The document discusses therapeutic communication and interpersonal relationships, including definitions, techniques, models, stages, and forms of each. Therapeutic communication involves establishing understanding and constructive relationships between healthcare providers and clients, while interpersonal relationships refer to interactions between individuals that can develop in personal or professional contexts and progress through different phases.
THERAPEUTIC COMMUNICATION AND NURSE-PATIENT-RELATIONSHIP.pdfTejal Virola
Therapeutic communication is a technique used by healthcare professionals, particularly in the field of mental health and counseling, to establish a supportive and trusting relationship with clients or patients. Its primary goal is to promote healing, foster understanding, and facilitate positive changes in a person's thoughts, feelings, and behaviors. Effective therapeutic communication is essential for building rapport, encouraging self-expression, and facilitating the healing process.
A therapeutic nurse-patient relationship is a professional relationship established between a nurse and a patient with the aim of promoting the patient's well-being, health, and healing. This relationship is built on trust, respect, communication, empathy, and collaboration to meet the patient's healthcare needs effectively. It's a fundamental aspect of nursing practice, especially in providing holistic and patient-centered care.
this ppt contains therapeutic communication and therapeutic nurse patient relationships which is part of basic B.Sc. and M.Sc. nursing
Communication
A. Process of Communication
B. Methods of Communication
C. Influence of Communication
D. Communication with Health Care Team
E. Therapeutic vs. Non-therapeutic Communication
F. Nurse-Client Communication
Among the health care givers, the nursing team would certainly being aware of the qualifications and responsibilities of a head nurse,
on the road to health care quality improvement
we communicate when we talk and also when we don't talk. the sharing of ideas, thoughts, perceptions, belief between two individuals (client and nurse) which will help nurse to provide effective care and treatment to the client.
Therapeutic communication and interpersonal relationship Neha Sharma
Therapeutic communication is defined as the face-to-face process of interaction that focuses on advancing the physical and emotional well-being of a patient. Nurses use therapeutic communication techniques to provide education and support to patients, while maintaining objectivity and professional distance.
THERAPEUTIC COMMUNICATION AND NURSE-PATIENT-RELATIONSHIP.pdfTejal Virola
Therapeutic communication is a technique used by healthcare professionals, particularly in the field of mental health and counseling, to establish a supportive and trusting relationship with clients or patients. Its primary goal is to promote healing, foster understanding, and facilitate positive changes in a person's thoughts, feelings, and behaviors. Effective therapeutic communication is essential for building rapport, encouraging self-expression, and facilitating the healing process.
A therapeutic nurse-patient relationship is a professional relationship established between a nurse and a patient with the aim of promoting the patient's well-being, health, and healing. This relationship is built on trust, respect, communication, empathy, and collaboration to meet the patient's healthcare needs effectively. It's a fundamental aspect of nursing practice, especially in providing holistic and patient-centered care.
this ppt contains therapeutic communication and therapeutic nurse patient relationships which is part of basic B.Sc. and M.Sc. nursing
Communication
A. Process of Communication
B. Methods of Communication
C. Influence of Communication
D. Communication with Health Care Team
E. Therapeutic vs. Non-therapeutic Communication
F. Nurse-Client Communication
Among the health care givers, the nursing team would certainly being aware of the qualifications and responsibilities of a head nurse,
on the road to health care quality improvement
we communicate when we talk and also when we don't talk. the sharing of ideas, thoughts, perceptions, belief between two individuals (client and nurse) which will help nurse to provide effective care and treatment to the client.
Therapeutic communication and interpersonal relationship Neha Sharma
Therapeutic communication is defined as the face-to-face process of interaction that focuses on advancing the physical and emotional well-being of a patient. Nurses use therapeutic communication techniques to provide education and support to patients, while maintaining objectivity and professional distance.
Therapeutic Communication In Nursing.pptxParul Prasher
Therapeutic And Non-Therapeutic communication in Nursing.Verbal communication consists of getting your message across using sounds, words, and languages, while nonverbal communication involves unsaid things like eye movement, body language, and tone.Verbal communication is the words and sounds that come out of our mouths when we're speaking, including tone of voice and things like sighs and groans. Nonverbal communication, on the other hand, is the signs and messages that we communicate using things like body language, gestures, and facial movements.
