MASTER PLAN

NAME OF THE INSTRUCTOR: Mrs. Shara Madam

NAME OF THE STUDENT: [Link] John
NAME OF THE TOPIC: Communication, Interpersonal relationship,
Individual & group dynamics & organizational
behaviour
UNIT: VIII
DATE OF SUBMISSION: 8-12-010
DATE OF PRESENTATION:

[Link]: CONTENT PAGE NO:

INTRODUCTION
DEFINITION OF COMMUNICATION
MODES OF COMMUNICATION
 Non verbal communication
 Personal appearance
 Posture and gait
 Facial expression
 Eye contact
 Gestures
 Sounds
 Verbal communication
 Characteristics:
 Clarity
 Brevity
 Simplicity
 Courtesy
 Tact
 Sincerity
 Originality
 Pleasantness of tone
 Written communication
 Symbolic communication
 Meta communication
TYPES OF COMMUNICATION
 One-way communication
 Two-way communication
 Verbal communication
 Non-verbal communication

 Formal communication
 Informal communication
 Visual communication
 Tele communication and interest
 Social communication
 Interpersonal communication
 Mechanical communication
 Physiological communication
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  Psychic communication
THE COMMUNICATION PROCESS
 Structural model
 Five functional components:
 Sender
 Message
 Receiver
 Feed back
 Context
 Transactional analysis model:
 Brene’s model of communication (ego
stages)
 Complementary transaction
 Crossed transaction
 Ulterior transaction
ELEMENTS OF COMMUNICATION
 Source
 Message
 Channel
 Receiver
 Feed back
 Context
FACILITATORS OF COMMUNICATION
 7 C’s of facilitators are:
 Clear
 Complete
 Concise
 Courteous
 Concrete
 Correct
 Candid
FACTORS INFLUENCING COMMUNICATION
 Ability of the communicator
 Perceptions
 Personal space
 Four phases
 Intimate distance
 Personal distance
 Social distance
 Public distance
 Territoriality
 Roles and relationship
 Time
 Environment
 Attitudes
 Caring and warmth
 Respect
 Acceptance
 Lack of interest

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  Coldness
 Emotions of self-esteem
BARRIERS OF COMMUNICATION
 Language deficits
 Sensory deficits
 Cognitive impairment
 Structural deficits
 Paralysis
METHODS OF OVERCOMING BARRIERS OF
COMMUNICATION:
 Manipulate the environment
 Provide support
 Employ measures to ensure
communication
 Educate the clients and support persons
THERAPEUTIC COMMUNICATION
Definition of therapeutic communication
 Active listening
 Physical Attending
 Actions of physical Attending
 Fare the person squarely
 Maintain good eye contact
 Lear toward the person
 Maintain eye posture
 Remain relatively relaxed
 Principles of therapeutic communication
 Acceptance
 Interest
 Respect
 Honesty
 Concreteness
 Assistance
 Permission
 protection
TECHNIQUES OF THERAPEUTIC COMMUNICATION
 Listening
 Broad Openings
 Restating
 Clarification
 Reflection
 Focusing
 Sharing Perceptions
 Theme Identification
 Silence
 Humour
 Informing
 Suggesting
INTER PERSONAL RELATIONSHIPS
 Introduction

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  Definition of Interpersonal Relationship
 purposes
 Types of interpersonal relationship
 Friendship
 Family
 Romantic
 Professional relationship
 Casual relationship
 Principles of interpersonal relationship
 Mutual benefit principle
 Credit principle
 Respect principle
 Tolerance principle
 Moderation principle
 Functions of interpersonal relationship
 Gaining information
 Building a context of understanding
 Establishing identity
 Interpersonal relationship needs
 Phases of interpersonal relationship
 Acquaintance
 Bulidup
 Continuation
 Deterioration
 Termination
 Barriers of interpersonal relationship
 Physical barriers
 Perception
 Emotions
 Culture
 Language
 Gender
 Cultural barriers
DEVELOPING INTERPERONAL RELATIONSHIP
Johari Window – by Joseph Luft &Harry Ingham
GROUP DYNAMICS
 Definition
 Functions
 Characteristics of effectively functioning
group
 Types of health care groups
 Task groups
 Teaching groups
 Self help groups
 Self awareness/growth groups
 Therapy groups
 Work related social support groups
ORGANIZATIONAL BEHAVIOUR
 Introduction

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  Definition
 Elements of organizational behaviour
 Models of organizational behaviour
 Autocratic behaviour
 Custodial behaviour
 Supportive behaviour
 Collegial behaviour
 Types of organizational behaviour
 Micro organizational behaviour
 Meso organizational behaviour
 Macro organizational behaviour
 Different approaches to organizational
behaviour
 Taylorsim and scientific management
approach of by Fredric Winslow Talor
 The human relations approach by Elton
mayo
 Weber’s bureaucracy approach
SUMMARY

COMMUNICATION, INTERPERSONAL RELATIONSHIP,

INDIVIDUAL&GROUPDYNAMICS& ORGANIZATIONAL BEHAVIOR

INTRODUCTION

The word communication is derived from the Latin word communis,

meaning ‘common’, shared. It belongs to the family of words that
includes communism, communion, and community.
Communication is the activity or process of expressing ideas and
feelings or giving information to the people. It is the exchange of
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thoughts, messages or information by speech, signals, writing or
behaviour. Whenever two or more people get aware of each other,
possibility of communication begins.
Communication is never a matter of handling over a bundle
of information; it is a matter of creating meaning out of that
information. if other person can’t understand what we mean, then our
attempts to communicate have failed

DEFINITION OF COMMUNICATION:

1. Communication is the interchange of information between two or

more people; in other words the exchange of ideas or thoughts.

KOZIER

2. Communication is defined as sending- receiving process for

channeling messages between individuals in person to person
relationship.
ANISHA
MAHESHWARI

3. Communication refers to “the countless ways that humans have

of keeping in touch with one another.

