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
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Intrapersonal
Interpersonal
Transpersonal
Small group
Public
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Basic Elements of
Communication
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Referent
Sender and receiver
Messages
Channels
Feedback
Interpersonal variables
Environment
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Forms of Communication
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Verbal
Nonverbal
Symbolic
Metacommunication
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Verbal Communication
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Vocabulary
Denotative and connotative meaning
Pacing
Intonation
Clarity and brevity
Timing and relevance
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Nonverbal Communication
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Personal appearance
Posture and gait
Facial expression
Eye contact
Gestures
Sounds
Territoriality and personal space
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Zones of Personal Space
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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
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Nurse—client
Nurse—family
Nurse—health team
Nurse—community
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Elements of Professional
Communication
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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
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Active listening (SOLER)
Sharing observations
Sharing empathy
Sharing hope
Sharing humor
Sharing feelings
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Therapeutic Communication
Techniques (cont’d)
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Using touch
Using silence
Providing information
Clarifying
Focusing
Paraphrasing
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Therapeutic Communication
Techniques (cont’d)
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Asking relevant questions
Summarizing
Self-disclosure
Confrontation
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Nontherapeutic Communication
Techniques
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Asking personal questions
Giving personal opinions
Changing the subject
Automatic responses
False reassurance
Sympathy
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Nontherapeutic Communication
Techniques (cont’d)
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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
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