Chapter 6
Communication and
Relationships
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The Communication Process
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Types of Communication
 Verbal
 Nonverbal
• Body language
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Factors That Affect Communication
 Personal space
• Proxemics
 Body position
 Language
 Attitude
 Emotion
• Denotative meaning
• Connotative meaning
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Active Listening
 Uses all senses
 Interprets verbal and nonverbal messages
 Demonstrates you are interested in patient’s
feelings, concerns and needs
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Clicker Question
Which of the following terms refer to words
that can elicit emotional responses, resulting
in a message that is distorted and altered?
A. Nonverbal communication
B. Therapeutic communication
C. Connotative meaning
D. Shared meaning
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Answer
Correct Answer: C. Connotative meaning
Words such as “love,” “death,” and “cancer”
are emotionally charged; they can elicit
emotional responses that distract the listener
because of past experiences, resulting in a
message that is distorted and altered.
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Styles of Communication
 Passive or avoidant
 Aggressive
 Assertive
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Therapeutic Communication Techniques
 Providing general leads
 Using silence
 Offering self
 Open-ended questions
 Restatement (validation)
 Seeking clarification
 Giving information
 Reflection
 Looking at alternatives
 Summarizing
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Barriers to Therapeutic Communication
 Asking questions that can be answered with
a “yes” or “no” response
 Giving false reassurance
 Asking too many personal questions
 Giving advice
 Belittling a patient’s feelings
 Expressing disapproval
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Communication Crisis
I – Introduction
S – Situation
B – Background
A – Assessment
R – Recommendation
R – Readback
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Communication With the Health-Care
Team
Upward Communication Examples
 Interaction with authority
 Health-care provider’s orders
• Written
• Over the phone
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Communication With the Health-Care
Team (continued_1)
Downward Communication Techniques
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Job instruction
Job rationale
Practices and procedures
Feedback
Role modeling
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Communication With the Health-Care
Team (continued_2)
Shift Report
 Must remain confidential
 Include appropriate data
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Basic patient data
Special safety issues
Sensory deficits
Scheduled procedures
Pertinent diagnostic results
Assistive equipment
Prosthetic devices
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Communication With the Health-Care
Team (continued_3)
Written Communication
 Know your audience
 Identify the purpose
 K I S S: Keep It Short and Simple!
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Components of Patient-Centered
Communication
 Encourage and empower patients to
participate in their care
 Attentiveness
 Friendly tone of voice
 Focus on patient, not solely on task
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Communication During a Patient Interview
Directive
 Who
 What
 When
 Where
 How
 Do
 Is
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Nondirective
 Open-ended
questions
 Patient explores
thoughts and feelings
Clicker Question
Which is characteristic of a nondirective
interview?
A. Questions are open-ended
B. Structured to elicit specific data
C. Time is limited
D. Conducted to gain factual information
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Answer
Correct Answer: A. Questions are open-ended
Open-ended questions are used in the
nondirective interview. The patient has much
more input in the nondirective interview and
is able to explore thoughts and feelings.
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Communicating During a Patient Interview
 Nonverbal communication
• Observe body language for unstated feelings or
behaviors
• Make eye contact with patient
• Assess health literacy
 Avoiding bias
• Remain open and relaxed
• Be sensitive while still obtaining factual
information that you need
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Special Communication Needs
 People who are deaf or hard of hearing
 Speech and language impairments
• Aphasia
 Vision impairments
 Mechanical ventilation
 Unresponsive
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