[Link]

4. Communication is a process whereby information is enclosed in

a package and is channeled and imparted by a sender to a receiver
via some medium

MODES OF COMMUNICATION

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 Communication is generally carried out in various types. Mainly
verbal communication and non-verbal communication is carried out.
Verbal communication uses the spoken or written word.
Non-Verbal Communication uses other forms, such as gestures or
facial expression, and touch.
There are many different areas of communication.
1. Non-Verbal Communication.
2. Verbal Communication.
3. Written Communication.
4. Symbolic Communication.
5. Meta Communication.
1. NON-VERBAL COMMUNICATION
Non-Verbal Communication is some times called body language. It
includes gestures, body movements, use of touch and physical
appearance. Non- Verbal Communication often tells other more about
what a person is feeling than what is actually said, because non-verbal
behavior.
Non-Verbal Communication includes all of the fine senses and
everything that does not involve the spoken or written word.
There are many kind of Non-Verbal behavior:-
a) Personal appearance:-
Personal appearance includes physical characteristics, facial
expression, manner of dress and grooming, and adornments
These factors help communicate physical well being,
personality, social status, occupation, religion, culture and self
concept.
 First impression is largely based on appearance.
 Nurses learn to develop a general impression of client’s health
and emotional status through appearance, as well as clients also
develop a general impression of the nurse’s professionalism and
caring in the same way.
b) Posture and gait:-

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 Posture and gait are forms of self-expression. The way people sit,
stand, and more reflect their attitudes, emotions, self concept, and
health status. Erect posture and an active, purposeful stride suggest a
feeling of well being.
Slouched posture and a slow shuffling gait suggest depression or
physical discomfort
c) Facial expression:-
No part of the body is as expressive as the face. Feelings of
surprise, fear, anger, disgust, happiness and sadness can be conveyed
by facial expression. Some persons have an expressionless face, or flat
affect, which reveals little about what they are thinking or feeling.
An inappropriate affect is a facial expression that does not match
the content of a verbal message.
Eg: Smiling while describing a sad situation.
d) Eye contact is another essential element of facial communication.
Mutual eye contact acknowledges recognition of other person who
feels weak or defenseless often asserts the eyes or avoids eye contact;
the communication received may be too embarrassing or too
dominating.

e) Gestures:-
Hand-body gestures may emphasize and clarify spoken word, or
they may occur with out words to indicate a particular feeling or to
give a sign.
Gestures emphasize, punctuate, and clarify the spoken word.
Gestures alone carry specific meanings or they may create messages
with other communication cues. A finger pointed towards a person may
communicate several meanings, but when accompanied by a frown or
stern voice, the gesture becomes on accusation or threat.
Pointing to an area of pain may be more accurate than describing
pains location.

f) Sounds:-

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 Sounds such as sight, moans, groans, or sobs also communicate
feelings and thoughts. Combined with other non-verbal
communication, sounds help send clear messages.
Sounds can be interpreted in several ways like crying can
communicate happiness, sadness, or anger.

2. VERBAL COMMUNICATION:
Verbal communication is when we communicate our message
verbally to the receiver. It is largely conscious because people choose
the words they use. The words used vary among individuals according
to the culture, socio-economic background, age and education.

CHARACTERISTICS OF VERBAL COMMUNICATION:

a) Pace and intonation:
The manner of speech as in the pace or rhythm and intonation, will
modify the feeling and impact of the message.
The intonation can express enthusiasm, sadness, anger or
amusement.
The pace of speech may indicate interest, anxiety, boredom or fear.
Eg: speaking slowly and softly to an exited client may help calm the
client.

b) Simplicity:
Simplicity includes the use of commonly understood words, brevity
and completeness. It makes the conversation beautiful. Nurses need to
learn to select appropriate understandable terms based on the age,
knowledge, culture and education of the client.
Eg: instead of saying to a client, “the nurses will be catheterizing
you tomorrow for a urine analysis,” it may be more appropriate and
understandable to say
“Tomorrow we need to get a sample of urine, so we will collect it by
putting a small tube in to your bladder.” By this the patient will
understand better.

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c) Clarity and brevity:
Clearness in speech is essential to get an exact meaning of the
spoken words.
A message that is direct and simple will be more effective. Clarity
is saying precisely what is meant and brevity is using the fewest words
necessary. The result is a message that is simple and clear. The goal is
to communicate clearly so that all aspects of a situation or
circumstance are understood. To ensure clarity the nurse need to
speak slowly and enunciate carefully.

d) Timing and relevance:

Nurses need to be aware of both relevance and timing when
communicating with the clients. No matter how clearly or simply words
are stated or written, the timing needs to be appropriate to ensure that
words are heard. Messages need to relate to the person or to the
persons interest and concern.
e) Adaptability:
Spoken messages need to be altered according to the behavioral
cues from the client. This adjustment is referred to as adaptability.
E.g.: The nurse who usually smiles, appears cheerful and greets
his client with an enthusiastic “hi Mr. Brown” notices that the client is
not smiling and appears distressed. It is important for the nurse to then
modify the tone of speech and express concern in his facial expression
while moving towards the client

f) Credibility:
It means worthiness of belief, trust-worthiness, and reliability. It
may be most important criteria for effective communication. Nurses
foster credibility by being consistent, dependable and honest. The
nurse needs to be knowledgable about what is being discussed and to
have accurate information.

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g) Humor:
The use of humor can be a positive powerful tool in the nurse-client
relationship, but it must be used with care. Humor can be used to help
the clients adjust to difficult end painful situations.

h) Courtesy:-
One of the present tendencies in conversation seems to be towards
bluntness, which is often confused with frankness. Every individual
possess his own opinion which may differ from others and he has full
right to express it. But he should be aware of the art of courtesy in
speech.

i) Tact:-
Tact is important if conversation is to be agreeable and friendly.
We should be quick to ascertain the feelings of the injured one, the
hurt expression, or the uncomfortable glance, and to repair it
appropriately as we can at the moment.
Conversations indicating personal prejudice, racial distinctions or
religious convictions should be avoided.

j) Sincerity: It is very necessary that whatever we speak should be

according to the level of the listener. Sincere conversations with
honest and considered convictions reflect the maturity level of the
speaker and make the conversation fruitful.

k) Originality: One of the most difficult qualities to achieve in

conversation is originality. To acquire an original conversational style
requires intensive thought and power of imagination.
We must have thought about a subject before we can submit it to
original treatment. We should see endless possibilities in subjects and
ideas, just like the scientist who when he has come to the end of a
piece of research, uses his results as a starting off point for another
scientific adventure.

