PVR Module 6


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PVR Module 6

  1. 1. COMMUNICATION DEFINED <ul><li>Communication is the basic element of human interactions. </li></ul><ul><li>Communication allows people to establish, maintain, and improve contacts with others. </li></ul><ul><li>Communication is an ongoing, dynamic series of events in which meaning is generated & transmitted. </li></ul>
  2. 2. COMMUNICATION DEFINED (cont’d) <ul><li>Communication is a complex process that involves behaviors & relationships & allows individuals to associate with others & the world around them. </li></ul><ul><li>Communication occurs at the intrapersonal, interpersonal, and public levels. </li></ul>
  3. 3. INTRAPERSONAL COMMUNICATION <ul><li>Occurs within an individual. </li></ul><ul><li>It is self-talk or an internal dialogue that occurs constantly & consciously. </li></ul><ul><li>Goal: self-awareness, which is influenced by self-concept & feelings of self-worth (efficacy). </li></ul>
  4. 4. INTERPERSONAL COMMUNICATION <ul><li>The interaction between 2 people or in a small group. </li></ul><ul><li>It is often face-to-face. </li></ul><ul><li>Most commonly used communication level in nursing situations. </li></ul><ul><li>Individuals are continuously aware of one another. </li></ul>
  5. 5. INTERPERSONAL COMMUNICATION <ul><li>Healthy interpersonal communication allows problem solving, sharing of ideas, decision making, and personal growth. </li></ul><ul><li>It is the heart of the nursing practice. </li></ul><ul><li>A nurse can help a patient by communicating at a meaningful interpersonal level. </li></ul>
  6. 6. PUBLIC COMMUNICATION <ul><li>Interaction with large groups of people (lecture style). </li></ul><ul><li>Being a competent communicator with an audience requires the ability to envision oneself speaking to a group. </li></ul><ul><li>Special platform skills (posture, body movements, tone of voice) help the speaker to express their ideas. </li></ul>
  7. 7. ELEMENTS OF COMMUNICATION <ul><li>STIMULUS (Referent): Motivates a person to communicate with another. It may be an object, experience, emotion, idea, or act. </li></ul>
  8. 8. ELEMENTS (cont’d) <ul><li>SENDER (encoder): The person who initiates the interpersonal communication or message. The sender puts the stimulus/referent into a form that can be transmitted and assumes responsibility for the accuracy of the content and the emotional tone of the message. </li></ul>
  9. 9. ELEMENTS (cont’d) <ul><li>MESSAGE: The information that is sent or expressed by the sender. The most effective message is clear and organized and is expressed in a manner familiar to the person receiving it. </li></ul><ul><li>CHANNELS: Means of conveying messages (visual, auditory, tactile). </li></ul>
  10. 10. ELEMENTS (cont’d) <ul><li>RECEIVER (decoder): The person to whom the message is sent. The receiver must perceive or become aware of the message. The receiver defines the communication message. </li></ul>
  11. 11. ELEMENTS (cont’d) <ul><li>FEEDBACK: Helps to reveal whether the meaning of the message is received. Mere intent to communicate is insufficient to ensure that a message is accurately received. Constructive feedback helps communicators change their language styles to meet each person’s needs. </li></ul>
  12. 12. MODES OF COMMUNICATION <ul><li>Language is a code that conveys meaning. </li></ul><ul><li>People send messages in the verbal and nonverbal modes, which are closely bound together during interpersonal interaction. </li></ul><ul><li>We express ourselves thru movement, tone of voice, facial expressions, and general appearance. </li></ul>
  13. 13. VERBAL COMMUNICATION <ul><li>Involves spoken or written words. </li></ul><ul><li>Words are tools or symbols used to express ideas or feelings, arouse emotional responses, or describe objects, observations, memories, or inferences. </li></ul><ul><li>Words may also convey hidden meanings, test the other’s interest or degree of concern, or express hostility, or fear. </li></ul>
  14. 14. VERBAL TECHNIQUES <ul><li>CLARITY AND BREVITY: Effective communication is simple, short, and direct. Fewer words spoken result in less confusion. </li></ul><ul><li>VOCABULARY: In nursing there are many technical terms/jargon. The client may become confused & unable to follow instruction or learn important information if the nurse does not chose his/her words carefully. </li></ul>
