Communication Concepts PDF

## Communication Concepts - A process that involves verbal and nonverbal exchanges of information and ideas. - An interpersonal process. - It imparts or interchanges thoughts, attitudes, emotions, opinions or information by speech. - Silence is also a means of communication. ### Levels of Communic...

## Communication Concepts - A process that involves verbal and nonverbal exchanges of information and ideas. - An interpersonal process. - It imparts or interchanges thoughts, attitudes, emotions, opinions or information by speech. - Silence is also a means of communication. ### Levels of Communication - **Intrapersonal Communication:** - Within an individual - Internal dialogue occurs constantly and consciously. - Make self awareness. - **Interpersonal Communication:** - Between two people or in a small group. - Face to face "most common" - The goal allows problem solving, sharing of ideas, decision making, and personal growth. - **Public Communication:** - Large groups of people ### Skills Used to Help the Speaker Express Ideas 1. Posture 2. Body movements 3. Tone of voice ### Elements of the Communication Process 1. **Referent:** "Stimulus" 2. **Sender:** "Encoder" 3. **Message** 4. **Communication Channels:** (means of conveying the message) 5. **Receiver:** (Decoder - change message into common language) 6. **Feedback** ### Referent or Stimulus - The thing that prompts communication; an object, experience, emotions, idea, or an act. ### Sender - The person who initiates the communication, or the encoder. - The sender transforms their thoughts or feelings into a message. - The role can switch when the receiver responds. ### Message - Information that is sent or expressed by the sender. - Clear and organized and expressed in a manner familiar to the receiver. ### Communication Channels - Conveying messages through visual, auditory, and tactile senses. - Facial expression visually conveys a message. ### Receiver or Decoder - The person to whom the message is sent. - They must receive or become aware of the message. ### Feedback - Communication is an ongoing process. - The receiver returns a message to the sender. - The receiver’s verbal and nonverbal responses send feedback to the sender. ### Roles and Relationships - People communicate in a style appropriate to their roles and relationships. - **Space and Territoriality** (proxemics) - The distance between the "sender" and the "receiver". ### Effective Communication - Listening effectively - Conveying acceptance and approval. - Asking related questions. - Clarifying the stated words or phrases or messages as giving examples to clarify vague ideas. - Focusing on the key elements or concepts of the message that has been sent. - Maintaining silence, which gives the client an opportunity to communicate interpersonally, to organize thoughts and information to make a decision. ### To be an Effective Communicator - Remember these four points and read the rest. ### Modes of Communications - **Verbal and Nonverbal modes:** - The modes can convey the same or different messages. ### Factors That Influence Communication 1. **Development:** - Must understand neurological and intellectual development, both of which affect how children communicate. - Include developmental disorders such as cerebral palsy, autism, and Down syndrome. 2. **Perceptions:** - Personal view of events. 3. **Values:** - Formed by experience and expressions. - Standards that influence behavior, affecting the expression of thought and ideas. - Nurses should not let personal values interfere with professional relationships. 4. **Emotions:** - A person’s subjective feeling about events. - Communication is influenced by emotions 5. **Socio-Cultural Background:** - Language, gestures, values, and attitudes reflect cultural origin. 6. **Knowledge:** - Communication can be difficult when the people communicating have different levels of knowledge. 7. **Environment:** - People tend to communicate better in a comfortable environment. - Environmental distractions distort the information sent between two people and make barriers to communication. ### Dyadic Interpersonal Communication Model - Introduced by Berlo (1960). - It describes a communication process where a sender (encoder) tries to be understood by a recipient (decoder). - The receiver processes, analyzes, and interprets the message. - Feedback helps the sender ensure that the message was clear and understood correctly. - This model is useful in improving communication between people, especially in fields like nursing. ### Experiential Communication Theories - By Virginia Satir (1967). - It emphasizes the importance of communication as a means to fulfill needs and ensure survival. - Defined communication as a process of exchanging information and stressed that it must be clear, honest, and direct. - This process includes interactions that include verbal and nonverbal messages. - Although the goal of communication is clarity, achieving complete clarity is impossible. - In addition to fulfilling needs, communication is also an important indicator of psychological and social well-being. - Satir's Communication