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l) Pleasantness of tone: To produce that richness which a pleasing
tone implies, there must be some emotion in the voice.
A voice, full of life, is always engaging and draws attention of the
listeners.

2. WRITTEN COMMUNICATION:

Written communication is the most often used type of

communication. Many types of written communication are used in
organizations.
Organizational policy, procedures, events and change may be
announced in writing. Job descriptions, performance appraisals, and
letters of reference also are forms of written communication.

RULES FOLLOWED IN WRITING:

 Keep the message short and concise.

 Focus on the recipients needs. Make sure that your
communication addresses the recipients expectations and what
he or she needs to know.
 Use simple language so that the message is clear. Keep
paragraphs to less than three or four sentences.
 Review the message and revise as needed. Almost all important
communication requires several drafts. Always re-read the
written communication before sending it.
 Use spelling and grammar checks to be sure that the
communication looks professional.

3. SYMBOLIC COMMUNICATION:

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 Symbolic communications are the things that we have given
meaning too an that represent a certain idea we have in place.
Eg: The American flag is a symbol that represent freedom for the
Americans but imperialism and evil for some other countries.
Good communication requires awareness of symbolic
communication. Art and music are forms of symbolic communication
that may be used by the nurse to enhance understanding and promote
healing. Dreams, drawings, metaphorical language, a childs play, and
even the symptoms of illness are all symbolic forms of self expression
that have rich messages for health care providers.

4. META COMMUNICATION:

It is the process of communicating about communication. To

discuss a past conversation and to determine the meanings behind the
certain words, phrases etc. Meta communication can be used as a tool
for sense making, or for better understanding events, places, people,
relationships etc…Meta communication help people better understand
what they have communicated.

TYPES OF COMMUNICATION

ONE-WAY COMMUNICATION

It is giving instructions or making announcements to the group

who are not allowed to communication effectiveness is determined by
how the messages are created and presented.
The leader presents the message and the group gives feedback on
how they understand it. Exchange is completed when the group
members indicate to the leader that they have received the message
correctly. Called coercive because no provision exists for mutual
influence or exchange. The communication begins with the belief that
the leader’s position is correct and the only information needs from the
group is that they correctly understand and accept the message.
The drawbacks are:
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  Knowledge is imposed
 Learning is authoritative
 Little audience participation
 No feedback
 Does not influence human behaviour
TWO – WAY COMMUNICATION (SOCRATIC METHOD)

The Socratic method is a two-way method of communication is

which both the communicator and the audience take part. The
audience may raise question, and add their own information, ideas and
opinions to the subject. The process of learning is active and
“democratic”.
It is reciprocal process in which each member starts messages and
tries to understand the other member’s message. The leader and the
members freely exchange ideas and information.
All members are able to participate at will. Minority opinions are
encouraged and more apt to be expressed.
 Feelings of resistance or doubt can be discussed and resolved at
the time.
 Tow-way communication encourages open interaction
 Distributed participation and leadership
 Consensual decision making
Sending messages effectively
 Clearly form your messages by using”I” language.
 Make your messages complete and specific.
 Make your verbal and nonverbal messages congruent.
 Be redundant.
 Ask for feedback concerning the way your messaged are being
received.
 Make the message appropriate to the receiver’s frame of reference.
 Describe your feelings by name, action, or figure of speech.
 Describe other member’s behavior without evaluating or interpreting.
 Acknowledge how the other person is feeling.

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 Make sure that your body language communicates your attentiveness
to the person. You should be looking at them, have a focused body
posture, etc.
Receiving messages effectively
 Paraphrase accurately and nonevaluatively the content of the
message and the feelings of the sender.
 Describe what you perceive from the sender’s feelings.
 State your interpretation of the sender’s message and negotiate with
the sender until there is agreement as to the meaning of the message.

VERBAL COMMUNICATION

The traditional way of communication has been by word of

mouth. Direct verbal communication by word of mouth may be loaded
with hidden meanings. It is persuasive. Non-direct or written
communication may not be as persuasive as the spoken word.

NON-VERBAL COMMUNICATION

Communication can occur even without words. It includes a

whole range of bodily movements, postures, gestures, facial
expression (e.g., smile, raised eye brows, frown, staring, gazing etc.).
Silence is non-verbal communication. It can speak louder then words.

FORMAL COMMUNICATION

The communication channels used are:

Upward communication: The manager is a subordinate to higher
management. Needs and wants are communicated upward to the next
level in the hierarchy. Those at this higher level make decisions for
greater segment of the of the organization than the lower level
manager.

Downward communication: The manager relays information to

subordinates. This is a traditional form of communication in
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organization and helps to coordinate activities in various levels of
hierarchy.
Horizontal communication: mangers interact with others on the same
hierarchical level as themselves who are managing different segments
of the organization. The need for horizontal communication increases
as departmental interdependence increases

Diagonal communication: The manager interacts with the personnel

and managers of other departments and groups such as physician,
who are not on the same level of the organizational hierarchy.

INFORMAL COMMUNICATION: (GRAPEVINE COMMUNICATION)

The most informal communication network is often called as

grapevine.
It follows quickly and haphazardly among people at all hierarchical
levels and usually involves three or four people at a time. Sender has
little accountability for the message, and often the message is
distorted as it speeds along.

