153-Wk1-Arnold And Boggs Ch 10 - Nikki Lannan

Front 1

define therapeutic communication

Back 1

- 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

Front 2

purposes of therapeutic communication

Back 2

- 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.

Front 3

characteristics of therapeutic communication

Back 3

- goal directed
- client centered
- rules and boundaries
- individualized strategies

Front 4

Active Listening

Back 4

- 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

Front 5

Barriers of active listening

Back 5

- preoccupation
- personal insecurity
- unusual speech patterns or behavioural mannerisms
- physical discomfort
- psychological discomfort
- too much information

Front 6

Effective attending behaviours in the nurse-client relationship

Back 6

- 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

Front 7

conditions that influence communication

Back 7

- physical factors
- time
- personal factors
- use of language

Front 8

guidelines to effective verbal expressions in the nurse-client relationship

Back 8

- 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

Front 9

Assessment strategies

Back 9

- building rapport
- observation
- asking questions

Front 10

Building rapport requires the following:

Back 10

- concentrating
- listening
- objectivity
- staying in the "here and now"
- basic respect
- confident manner

Front 11

define open-ended questions

Back 11

- 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

Front 12

define closed-ended questions

Back 12

- resemble multiple-choice questions
- limited answer options
- useful in emergency situations

Front 13

define circular questions

Back 13

- focus on the interpersonal context in which an illness occurs

Front 14

define linear questions

Back 14

- explore the descriptive characteristics of a situation

Front 15

8 things that the nurse listens for

Back 15

- 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

Front 16

Therapeutic listening responses

Back 16

- minimal cues and leads
- clarification
- restatement
- paraphrasing
- reflection
- summarization
- silence
- touch

Front 17

define healing touch

Back 17

- an energy-based form of therapeutic communication that, used judiciously, can deepen the nurse-client connection

Front 18

communication strategies that help the client feel understood include the following:

Back 18

- 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

Front 19

good use of verbal responses include:

Back 19

- 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

Front 20

Interviewing and relationship skills phases (3)

Back 20

- orientation
-->rapport and structuring with the client
- intervention
--> assessment, engagement, and beginning active
--> planning, active
--> implementation, active
- termination
--> evaluation

Front 21

ABCs of a cognitive behavioural approach

Back 21

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

Front 22

cognitive behavioural strategies

Back 22

- helpful in assisting resistant clients challenge self-defeating thoughts that threaten their productive involvement in their care

Front 23

when face-to-face communication is not possible

Back 23

- 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