Chapter 24 and 25 Communication and Patient Education

saying

competent communication maintains effective relationships within the entire sphere of professional practice and meets legal, ethical, and clinical standards of care. In other words… all behavior communicates, and all communication influences behavior

therapeutic communication

occurs within a healing relationship between a nurse and

patient

developing communication skills

• nurses who develop critical thinking skills and clinical judgment make the best

communicators

critical thinking applied during any patient interaction helps to overcome perceptual biases or stereotypes that interfere with accurately perceiving and interpreting messages from others

levels of communication

• intrapersonal

• interpersonal

• small-group communication

• public communication

• electronic communication

verbal communication

• vocabulary

• denotative and connotative meaning

• pacing

• intonation

• clarity and brevity

• timing and relevance

nonverbal communication

• personal appearance

• posture and gait

• facial expression

• eye contact

• gestures

• sounds

• territoriality and personal space

• metacommunication

nurse-patient caring relationships

courtesy, use of names

motivational interviewing

• nurse-family relationship: trustworthiness, autonomy, responsibility, and assertiveness

• nurse-health care team relationships: lateral violence

• nurse community relationships

motivational interviewing (OARS)

O- ask open ended questions

A-affirmations

R-reflective listening

S-summarize

therapeutic communication techniques

• active listening

• sharing observations

• sharing empathy

• sharing hope

• sharing humor

• sharing feelings

• using touch

• using silence

• providing information

• clarifying

• focusing

• paraphrasing

• validation

• asking relevant questions

• summarizing

• self-disclosure

• confrontation

nontherapeutic communication techniques

• asking personal questions

• giving personal opinions

• changing the subject

• automatic responses

• false reassurance

• sympathy

• asking for explanations

• approval or disapproval

• defensive responses

• passive or aggressive responses

• arguing

implementation

• sociocultural considerations: culture influences thinking, feeling, behaving, and communicating

• speech and language considerations: use appropriate interventions based on patient needs to adapt your communication techniques

patient education

teaching as communication. effective communication involves feedback from the sender and receiver

primary

promote health and reduce disease

secondary

focus on early diagnosis and prompt treatment of illness, limit disability, return patient to a normal level of health as soon as possible

tertiary

prevention of rehabilitation instead of disease detection and treatment

teaching

imparting knowledge through a series of directed activities

learning

process of understanding and applying newly acquired concepts

role of the nurse in teaching and learning

nurses are legally responsible for providing education to all patients

domains of learning

• cognitive learning

• affective learning

• psychomotor learning

motivation to learn

• use of theory to enhance motivation and learning

• cultural factors

• active participation

readiness to learn/health literacy

basic learning principles

ability to learn

• developmental capability

• learning in children

• adult learning

• health literacy and learning disabilities

• physical capability

• learning environment

clinical judgment in patient education

in clinic, home care, and rehabilitation settings, nurses have more time to identify patients’ learning needs and to provide comprehensive ongoing education. in an acute care setting, learn the resources a patient has as early as possible so they are prepared to go home.

planning and outcomes identification

• outcomes

• setting priorities

  • timing

  • organizing teaching material

• teamwork and collaboration

implementation

• maintaining learning attention and participation

• involve the family

• building on existing knowledge and ability

• incorporation teaching with nursing care

things to think about

• cultural diversity

• using teaching tools

• special needs of children and older adults

implementation

• instructional methods

  • one-on-one discussion

  • group instruction

  • preparatory instruction

  • demonstrations

  • analogies

  • role playing

  • simulation

  • cognitive reappraisal

evaluation

patient outcomes

• teach-back