HEALTHCARE -STRESS ADAPTATION, COMMUNICATION, INTERPERSONAL RELATIONSHIP

Stress

➢ is a condition in which the person experiences changes in the normal balanced state

Adaptation

➢ sustaining homeostasis; the ability to mobilize resources and adjust to demands of internal and external environments.

➢ is characterized by chain or pattern of physiologic events.

➢ occurs with the release of certain adaptive hormones and subsequent changes in the structure and chemical composition of the body

Concept of Adaptation General Adaptation Syndrome or stress syndrome

1. Alarm reaction-

2. Stage of Resistance-

3. Stage of Exhaustion

Three Stages of Adaptation:

1. Alarm reaction-

initial reaction of the body that alerts body's defenses

2. Stage of Resistance-

when the body's adaptation takes place. In other words, the body attempts to cope with the stressor and to limit the stressor to the smallest area of the body that can deal it.

3. Stage of Exhaustion-

the adaptation that the body made during the second stage cannot be maintained. This means that the ways used to cope with the stressors have been exhausted.

1. Homeostasis 2. Alarm 3. Resistance 4. Exhaustion 5. Death 6. Recovery

Stages of Adaptation to Stress

Communication

▪ is transmitting, giving or receiving information, signals, or messages by talk, gestures, writing

Verbal ,Nonverbal

Type of Communication

Verbal

▪ consists of words a person uses to speak to one or more listeners.

content

- is the literal words that a person speaks.

Nonverbal

▪ is the transmission of messages without the use of words

• Source or Sender-

• Source or Sender-

• Message-

Channel-

• Decoder-

Receiver-

• Feedback- r

Elements of Communication

Source or Sender-

individual / group/ organization with ideas, needs, intentions, information and a purpose for communicating with one or more people. This initiates or starts the process of communication.

Encoder-

takes the idea of the source and puts them into a code so that the sources purpose can be expressed into a message; set of motor skills

• Message-

a physical form into which the source translates ideas, programs and intentions into a code or systematic set of symbols (words, sounds, or actions that represent meaning) which he/she wants to communicate.

Channel-

medium; carrier of messages; mode of transmission; messages can exist only in some channel; the choice of the channel is important in the effectiveness of communication

• Decoder-

retranslates the messages and puts it into a form that the receiver can use; set of sensory skills of the receiver; sense.

• Receiver-

target of communication; person, group, or entire community; considered in selecting a channe

Feedback-

reaction or response of the receiver to the message sent by the source; verbal or nonverbal; signals that allow communication participant to monitor and evaluate the success of their communication.

1. Thinking

2. Encoding

3. Transmitting

4. Perceiving

5. Decoding

6. Understanding-

Steps of Communication Process

1. Thinking-

start forming the idea in sender's mind.

2. Encoding

- putting thoughts into a form possible communication; include translating experiences into facial expressions, body movements, eye movements (winking) posture, smiling, crying, words, etc.

3. Transmitting

- spreading the message through a medium (oral, over the phone, lecture, writing, typing, faxing).

4. Perceiving

- receiver perceives message through senses.

5. Decoding

- receiver retranslates the incoming message into an understandable form.

6. Understanding-

receiver understands the intended message of the source

• Environmental Barrier

Term's Used or Complex Messages

Personal Barriers

Barriers to Communication

Environmental Barrier

- like noise or sounds that make messages difficult to hear also competition for attention which causes the receiver not to listen attentively, time is also a barrier which has something to do with comprehension

• Term's Used or Complex Messages

- can also be considered barriers to communication

• Personal Barriers

- includes experiences, beliefs, and selective.

Therapeutic Communication Technique

❖ is an interpersonal interaction between the nurse and client during which the nurse focuses on the client's specific needs to promote an effective exchange of information.