Merits of the grapevine phenomenon:

A. Speedy transmission: The greatest merit of this phenomenon is
that it transmits information very speedily. A rumor spreads like
wild fire. The very moment the worker comes to know that
something is ‘top secret’ or ‘confidential’ he tries to look into it
or have some idea of it and pass it on to others.
B. Feedback value: It is primarily through the grapevine that the
managers get feed back regarding their policies, decisions,
memo etc.. The feed back reaches them faster through
informal channel than a formal one.
C. Support to other channels: The informal channel functions as a
supplementary or parallel channel of communication. The
formal channels not only take more time but also impose
certain constraints on the process of communication. So,

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 whatever is deemed to be unsuitable for the formal channels
can be successfully transmitter through the grapevine.
D. Psychological satisfaction: Grapevine gives immense
satisfaction to the workers and strengthens their solidarity. It
draws them nearer to each other and thus keeps the
organization intact as a social entity.
Demerits of the grapevine phenomenon:
A. The information through the grapevine is less credible than the
one given by the formal channel. Since the grapevine spreads
information through the word of mouth it cannot always taken
seriously.
B. The grape vine does not always carry the complete information.
Thus one may not get the complete picture on its basis.
C. The grapevine always distorts the picture or often misinforms.
As its origin lies in the rumor mill it may spread any kind of
stories about responsible people. It may spoil the image of the
organization.

VISUAL COMMUNICATION

The visual forms of communication comprise: charts and graphs,

pictograms, tables, maps, posters etc.

TELECOMMUNICATION AND INTERNET

Telecommunication is the process of communicating over

distance using electromagnetic instruments designed for the purpose.
Radio, TV and internet etc. are mass communication media, while
telephone, telex (or teletype) and telegraph are known as point-to-
point telecommunication systems.

SOCIAL COMMUNICATION is a field of study that mainly explores the

ways information can be perceived, transmitted and understood, and

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the impact those ways will have on a society. Thus, the study of Social
Communication is more politically and socially involved than the study
of Communication, even tough it takes the former in great regard.

Instructions to improve social communication

1. Make conversation with one new person a day. we see people at

coffee shops, work, bookstores and grocery stores. Practice
approaching someone and making conversation. This will help reduce
anxiety when talking to new people and will let to practice social
communication skills.

2. Ask a friend to observe. According to "Thinking Ahead,"

published by the research department at Craig Hospital, having a
friend or family member observe your communication skills helps
provide feedback so you know what areas you need to improve.

3. Use positive body language. Keep the posture straight and look
people in the eye while talking to them. Lean toward people to let
them know you are interested and engaged in what they say.

4. Listen to people. Social communication involves listening as much

as talking. Avoid interrupting people when they talk. Ask questions to
show interest in what people say. Recognize when you talk too much
and let people reflect on your statements.

5. Rehearse your statements. If you struggle significantly with

social communication, you may need to practice before approaching
people. According to the Mayo Clinic, practice a variety of scenarios
where you will need to communicate. Practice your response to people
based on what you think they might say. Practice with someone in your
family so it mimics a real scenario.

INTERPERSONAL COMMUNICATION

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 It is usually defined by communication scholars in numerous ways,
usually describing participants who are dependent upon one another
and have a shared history. Communication channels, the
conceptualization of media that carry messages from sender to
receiver, take two distinct forms: direct and indirect.

 Direct channels:
These are obvious and easily recognized by the
receiver. Both verbal and non-verbal information is completely
controlled by the sender. Verbal channels rely on words, as in written
or spoken communication. Non-verbal channels encompass facial
expressions, controlled body movements (police present hand gestures
to control traffic), color (red signals 'stop', green signals 'go'), and
sound (warning sirens).

 Indirect channels:
These are usually recognized subconsciously by the
receiver, and are not always under direct control of the sender. Body
language, comprising most of the indirect channel, may inadvertently
reveal one's true emotions, and thereby either unintentionally taint or
bolster the believability of any intended verbal message.

Subconscious reception and interpretation of these signals is often

described with arbitrary terms like gut-feeling, hunch, or premonition.

THE COMMUNICATION PROCESS

There are three elements of communication. They are perception,

evaluation, and transmission.
Perception occurs by activating the sensory organs of the receiver. The
impulse is then transmitted to the brain. When the sensory impulses
reaches the brain, evaluation takes place. Personal experience allow
for the evaluation new experience.

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Evaluation results in two responses. A cognitive response related to
the informal aspect of the message and an affective response related
to the relationship aspect of the message.
When evaluation of the message is complete, transmission takes
place. This is perceived by the sender as feedback. Feed back
stimulates perception, evaluation, and transmission by the original
sender.
Theoretical models of communication process show visual
relationships more clearly and can aid in finding and correcting
communication break down or problems. Two models, the structural
model, and the transactional analysis models are presented.

I. Structural model:
The structural model has five functional components in
communication:
The sender: is the originator of the message.
The receiver: is the perceiver of the message
The feed beck is the verbal or behavioral response of the receiver
Context is the setting in which the communication takes place.
In evaluating communication from the perspective of the
structural model, specific problems can be identified. If the sender is
communicating the same message on both verbal and non verbal
levels, then communication is congruent. If the levels are not in
agreement, the communication is incongruent, which is problematic.

Communicating problems:
Problems encountered with structural elements of the
communication process:
SENDER: Incongruent communication (Lack of agreement between the
verbal and levels), Inflexible communication: (Exaggerated control
or permissiveness by the sender)

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MESSAGE: Ineffective messages (messages that are goal directed or
purposeful), inappropriate messages (messages not relevant to the
progress of the relationship)
Inadequate messages (messages that lack a sufficient amount of
information), inefficient messages (messages that lack clarity,
simplicity, and directness)
RECEIVER: Errors of perception (various forms of listening problems),
errors of evaluation (misinterpretation due to personal beliefs and
values)
FEEDBACK: Misinformation (communication of incorrect information),
lack of validation (failure to clarify and ratify understanding of the
message
CONTEXT: constraints of physical setting (noise, temperature, or
various distraction), constraints of psychological setting (impaired
previous relationship between the communicators)

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II. Transactional Analysis model

Transactional analysis is the study of the communication or

transactions that take place between people; it uncovers the
sometimes unconscious and destructive ways (games) in which people
relate to each other. This approach to personality was developed by
Berne (1964), a psychiatrist who made transactional analysis a popular
theory.