It is an interpersonal interaction between the nurse and the patient during which the nurse focuses on the patient’s specific needs to promote an effective exchange of information.
Guidance and Counselling for children. The basic skills which need to be mastered by a counselor to provide effective service.
Attending skills, listening skills, paying attention skills, giving responses skills, identifying problems skills and intervention skills.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
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RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Presentaion on therapeutic relationship
1. PRESENTAION ON THERAPEUTIC
COMMUNICATION &
INTERPERSONAL RELATIONSHIP
Presented To: Presented By:
Dr. Monika Dutta Miss Pratibha
(Lecturer NINE ) M.Sc. Nursing 1st Year
2. LEARNING OBJECTIVE:
• Definition of therapeutic communication.
• Techniques of therapeutic communication
• Forms and stages of achieving therapeutic
communication
• Barrier of therapeutic communication
• Model of therapeutic communication
&
• Definition of interpersonal relationship
• Forms of interpersonal relationship
• Phases of interpersonal relationship
• Model of interpersonal relationship
4. INTRODUCTION:
The therapeutic communication
(also therapeutic alliance, the helping alliance,
or the working alliance) refers to the relationship
between a healthcare professional and
a client (or patient).
Therapeutic communication involves a wide range of
different types of communication with the user of
health care in the treatment process .
5. DEFINITION
“Promotes mutual understanding, establishes a
constructive relationship between the nurse and
the client”.
(Kozier, 2004)
“It is the process, in which the nurse utilizes a
planned approach to learn about the client”.
(Potter A, 1997)
6. TECHNIQUES OF THERAPEUTIC
COMMUNICATION
Using Silence
Providing general leads
Being specific and tentative
Using tentative questions
Restating and paraphrasing
8. Using silence: Accepting pauses or silences that
may extend for several seconds or minutes without
interjecting any verbal response.
Example : Sitting quietly (or walking with the
client)waiting attentively until the client is able to put
thoughts and feelings into words.
9. Cont….
Providing general leads: Using statements or
questions that –
(a) Encourage the client to verbalize
(b) Choose a topic of conversation
(c) Facilitate continued verbalization
Example:
“Can you tell me how it is for you?”
“Perhaps you would like to talk about. . . .”
“Would it help to discuss your feelings?”
“Where would you like to begin?”
“And then what?”
10. Cont…
Being specific and tentative: Making
statements that are specific rather than general,
and tentative rather than absolute.
Example:
“Rate your pain on a scale of zero to ten.” (specific
statement)
“Are you in pain?” (general statement)
“You seen unconcerned about your diabetes.”
(tentative statement)”
11. Using open-ended questions: Asking broad
questions that lead or invite the client to explore
(elaborate, clarify, describe, compare, or illustrate)
thoughts or feelings.
Open-ended questions specify only the topic to be
discussed and invite answers that are longer than one
or two words.
Example:
“I’d like to hear more about that.”
“Tell me more. . . .”
“What brought you to the hospital?”
“What is your opinion?”
“You said you were frightened yesterday. How do you
feel now?
12. Cont…
Restating or paraphrasing
Actively listening for the client’s basic message and
then repeating those thoughts and/or feelings in
similar words. This conveys that the nurse has
listened and understood the client’s basic message
and also offers clients a clearer idea of what they
have said.
Example:
Client: “I couldn’t manage to eat any dinner last
night— not even the dessert.”
Nurse: “You had difficulty eating yesterday.”
Client: “Yes, I was very upset after my family left.”
13. Cont…
Offering self:
Suggesting one’s presence, interest, or wish to
understand the client without making any demands
or attaching conditions that the client must comply
with to receive the nurse’s attention.
Example
“I’ll stay with you until your daughter arrives.”
“We can sit here quietly for a while; we don’t need to
talk unless you would like to.”
14. Cont…
Giving information :
Providing, in 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 will obtain it.
Example:
“Your surgery is scheduled for 11 am tomorrow.”
“You will feel a pulling sensation when the tube
is removed from your abdomen.”
“I do not know the answer to that, but I will find
out from Mrs. King, the nurse in charge.”
15. Cont…
Presenting reality :
Helping the client to differentiate the real from the
unreal.
