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Each of you have probably left a conversation at sometime thinking “ what did s/ he mean by that?”
You are trying to understand the process and make it more meaningful
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Introduction…
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“you can not, not communicate”
Then “all human behavior” is communication…
We often assume that that words and phrases are stable and consistent ( واضح و ثابت) , yet meaning is arbitrary and subjective ( عشوائي و شخص ي) .
e.g:
when we say I “like” you for the speaker “like” might mean do not dislike, while the listener it is almost love.
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Communication theories….
Linear theory:
This model refer to three components: Sender: source that
encode the message (information) into verbal and, or
nonverbal symbols that convey ideas (knowledge, feelings,
personal agendas, past experiences).
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Message: consist of verbal and nonverbal expressions of
thoughts or feelings. Receiver: the recipient of the
message that decode (translate or interpret) the message to
make meaning.
Channels of communication: refer to sensory receptors
that transmit information (one or more of the five senses)
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Circular transactional theoretical models
This model expands the linear model to include context of
communication, feedback loops and validation.
the sender and receiver construct a mental picture of the
other which influences the message and includes others
perceptions, attitudes and potential reaction to the
message.
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Components of communication…
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Receiver: both receives and interprets the message
Encoding and decoding processes: refer to our ability to select symbols that most effectively convey our thoughts and feelings to another
Filter: some models will show a filter as the place where meaning is assigned and symbols are selected to share, the size of your vocabulary can impact your ability to select appropriate symbols ( encoding) and understand the meaning of symbols used by others (decoding)
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Modes of communication…verbal nonverbal
Refers to the spoken words that encompass the symbols of language
It is largely conscious because people choose words they use.
Splits of tongue.
It includes elements such as tone of voice, hand and body movements, facial expressions
It is less consciously controlled than verbal.
Called body language
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Many wards or phrases have slang meaning or have developed new meanings
Involves 5 senses , adds to the meaning of the verbal message by expression of feelings, the contradiction or validation of verbal message often tells more about what a person is feeling than what actually said.
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Nonverbal communication…. Is believed to be the most important part of any
message.
nonverbal cues involve all five senses.
Functions of nonverbal cues / communication
1. add to the meaning of verbal messages
2.expression of feelings (contradiction or validation of verbal message)
3. preservation of both ego and the relationship
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Nonverbal cues are grouped into four groups: Body cues (kinesics)
Space (proxemics)
Touch
appearance
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Body cues… Facial expressions, reflexes, body posture, hand
gestures, eye movement mannerisms, gait of an individual
Paralinguistics (paralanguage) behavior includes any audible sound that is not a spoken word (voice tone, inflection, word spacing, rate, groaning, coughing, laughing, crying, grunting, moaning, along with silent cues.
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Space … Is the study of distance between people in their
interaction
Personal space: is the distance people prefer in interaction with others
Communication is affected by four distances:
• Intimate
• Personal
• Social
• public
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Intimate distance… Around 30 cm to 45 cm.
Communication is characterized by body contact.
Heightened sensations of body heat and smell.
Vocalization is low.
Nurses very often are required to violate personal space.
However it is important to be aware when this will occur and foreworn the client.
The nurse can respect a person’s intimate space, in other instances nurse may come within intimate distance to communicate care and warmth.
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Personal distance…. Around 45cm to 122 cm.
Less overwhelming .
Voice tones are moderate.
Physical contact is possible.
More of the person is perceived at a personal distance.
Facilitate sharing of thoughts and feelings.
Can create tension if the distance encroaches upon other’s personal space.
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Social distance… 122 cm to 300 cm.
Clearer visual perception of the whole person.
body heat and odor are imperceptible.
Vocalization is loud.
Communication is more formal.
Limited seeing and hearing.
Allows more activity and movement.
Person is protected and out of reach of touch.
Several people at the same time or within a short time.
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Public distance…. 400 cm and more.
Faces and forms of people might be seen but individuality is lost.
The perception is of the group of people or community.
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Territoriality… Is a concept of the space and things that an individual
considers as belonging to self.
The human tendency to claim territory must be recognized by all health care workers.
Clients often feel the need to defend their territory when it is invaded by others.
So… nurses need to take permission from clients to remove, rearrange, or borrow objects in the hospital area.
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Touch… Is a nonverbal method of communication that may
convey many and messages
Handshaking, holding hands, hugging, all demonstrates positive feelings
Nurse should use caution when touching a client
For touch to convey warmth, the nurse should be comfortable with it
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Appearance… Refers to the way an individual uses clothing, makeup,
hairstyle, jewelry, glasses, as well as grooming and hygiene
It communicates a particular image as well as mental status
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Therefore it is important for the nurse to observe and consider the client’s entire message, both verbal and nonverbal, before arriving at a conclusion
Nurse must try to interpret a clients nonverbal behavior when evaluating the verbal content
These observations need to be incorporated in the assessment and plan of care
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Factors influencing communication
Environmental factors (Time, Place, Noise, Privacy, Comfort, temperature)
Relationship between sender and receiver
Context or circumstances in which the message is given
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Attitude (past experiences, level of openness, socioeconomic class,
Knowledge
perception
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Types of communication…. Intrapersonal communication
Interpersonal communication (social, theraputic)
Intrapersonal communication
Self-talk: is language use or thought internal to the communicator. It can be useful to imagine intrapersonal communication occurring in the mind of the individual in a model which contains a sender, receiver, and feedback loop.