The corner stone of this theory is that each persons personality is

made up of three distinct components called ego [Link] ego state
is a consistent pattern of feeling, experiencing, and behaving.

The three ego stages that makeup personality are:

 The parent ego state

 Adult ego state
 Child ego state

It is as though three people reside reside in each person; the

parent incorporates all the attitudes and behaviors the individual
was taugh (directly or indirectly) by the parents.
The child contains all the feelings the individual had as a child
The adult deals with reality in logical, rational, computer like
manner

The parent ego state consists of all the nurturing, critical, and
prejudicial attitudes, behaviors, and experiences learned from other
people, especially parents and teachers.

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 The adult ego state is the really oriented part of the personality. It
gathers and processes information about the world and is objective,
emotionless and intelligent in problem solving.
The child ego state is the feeling part of the personality. It resides
feelings of happiness, joy, sadness, depression and anxiety.

A transaction or communication between two people can be:

 Complementary transaction
 Crossed transaction
 Ulterior transaction

Complementary transaction: The arrows in the ego state diagram

are parallel, and the communication flows smoothly.

DIAGRAM OF COMPLEMENTARY TRANSACTION

Patient Nurse

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 Parent Parent

Adult Adult

Child Child

Crossed transaction: If the arrows in the ego state diagram cross,

the communication breaks down

DIAGRAM OF CROSSED TRANSACTION

Patient Nurse

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 Parent Parent

Adult Adult

Child Child

Ulterior transaction: It takes place on two levels: the social or overt

level and the psychological or covert level. These transactions tend to
be destructive because the communicators conceal their true
motivations. This model provides framework for the nurse to use in
exploring in the patients recurrent behaviors, identifying patterns,
thinking about causes and planning alternative ways to respond.

DIAGRAM OF ULTERIOR TRANSACTION

Patient Nurse

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 Parent Parent

Adult Adult

Child Child

The Transactional analysis model of communication provides a

frame work for the nurse to use in exploring the patients recurrent
behaviors, identifying patterns, thinking about causes, and
planning alternative ways to respond.

ELEMENTS OF COMMUNICATION

The elements of communication are:

• Sender/encoder/speaker
• Receiver/decoder/listener
• Message
• Medium
• Feedback/reply

1. Sender/encoder/Speaker:

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 One who sends the message is called as sender, technically called
as encoder. The person who initiates the communication process is
normally referred to as the sender. It may be one individual or a group
of individuals. From his personal data bank he selects ideas, encodes
and finally transmits them to the receiver. This process of arranging
the ideas and preparing the message is called encoding.
2. Message:
Message is the encoded idea transmitted by the sender. Since
the message is likely to evoke response it can be considered as a
stimulus. The stimulation can be effected through any of the special
sensory organs of the body. The formulation of the message is very
important for an incorrect patterning can turn the receiver hostile or
make him lose interest.
3. Receiver/decoder/listener:
The listener receives an encoded message which he attempts to
decode. This process is carried on in relation to the work environment
and the value perceived in terms of the work situation.
[Link]/channel:
Another important element of communication is the medium or
channel. It could be oral, written, or non-verbal, prior to the
composition of the message, the medium/ channel should be decided.

[Link]:
This is the most important component of communication. Feed back
involves the reaction of the receiver. Feedback is the heart of
communication. Effective communication takes place only when there
is feedback. The errors and faults that abound in business situations
are a result of lack of feedback.

FACILITATORS OF COMMUNICATION

Factors that facilitate in the communication process are:

1. Sender:

27
  The communicator should be intelligent and
understanding. He should know the need of the
audience
 Should have skill in communicating
 Should have knowledge of channel
 Should have knowledge about the audience
 Should have good attitude towards the subject
 Should have skill in encoding and decoding
 Should have skill in utilizing the channel
 Should be confident
2. Message: Message with good vocabulary of language, having
pictures, paintings, signs, symbols are good facilitators.
Message should be accurate, correct.
Clear message is important
A good message which is clear, simple, specific, in level with the
mental, social, and economic capabilities of the audience, timely
and appropriate, appealing and attraction, applicable
[Link] good communication.
3. Channel: The sender, receiver has to be connected with each
other through a channel. This facilitates proper communication a
noise control aids in communication.
4. audience or receiver: The receiver should have proper
attitude to receive communication receiver must be in good
position to receive physically, mentally, psychologically. ability
to listen, to see, to read, to think, to feel helps in
communication.
Receiver should have faith in the source or sender.
Message which is liked, found useful is accepted.
Receiver should know how to use the channel.

7C’s which are essential to facilitate communication :

Adherence to the 7C’s & 4S’s helps the sender in transmitting his
message with ease and accuracy. They are:

28
C’s Relevance
1. Credibility: Builds trust
2. Courtesy: The communication should be in a calm and courteous
manner to be effective. Improves relationship
3. Clarity: The communication should be clear. Makes comprehension
easier
4. Correctness: Correct and authentic information should be passed
on. It builds confidence.
5. Consistency Introduces stability
6. Concreteness: planned communication is effective. It reinforces
confidence
7. Conciseness: The communication made should be to the point of
conveying exactly what it is intended to be conveyed. It saves time.

FACTORS INFLUENCING THE COMMUNICATION PROCESS

Ability of the communicator

The person’s abilities speak, hear, see, and comprehend stimuli
influence communication process. The receiver of a message also
needs to be able to interpret the message. Mental faculties can be
impaired such reasons as brain damage or use of sedative drugs or
alcohol. Even if a client is free of physical impairments, the nurse
needs to determine how many stimuli the client is capable of receiving
in a given time frame. The nurse must be careful not to talk too quickly
or present too many ideas at once, particularly when offering health
instruction.