Example:
“That telephone ring came from the program on
television.”
“Your magazine is here in the drawer. It has not
been stolen.”
16. Cont…
Reflecting : Directing ideas, feelings, questions, or
content back to clients to enable them to explore
their own ideas and feelings about a situation.
Example:
Client: “What can I do?”
Nurse: “What do you think would be helpful?”
Client: “Do you think I should tell my husband?”
Nurse: “You seem unsure about telling your
husband.”
17. Cont…
Summarizing and planning:
Stating the main points of a discussion to clarify
the relevant points discussed. This technique is
useful at the end of an interview or to review a
health teaching session. It often acts as an
introduction to future care planning.
Example:
“During the past half hour we have talked about. . .”
“Tomorrow afternoon we may explore this further.”
“In a few days I’ll review what you have learned
about the actions and effects of your insulin.”
18. The division of stages of therapeutic
communication has primarily didactic
importance and its primary function is to make
guidelines for achieving favourable therapeutic
communication in health care system .There are
three stages of therapeutic communication these
are :
19. Stage 1st : Beginning from
conversation
Greet the user by name
Offer the user to sit
Introduce oneself
Explain the purpose of the interview
Loudly indicate the planned duration of the
interview
Turn off the phone
Do not start a conversation by criticism
20. Stage 2nd : conducting a flow of
conversation
Provide privacy
Start a conversation with open questions
Use closed questions only when necessary
Do not ask too many questions
Maintain eye contact
Encourage and stimulate the user
Listen carefully
Perceive the user’s non-verbal communication
Express support, understanding and
compassion
21. Stage 3rd : End of conversation
Repeat in front of the user everything
important what they said.
Check with the user whether all is well
understood.
Ask the user if she/he missed something and
whether she/he wants to say something else.
thank the user for the interview, greet, escort
them to the door.
22. The Importance of Feedback in
Therapeutic Communication
Feedback is extremely important in all aspects
of communication, and therefore in the
therapeutic one also.
The five main categories of feedback that occur
when conducting therapeutic communication;
categories and their characteristics are given
here:
23. S.No.
Categories Characteristic
1. Evaluation Making opinion about value of
interviewee’s statement.
2. Interpretation
(Paraphrasing)
Intention to explain the meaning of the
sent message.
3. Supporting Giving support to the interviewee.
4. Examination Intention do find out further information,
develop discussion or clarify conclusion.
5. Understanding Intention to fully reveal the interviewee’s
message.
24. BARRIER OF THERAPEUTIC
COMMUNICATION
Stereotyping
Being defensive
Challenging
Testing
Rejecting
Changing topic and subjects
Giving common advice
25. Stereotyping :
Offering generalized and oversimplified beliefs about
groups of people that are based on experiences too
limited to be valid. These responses categorize clients
and negate their uniqueness as individuals.
Example :
“Women are complainers.”
“Men don’t cry.”
“Most people don’t have any pain after this type of
surgery”
26. Cont…
Being defensive :
Attempting to protect a person or health care services
from negative comments. These responses prevent the
client from expressing true concerns. The nurse is
saying, “You have no right to complain.” Defensive
responses protect the nurse from admitting weaknesses
in the health care services, including personal
weaknesses.
Example:
Client: “Those night duty nurses just sit around and
talk all night. They didn’t answer my questions for over
an hour.”
Nurse: “Let me know you we literally run around
whole night. You’re not the only client, you know.”
27. Cont…
Challenging:
Giving a response that makes clients prove their
statement or point of view. These responses
indicate that the nurse is failing to consider the
client’s feelings, making the client feel it necessary
to defend a position.
Example :
Client: “I felt nauseated after that red pill.”
Nurse: “Surely you think I gave you the wrong
pill?”
Client: “I feel as if I am dying.”
Nurse: “How can you feel that way when your
pulse is 70?”
28. Cont…
Testing :
Asking questions that make the client admit to
something. These responses permit the client only
limited answers and often meet the nurse’s need
rather than the client’s.
Example:
“Who do you think you are?” (forces people to admit
their status is only that of client)
“Do you think I am not busy?” (forces the client to
admit that the nurse really is busy)
29. Cont…
Rejecting :
Refusing to discuss certain topics with the client.
