What is communication? - behavior, conscious and unconscious, verbal and nonverbal
What is nonverbal communication? - A way of communicating that may be reflective of
true feelings; less under conscious control
What are the 5 types of nonverbal communication? - vocal cues, action cues, object
cutes, personal space and touch
Examples of vocal cues - pitch, tone, quality of voice--moaning, crying and groaning
Examples of action cues - posture, facial expression, and gestures
Examples of object cues - clothing, jewlery, and hairstyles
What internal factors influence communication? - liking others, empathy, ability to listen,
self-awareness (setting aside your biases)
External factors influencing communication: - dress, privacy, attentiveness, physical
environment (if room is comfortable, has equal status seating, low noise/distraction)
What does SOLER stand for? - S=sit squarely facing client
O=observe an open posture
L=lean forward toward client
E=establish eye contact
R=relax
What is active listening? - silent attentiveness to what the pt is expressing both verbally
and non verbally
Why is active listening important? - gives the patient time to think of what to say without
interruption; gives you a chance to observe them unobtrusively and note nonverbal cues
Example of active listening - two ears/one mouth to sit quietly and listen
What is facilitation? - provides general leads for pt to say more
Example of facilitation - "uh huh, go on..."
What is reflection? - echoes pt's words, repeats what they just said
,Why is reflection important? - focuses further attention on a specific phrase and helps
person continue on their way
Example of reflection - patient states: i am worried i need a blood transfusion
nurse states: you feel worried about needing to get a blood diffusion?
What is the sharing observations strategy? - Observing the client by making comments
on how they look, sound or act
Why is sharing observations important? - eliminates need for extensive questioning,
focusing, or clarification
example of sharing observations - "you look like you are uncomfortable"
What is empathy - Recognizing a feeling and putting it into words
Why is empathy important? - names the feeling and allows expression of it without
judgements
Example of empathy - Pt: "I don't have strength to brush my hair"
Nurse "This must be very hard for you"
What is sharing hope and why is it important? - provides positive feedback and
encouragement; essential for healing
Example of sharing hope - "although you don't have enough strength to comb your hair
right now, I can see that you're getting more muscle strength each day"
Sharing humor - must be appropriately used but can reduce stress and help with
positive interactions
What to use clarification - when person's words are ambiguous or confusing to simplify
example of clarification - nurse: are you saying your pain is interfering with your ability to
get out of bed?
pt: yes that is correct
What is focusing - centers on key elements or concepts of a message; guides the
direction of the conversation on the more important aspects
example of focusing - "let's talk more about your pain"
, Describe explanation - sharing factual and objective info, offering reasons for
requirements or actions
example of explanation - "it will take about 15 min for pain meds to start working"
what is the importance of using summary technique - gives final review of what pt has
said and gives a chance for pt to agree with or correct you
Example of summary - "from what you have said, your back pain has gotten worse over
the past 2 days and now radiates to your hips. your pain meds aren't working and that's
why you have come to the clinic"
Asking relevant questions - provides further exploration into a subject matter
example of relevant questions - "describe where your pain radiates to" (open-ended)
What is confrontation - making pt aware of inconsistencies in their behavior, use this
only after trust has been established
example of confrontation - pt: i dont have any pain in my feet
nurse: when i press your feet to check for swelling you grimace but you said your feet
don't hurt
barriers to therapeutic communication - -providing false assurance
-giving unwanted advice
-using authority
-using avoidance language
-engaging in distancing
-professional jargon
-talking too much
-interrupting
-using "why" questions
"don't worry everything will be okay" - false assurance or reassurance
"nurse knows best" - using authority
"there is a lump in the breast" vs. "your breast" - distancing
"you don't smoke, do you" - leading/biased questioning
developmental competence in interviewing infants - nonverbal: handle gently, use quiet
calm voice, face directly
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