theory is similar to those of other theorists. ### Types of Communication - **Clearly state the message:** The sender sends a message. - **Receive verbal response and nonverbal behavior:** The receiver receives and deciphers the message. - **Ask for feedback:** The sender validates the message by conversing with the receiver. - **Deliver receptive feedback:** The sender is willing to clarify the message if it is unclear. ### Verbal and Nonverbal Cues in Communication - **Nonverbal communication** conveys information without words. - It uses cues like body language and tone of voice to help interpret spoken words. ### Verbal Communication - Involves spoken or written words to convey ideas, emotions, feelings, or responses. - Words can carry hidden meanings or gauge reactions. - Language acts as a code to communicate meaning. - To make the message clear, the nurse educator uses **verbal communication** at the level of understanding of the client. ### Effective Verbal Communication Includes: 1. **Clarity and Brevity** - Effective communication should be simple, short, and direct. - Fewer words reduce confusion. - Speak slowly and clearly and repeat important parts to enhance understanding. 2. **Vocabulary** - Communication fails if the receiver doesn't understand the sender’s words. - In medical fields, technical terms may confuse clients, so it is essential to use words the client understands. 3. **Denotative and Connotative Meaning** - A single word can have several meanings. - **Denotative meaning:** The agreed-upon meaning shared by everyone. - **Connotative meaning:** Reflects personal interpretation rather than the literal definition. 4. **Pacing** - Communication is more effective with appropriate speed and tone. - Include pauses at key points to give the listener time to understand. - Proper pacing is achieved by thinking about what to say before saying it. 5. **Timing and Relevance** - Good timing is essential for clear message reception. - Especially in sensitive discussions, words should be carefully curated. ### Nonverbal Communication: "Body Language" - **Body language,** such as posture and gestures, conveys messages without words, expressing willingness to communicate and emotion. - It plays an important role in communication between nurses and patients, expressing openness to conversation. - Assessing body language is part of active listening and provides essential information that aids assessment, diagnosis, treatment, and counseling. ### Types of Body Language 1. **Facial expressions and eye contact** 2. **Hand and arm gestures** 3. **Posture** 4. **Body space** 5. **Touch** ## What Should A Patient Be Told? - The definitive answer is the truth and nothing but the truth. The doctor's responsibility is to the patient, considering their information preferences. - Provide the truth respectfully, and according to the patient needs. Always inform the patient first, except in the case of minors. - Those with disabilities or who are minors should receive information with sensitivity and support. ## Common Responses To Bad News : 1. Denial 2. Anger 3. Blame 4. Shock 5. Helplessness 6. Agitation 7. Misinterpreting information 8. Guilt 9. Sense of unreality 10. Regret/anxiety ## Telling The Bad News ### How to Give Information: 1. **Assess understanding:** Ask the patient or family what they know. 2. **Use the same vocabulary:** Speak in the patient’s language. 3. **Prepare emotionally:** Give a heads-up before delivering bad news. 4. **Use visual aids:** Use diagrams for reflection and clarity. 5. **Listen and allow time:** Give time for reflection and emotional expression. ### Demonstrating Empathy - It is important to show empathy when delivering bad news to a patient, instead of minimizing their anxiety or avoiding their emotional response. - Acknowledge their feelings. Empathic responses help validate the patient's emotions and show that you care. ## Breaking Bad News ### Definition of Bad News - Bad news is any news that drastically changes a patient’s view of their life. Such as the death of a loved one or a devastating diagnosis. ### Principles of Breaking Bad News To Patients - **Accurate and true information:** Patients have the right to accurate and true information. - **Receiver or not receive bad news:** The receiver must decide how much information they want. - **Decide who should present during the consultation:** The patient should be present during the consultation. - **Decide who should informed about the diagnosis:** Patients and circumstances differ. - **The impact of bad news depends on the difference between the patient’s expectations and medical reality:** We should consider their ability to understand and respect natural responses like denial. - **Communication and process:** Communication is a process involving follow-up and varies based on the situation and parties involved. ### A Process For Breaking Bad News 1. **Elicit person’s understanding:** Does the person know or suspect the truth? - Yes: Explore level of knowledge. - No: Confirm new at person's pace. 2. **Acknowledge immediate reactions:** Allow the person time for initial shock. Deal with emotional reactions and questions. Offer supports as appropriate. 