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Interpersonal communicationIs a dynamic two-way circular process in which all
types of information are shared between two or
more people and their environment.
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Social therapeutic
Friends, family, acquaintances
Home, away from work
Mutual sharing of information, thoughts, feelings to maintain relationship
Spontaneous, superficial, light, focuses on both
Helper and client
Clinical setting
Promote growth and change in clients
Learned skills, purposeful, client focused.
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Therapeutic communication… a process in which the nurse consciously influences a
client or helps the client to a better understanding through verbal or nonverbal communication.
Therapeutic communication involves the use of specific strategies that encourage the patient to express feelings and ideas and that convey acceptance and respect.
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an interactive process between nurse and client that is goal-directed to help the client overcome temporary stress, to get along with other people, to adjust to the unalterable, and to overcome psychological blocks which stand in the way of self-realization .
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In summary it has 3 essential purposes:1. To allow the client to express thoughts, feelings,
behaviors and life experiences, and life experiences in a meaningful way in order to promote healthy growth
2. To understand the significance of the client’s problems and the role of the client and the significant people in his or her life
3. To assist in the identification and resolution processes of the client’s problem areas
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Personal elements important for therapeutic communication. The nurse’s use of self is a primary tool in the
therapeutic relationship
All of the elements essential to help another individual are within the nurse.
Therapeutic use of self begins with knowing oneself
Knowing the self is a complex lifelong learning process
It is essential to have selfknowledge for a better use of therapeutic self
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The core of self knowledge is:
the nurse’s ability to correctly identify negative or unresolved issues of the self
What values and beliefs the nurse’s hold
Important to know and understand own family background (dynamic and cultural) and social issues (values, biases and prejudices)
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Since therapeutic communication occurs for the purpose of helping others, it is vital that nurses understand what motivates them to help others
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the nurse needs to be able to conduct a periodic self evaluation to her/his responses to the client:
Am I open or closed minded regarding …….
Am I accepting
Am I being supportive
Am I objective
Am I remaining calm, what are my true feelings
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Johari Window model… The Johari Window model is a simple and useful tool
for illustrating and improving self-awareness, and mutual understanding between individuals within a group.
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The Johari Window model is also referred to as a 'disclosure/feedback model of self awareness', and by some people an 'information processing tool'. The Johari Window actually represents information -feelings, experience, views, attitudes, skills, intentions, motivation, etc - within or about a person - in relation to their group, from four perspectives, which are described below.
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The Johari Window's four regions, (areas, quadrants, or perspectives) are as follows, showing the quadrant numbers and commonly used names:
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Johari window…
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1.what is known by the person about him/herself and is also known by others - open area, open self, free area, free self, or 'the arena'
2.what is unknown by the person about him/herself but which others know - blind area, blind self, or 'blindspot'
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3.what the person knows about him/herself that others do not know - hidden area, hidden self, avoided area, avoided self
4.what is unknown by the person about him/herself and is also unknown by others - unknown area or unknown self
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Roles of the nurse in therapeutic communication The nurse acts as teacher, socializer, technician,
advocate, counselor, and therapist
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Traits of therapeutic communication… These characteristics allow the nurse to influence
growth and change in others because they incorporate verbal and nonverbal behaviors, as well as attitudes, beliefs, and feelings behind the communication. Thus they are necessary for therapeutic communication to take place
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Traits of therapeutic communication…Genuineness
Positive regard
Empathy
Trustworthiness
Clarity
Responsibility
Genuineness… Consistent verbal and nonverbal behavior implies that
the nurse is open, honest, and sincere
Trust is built when the nurse does not appear mechanical but rather responds with sincerity
Does not mean disclosing personal information or relating to client in social manner
Nurses cannot expect a client to be open and honest if they do not display these characteristics themselves
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Positive regard… Refers to respect and acceptance to show that nurses
view their clients as worthy (addressing clients by names they prefer)
Conveyed by sitting and listening ,expressing appropriate emotion about events affecting a client, validating the client’s feelings, effectively responding to a client’s inappropriate behavior
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Part of it being nonjudgmental, labeling behaviors based on own value system is not useful (stereotyping)
The nurse should help clients explore their behavior by discussing the thoughts and feelings that determine the behavior
Empathy… Empathic understanding, it is the nurse’s ability to see
things from the client’s viewpoint and communicate this understanding to the client
It can be natural or trained
Should not be confused with sympathy
Closely aligned with empathy is active listening
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Trustworthiness… Being responsible and dependable
Adhere to commitments (keep promises)
Respect the client’s privacy, rights and the need for confidentiality
Information client’s share must not go beyond the health care team
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Clarity… Selecting concise words when speaking and asking
questions to clarify meaning
Nurses need to make a conscious effort to speak at a level the client will understand
Avoidance of abstract lengthy explanations is also necessary
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Responsibility… Being accountable for the outcome of one’s
professional interactions
Nurses need to be responsible for their part in the interaction and ensure that all messages are received and interpreted correctly
Responsibility language involves the use of I statments
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Assertiveness… Is the ability to express thoughts and feelings
comfortably and confidently in a positive, honest, and open manner that demonstrate respect for self while respecting others
Learn to use responsibility language
Non verbal assertive language includes eye to eye contact while speaking
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