health assesment

2.  Communication is a critical nursing skill used
to gather assessment data for nursing
diagnoses, to teach and persuade, and to
express caring and comfort.
• Communication is a two-way interpersonal
process involving the sender of the message
and the receiver of the message. It also
involves intrapersonal messages, or self-talk,
which can affect the message, the
interpretation of the message, and the
response.

3. • The communication process includes four
elements: sender, message, receiver, and
response/feedback. The sender must encode
the message and determine the appropriate
form for transmitting it. The receiver must
perceive the message, decode it, and then
respond.
• Verbal communication is effective when the
criteria of pace and intonation, simplicity,
clarity and brevity, timing and relevance,
adaptability, credibility, and humor are met.

4. 1. Development
 Language, psychosocial, and
intellectual development move
through stages across the life span.
Knowledge of a client’s developmental
stage will allow the nurse to modify
the message accordingly

5. 2. GENDER
 From an early age, females and males
communicate differently. Girls tend to
use language to seek confirmation,
minimize differences, and establish
intimacy. Boys use language to
establish independence and negotiate
status within a group.

6. 3. VALUES AND PERCEPTIONS
 Values are the standards that
influence behavior, and perceptions
are the personal view of an event.
Because each person has unique
personality traits, values, and life
experiences, each will perceive and
interpret messages and experiences
differently.

7. 4. PERSONAL SPACE
Personal space is the distance people
prefer in interactions with
others.

8. 5. TERRITORIALITY
 Territoriality is a concept of the space
and things that an individual
considers as belonging to the self.
 Nurses need to obtain permission
from clients to remove, rearrange, or
borrow objects in their hospital area.

9. Models of communication are
conceptual models used to explain the
human communication process

10.  Communication is generally carried out in two
different modes i.e. verbal communication and
nonverbal communication.
 Verbal communication uses spoken or written
words.
 Nonverbal communication uses other forms,
such as gestures, facial expressions and touch.
 Although both kinds of communication occur
concurrently, the majority of communication is
nonverbal.

11.  Another form of communication has
evolved with technology i.e. electrical
communication. A common form of
electrical communication is e mail.

12.  Verbal communication is largely conscious
because people choose the words they use
 Words used vary among individuals according
to; culture socioeconomic background, age
and education.
 In this kind of communication a wide variety
of feelings can be transmitted when people
talk

13.  What nurses need to consider when choosing
words to say or write; pace and intonation,
simplicity, brevity, timing and relevance,
adaptability, credibility and humor

14. PACE AND INTONATION The manner of
speech, as in the rate or rhythm and
tone, will modify the feeling and impact
of a message. The tone of words can
express enthusiasm, sadness, anger, or
amusement. The rate of speech may
indicate interest, anxiety, boredom, or
fear. For example, speaking slowly and
softly to an excited client may help
calm the client.

15.  SIMPLICITY Simplicity includes the use of
commonly understood words, brevity, and
completeness.
 CLARITY AND BREVITY A message that is
direct and simple will be effective.
 TIMING AND RELEVANCE Nurses need to
be aware of both relevance and timing
when communicating with clients.
 ADAPTABILITY The nurse needs to alter
spoken messages in accordance with
behavioral cues from the client.

16.  HUMOR The use of humor can be a
positive and powerful tool in the nurse–
client relationship, but it must be used
with care.
 CREDIBILITY Credibility means
worthiness of belief, trustworthiness,
and reliability.

17.  Nonverbal communication, sometimes
called body language, includes gestures,
body movements, use of touch, and
physical appearance, including adornment.
 Nonverbal communication often tells others
more about what a person is feeling than
what is actually being said, because
nonverbal behavior is controlled less
consciously than verbal behavior.
 Nonverbal communication either reinforces
or contradicts what is said verbally.

18.  Observing and interpreting the client’s
nonverbal behavior is an essential skill for
nurses to develop. To observe nonverbal
behavior efficiently requires a systematic
assessment of the person’s overall physical
appearance, posture, gait, facial
expressions, and gestures.
 The nurse, however, needs to exercise
caution in interpretation, always clarifying
any observation with the client.

19.  Clients who have altered thought processes,
such as in schizophrenia or dementia, may
experience times when expressing themselves
verbally is difficult or impossible. During these
times, the nurse needs to be able to interpret
the feeling or emotion that the client is
expressing nonverbally.
 The nurse cannot always be sure of the correct
interpretation of feelings that are expressed
nonverbally. The same feeling can be
expressed nonverbally in more than one way,
even within the same cultural group.

