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23 Cards in this Set
- Front
- Back
define therapeutic communication
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- a purposeful form of conversation designed to help a client achieve identified health-related goals through participation in a focused relationship
- a specialized form of communication used in health care settings to support, educate, and empower people to effectively cope with difficult health-related issues. - includes a wide range of nonverbal behaviours and activities that embrace reading, art, expression, touch, and writing. - can take place in a variety of clinical settings ranging from neonatal intensive care units to nursing homes |
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purposes of therapeutic communication
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- to provide a safe place for the client to explore the meaning of the illness experience
- to provide the information and emotional support that each client needs to achieve maximum health and well-being. |
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characteristics of therapeutic communication
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- goal directed
- client centered - rules and boundaries - individualized strategies |
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Active Listening
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- a dynamic, interactive process in which a nurse hears a client's message, decodes it's meaning, and provides feedback to the client regarding the nurse's understanding of the message.
- means being sensitive to not only "what" is said, but also"how" it is said - listening without making judgments or letting your own perceptions serve as a barrier to really hearing the client - a two-way interactive process between speaker and listener - involves aesthetic (as well as scientific, personal, and ethical) patterns of knowing in making interpretations - allows a health care provider to see a situation from the client's perspective and to convey their understanding |
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Barriers of active listening
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- preoccupation
- personal insecurity - unusual speech patterns or behavioural mannerisms - physical discomfort - psychological discomfort - too much information |
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Effective attending behaviours in the nurse-client relationship
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- full focus on the client and what he or she is saying
- erect, open posture, with the upper torso slightly inclined toward the client - direct eye contact - minimal cues and nonverbal gestures, such as nodding, smiling - nonjudgmental facial expressions mirroring the conversation - avoidance of premature or judgmental responses |
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conditions that influence communication
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- physical factors
- time - personal factors - use of language |
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guidelines to effective verbal expressions in the nurse-client relationship
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- define unfamiliar terms and concepts
- match content and delivery with each client's developmental and educational level, experiential frame of reference, and learning readiness - keep messages clear, concrete, honest, and succinct - put ideas in a logical sequence of related material - relate new ideas to familiar ones when presenting new information - repeat key ideas - reinforce key ideas with vocal emphasis and pauses - keep language as simple as possible; use vocabulary familiar to the client - focus only on essential elements; presents one idea at a time - use as many sensory communication channels as possible for key ideas - make sure that nonverbal behaviours support verbal messages - seek feedback to validate accurate reception of information |
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Assessment strategies
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- building rapport
- observation - asking questions |
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Building rapport requires the following:
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- concentrating
- listening - objectivity - staying in the "here and now" - basic respect - confident manner |
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define open-ended questions
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- telling the story of an illness rather than listing discrete facts
- similar to an essay question on a test - open to interpretation - cannot be answered by "yes", "no", or a one-word response |
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define closed-ended questions
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- resemble multiple-choice questions
- limited answer options - useful in emergency situations |
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define circular questions
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- focus on the interpersonal context in which an illness occurs
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define linear questions
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- explore the descriptive characteristics of a situation
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8 things that the nurse listens for
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- content themes
- communication patterns - discrepancies in content, body language, and vocalization - feelings, revealed in a person's voice, body movements, and facial expressions - what is not being said as well as what is being said - the client's preferred representational system (auditory, visual, tactile) - the nurse's own inner responses - the effect communication produces in others involved with the client |
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Therapeutic listening responses
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- minimal cues and leads
- clarification - restatement - paraphrasing - reflection - summarization - silence - touch |
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define healing touch
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- an energy-based form of therapeutic communication that, used judiciously, can deepen the nurse-client connection
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communication strategies that help the client feel understood include the following:
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- allowing the client enough time to answer questions
- informing the client of what the nurse is going to do and why - asking the client what his or her feelings are about what is happening |
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good use of verbal responses include:
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- mirroring depth in verbal response from the client's message
- using appropriate vocabulary - match response with verbal content - focus in o what is important in the verbal exchange - use metaphors - reframing situations (changing the frame in which a person perceives events in order to change the meaning) - presenting reality - use humour - confirming responses - give feedback - ask for validation - anticipatory guidance |
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Interviewing and relationship skills phases (3)
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- orientation
-->rapport and structuring with the client - intervention --> assessment, engagement, and beginning active --> planning, active --> implementation, active - termination --> evaluation |
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ABCs of a cognitive behavioural approach
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A= the Activating agent, which creates an image in the person's mind
B= the Beliefs surrounding the activating event. C= the Consequences, which include a person's decision and behaviours representing the person's beliefs |
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cognitive behavioural strategies
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- helpful in assisting resistant clients challenge self-defeating thoughts that threaten their productive involvement in their care
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when face-to-face communication is not possible
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- consider how words might be interpreted
- telephone is a more distant way of communicating - letter is the most detached form of interpersonal contact (but better than nothing) - consider the relevance of indirect communication cues such as the formality of the message, typed versus handwritten, and the nature of closing remarks |