Studied by 20 people
communication
process of exchanging information and generating meanings
source (encoder)
person/group that begins communication process
message
actual communication product from the source
channel
medium the source has selected to send the message
receiver (decoder)
person who receives the message and interprets it
auditory channel
spoken words and cues
visual channel
sight, observations, and perception
kinesthetic
touch
noise
factors that distort the quality of the message (ex. tv, roommates, visitors, pain/discomfort)
physical barriers
hearing, sight, and cognitive distractors
interpersonal
self-talk, communication within a person (can be positive or negative)
intrapersonal
talk between two or more people, goal is to exchange messages
small group
nurses interact with two or more people (ex. staff meeting)
organizational group
people within groups and organizations communicate to achieve established goals (ANA, etc.)
group dynamics
how well group members work with each other towards a goal, determines effectiveness of a group
task oriented roles
getting the work done
group building/maintenance roles
focusing on the well being of the people doing the work
self serving roles
advance the needs of individual members at the groups expense
ground rules
identify goals, set direction, ensure group cohesiveness
verbal communication
exchange of info using words, depends on the language
spoken/written
reveals aspects of the patient's intellectual development, educational level, and geographic/cultural origin
nonverbal communication
help nurses understand subtle and hidden meanings in what the person is feeling
body language
communication via the movements or attitudes of the body
touch
personal behavior, express affection, anger, etc
eye contact
willingness to listen, anxiety, avoidance
facial expressions
can read what the person is feeling by their face, some people can mask feelings
posture
depressed/tired = slouch, positive/good health = sits upright, can give clues to pain
gait
the way someone walks can indicate well being; bouncy, shuffling, slowly, limping
gestures
thumbs up, kicking, tapping foot, waving hand
general physical appearance
paleness, sunken eyes, dry skin, fullness of cheeks
dressing and grooming
interest in physical appearance can vary depending on health (depression may equal lack of keeping up w/ appearance)
sounds
crying, moaning, gasping, sighing
silence
many meanings, understanding, anger, dying
factors influencing communication
developmental level, biological sex, sociocultural responsibilities, space and territory, physical/emotional/mental state, values, environment
helping relationship
relationship between caregiver/nurse and patient
a helping relationship...
does not occur spontaneously, has unequal sharing of info, and is built on the client's needs
characteristics of helping relationship
dynamic, purposeful, time limited, professional accountability
orientation phase
identify each other by name, agreement is established, data gathered
working phase
longest phase, meet patient's physical and psychosocial needs, nurse provides assistance, nurse is teacher and counselor
termination phase
conclusion of agreement, patient is discharged or nurse leaves, evaluation of outcomes, patient verbalizes feelings about termination
dispositional traits
characteristics/way of behaving that affects relationship: warmth and friendliness, openness and respect, empathy, honesty/authenticity and trust, caring, competence
rapport
feeling of mutual trust in a relationship that facilitates open communication
rapport builders
specific objectiveness (having a purpose for interaction), comfortable environment, privacy, confidentiality, patient vs. task focus (focus on patient and their needs), using nursing observations (ex. nonverbal messages), optimal pacing, respecting personal space
different cultures
release personal bias, learn about client's cultures/beliefs, adjust your care to meet their needs, use interpreters when necessary
therapeutic communication
focusing on the patient's needs
non-therapeutic communication
not making the patient feel comfortable
conversation skills
tone of voice, knowledgeable, flexible, concise, avoid slang, truthful, open-minded, facilitate conversation at optimal times
listening skills
sit and be conscious about body language, be alert and relaxed, keep conversation natural, maintain eye contact, think before responding, listen and identify themes
silence technique
allows patients to gather their thoughts and proceed at their own pace
touch technique
express comfort and affection
humor technique
accept failures, lighten situation, maintain balanced perspective in work
openended questions
allows for wide range of response
close ended questions
limited to yes/no/short answers, gather specific info
validating question
validate what nurse believes they've heard/observed (do not overuse)
clarifying question
gain understanding of patient's comment
reflective question
repeating what the patient said or describing patient's feeling
sequencing question
place events in chronological order or investigate a possible cause and effect relationship in events
direct question
obtain more info about a topic brought up earlier or introduce new aspect
assertive behaviors
empathy, describing feelings and situations, clarifying expectations, anticipating consequences
communication blockers
changing subject, false assurance, gossip/rumors, disruptive interpersonal behavior and communication, failure to perceive the patient as a human being, failure to listen, non therapeutic comments and questions
visually impaired communication
acknowledge presence, identify yourself
hearing impaired communication
face patient, keep mouth clear, use gestures
physical barrier communication
eye blink, hand squeezes
cognitively impaired communication
maintain eye contact for attention, talk simple and concrete
unconscious
assume patient can hear you
non-english speaking
speak in simple sentences, find interpreter, universal nonverbal cues
maintain/promote health (aims)
helps patients value health and develop specific health practices (ex. passive exercise, making safe exercise program)
preventing illness (aims)
teach patients how to prevent illness (ex. screening)
restoring health (aims)
counseling someone who is already ill, practice self-care, improve health (ex. teach someone w/ STI to use condoms)
facilitating coping (aims)
help come to terms w/ changes and cope
promoting outcomes
high-level wellness, self-care practices, recovery from trauma, enhanced ability to adjust to developmental lifestyle
T
tune into patient
E
edit patient info
A
act on every teaching moment
C
clarify often
H
honor the patient as a partner in the education process
ADPIE
Assess, Diagnose, Plan, Implement, Evaluate
factors affecting patient learning
age (emotional maturity and moral/spiritual dev.), developmental level (degree of understanding), adult learners, family support and financial resources, cultural influence, language deficits, health literacy
pedagogy
child learning
andragogy
adult learning
cognitive learning
storing/recalling new knowledge int he brain, comprehension
psychomotor learning
learning a physical skill
affective learning
changes in attitudes, values, and feelings
effective communication techniques
sincerity, honesty, stick to the basics (avoid giving too much detail), simple words, clear and concise, vary tone of voice, listen (do not interrupt the patient), environment is free of interruptions
assessing
patients are considered primary sources of info, review medical records, assess learning readiness, motivation, compliance, and patient strenghts
diagnosing
nursing diagnosis is not a medical diagnosis (ex. ineffective breathing, risk for infection, risk for falls, pain)
outcome identification and planning
goals of patient, time line, teaching strategy/learner activity, goal met or not met, teacher content
role modeling
actions speak louder than words
lecture
present info, but be interactive and collaborate with patient
discussion
exchange info, ideas, feelings
panel discussion
presentation of info by two or more people, debate, share experiences and emotions
demonstration and return demonstration
evaluate patient learning by having them teach back what they've learned
discovery
offer info (like a pamphlet) to patient and let them conduct their own research
role playing
give learner a chance to experience, relive, or anticipate event
contractual agreements
pact between two people setting out mutually agreed on goals
time constraints
set priorities for essential content
scheduling
plan shorter, more frequent teaching sessions
group vs. individual
depends on skill being taught (ex. getting dressed would be individual, while expressing feelings may be done in a group)
formal vs. informal
informal (unplanned) deals w/ immediate concerns while formal is planned sessions for anticipated outcomes
implementing
prepare and organize teaching aids, make it fun and creative, have a positive attitude, review patient expectations and role functions as learner to avoid misunderstandings, consider environment, assess comfort level
