Ch 18

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Ch 18
2011-09-29 23:47:31

Module 4 Therapeutic Communication
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  1. Elements of Communication process
    • Message: Words, gesture, letter
    • Sender: Initiates content delivery
    • Channel: Face-to-face, written, audiovisual, telephone, e-mail
    • Receiver: Interprets the message
    • Feedback: Verifies that the message was received
  2. Factors that influence communication process
    • Environment
    • Lifespan variations
    • Gender
    • Personal space
    • Territoriality
    • Sociocultural factors
    • Roles and relationships
    • Attitudes
  3. Identify and describe the phases of the therapeutic relationship.
    • The therapeutic relationship has four phases: pre-interaction, orientation, working, and termination.
    • The pre-interaction phase occurs before you meet the client. In this phase you gather information about the client.
    • The orientation phase begins when you meet the client. The goal of this phase is to establish rapport, trust, and a timeline.
    • The working phase Use of therapeutic communication techniques. Client clarifies feelings and concerns through verbal and nonverbal communication
    • The termination phase is the conclusion of the relationship.
  4. Enhancing therapeutic Communication
    • Listen Actevily- node
    • Establish trust - ex. do what you say
    • Be assertive - budut hodit' vo krug da okolo, and you have tobe assertive - ask direct questions, could be uncomfortable.
    • Restate, clarify, and validate message - summarize what they are saying, what I hear you are saying....and this is what I'll do.
    • Interpret body language -
    • Share your observations to clarify - this is what i see, is this right?
    • Use open-ended question - is there anything else that you need
    • Use silence
    • Sumarize the conversation - through out conversation and at the end.
  5. Qualities of nurse patient therapeutic communication
    • Empathy: the desire to undestand and be sensitiveto the feelings, beliefs, and situation of another person - adapt your style, tone, vocabulary, and behavior to create the bestapproach for eachclient situation.
    • Respect: by valuing the client and being flexible to meet the client's needs
    • Genuineness: chestnost', expect clients to respond truthfully.
    • Conreteness: espress in concrete, specific terms what you mean, the message must be constructedan delivered in a manner that is suitable for the client.
    • Communication: reciprocal (vzaimnii) process. If client is unable to espress his thoughts clearly, you must be willing toconfront her to request clarification. YOu must be willing to be confronted too.
  6. Therapeutic Relationship
    focuses on improving the health of the client, whether an individual or community.
  7. Therapeutic communication
    is client-centered communication directed at achieving cient goals. It is used to establish therap. relashionship
  8. Barriers to Therapeutic Communication
    • Asking too many questions: - could be disrespectful
    • Asking "why": - suggests critisism, may become defensive and stop talking " What concerned do you have....tell me more..
    • Changing the subject inappropriately: - makes you unintereseted.
    • Failing to probe: - failing to explore issues in detail
    • Expressing approval or disaproval: - be mutual, we are their resourece, we can educate
    • Offering advice: - help clearify options, provide info about the choices
    • Giving false reasurance: don't say "its going to be okey"
    • Stereotyping: reacial, cultural, religious, are-related, gender stereotypes distort assesment. Blatant - "He is old. he won't remember" to a women, Sutble - assumming something about the patient.
    • Using patronizing language: ex. "you should have used a call light" or using endearing words ex. 'honey.
  9. Verbal Communication
    • Vocabulary: - speak at the level of their knowledge, simple terms
    • Denotative and Connotative Meaning: Denotative - is a literal (dictionary) meanig of the word. Connotative - implied(podrazumivaetsa) or emotionaly meaning of the word. Denot - "hey baby" to a baby. or in conatative to a women.
    • Pacing of conversation: - rhythm
    • Intonation: - tone of voice, reflects the feeling behin the words. pitch, cadence, volume
    • Clearity and brevity: - words and nonverbal language send the same message using fewest words possible.
    • Timing and Relevance: do teaching at a good time, when they are not in pain. Convince the person that the info we are saying is relevant to them.
    • Crediblility of the sender: (believability) . your credibility depends on a pattern of honest and timely response to patient concerns, as well as congruence between your verbal and nonberbal communication.
    • Humor: can have positive or negative effect, be careful about.
  10. Nonverbal Communication
    • Facial expression: Communicates feelings behind a message
    • Posture and gaint: Clue to attitude, self-concept
    • Personal appearance: Clue to socioeconomic status, culture, feelings
    • Distance: Indicates extent of familiarity
    • gestures: emphasize and clarify spokne words; can have different meanings
    • Touch: can be misinterpreted.
  11. Other Factors affecting c
    • Environment: quite, private
    • Lifespan variations
    • Gender
    • Personal space
    • Territoriality
    • Sociocultural factors
    • Roles and relationships