These responses often make clients feel that the
nurse is rejecting not only their communication but
also the clients themselves.
Example:
“Let’s discuss other areas of interest to you rather
than the two problems you keep mentioning.”
30. • Cont…
Changing topics and subjects:
Directing the communication into areas of self-interest
rather than considering the client’s concerns is often
a self-protective response to a topic that causes
anxiety. These responses imply that what the nurse
considers important will be discussed and that clients
should not discuss certain topics.
Example:
Client: “I’m separated from my wife. Do you think I
have to make sexual relationship with another
woman?”
Nurse: “I see that you’re 36 and that you like
gardening. I have a beautiful rose garden.”
31. Cont…
Giving common advice
Telling the client what to do. These responses deny
the client’s right to be an equal partner. Note that
giving expert rather than common advice is
therapeutic.
Example:
Client: “Should I move from my home to a nursing
home?”
Nurse: “If I were you, I’d go to a nursing home,
where you’ll get your meals cooked for you.”
33. SOLER: Stands for
S • Sit facing the client
O • observe an open posture
L • Lean towards
E • Eye contact
R
• Relaxed
•Active listening shows respect towards the person who is speaking and powerful as it reinforces the relationship ; allows the client to talk more ope
•Active listening shows respect towards the person who is speaking and powerful as it reinforces the relationship ; allows the client to talk more ope
•Active listening shows respect towards the person who is speaking and powerful as it reinforces the relationship ; allows the client to talk more ope
34. S- Sit facing the client – It depicts Nurse is interested
in listening to the client.
O- observe an open posture- Adopt an open posture.
The non defensive position is one in which neither
arms nor legs are crossed. It conveys that the person
wishes to listen to what the other has to say.
L- Lean towards – Lean toward the person. People
move naturally toward one another when they want
to say or hear something—by moving to the front of a
class, by moving a chair nearer a friend, or by leaning
across a table with arms propped in front. The nurse
conveys involvement by leaning forward, closer to the
client.
35. E- Maintain good eye contact- The interest is further
enhanced by eye contact. Maintaining eye contact
shows interest and concern. However, it is
important to vary the eye contact so that the other
party does not feel threatened or intimidated.
R- Relaxed-client will be relaxed and comfortable
when the Nurse is actively listening to them .
36. This model depicts that active listening shows
respect towards the person who is speaking and
powerful as it reinforces the relationship ; allows
the client to talk more openly without any
inhibitors or bias; It wins the trust or
confidentiality ; establishes therapeutic nurse
patient relationship. Promotes effective
communication.
37. SBAR: Stands for
S •Situation
B •Background
A •Assessment
R •Recommendation
38. • This communication model has gained popularity
in healthcare settings, especially among
professionals such as physicians and nursing. It is
a way for health care professionals to communicate
effectively with one another, and also allows for
important information to be transferred accurately.
The format of SBAR allows for short, organized and
predictable flow of information between
professionals.
39. S- Situation: Clearly and briefly describe the
current situation.
B- Background: Provide clear, relevant background
information of the patient.
A- Assessment: State your professional conclusion,
based on the situation and background.
R- Recommendation: Tell the person with whom
you’re communicating what you need from him or
her, in a clear and relevant way.
40. Example : Example of SBAR being used in a phone
call between a nurse and a physician.
“Dr. Rajesh, this is Priya RN, I am calling from ABC
Hospital about your patient Riya.”
Situation : “Here’s the situation: Mrs. Riya is
having increasing dyspnea and is complaining of
chest pain.”
Background: “The supporting background
information is that she had a total knee replacement
two days ago. About two hours ago she began
complaining of chest pain. Her pulse is 140b/min
and her blood pressure is 128 /54mmhg. She is
restless and short of breath.”
41. Assessment: “My assessment of the situation is
that she may be having cardiac event or a
pulmonary embolism”.
Recommendation: “I recommend that you see
her immediately and that we start her on O2 stat.
Do you agree?”
42. The introduction of SBAR increased the experience of having a well-
functioning structure for oral communication among health care
professionals regarding patients’ conditions. Qualitative findings
revealed the categories: Use of SBAR as a structure, Reporting time,
Patient safety, and Personal aspects
44. INTRODUCTION:
Interpersonal relationship is also defined as the
close association between the individuals who
share common interest and goals.
