Communication II (Part II) PDF

Communication (Part II) prepared by Assist. prof/ Asmaa Elsayed Farid Outlines  Forms of communication.  Methods of communication.  Barriers to effective communication.  Characteristics of successful communication.  Therapeutic techniques for nurse...

Communication (Part II) prepared by Assist. prof/ Asmaa Elsayed Farid Outlines  Forms of communication.  Methods of communication.  Barriers to effective communication.  Characteristics of successful communication.  Therapeutic techniques for nurse client relationship.  Forms of communication Communication is generally carried out in two different but interdependent forms of communication; Verbal and nonverbal.  Verbal communication  nonverbal communication Verbal communication refers to the process of communicating through the use of words, sentences and language. Non-verbal communication refers to the process of communicating information through body language, facial expressions, eye contact, intonations, artefacts etc. Verbal And Non-Verbal Communication Are Used Simultaneously Both types of communication are used together for the following reasons :  To facilitate easy comprehension on the part of the listener, we use verbal and non-verbal information at once. For example, if the listener faces language barriers or if they have hearing impairment or any other psychological or physiological issues, people use hand gestures and body movements along with verbal information.  We also use both types of communication when we want the former and latter to complement each other. Verbal – nonverbal communication 1.Medium of communication a. Verbal: Use of words and languages. Oral communication and written communication. b. Non-Verbal: Absence of words or language. Expressed through body movements, gestures, facial expressions, silence, space, touch, smell etc. 2. Consciousness of the message sent a. Verbal: Exchange of messages occur consciously b. Non-Verbal: Non-verbal body cues may occur alone or along with verbal communication. Normally expressed using body and hand gestures voluntarily or involuntarily motions. 3. Direct and indirect message a. Verbal: Since the messages are expressed in words, it is easy to decode verbal information than non-verbal information. b. Non-Verbal: Non-verbal bodily cues alone can never bring out the direct meaning of the messages. 4. Decoding the message a. Verbal: In the case of verbal content, it is easy to decode the meaning behind it. b. Non-Verbal: Decoding the bodily cues is a bit difficult, since a single gesture or a minute facial expression may hold many different meanings behind it. 5. Mode of communication a-Verbal: Verbal communication occurs in a written and oral format. Writing e-mails, letters and SMS includes written messages. Whereas oral communication denotes our speech and interaction with others. b. Non-Verbal: Non-verbal messages could be transferred through various modes such as visual, aural, spatial proximity and gestural including facial expressions, eye movements, body postures and movements, etc. 6. Time consumption a-Verbal: aIt is quite easy to conclude that sharing information verbally is less time-consuming. The meanings behind verbal messages are straightforward and do not need further understanding. b. Non-Verbal: Sharing information using gestures and other non- verbal cues is more time-consuming than the former. A single non- verbal message may hold many potential interpretations and needs further knowledge of the true intention of the message conveyed. So a person must understand the mood, situation and context of the message delivered. Obviously, it’s time-consuming.  7. Physical presence a-Verbal: With the advancements in technology, today verbal messages could easily be transmitted across the globe within a matter of seconds. Therefore verbal communication transcends the boundaries of space and time. b. Non-Verbal: However, non-verbal communication would require the physical presence of the person sending in the message. Although physical presence is a prerequisite for non-verbal communication, technology has bridged that gap to a certain extent as well. Through the use of video-conferencing, people can see each other although they are seated at two opposite poles of the world. This gives room for non- verbal communication to take place.  Communication Verbal Non-verbal Speech Body behavior Writing Facial expression Signs Eye contact Paralanguage Appearance Figure 2: Forms of communication  Methods of nonverbal communication 1. Body behaviors:Body behavior includes posture, gestures and gait. Posture : The way the person walks and holds their bodies are reliable indicators of self-concepts, current mood, and health. People in good health and with a positive attitude usually hold their bodies in good alignment. Depressed or tired people are more likely to slouch. Tense posture and a rapid, determined gait suggest anxiety or anger. The nurse must clarify the meaning of the observed behavior.  Methods of nonverbal communication Gesture: hand and body gestures may emphasize and clarity the spoken word or they may occur without words to indicate a particular feeling or to give a sign. For example, waving hand serves to beckon someone to come, if waved another way, signifies that someone should leaves. Gestures are used extensively when two people speaking different language attempt to communicate with each other, or communicating with people with special communication problems as deaf people. Methods of nonverbal communication  Methods of nonverbal communication Gait: A bouncy, purposeful walk usually caries a message of well-being. Certain gaits are associated with illness or abnormal feelings (as, sad, anxiety, fear), for example, client recovering from recent abdominal surgery usually walk slightly bent over and slowly and may need assistance.  Methods of nonverbal communication 2. Facial expression: The face is the most expressive part of the body. Facial expression will either complement or contradict verbal communication, giving away real emotion and attitudes. Facial expression can be include frowns, smiles, and grimaces, raised eyebrows, pursed lips, licking lips and tongue movements. Facial expression is a very important tool for nurses to use when communicating with clients as it will reinforce or negate the verbal message.  Methods of nonverbal communication 3. Eye contact: Communication often begins with eye contact. Eye contact suggests respect and a willingness to listen and to keep communication open. The eye allows observation of another person’s total nonverbal signal. It can inform as to whether the massage is being received and give extra information about the other’s message. Eye contact covey messages mean that the other is listening and wants the speaker to proceed. Too much eye contact can make the participants feel uneasy. Lack of eye contact can imply lack of interest or anxiety. 