 29 of 2004 concerning health actions conveyed that patients are humans who need health information in order to get a medical action needed directly and indirectly by experts in the health field. Its nature is mutually exchanging and produces a certain response. From the existence of a response that is obtained, communication will result. Effective communication certainly needs reciprocity, communication is effective if there is a stimulus received and the delivery of the source is related through actions that can be understood through the recipient of the message. The following are the requirements for communicating effectively:

1. Produce a favorable atmosphere
2. Use of easy to understand language sentences
3. The information provided may raise concerns
4. Messages can give rise to an award or reward

Communication Effectiveness can be seen as an important thing because there are many kinds of dynamics of life that usually get into critical situations.

RESULTS

Healthy lifestyle becomes a culture that is understood and educated to the wider community. Health does not focus on eating nutritious food, exercising regularly and getting enough rest, in more detail and in depth, health is an important investment that is sustainable. Maintaining a healthy and fit body condition is a new tradition, especially after going through the dark times of COVID 19. Endemic provides space for people to care more about their health. Health education must be encouraged, so that literacy related to healthy physical and spiritual living is not just a slogan. Through the Medical Check Up program, people can start checking themselves before it is too late when the disease has spread or even become acute. The caution of medical personnel to provide education on the benefits of early health checks must continue to be disseminated to various health centres, such as: hospitals, health centres, regional health centres, village clinics. Taking a cultural approach and building openness and intimate relationships with prospective patients. The figure of medical personnel is not a figure to be feared but they can accept it comfortably. Indonesia as an archipelagic country with a very wide distribution of people to remote and interior areas and a diverse character of society, should prioritize healthy lifestyle education and cultivate early health checks. So it can be concluded:

1. The interpersonal communication skills of a medical professional play a role in establishing friendly and open relationships so that people who want to undergo health checks feel comfortable.
2. The sense of empathy that is developed from the interaction between medical personnel and prospective patients is an important asset in building trust.
3. Positioning oneself as a form of equality, namely becoming a public servant in the health aspect, must be practiced and carried out every time providing education and direction as well as explaining the importance of healthy living for all ages.
4. The concerns and fears of prospective patients can be reduced with moral support from medical personnel in providing positive solutions for patient recovery.
5. The competencies referred to above are basic competencies as a foundation that includes; maturity, responsibility, persuasion, improvisation, innovation, decision making, ability, and creativity in a medical personnel (doctor, midwife, nurse) with good communication, a medical personnel can present products or services to consumers more optimally.
6. The following discussion is related to Social Penetration Theory and interpersonal communication, medical personnel must utilize their relationships both professionally and personally. Communicate well and avoid conflict between medical personnel and patients as Customers.

Scheme 1. Persuading Potential Medical Check Up Patients, Researcher 2024

CONCLUSION

Interpersonal communication or also called interpersonal communication is very important in professional medical personnel. Devito (2015) said, someone communicates because there is something he wants to convey to others and get feedback that is in accordance with his expectations. A patient’s expectations include self-health care and improving a fit or healthy appearance. This is important in interpersonal communication between medical personnel and patients or prospective customers, because intimate communication does not only refer to intimate situations physically but also emotionally and intellectually. The social penetration process requires verbal and nonverbal interaction or behavior, so prospective patients are more comfortable communicating and can express what they want to be healthier and fitter and away from the possibility of contracting critical illnesses. According to the theory of Altman & Taylor (1973), it explains how the development of the closeness of a relationship between a person and another individual becomes closer, and more intimate, and there is mutual trust. What is expressed in the Social Penetration Theory is applied at the Moh Ridwan Meuraksa Class II Hospital. DeVito said that interpersonal communication includes the following elements: source-receiver, encoding-decoding, messages, feedback and feedforward, channels, noise, context, and ethics. RS Moh. Ridwan Meuraksa consistently applies intrapersonal communication to increase patient interest. This is done because it has its characteristics, a medical worker will explain the treatment in the clinic, requiring a demonstration or direct teaching of the patient’s body parts, considering that the consumer’s understanding varies greatly so that a direct approach through presentation or direct explanation is needed to avoid misperception.

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Journal Articles:

1. Abraham Wahyu Nugroho 2009. Interpersonal Communication between Nurses and Patients Arlene H Spinner-gelfar 2013. Using Simulation to Promote Effective Communication with a diverse Stuent  population,      teaching           and learning    in         nursing,           8(3),96-101. https://doi.org/10.1016/j.teln/2013.01.004
2. Nindito, V. (2017). Interpersonal Communication in Health Services. Journal of Communication Science, 15(2), 112-123.
3. Syafrizal, A., & Mahendra, D. 2020. The Role of Communication in Improving the Quality of Health Services. Journal of Health Communication, 9(3), 213-228.

Scientific Report/Work:

1. Pratama, DA 2018. Interpersonal Communication Strategy in Increasing Patient Trust at XYZ Hospital. Thesis. University of Indonesia.

Website

1. Ministry of Health of the Republic of Indonesia. 2020. The Importance of Regular Medical Check Ups. Retrieved on October 15, 2024, from https://www.kemenkes.go.id/article-mcu

Laws or Government Documents:

1. Department of Health of the Republic of Indonesia. 2009. Law No. 36 of 2009 concerning Health. Jakarta: Department of Health of the Republic of Indonesia