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Chapter 23

Communication

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Communication and Interpersonal Relationships

• Vehicle for establishing a therapeutic relationship

• Means of influencing the behavior of another to lead to successful outcomes

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Levels of Communication

• Intrapersonal

• Interpersonal

• Transpersonal

• Small group

• Public

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Basic Elements of Communication

• Referent

• Sender and receiver

• Messages

• Channels

• Feedback

• Interpersonal variables

• Environment

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Forms of Communication

• Verbal

• Nonverbal

• Symbolic

• Metacommunication

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Verbal Communication

• Vocabulary

• Denotative and connotative meaning

• Pacing

• Intonation

• Clarity and brevity

• Timing and relevance

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Nonverbal Communication

• Personal appearance

• Posture and gait

• Facial expression

• Eye contact

• Gestures

• Sounds

• Territoriality and personal space

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Zones of Personal Space

• Intimate zone: 0 to 18 inches

• Personal zone: 18 inches to 4 feet

• Social zone: 4 to 12 feet

• Public zone: 12 feet and beyond

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Professional Helping Relationships

• Nurse—client

• Nurse—family

• Nurse—health team

• Nurse—community

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Elements of Professional Communication

• Courtesy

• Use of names

• Privacy and confidentiality

• Trustworthiness

• Autonomy and responsibility

• Assertiveness

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Communication in the Nursing Process

• Assessment– Physical and emotional factors– Developmental factors– Sociocultural factors– Gender

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Communication in the Nursing Process (cont’d)

• Nursing diagnosis examples– Impaired verbal communication– Anxiety– Social isolation– Ineffective coping– Impaired social interaction– Powerlessness

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Communication in the Nursing Process (cont’d)

• Planning– Goals and outcomes– Priorities– Continuity of care

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Communication in the Nursing Process (cont’d)

• Implementation– Therapeutic communication techniques

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Therapeutic Communication Techniques

• Active listening (SOLER)

• Sharing observations

• Sharing empathy

• Sharing hope

• Sharing humor

• Sharing feelings

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Therapeutic Communication Techniques (cont’d)

• Using touch

• Using silence

• Providing information

• Clarifying

• Focusing

• Paraphrasing

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Therapeutic Communication Techniques (cont’d)

• Asking relevant questions

• Summarizing

• Self-disclosure

• Confrontation

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Nontherapeutic Communication Techniques

• Asking personal questions

• Giving personal opinions

• Changing the subject

• Automatic responses

• False reassurance

• Sympathy

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Nontherapeutic Communication Techniques (cont’d)

• Asking for explanations

• Approval or disapproval

• Defensive responses

• Passive or aggressive responses

• Arguing

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Communication in the Nursing Process

• Implementation– Adapting communication techniques for

clients with special needs

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Communication in the Nursing Process (cont’d)

• Evaluation– Analysis of communication patterns– Process recordings