3. **Give warning shots:** Break news at person’s pace, in manageable chunks. ## How Should I Tell Bad News 1. **Identify correct patient and family:** Ensure the correct patient and, if applicable, the right family members are informed. All shared information must be documented in the patient’s record. Ensure that all information available is accurate. 2. **Who should break bad news?:** - Breaking bad news ideally given to junior staff. It's best to have an experienced team member, such as a doctor or another health care professional (nurse, social worker, or pastoral carer) deliver it. 3. **Where should I tell bad news?**: - The location for telling bad news is important. We should ensure privacy and confidentiality and help the patient feel comfortable. If the patient is bedridden, they will need to be moved to an appropriate location. Give the patient time to process the news. Minimize distractions from devices. If at the bedside, ensure the patient agrees and sit at eye level. 4. **When do I tell bad news?**: - The team should prepare the patient for the possibility of bad news in the diagnosis. Inform them as soon as possible if they’re able to receive it and have support. - Respect the patient’s preference for receiving news alone. - Allocate time for delivering bad news and plan it into schedules. ### Methods of Dealing With Anger - **Effective Approach** - Acknowledge anger. - Identify the focus. - Legitimize (if appropriate). - Encourage the expression of anger. - **Ineffective Approach:** - Dismiss anger. - Reject focus. - Defend actions or colleagues. ### How To Handle Difficult Questions - See the table (pg. 34) in the attached book. ## Self-Awareness - A crucial element in nursing, as it helps nurses understand their reactions to intense emotional situations and recognize the impact of their feelings on their relationships with patients. - This awareness reduces biases and negative interactions, preventing personal emotions from affecting patient assessment and diagnosis. - Self-awareness enables nurses to better manage their emotions, especially with critically ill or end-of-life patients. - It also helps them recognize their strengths and personal limitations, improving the therapeutic environment and reducing stress and burnout. ### Strategies Nurses Can Use In Response to End-Of-Life And Stressful Circumstances - Recognize and accept emotional and behavioral responses as natural. - Examine the reasons behind personal reactions to avoid negative impacts. - Discuss feelings with others for self-awareness support. ### Lack of Self-Awareness - Weakens communication, reduces trust, and negatively affects treatment planning and health outcomes. - If a client shows a negative response, it is essential to review communication to ensure the information is aligned with their needs. ### The Johari Window - A model used to improve communication between people by exploring self-awareness. - It helps us understand how we present ourselves to others. - The model is divided into four quadrants: - **Open/Free area:** Known to self and known to others. - **Hidden area:** Known to self but not known to others. - **Blind area:** Known to others but not known to self. - **Unknown area:** Unknown to both self and others. ### Telemedicine - **Advantages:** - Easy access to care, especially in remote areas. - Provides healthcare to patients in remote areas. - Continuous monitoring. - Daily tracking of symptoms and treatment. - Emotional and educational support. - Encourages patients’ adherence to treatment. - Emergency referrals and referrals to urgent care when needed. - **Disadvantages:** - Lack of technology limits access for some patients. - No face-to-face contact may affect the human connection. - Dependence on patient reports can affect diagnosis accuracy. - Training is required and patients need training to use the devices. ## The Impact of Technology on Communication - **Advantages:** - Convenience and Accessibility: The internet facilitates easy communication between patients and nurses, making healthcare more accessible, especially in remote areas. - Cost effectiveness: Email reduces costs and achieves high patient satisfaction, decreasing the needs for person visits. - Patient empowerment: Provides patients with the knowledge to clearly express their health needs, enhancing effective healthcare interaction. - Self-management: Increases patient adherence to chronic disease management, allowing for better control without frequent visits. - Remote care: Telemedicine enables healthcare to be delivered at home, broadening access to services. - **Disadvantages:** - Privacy Risks: There is a potential risk to patients' privacy due to insufficient security on some digital platforms. - Reduced personal interaction: Lack of face-to-face communication may lead to weaker support and a higher chance of misunderstandings. - Ethical concerns: Concerns over who has access to health data requiring adherence to privacy policies. - Dependence on technology: Any technical malfunction could negatively affect the continuity of healthcare service.