1. Accepting-

2. Broad openings

3. Consensual validation

4. Encouraging comparison-

5. Encouraging description of perceptions

6. Encouraging expression

7. Exploring

8. Focusing-

9. Formulating a plan of action

10. General leads

11. Giving information

12. Giving recognition

13. Making observations

14. Offering self

15. Placing event in time or sequence

16. Presenting reality

17. Reflecting

18. Restating

19. Seeking information

20. Silence

21. Suggesting collaboration

22. Summarizing

23. Translating into feelings

24. Verbalizing the implied

25. Voicing doubt

Therapeutic Communication Technique

1. Acceptingx

- indication reception

7. Exploring-

delving further into a subject or idea

8. Focusing-

concentrating on a single point

10. General leads-

giving encouragement to continue

11. Giving information-

making available the facts that the client needs

12. Giving recognition-

acknowledging, indication awareness

14. Offering self-

making oneself available

16. Presenting reality-

offering for consideration that which is real

17. Reflecting-

directing client actions, thoughts, and feelings back to client

18. Restating-

repeating the main idea expressed

19. Seeking information-

seeking to clear that which is not meaningful or that which is vague

20. Silence-

absence of verbal communication, which provides time for the client to put thoughts or feelings into words, to regain composure, or to continue talking

22. Summarizing-

organizing or summing up that which has gone before

1. Advising

2. Agreeing

3. Belittling feelings expressed

4. Challenging

5. Defending

6. Disagreeing

7. Disapproving

8. Giving approval

9. Giving literal responses

10. Indicating the existence of an external source

11. Interpreting

12. Introducing an unrelated topic

13. Making stereotyped comments

14. Probing

15. Reassuring

16. Rejecting

17. Requesting an explanation

18. Testing

19. Using denia

Non-therapeutic Communication Techniques

1. Advising

- telling the client what to do

2. Agreeing-

indicating accord with the client

4. Challenging-

demanding proof from the client

5. Defending- x

attempting to protect someone or something from verbal attack

6. Disagreeing-

opposing the client's ideas

7. Disapproving-

denouncing the client's behavior or ideas

15. Reassuring-

indicating there is no reason for anxiety or other feelings of discomfort

16. Rejecting-

refusing to consider or showing contempt for the client's ideas or behaviors

18. Testing-

appraising the client's degree of insight

19. Using denial-

refusing to admit that a problem exists.

Interview ➢

is a verbal and non-verbal exchange that provides for the beginning and development of a relationship.

1. Interview schedule

2. Interview guide

Two instruments Used During Interview:

1. Interview schedule-

is a questionnaire that is read to the respondent.

2. Interview guide-

one that provides ideas but allows the interviewer freedom to pursue relevant topics in depth.

• Standardized

• Nonstandardized-

• Semi-standardized-

• Focused-

• Nondirective

Categories of Interview

• Standardized-

the interviewer is not permitted to change the specific wording of the interview question schedule

Nonstandardized-

the interviewer has complete freedom to develop each interview in the most appropriate manner for each situation. He is not heal to any specific questions

Semi-standardized

- the interviewer may be required to ask a number of specific major questions, but beyond these he is free to probe as he chooses.

• Focused-

the interviewer approaches the respondent with a series of questions based on previous understanding and knowledge of the problem and phenomenon being studied. The interviewer is thus able to direct his questioning so as to discover the kinds of backgrounds and experiences that have influence the subject.

Nondirective-

the subject is allowed the opportunity to express his feelings without fear of disapproval. There is freedom to discuss a topic without pressure from the interviewer.

Open Ended Questions-

Closed Questions

Biased or Leading Questions

Types of Questions

Open Ended Questions-

or suggestion is one aimed at eliciting response that is more than one or two words in length. This type of question is effective in stimulating descriptive or comparative responses

Closed Questions-

a type of inquiry that requires no more than one or two word answer. This might be agreement or disagreement.

Biased or Leading Questions-

are questions that carry a suggestion of the kind of information that should be included in the responses.

Report- i

s oral, written or computer-based communication intended to convey information to other

• Record-

is written or computer-based.

Recording/ charting/ documentation

- the process of making an entry to client's record.

• Communication

• Planning of Care

• Audit

• Research

• Education

• Reimbursement

• Legal Documentation

• Health Care Analysis

Purpose of Client Records

• Self-awareness-

refers to the relationship between one's perception of himself or herself and other's perceptions of him or her.

Body Image-

the image of physical self; how the person perceives the size, appearance and functioning of the body and its parts.

Johari's window

➢ is a technique that helps people better understand their relationship with themselves and others.

Transactional analysis

➢ a system of popular psychology based on the idea that one's behavior and social relationships reflect an interchange between parental (critical and nurturing), adult (rational), and childlike (intuitive and dependent) aspects of personality established early in life.