20.  PERSONAL APPEARANCE Clothing and
adornments can be sources of information
about a person.
 POSTURE AND GAIT The ways people walk and
carry themselves are often reliable indicators
of self-concept, current mood, and health.
 FACIAL EXPRESSION No part of the body is as
expressive as the face. Feelings of surprise,
fear, anger, disgust, happiness, and sadness
can be conveyed by facial expressions.

21.  GESTURES Hand and body gestures may
emphasize and clarify the spoken word, or
they may occur without words to indicate a
particular feeling or to give a sign.

22.  Many health care agencies are moving
toward electronic medical records where
users document their assessments and
nursing care. Electronic mail can be used in
health care facilities for many purposes: to
schedule and confirm appointments, report
normal lab results, conduct client
education, and for follow up with
discharged clients.

23.  ADVANTAGES E-mail has many positive
advantages. It is a fast, efficient way to
communicate and it is legible. It provides a
record of the date and time of the message
that was sent or received. Some health
facilities provide information to their clients
on how they can reach, via e-mail, specified
staff members. This improves
communication and continuity of client
care.

24.  DISADVANTAGES One disadvantage or
negative aspect of e-mail is concern by
both clients and primary care providers
regarding privacy, confidentiality, and
potential misuse of information .
 Socioeconomics. Not everyone has a
computer, and even if people have access to
computers not everyone has the necessary
computer skills.

25.  ANY QUESTIONS?

26.  Therapeutic communication promotes
understanding and can help establish
a constructive relationship between
the nurse and the client.

27.  Accepting pause or silence that may
extend for several seconds or minutes
without interjecting any verbal
response

28.  Using statements or questions
that
 a) encourage the client to verbalize
 b) choose a topic for conversation
 c) facilitate continued verbalization

29.  Making statements that are specific rather
than general, and tentative rather than
absolute

30.  Asking broad questions that lead or invite the
client to explore thoughts or feelings.
 Open ended questions specify only the topic
to be discussed and invite answers that are
longer than one or two words

31.  Provide appropriate forms of touch to
reinforce caring feelings.
 Tactile contacts vary among individuals,
families and cultures, the nurse must be
sensitive to the difference in attitude and
practices of clients and self.

32.  Actively listening for the client’s basic
message and then repeating those thoughts
and/ or feelings in similar words
 Conveys that the nurse has listened and
understood the client’s basic message and
also offer a clearer idea of what they had said

33.  A method of making the client’s broad overall
meaning of the message more
understandable.
 It is used when paraphrasing is difficult or
when the communication is rambling or
garbled.

34.  A method similar to clarifying that verifies
the meaning of specific words rather than the
overall meaning of a message

35.  Suggesting one’s presence, interest or wish
to understand the client without making
demands or attaching conditions that the
client must comply with to receive to nurse’s
attention

36.  Providing a simple and direct manner,
specific factual information the client may or
may not request.
 When information is not known the nurse
states this and indicates who has it or when
the nurse obtain it.

37.  Giving recognition, in a non-judgmental way,
of a change in behavior, an effect the client
has made, or a contribution to a
communication.
 Acknowledgement may be with or without
understanding verbal or non verbal

38.  Helping the client clarify an event, situation
or happening in relationship in time

39.  Helping the client to differentiate the real
from the unreal

40.  Helping the client expand on and develop a
topic of importance.

41.  Directing ideas, feelings, questions, or
content back to clients to enable them
explore their own ideas and feelings about a
situation

42.  Stating the main point of a discussion to
clarify the relevant points discussed.
 It often acts as an introduction to future care
planning

43.  People with special needs refers to those
individuals who have barriers to achieving
good oral health because of disability or
medical condition

44.  Face the patient squarely
 Speak slowly
 If the client cant read lips, you can use a
notepad
 You can also try to learn a few sign language

45.  Minimize distractions
 Use short explanations
 Use simple language
 Take time to explain information
 Use verbal phrases

46.  Always speak when you enter the room so he
will know you are there
 Speak directly to the patient; do not turn your
back
 Speak to the patient in a normal tone of voice
 Speak to the patient before touching him or
her
 Offer to help with arrangements for patients
who may enjoy tapes or reading Braille

47.  Create communication strategies
 Give them choices
 Use visual aids
 Talk softly and remain calm
 Explain your expectations

48. THANK YOU