  15. 15. VERBAL TECHNIQUES <ul><li>DENOTATIVE MEANING: A meaning shared by individuals who use a common language (i.e. baseball). </li></ul><ul><li>CONNOTATIVE MEANING: The meaning of the word reflects the shade or interpretation of a word’s meaning rather than the definition (i.e. serious). </li></ul>
  16. 16. VERBAL TECHNIQUES <ul><li>PACING: Verbal communication is more successful when expressed at an appropriate speed or pace. </li></ul><ul><li>TIMING/RELEVANCE: Critical to reception of a message. Even though a message is clearly & concisely stated, poor timing can prevent it from being accurately received. </li></ul>
  17. 17. VERBAL TECHNIQUES <ul><li>HUMOR: Can be a powerful tool in promoting well-being. Laughter serves as a psychological and physical release. Humor can enhance feelings of well-being, reduce anxiety, and increase pain tolerance. </li></ul>
  18. 18. NONVERBAL COMMUNICATION <ul><li>The transmission of messages without the use of words. </li></ul><ul><li>One of the most powerful ways people convey messages to others. </li></ul><ul><li>We continuously communicate non-verbally in every face-to-face encounter. </li></ul>
  19. 19. NONVERBAL (cont’d) <ul><li>Gestures impart meanings that are more significant than words. </li></ul><ul><li>Nonverbal cues add meaning to the verbal message. </li></ul>
  20. 20. NONVERBAL TECHNIQUES <ul><li>METACOMMUNICATION: A message within a message that conveys a sender’s attitude toward the self and the message and the attitudes, feelings, and intentions toward the listener. </li></ul><ul><li>Example: Crying patient states, “I’m great, really I am.” </li></ul>
  21. 21. NONVERBAL TECHNIQUES <ul><li>PERSONAL APPEARANCE: A person’s appearance is one of the first things noticed during an interpersonal encounter. Physical characteristics, dress, grooming, & the presence of jewelry & adornment provide clues to the person’s physical well-being, personality, social status, occupation, religion, culture, & self-concept. </li></ul>
  22. 22. NONVERBAL TECHNIQUES <ul><li>PERSONAL APPEARANCE (cont’d): Physical characteristics, such as the condition of hair, color of skin, weight, energy level, & presence of a physical deformity, also communicate information about the level of health. </li></ul>
  23. 23. NONVERBAL TECHNIQUES <ul><li>PHYSICAL APPEARANCE: The nurse’s physical appearance influences the patient’s perception of care received. Each patient has a preconceived image of a nurse. </li></ul><ul><li>It may become more difficult to establish a sense of trust & reliability if nurses don’t meet the patient’s image. </li></ul>
  24. 24. NONVERBAL TECHNIQUES <ul><li>NURSE’S APPEARANCE: A neat, well-tailored look conveys the message of a competent professional. Conversely, a nurse who has bad breath or cigarette breath, “messy” hair, poorly manicured nails, dirty shoes, for example, may be considered unprofessional & may be taken less seriously than a nurse who has paid attention to these details of personal appearance and hygiene. </li></ul>
  25. 25. NONVERBAL TECHNIQUES <ul><li>INTONATION: The tone of a speaker’s voice can express enthusiasm, concern, hostility, or indifference. </li></ul><ul><li>FACIAL EXPRESSION: Rich communication potential.The face & eyes send overt & subtle cues that assist in message interpretation. Due to cultural differences, their meanings may be difficult to judge. </li></ul>
  26. 26. NONVERBAL TECHNIQUES <ul><li>EYE CONTACT: An important facial expression. Wide eyes are associated with frankness, terror, & Naivete. Downward glances reflect modesty or shyness. Raised upper eyelids reveal displeasure. Staring is often associated with anger and coldness. </li></ul><ul><li>Persons who maintain eye contact during a conversation are perceived as trust-worthy and believable. </li></ul>
  27. 27. NONVERBAL TECHNIQUES <ul><li>TOUCH: Touch is an important part of the nurse-patient relationship, but it must be used with discrimination because strong social norms govern its use. </li></ul>