A strong bond between two or more people
refers to interpersonal relationship. Attraction
between individuals brings them close to each
other and eventually results in a strong
interpersonal relationship
45. DEFINITION:
Interpersonal relationships refer to reciprocal
social and emotional interactions between two
or more individuals in an environment.
Any or all behavior which a person undertake in
the presence of others (Jourald).
46. FROMRS OF INTERPERSONAL
RELATIONSHIP:
An interpersonal relationship can develop
between any of the following:
Individuals working together in the same
organization.
People working in the same team.
Relationship between a man and a woman (Love,
Marriage).
Relationship with immediate family members
and relatives.
Relationship of a child with his parents.
47. Different Types of Interpersonal
Relationships:
• Friendship
• Love
• Family Relationship
• Professional Relationship (Work Relationship).
49. PREINTERACTION PHASE
Tasks:
The nurse reviews pertinent assessment data and
knowledge, considers potential areas of concern,
and develops plans for interaction.
Skills:
Organized data gathering; recognizing limitations
and seeking assistance as required.
50. INTRODUCTORY PHASE
Opening the relationship:
Tasks: Both client and nurse identify each other by
name. When the nurse initiates the relationship, it
is important to explain the nurse’s role to give the
client an idea of what to expect. When the client
initiates the relationship, the nurse needs to help
the client express concerns and reasons for seeking
help. Vague, open-ended questions, such as “What’s
on your mind today?” are helpful at this stage.
Skills: A relaxed, attending attitude to put the client
at ease.
51. Clarifying the problem :
Tasks: Because the client initially may not see the
problem clearly, the nurse’s major task is to help
clarify the problem.
Skills: Attentive listening, paraphrasing, clarifying,
and other effective communication techniques as
discussed before . A common error at this
stage is to ask too many questions of the client.
Instead focus on priorities.
52. Structuring and formulating the contract
(obligations to be met by both the nurse
and client):
Tasks: Nurse and client develop a degree of trust
and verbally agree about :
(a) location, frequency, and length of meetings.
(b) overall purpose of the relationship.
(c) how confidential material will be handled.
(d) tasks to be accomplished.
(e) duration and indications for termination of
the relationship.
Skills: Communication skills listed above and ability
to overcome resistive behaviors if they occur.
53. WORKING PHASE :
Tasks: Nurse and client accomplish the tasks
outlined in the introductory phase, enhance trust
and rapport, and develop caring.
Skills: Listening and attending skills, empathy,
respect, genuineness, concreteness, self-disclosure.
Skills acquired by the client are Non defensive
listening and self-understanding
54. Cont…
1. Exploring and understanding thoughts and
feelings:
The nurse assists the client to explore thoughts
and feelings and acquires an understanding of the
client. The client explores thoughts and feelings
associated with problems, develops the skill of
listening, and gains insight into personal behavior.
55. Cont…
2. Facilitating and taking action:
Tasks : The nurse plans programs within the client’s
capabilities and considers long- and short term
goals. The client needs to learn to take risks (i.e.,
accept that either failure or success may be the
outcome). The nurse needs to reinforce successes
and help the client recognize failures realistically.
Skills:
Decision-making and goal-setting skills. Also, for
the nurse: reinforcement skills; for the client: risk
taking.
56. TERMINATION PHASE :
Tasks: Nurse and client accept feelings of loss. The
client accepts the end of the relationship without
feelings of anxiety or dependence.
Skills: For the nurse: summarizing skills; for the
client: ability to handle problems independently.
57. REDE MODEL OF HEALTH CARE
SYSTEM:
REDE:
The REDE model is a conceptual framework for
teaching relationship-centered healthcare
communication.
The REDE model applies effective communication
skills to optimize personal connections in three
primary phases of Relationship Establishment,
Development and Engagement (REDE). The REDE
model and its application to a typical provider-
patient interaction.
58. Phase 1: Establishment
Convey & respect with the welcome
Review chart in advance and comment on their
history.
Knock and inquire before entering room
Greet patient and companions formally with
smile and handshake .
