Chapter 10
Communication and the
Clinical Interview
Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.
The Communication Process
• Stimulus for information, comfort, or
advice
• Sender – initiates contact
• Message – sent or expressed
• Variety of media – hearing, visual,
touch, smell
• Feedback received
Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Factors That Affect
Communication
• Personal factors
• Environmental factors
• Relationship factors
Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Nonverbal Communication
• Tone of voice
• Emphasis on certain words
• Physical appearance
• Facial expressions
• Body posture
• Amount of eye contact
• Hand gestures
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Verbal Communication
• All words a person speaks
• Communicates
– Beliefs and values
– Perceptions and meaning
• Can convey
– Interest and understanding
– Insult and judgment
– Double or mixed messages
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Therapeutic Communication
Techniques
• Tools for enhancing communication
– Using silence
– Active listening
– Listening with empathy
Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Clarifying Techniques
• Paraphrasing
• Restating
• Reflecting
• Exploring
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Asking Questions and Eliciting
Patient Responses
• Open-ended questions
• Closed-ended questions
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Nontherapeutic Communication
Techniques
• Excessive questioning
• Giving approval or disapproval
• Giving advice
• Asking “why” questions
Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Cultural Considerations
• Communication style
• Eye contact
• Touch
• Cultural filters – form of bias or
prejudice
Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Preparing for the Interview
• Pace
• Setting
• Seating
• Introductions
• Initiating the interview
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Attending Behaviors
• Foundation of the interview
– Eye contact
– Body language
– Vocal quality
– Verbal tracking
Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Process Recording
• Written record of a segment of the
nurse-patient session that reflects as
closely as possible the verbal and
nonverbal behaviors of both patient and
nurse
• Useful tool for identifying
communication patterns
Elsevier items and derived items © 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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