Perceptions
Because each person has unique personality traits, values, and life
experiences, each will perceive and interpret messages differently. For
example, the nurse may draw the curtains around a crying woman and
leave her alone. The women may interpret this as “The nurse thinks
that I will upset others in the room and that I shouldn’t cry” or “The

29
nurse doesn’t like crying” or “The nurse respects my need to be
alone.” It is important in many situations to validate or correct the
perceptions of the receiver.

Personal Space
Personal space is the distance people prefer in interactions with
others. Proxemics is the study of distance between people in their
interactions.
1. Intimate: Physical contact to 1½ feet
2. personal: 1 ½ to 4 feet
3. Social: 4 to 12 feet
4. Public: 12 feet and beyond
 Intimate distance communication is characterized by body
contact, heightened sensations of body heat and smell, and
vocalizations that are low. Vision is intense, restricted to a small
body part, and may be distorted. Intimate distance is frequently
used by nurse. Examples occur in cuddling a baby, touching the
sightless client, positioning clients, observing an incision, and
restraining a toddler for an injection. It is a natural protective
instinct for people to maintain a certain amount of space
immediately around them, and the amount varies with
individuals and cultures. When someone who wants to
communicate steps too close, the receiver automatically steps
back a pace or two.
 Personal distance is less overwhelming then intimate distance.
Voice tones are moderate, and body heat and smell are noticed
less. Physical contact such as a handshake or touching a
shoulder is possible. More of the person is perceived at a
personal distance, so that nonverbal behaviors such as body
stance or full facial expressions are seen with less distortion.
Much communication between nurses and clients occurs at this
distance. Examples occur when nurses are sitting with a client,
giving medications, or establishing an intravenous infusion.

30
 Communication at a close personal distance can convey
involvement is conveyed. Bantering and some social
conversations are usual at this distance.
 Social distance is characterized by a clear visual perception of
the whole person. Body heat and odor are imperceptible, eye
contact is increased and vocalizations are loud enough to be
overheard by others. Communication is therefore more formal
and is limited to seeing and hearing. The person is protected and
out of reach for touch or personal sharing of thoughts or feelings.
Social distance allows more activity and movement back and
forth. It is expedient in communication with several people at the
same time or within a short time. Examples occur when nurses
make rounds or wave a greeting to someone. Social distance is
important in accomplishing the business of the day.
 Public distance requires loud, clear vocalizations with careful
enunciation. Although the faces and forms of people are seen at
public distance, individuality is lost. Instead, a general notion is
perceived about a group of people or a community.

Territoriality:
Territoriality is a concept of the space and things that an individual
considers as belonging to the self. Eg: client in a hospital often
consider their territory as bounded by the curtains around the bed unit
or by the walls of a private room. Clients often need to defend their
territory when it is invaded by others.

Roles and relationship:

The roles and relationship between sender and receiver affect the
communication process. Roles such as nursing student and instructor,
parent and child affect the content and responses in the

31
communication process. Choice of words, sentence structure and tone
of voice vary from role to role. The nurse who meets the client for the
first time communicates differently from the nurse who has previously
developed a relationship with the client.

Time:
The time factor in communication includes the events that precede
and follow the interaction.
The hospitalized client who is anticipating surgery or who has just
received news that a spouse has lost a job will not be very receptive to
information.

Environment:
People usually communicate in comfortable environment.
Temperature extremes, excessive noise, and a poorly ventilated
interfere with communication. Lack of privacy any interfere with
client’s communication about matters the client considers private.

Attitudes:
Attitudes convey beliefs, thoughts, and feelings about people.
Attitudes are communicated convincingly and rapidly to others.

Caring and warmth:

It conveys the feeling of emotional closeness, in contrast to
impersonal distance. Caring is more enduring and intense than
warmth. It conveys deep and genuine concern for the person, whereas
warmth conveys friendliness and consideration, shows by acts of
smiling and attention to physical comfort. Caring involves giving
feelings, thoughts, skill and knowledge.

Respect:

32
 It is an attitude that emphasizes the other persons worth and
individuality. It conveys that the persons hopes and feelings are special
and unique even though similar to others in many ways.
A nurse conveys respect by listening open mindedly to what the
person is saying, even if the nurse disagrees.

Acceptance:
It emphasizes neither approval nor disapproval. The nurse willingly
receives the client’s honest feelings and actions with out judgment. An
accepting attitude allows clients to express personal feelings freely
and to be themselves.

Lack of interest:
It inhibits communication by indicating a lack of concern or a belief
that what the person is saying is not important. The nurse conveys lack
of interest by forgetting part of the client’s conversation or not
concentrating on it sufficiently to respond.

Coldness:
It is the opposite of caring and warmth. Nurses convey this attitude
to clients by appearing more interested in the technical and procedural
aspects of Nursing than in the concerns of the person receiving the
therapy.

Emotions and self -esteem:

Overwhelming joy or sorrow or that is difficult to express in words.
Anger may produce loud profane vocalizations or controlled
speechlessness. Fright may produce screams of terror or paralyzed
silence.
Emotions also affect a person’s ability to interpret messages. Large
parts of message may not be heard or the message may be
misinterpreted when the receiver is experiencing strong emotion

33
People whose self- esteem is high communicate honestly, with
confidence.

Congruence:
In congruent communication, the verbal and non-verbal aspects
match. Clients more readily trust the nurse when they perceive the
communication as congruent.

BARRIERS TO COMMUNICATION:

1. Stereotyping:
Offering generalized and over simplified beliefs about groups of
people that based on experiences too limited to be valid. These
responses categorize the clients and negate their uniqueness as
individuals.

2. Agreeing and disagreeing:

Agreeing and disagreeing imply that the client is either right or
wrong and that the nurse is in position to judge this. These responses
deter clients from thinking through their position and may cause a
client to become defensive.

3. Being defensive:
Attempting to protect a person or health care services from negative
comments.
These responses prevent the client from expressing true concerns.
Defensive responses protect the nurse from admitting weaknesses in
the health care services.