  28. 28. NONVERBAL TECHNIQUES <ul><li>POSTURE/GAIT: The way people stand & move is a visible form of self-expression. Posture/gait reflect attitudes, emotions, self-concept, & physical wellness. </li></ul><ul><li>An erect posture & a quick, purposeful gait communicate a sense of well-being & assuredness. </li></ul>
  29. 29. NONVERBAL TECHNIQUES <ul><li>POSTURE/GAIT (cont’d): </li></ul><ul><li>Leaning forward to toward a person conveys attention and interest to that person. </li></ul><ul><li>Leaning backward in a more relaxed manner shows less interest and caution. </li></ul>
  30. 30. NONVERBAL TECHNIQUES <ul><li>GESTURES: Used to illustrate an idea that is difficult or inconvenient to describe in words. </li></ul><ul><li>Visual enhancers, that emphasize, punctuate, & clarify the spoken word. </li></ul>
  31. 31. NONVERBAL TECHNIQUES <ul><li>TOUCH: A personal form of communication. Because touch is more spontaneous than very communication, it generally seems more authentic. </li></ul><ul><li>Affection, Support, Encouragement, Respect Tenderness, & Personal attention, are conveyed through touch. </li></ul>
  32. 32. LISTENING <ul><li>One of the most effective therapeutic communication techniques </li></ul><ul><li>Nonverbal method to convey interest in the patient’s needs, concerns, and problems. </li></ul><ul><li>Attempts to understand the entire verbal & nonverbal message that a person is communicating. </li></ul>
  33. 33. LISTENING (cont’d) <ul><li>Requires the nurse’s complete attention. </li></ul><ul><li>Hearing is a passive, neurological process of receiving information. </li></ul><ul><li>Listening is an active, learned process. </li></ul><ul><li>Listening requires as much effort & energy as the presentation of information requires. </li></ul>
  34. 34. TOOLS FOR EFFECTIVE LISTENING <ul><li>Face patient while they speak. </li></ul><ul><li>Maintain natural eye contact to show willingness to listen. </li></ul><ul><li>Assume an attentive posture. </li></ul><ul><li>Avoid crossing legs/arms because this conveys a defensive posture. </li></ul><ul><li>Lean toward patient to communicate involvement. </li></ul>
  35. 35. TOOLS FOR EFFECTIVE LISTENING (cont’d) <ul><li>Avoid distracting body movements, such as wringing hands, tapping feet, or fidgeting with an object. </li></ul><ul><li>Nod in acknowledgment when clients talk about important points. </li></ul><ul><li>Look for and encourage patient feedback with the communication process. </li></ul>
  36. 36. THERAPEUTIC COMMUNICATION <ul><li>Process in which the nurse, utilizing a planned approach, learns about the patient. </li></ul><ul><li>Focuses on the patient, but is planned and directed by the professional. </li></ul><ul><li>An interpersonal relationship between a patient and a nurse. </li></ul>
  37. 37. THERAPEUTIC COMMUNICATION <ul><li>This process involves significant skill, since the nurse must pay attention to multiple interacting and nonverbal behaviors. </li></ul><ul><li>Therapeutic communication conveys confidentiality. </li></ul>
  38. 38. SOCIAL COMMUNICATION <ul><li>Messages conveyed are superficial in that neither the nurse nor the patient discusses deeply personal matters of concern. </li></ul><ul><li>Tends to be based on intuitive, unthinking, & automatic responses. </li></ul><ul><li>Makes patients feel safe because the discussion has no hidden intent for pers </li></ul>
  39. 39. SOCIAL COMMUNICATION <ul><li>A nurse often uses superficial social interaction at the beginning of a conversation with a patient to lay a foundation for a closer relationship. </li></ul><ul><li>Skillful nurses do not allow social interaction to dominate a conversation but does maintain a congenial and warm style to build the patient’s trust. </li></ul>
  40. 40. SOCIAL COMMUNICATION <ul><li>Goal: To help the patient feel comfortable in sharing attitudes and feelings. </li></ul>
  41. 41. COMMUNICATION BARRIERS <ul><li>Interpersonal communication is made more complex because each person is influenced differently by variables. </li></ul><ul><li>Intrapersonal variables make each interpersonal communication unique. </li></ul>
