Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.

Chapter 10Chapter 10Communication and the Communication and the

Clinical InterviewClinical Interview

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The Communication ProcessThe Communication Process

• Stimulus for information, comfort, or Stimulus for information, comfort, or adviceadvice

• Sender – initiates contactSender – initiates contact

• Message – sent or expressedMessage – sent or expressed

• Variety of media – hearing, visual, Variety of media – hearing, visual, touch, smelltouch, smell

• Feedback receivedFeedback received

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Factors That Affect Factors That Affect CommunicationCommunication

• Personal factorsPersonal factors

• Environmental factorsEnvironmental factors

• Relationship factorsRelationship factors

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Nonverbal Communication Nonverbal Communication

• Tone of voiceTone of voice

• Emphasis on certain wordsEmphasis on certain words

• Physical appearancePhysical appearance

• Facial expressionsFacial expressions

• Body postureBody posture

• Amount of eye contactAmount of eye contact

• Hand gesturesHand gestures

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Verbal Communication Verbal Communication

• All words a person speaksAll words a person speaks

• CommunicatesCommunicates

– Beliefs and valuesBeliefs and values

– Perceptions and meaning Perceptions and meaning

• Can conveyCan convey

– Interest and understandingInterest and understanding

– Insult and judgmentInsult and judgment

– Double or mixed messagesDouble or mixed messages

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Therapeutic Communication Therapeutic Communication TechniquesTechniques

• Tools for enhancing communicationTools for enhancing communication

– Using silenceUsing silence

– Active listeningActive listening

– Listening with empathyListening with empathy

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Clarifying TechniquesClarifying Techniques

• ParaphrasingParaphrasing

• RestatingRestating

• ReflectingReflecting

• ExploringExploring

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Asking Questions and Eliciting Asking Questions and Eliciting Patient ResponsesPatient Responses

• Open-ended questionsOpen-ended questions

• Closed-ended questionsClosed-ended questions

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Nontherapeutic Communication Nontherapeutic Communication TechniquesTechniques

• Excessive questioningExcessive questioning

• Giving approval or disapprovalGiving approval or disapproval

• Giving adviceGiving advice

• Asking “why” questionsAsking “why” questions

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Cultural ConsiderationsCultural Considerations

• Communication styleCommunication style

• Eye contactEye contact

• TouchTouch

• Cultural filters – form of bias or Cultural filters – form of bias or prejudice prejudice

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Preparing for the InterviewPreparing for the Interview

• PacePace

• SettingSetting

• SeatingSeating

• IntroductionsIntroductions

• Initiating the interviewInitiating the interview

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Attending BehaviorsAttending Behaviors

• Foundation of the interviewFoundation of the interview

– Eye contactEye contact

– Body languageBody language

– Vocal qualityVocal quality

– Verbal trackingVerbal tracking

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Process RecordingProcess Recording

• Written record of a segment of the Written record of a segment of the nurse-patient session that reflects as nurse-patient session that reflects as closely as possible the verbal and closely as possible the verbal and nonverbal behaviors of both patient and nonverbal behaviors of both patient and nursenurse

• Useful tool for identifying Useful tool for identifying communication patternscommunication patterns