4. Challenging:
Giving a response that makes the clients prove their statement or
point of view. These responses indicate that the nurse is failing to

34
consider the client’s feelings, making the client feel it necessary to
defend a position.

5. Probing:
Asking for information chiefly out of curiosity rather than with the
intent to assist the client. These responses are considered prying and
violate the client’s privacy.
6. Testing:
Asking questions that make the client admit to something. These
responses permit the client only limited answers and often meet the
nurse’s needs rather than the client’s.

7. Rejecting:
Refusing to discuss certain topics with the client. These responses
often make the clients feel that the nurse is rejecting not only their
communication but also the client themselves.

8. Changing topics and subjects:

Directing the communication in to areas of self interest rather than
considering the clients concerns is often a self protective response to a
topic that causes anxiety. These responses imply that what the nurse
considers important will be discussed and that clients should not
discuss certain topics.

9. Unwarranted reassurance:
Using clichés or comforting statements of advice as a means to
reassure the client. These responses block the fears, feelings, and
other thoughts of the client

10. Passing judgment:

Giving opinions and approving and disapproving responses,
moralizing, or implying one’s own values. These responses imply that
the client must think as the nurse thinks, fostering client dependence.

35
11. Giving common advice:
Telling the client what to do. These responses deny the client’s
right to be an equal partner. Note that giving expert rather than
common advice is therapeutic.

METHODS OF OVERCOMING BARRIERS OF COMMUNICATION

Manipulate the environment: A quiet environment with limited

distractions will make the most of the communication efforts of both
the client and the nurse and increase the possibility of effective
communication. Sufficient light will help in conveying non-verbal
messages, which is especially important if visual or auditory acuity is
impaired.

Provide support:
The nurse should convey encouragement to the client and provide
nonverbal reassurance(perhaps by touch). If the nurse does not
understand, it is critical to let the client know so that he or she can
provide clarification with other words through some other means of
communication. When speaking with the client who will have difficulty
in understanding, the nurse should check frequently check to
determine what the client has heard and understood. Using open
ended questions will assist the nurse in obtaining accurate information
about the effectiveness of the communication

Employ measures to enhance communication: First determine how the

client can best receive messages: by listening, looking, through touch
or an interpreter. Ways to help communication include keeping words
simple and concrete and discussing topics of interest to the client.

36
Educate the client and support persons: Some times clients and
support persons can be prepared in advance for communication
problems.
Eg: before intubation or throat surgery. By explaining anticipated
problems, the client is often less anxious when problems arise.

THERAPEUTIC COMMUNICATION

DEFINITION
Therapeutic Communication promotes understanding and can
help establish a constructive relationship between the nurse and the
client.
Nurses need to respond not only to the content of a client’s verbal
message but also to the feelings expressed. It is important to
understand how the client views the situation and feels about it before
responding.

Attentive listening
Attentive listening is listening actively, using all the senses, as
opposed to listening passively with just the ear. Attentive listening is
an active process that requires energy and concentration. It involves
paying attention to the total message, both verbal and nonverbal, and
noting whether these communication are congruent. Attentive listening
means absorbing both the content and the feeling the person is
conveying, without selectivity.

Physical attending
Egan (1998) has outlined five specific ways to convey physical
attending, which he defines as the manner of being present to another
or being with another. Listening, in his frame of reference, is what a
person does while attending.
Actions of physical attending are:

37
  Face the other person squarely: This position says, “I am
available to you.” Moving to the side lessens the degree of
involvement.
 Adopt an open posture: The nondefensive position is one on
which neither arms nor legs are crossed. It conveys that the
person wishes to encourage the passage of communication, as
the open door of a home or an office does.
 Lean toward the person: People move naturally toward one
another when they want to say or hear something by moving to
the front of a class, by moving a chair nearer a friend or by
learning across a table with arm propped in front. The nurse
conveys involvement by leaning forward, closer to the client.
 Maintain good eye contact: Mutual eye contact, preferably at
the same level, recognizes the other person and denotes
willingness to maintain communication.
Eye contact neither glares at nor stares down another but is
natural.
 Try to be relatively relaxed: total relaxation is not feasible when
the nurse is listening with intensity, but the nurse can show
relaxation by taking time in responding, allowing pauses as
needed, balancing periods of tension with relaxation and using
gestures that are natural.

PRINCIPLES OF THERAPEUTIC COMMUNICATION

Each therapeutic communication skill or technique is based on

principles like:

 Acceptance: Accepting nurses communicate a favorable

reception of another person. One does not have to approve of
another behavior to be accepting. It is only when people feel
accepted for what they are that they will consider changing.

38
 Interest: Nurses communicate interest when they are genuinely
curious and express a desire to know another person. Interest is
conveyed by asking about those aspects of a persons life that
others often reject.

 Respect: Nurses show consideration by communicating their

willingness to work with the client and accept the client’s ideas,
feelings, and rights. It is communicated by listening attentively,
expressing belief in the clients ability to solve personal problems
with assistance and assume responsibility for his own life.

 Honesty: Nurses are honest when they are consistent, open and
frank. they do not take refuge behind a professional mask but
instead communicate with the client as authentic person. They
use tact and timing in Judging the use of honesty so that clients
are not burdened with the information they are not ready to
hear.

 Concreteness: Concrete nurses are specific to the point, and

clear when they communicate. They use understandable
language and avoid the use of jargon.

 Assistance: Nurses assist the clients’ by committing time and

energy to therapeutic relationships.

 Permission: Nurses communicate permission by conveying the

message that is acceptable to try new ways of behaving.

 Protection: Nurses protect clients by ensuring clients safety.

Nurses assume responsibility of working with clients to anticipate
trouble spots with new behaviour and develop effective ways of
dealing with anticipated or actual problems, thus maximizing the
possibility of success.