  42. 42. BARRIERS/VARIABLES <ul><li>DEVELOPMENTAL STAGE: Lead to varied capacity levels of understanding </li></ul><ul><li>PERCEPTIONS: Personal view of events </li></ul><ul><li>VALUES: What a person considers important in life and thus influence expression of thoughts and ideas. </li></ul>
  43. 43. BARRIERS/VARIABLES <ul><li>EMOTIONS: A person’s subjective feelings about events. </li></ul><ul><li>SOCIOCULTURAL BACKGROUND: The sum total of learned ways of doing, feeling, & thinking; it is a form of conditioning that shows itself through behavior. Language, gestures, values and attitudes reflect cultural origin. </li></ul>
  44. 44. BARRIERS/VARIABLES <ul><li>GENDER: Men & women have different communication styles & each influences the communication process uniquely. GIRLS use language to seek confirmation, minimize differences, & establish or reinforce intimacy. BOYS use language to establish independence & negotiate status. </li></ul>
  45. 45. BARRIERS/VARIABLES <ul><li>KNOWLEDGE: Communication can be difficult when the persons have different levels of knowledge. </li></ul><ul><li>ROLES/RELATIONSHIPS: People communicate in a style appropriate to their roles/relationships. People feel more comfortable expressing ideas to others whom they have developed positive, satisfying relationships. (Example: Students talk differently with friends than they do with instructors.) </li></ul>
  46. 46. BARRIERS/VARIABLES <ul><li>ENVIRONMENT: People tend to communicate better in a comfortable environment. A warm room free of noise & distraction is best. Noise & lack of privacy or space may create confusion, tension, or discomfort. </li></ul>
  47. 47. BARRIERS/VARIABLES <ul><li>SPACE/TERRITORIALITY: Territoriality defines the meaning of a person’s right to an area of space & surroundings. It is important because it provides people with a sense of identity, security, & control. </li></ul>
  48. 48. BARRIERS/VARIABLES <ul><li>Giving an opinion. </li></ul><ul><li>Offering false reassurance. </li></ul><ul><li>Being defensive. </li></ul><ul><li>Showing approval of disapproval. </li></ul><ul><li>Stereotyping. </li></ul><ul><li>Asking why. </li></ul><ul><li>Changing the subject inappropriately. </li></ul>
  49. 49. HOW TO IMPROVE COMMUNICATION <ul><li>Listen attentive </li></ul><ul><li>Convey Acceptance </li></ul><ul><li>Ask related questions </li></ul><ul><li>Paraphrase </li></ul><ul><li>Clarify </li></ul><ul><li>Focus </li></ul><ul><li>State observations </li></ul>
  50. 50. HOW TO IMPROVE COMMUNICATION <ul><li>Offer information </li></ul><ul><li>Maintain silence </li></ul><ul><li>Use Assertiveness </li></ul><ul><li>Summarize </li></ul>
  51. 51. DIMENSIONS OF THERAPEUTIC TALK <ul><li>Common features of a therapeutic relationship are trust, empathy, caring, autonomy, and mutuality. </li></ul><ul><li>They are essential if the nurse wants to establish positive & supportive relationships with patients. </li></ul>
  52. 52. TRUST <ul><li>The belief that other people will provide help in times of need and distress. </li></ul>
  53. 53. EMPATHY vs SYMPATHY <ul><li>EMPATHY: The ability to try to understand and enter the patient’s frame of reference. Sensing, comprehending, & sharing the patient’s frame of reference, beginning with the patient’s problem. </li></ul><ul><li>It is a fair, sensitive, & objective look at what another person experiences. </li></ul>
  54. 54. EMPATHY vs SYMPATHY <ul><li>SYMPATHY: The expression of one’s for own feelings about another’s predicament. </li></ul><ul><li>It is the concern, sorrow, or pity shown by the nurse for the patient in which the needs of the patient are seen as the nurse’s needs. </li></ul><ul><li>May cause problems by preventing the development of an effective helping relationship. </li></ul>
  55. 55. CARING <ul><li>Having a positive regard for another person. </li></ul>
  56. 56. AUTONOMY & MUTUALITY <ul><li>AUTONOMY: The ability to be self-directed. </li></ul><ul><li>MUTUALITY: Involves sharing with another. </li></ul><ul><li>Both important because the nurse and the patient work as a team, participating in care. </li></ul>
  57. 57. MORE NURSE TOOLS <ul><li>Connect with the patient. </li></ul><ul><li>Appreciate the patient’s situation. </li></ul><ul><li>Respond to the patient. </li></ul><ul><li>Empower the patient. </li></ul>
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