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Chapter 9: Therapeutic Communication

Terms in this set (58)

Feeling safer and protected
More satisfied with the care
Increased recovery rates
Improved adherence to treatment
Therapeutic Communication Benefits to The Patient
patient-centered care
Refers to the patient as a full partner in care whose values, preferences, and needs are respected.
Patient-centered
Goal-directed
Scientifically based
what three things would describe therapeutic communication?
Communicator
Message
Channel
Feedback
Encoding/Decoding
Context
Environmental Noise
The Transactional Model includes
communicator
senders and receivers are both considered to be...
message
the content and the ideas that are being exchanged
channel
the method by which the communication takes place
feedback
The receiver's response to a message
encoding/decoding
While interacting, individuals __________ (develop) messages and send to the other and _________ (determine meaning) messages received from the other
context
frames and influences our interactions
social context
refers to the stated rules or unstated norms that guide communication
relational context
includes the previous interpersonal history and type of relationship we have with a person
cultural context
refers to the influence that our cultural identities have on communication; this includes gender, race, ethnicity, nationality, sexual orientation, and socioeconomic class
environmental noise
noise disturbs the message flow and serves as a barrier to interaction
physical noise
is experienced by such conditions as loud units, background noise, or overheard announcements
physiological noise
includes biological factors that reduce the quality of interactions
psychological noise
refers to the factors within a person's mind such as not wanting to converse or being preoccupied about finances
clarity and continuity
the two main guiding principles that guide the communication process in Peplau's Interpersonal Theory
clarity
Ensures that the meaning of the message is accurately understood by both parties
continuity
Promotes connections among ideas, feelings, events, and themes
non directive listening
what allows nurses to provide reflective and nonjudgmental feedback and thereby enables patients to clarify their thoughts
Depression
Cognition
Language/cultural barriers
Personal Factors That Affect Communication
The setting
Environmental Factors That Affect Communication
Level of equality within the relationship
Relationship Factors That Affect Communication
verbal communication
All words a person speaks
Beliefs and values
Perceptions and meaning
verbal communication communicates...
Interest and understanding
Insult and judgment
Clear or conflicting messages
Honest or distorted feelings
verbal communication conveys...
nonverbal communication
Tone of voice
Emphasis on certain words
Physical appearance
Facial expressions
Body posture
Amount of eye contact
Hand gestures
content
Verbal messages can be called the ____________
process
the nonverbal behavior is the ________
double-bind messages
Mutually contradictory messages, usually given by a person in power
silence, active listening, clarifying techniques, questions
therapeutic communication techniques
active listening
Nurses focus, respond, and remember what the patient is saying verbally and nonverbally
Clarifying techniques
Include paraphrasing, restating, reflecting, and exploring
Open-ended questions
Encourage patients to share information about experiences, perceptions, or responses to a situation.
Closed-ended questions
("yes" or "no"), when used sparingly, can give you specific and needed information. Closed-ended questions are most useful during an initial assessment or intake interview or to determine specific results.
Projective questions
Usually start with a "what if" to help people articulate, explore, and identify thoughts and feelings
The miracle question
Is a goal-setting question that helps patients to see what the future would look like if a particular problem were to vanish
Excessive questioning
Giving approval or disapproval
Giving advice
Asking "why" questions
Nontherapeutic Communication Techniques
communication style
In some cultures, expression of positive or negative emotions is a private affair, and open expression of them is considered to be in bad taste and possibly a weakness
use of eye contact
Cultural norms dictate a person's comfort or lack of comfort with direct eye contact. Therefore, do not use the amount of eye contact to assess attentiveness, judge truthfulness, or make assumptions on the degree of engagement one has with a patient
perception of touch
May be seen as healing and supportive, but it may be experienced as patronizing, intrusive, aggressive, or sexually inviting in other cultures.
cultural filters
form of bias or prejudice
Information Communication Technologies
Use of electronic information and telecommunication technologies to support long-distance clinical health care
Information Communication Technologies uses
Live interactive mechanism, as a way to track clinical data and to provide access to people who otherwise might not receive good medical or psychosocial help.
Telehealth Technologies
Video conferencing
Internet sources
Phone consultation and counseling
Image transmission
Interactive video sessions
Mobile applications
Monitor, diagnose, treat, and communicate with patients
Mobile phones are used at a high rate
Many quickly adoptable apps available
More research is needed
SAMHSA free apps for suicide prevention, bullying prevention, and underage drinking prevention
Privacy and confidentiality issues
Lack of data for efficacy and safety
Liability issues
Research is needed to evaluate risks versus benefits
Professional and ethical guidelines needed
Some Concerns of Information Communication Technologies
preparing for the clinical patient interview
Pace
Setting
Seating
Introductions
Initiating the interview
Arguing, minimizing, or challenging the patient
Giving false reassurance
Interpreting or speculating
Probing into sensitive areas the patient doesn't want to discuss
Trying to "sell" the patient on accepting treatment
Joining in attacks patients launch on others
Participation in criticizing other staff members
tactics to avoid
kinetic communication
Is a type of nonverbal communication made by body movement
Facial expressions, body posture, and gestures
Proxemics:
The study of personal space
Intimate distance
0 to 18 inches
Personal distance:
18 inches to 4 feet
Social distance:
4 to 12 feet
Public distance:
12 feet or more
Clinical Supervision & Debriefing
Communication and interviewing are acquired skills
Fosters professional growth and helps minimize the development of non therapeutic nurse-patient relationships.
process recording
Written record of a segment of the nurse-patient session that reflects as closely as possible the verbal and nonverbal behaviors of both patient and nurse
Useful tool for identifying communication patterns
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