3. Eye contact:  Methods of nonverbal communication 4. Appearance: Appearance is an overall notion of how people present themselves such as Grooming, dress and hygiene. Appearance can be rich source of information about a person’s social status, financial status, culture, religion, and self concept.  Methods of nonverbal communication 5. Paralanguage Paralanguage is vocalization other than expression of words and includes many aspects of sound. Sounds as crying, moaning, gasping and sighing are oral but nonverbal forms of communication. Silence: Period of silence during communication often carry important nonverbal messages. Silence between two persons may indicate complete understanding or angry.  Methods of Communication : 1- Intra - Personal communication 2. Inter - Personal communication 3. Mass communication 1-Intra-Personal communication It takes place inside a person. It includes the beliefs, feelings, thoughts and justification we make for our actions. E.g. a person may look at an object and develop a certain understanding. However, this could be affected by a number of factors including previous experience, language, culture, personal needs, etc..  2-Interpersonal Communication It means interaction between two or more people who are together at the same time and place. E.g. between health extension worker and community member, a teacher and students in a class. The decisive criterion for personal communication is that communication happens at the same time and place.  2-Interpersonal Communication  Advantages: Two way communication The communication could utilize multi-channels (both verbal and non -verbal) i.e. far more channels are involved than is possible in mass communication. Useful when the topic is a taboo or sensitive. Limitations Requires language ability of the source. Requires personal status. Needs professional knowledge and preparation.  3- Mass communication It is a means of transmitting messages to a large audience that usually reaches a large segment of the population. It uses mass media. Mass media includes broadcast media (radio and television) as well as print media (newspapers, books, leaflets.(and posters Advantage: Reach many people quickly They are believable specially when the source is a credible one  Barriers to effective communication 1-Ineffective techniques: 2. Anxiety: 3. Attitudes 4. Gaps between the nurse and client 5. Resistance 6. Sensory barrier 7. Failure to address concerns or needs 8. Setting (environment) 1. Ineffective techniques: The most obvious barrier is the nurse’s failure to use the types of therapeutic techniques. Lack of knowledge or experience can limit the nurse’s ability to assess the client needs and list of skills. Failure to send a clear message, receive and interpret the message correctly or provide useful feedback can interfere with communication. 2-Anxiety: When the nurse or client is highly anxious during an interaction, perception is altered and the ability to communicate effectively is sharply curtailed. The use of defense mechanisms such as denial, projection, or displacement reduces understanding of true meaning of an interaction. Anxiety and the use of defense mechanism distort reality and lead to disordered communication. 3-Attitudes If the nurse fails to examine her attitude toward the client, negativity may be communicated and the interaction may be distorted. 4- Gaps between the nurse and client Gaps in gender, age, socioeconomic background, race, religion, ethnicity, or language can block functional communication between the nurse and the client. The nurse can help the client to recognize how perceptions may different and to clarify meanings. 5-Resistance Resistance comprises all phenomena that inhibit the flow of thoughts, feeling, and memories in an interpersonal encounter, as well as behaviors that interfere with therapeutic goals. Resistance arises from anxiety when a person feel threatened. To reduce this anxiety, the person implements resistance such as being late, changing the subject, forgetting, blocking, or becoming angry. 6- Sensory barrier When the client has any sensory limitations, the nurse may need to use extra skill in communicating. Use the other senses to send or receive messages attempted. Special help is often should be available. 7- Failure to address concerns or needs The failure to meet client’s needs or recognize the client’s concerns is the most serious barrier to effective interaction. It can arise from - Inadequate assessment - Lack of knowledge - Inability to separate the nurse’s needs from the client’s needs - Confusion between friendship and a helping relationship. 8-Setting (environment) The setting of a nurse client interaction can affect the goals and the nature of the communication. The most important aspect of any setting that the nurse and client are able to attend to each other. The nurse’s attention to the client helps create such atmosphere. The nurse should assess the possible influence such as lighting noise, temperature, comfort, physical distance and privacy; potentially disturbing factors can be controlled within the limits of the setting. Characteristics of successful communication: 1. The message conveyed by the sender should be clear. 2. Provide feedback at appropriate time and place. 3. The content of the message (verbal message) should be appropriate with the nonverbal message to ensure clarity. 4. Communication must have a goal and not left to chance. 5. Establishing an appropriate climate for communication (ensure privacy and confidentiality). Therapeutic techniques for nurse client relationship  Keep client in focus: the nurse must focus on the client’s needs  Assisting the client to acquire new knowledge and develop skill to explain events to change and to solve problems.  Clarify content and meaning  Use reflection: the nurse restatement of what the client has said or summarizing the main point to indicate interest and to focus the discussion.  Therapeutic techniques for nurse client relationship  Use constructive confrontation: the nurse points out a specific behavior and assists the client to examine its meaning or consequences.  Use silence: Silence at interval help the client to talk at his own pace without pressure to perform for the nurse.  Accept communication: allowing the client to communicate verbally and nonverbally in his own fashion make the client feel safe and respected. 