Introduce self team, clarify role.
Position self at patient’s eye level
Recognize and respond to signs of physical or
emotional distress
59. Collaboratively set the agenda :
Orient patient to elicit a list of their concerns.
Use a open ended question to initiate survey.
Ask “ What else?” until all concerns are identified
Summarize list of concerns to check accuracy ; ask
patient to prioritize.
Demonstrate empathy using SAVE:
Recognize emotional cues & respond “in the
moment”.
Allow space to be with the patient & their emotion
with judgment.
Clarify the emotions if needed .
60. Demonstrate verbally with SAVE
S- Support- “Let’s work together…”
A- Acknowledge- “This has been hard on you .”
V- Validate – “Most people would feel the way
you do.”
E- Emotional naming – “ You seem sad.”
Nonverbally – doing only that which feels natural
and authentic to you.
61. Phase 2 : Development
Engage in reflective listening :
Nonverbally – e.g. , direct eye contact, forward
lean, nodding .
Verbally using continue such as
“What I hear you saying is ……” or “ Sounds like…”
Avoid expressing judgment , getting distracted ,
or redirecting.
Express appreciation for sharing.
62. Elicit the patient narrative :
Use transition statement to orient patient to the
history of present illness.
Use open- ended questions (s) to initiate patient
narrative.
Maintain the narrative with verbally & nonverbal
continuers –
“Tell me more…..” or
“What next?”
Summarize patient narrative to check accuracy .
63. Explore the patient’s perspective using
VIEW
V- Vital activities :
“ How does it disrupt your daily activity?”
or
“How does it impact your functioning ?”
I- Ideas:
“What do you think is wrong ?”
E- Expectations:
“ What are you hoping I can do for you today?”
W- Worries :
“What worries you most about it?”
64. Phase 3 : Engagement
Share diagnosis & information:
Oriented patient the education & planning portion
of the visit.
Present a clear , concise diagnosis
Pause necessary
Provide additional education, if desired & helpful
to the patient.
65. Collaboratively develop the plan
Describe treatment goals and options including
risks , benefits ,& alternatives.
Elicit patient’s preferences & interrogate into a
mutually agreeable plan.
Check for mutual understanding
Confirm patient’s commitment to plan
Identify potential treatment barriers & need for
additional resources .
66. Provide closure:
Alert patient that the visit is ending
Affirm patient’s contributions and collaboration
during visit.
Arrange follow up with patient and consultation
with other team members
Provide handshake & a personal good-bye.
Dialogue throughout using ARIA
A- Assess using open – ended questions
What the patient knows about diagnosis &
treatment.
67. Cont…
How much & what types of education the patient
desires/needs.
Patient treatment preferences
Health literacy
R- Reflect patient meaning emotion
I- Inform
Tell information to patient
Speak slow & provide small chunks of information
at a time.
Use understandable language & visual aids.
A- Assess patient understanding & emotional
reaction to the information provided.
68. The REDE model builds on a significant research base including
placebo, therapeutic alliance, communication skills and patient-
centeredness that recognizes the healing potential of the healthcare
relationship for not only patients but also providers. The REDE model
helps frame the specific communication strategies that optimize their
effect(s) on processes, outcomes of care and the patient-provider
relationship itself. It is hoped that such system wide efforts will result
in improved experience of care and self-efficacy for patients, and
increased confidence, emotional connectedness and resiliency for
providers
69. Summarization:
Definition of Therapeutic communication
Technique of therapeutic communication
Forms and stages of therapeutic communication.
Barrier of therapeutic communication
Model of therapeutic communication
&
Definition of Interpersonal relationship
Phases if interpersonal relationship
REDE model of health care system .
70. References:
1. B. Audrey, S.J. Shirlee , F. Geralyn. Kozier &
Erb’s fundamentals of nursing:Integral Aspects
of Nursing.10TH ed. United States of
America:Julie Levin Alexander;2016
2. Available from
https://www.managementstudyguide.com/typ
es-of-interpersonal-relationships.htm on date
12/09/2020
3. WK Amy. A Boissy. R Thomas. The REDE
Model of Healthcare Communication:
Optimizing Relationship as a Therapeutic
Agent.USA: SAGE Publication;2014