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Therapeutic communication Techniques

The collection of data and planning, implementation and evaluation

activities are carried out with the patient, not for the patient, when the
nurse uses therapeutic communication skills. Because they are
techniques, they are only as effective as the person using them.
If they are used appropriately, they can enhance the nurses
effectiveness. If they are used as automatic responses, they will block
the formation of a therapeutic relationship, negate both the nurse’s
and patient’s individuality and divest them of their dignity.

The following are the techniques used:

Listening:-
An active process of receiving information and examining reaction to
the messages received.
Example: Maintaining eye contact and receptive nonverbal
communication.
Therapeutic value: Nonverbal communications to the patient the
nurse’s interest and acceptance.
Nontherapeutic threat: Failure to listen.
Broad Openings:-
Encouraging the patient to select topics for discussion
Example: “What are you thinking about?”
Therapeutic value: Indicates acceptance by the nurse and the value of
the patient’s initiative
Nontherapeutic threat: domination of the interaction by the nurse;
rejecting responses
Restating:-
Repeating the main thought the patient expressed
Example: “You say that your mother left you when you were 5 years
old.”
Therapeutic value: indicates that the nurse is listening and validates,
reinforces, or calls attention to something important that has been said

40
Nontherapeutic threat: lack of validation of the nurse’s interpretation
of the message; being judgmental; reassuring defending
Clarification:-
Attempting to put into words vague ideas or unclear thoughts of the
patient to explain what he or she means
Example: “I’m not sure what you mean. Could you tell me about that
again?”
Therapeutic value: helps to clarify feelings, ideas, and perceptions of
the patient and provide an explicit correlation between them and the
patient’s actions
Nontherapeutic threat: failure to probe; assumed understanding
Reflection:-
Directing back the patient’s ideas, feelings, questions, or content
Example: “You’re feeling tense and anxious and it’s related to a
conversation you had with your husband last night?”
Therapeutic value: Validates the nurse’s understanding of what the
patient is saying and signifies empathy, interest, and respect for the
patient
Nontherapeutic threat: stereotyping the patient’s responses;
inappropriate timing if reflections; inappropriate depth of feeling of the
reflections; inappropriate to the cultural experience and educational
level of the patient

Focusing:-
Questions or statements that help the patient expand on a topic of
importance
Example: “I think that we should talk more about your relationship with
your father.”
Therapeutic value: allows the patient to discuss central issues and
keeps the communication process goal-directed
Nontherapeutic threat: allowing abstractions and generalizations;
changing topics

41
Sharing perceptions:-
Asking the patient to verify the nurse understands of what the
patient is thinking or feeling
Example: “You’re smiling, but I sense that you are really very angry
with me.”
Therapeutic value: conveys the nurse’s understanding to the patient
and has the potential for clearing up confusing communication
Nontherapeutic threat: challenging the patient; accepting literal
responses; reassuring; testing; defending
Theme identification:-
Underlying issues or problems experienced by the patient that
emerge repeatedly during the course of the nurse-patient relationship
Example: “I’ve noticed that in all of the relationships that you have
described, you’ve been hurt or rejected by the man. Do you think this
is an understanding issue?”
Therapeutic value: allows the nurse to best promote the patient’s
exploration and understanding of important problems
Nontherapeutic threat: giving advice; reassuring; disapproving

Silence:-
Lack of verbal communication for a therapeutic reason
Example: sitting with a patient and nonverbally communicating
interest and involvement
Therapeutic value: allows the patient time to think and gain insights,
slows the pace of the interaction.

Humor:-
The discharge of energy of through the comic enjoyment of the
imperfect
Example: “That gives a whole new meaning to the word nervous,” said
with shared kidding between the nurse and patient

42
Therapeutic value: can promote insight by making conscious repressed
material, resolving paradoxes, tempering aggression, and revealing
new options; a socially acceptable form of sublimation
Nontherapeutic threat: indiscriminate use; belittling patient; screen to
avoid therapeutic intimacy

Informing:-
The skill of information giving
Example: “I think you need to know more about how your medication
works.”
Therapeutic value: Helpful in health teaching or patient education
about relevant aspects of patient’s well-being and self-care
Nontherapeutic threat: giving advice.

Suggesting:
Presentation of alternative ideas for clients consideration
relative to problem solving
Eaxmple: “Have you thought about responding to your boss in
adifferent way when he raises that issue with you? For ex: you could
ask him if a specific problem has occurred.”
Therapeutic value: increases client’s perceived options or choices.
Non- therapeutic threat: giving advice; inappropriate timing; being
judgmental

INTERPERSONAL RELATIONSHIP

INTRODUCTION:
An interpersonal relationship is a relatively long-term association
between two or more people. This association may be based on
emotions like love liking, regular buiseness interactions or some other
type of social commitment.
Interpersonal relationships take place in a great variety of
contexs such as family,friends, marriage, acquaintances,religious

43
[Link] may be regulated by law, custom or mutual
agreement.
Interpersonal relationships are dynamic systems that change
continuously during their [Link] relationships have a
beginning, a life span, and an [Link] tend to glow and improve
gradually as people get to know each other and become closer
emotionally or they gradually deteriorate as people drift apart and
form new relationships with others.

DEFINITION:

Interpersonal relationships are social associations, connections or

affiliations between two or more people who may interact overtly,
covertly, face to face or may remain effectively unknown to each other
such as those in a virtual community who maintain anonymity and do
not socialize outside of a chat room.
Anisha
Maheshwari

Interpersonal relations are social associations, connections or

affiliations, between two or more people. There is a different levels of
intimacy and sharing, implying the establishment of common ground,
may be centered around something shared in common.
[Link]
Sheeba

PURPOSES OF INTERPERSONAL RELATIONSHIPS

 To learn about self, about society

 To establish and maintain relationships
 To alleviate loneliness
 To influence, control, and direct
 Helps for diversion
 Helps to meet the needs of others
 Gain confidence and satisfaction

44
  Provides intellectual and emotional bond among the people.

TYPES OF INTERPERSONAL RELATIONSHIP:

1. Friendship: Theories of friendship emphasize the concept of

friendship as freely chosen association.
2. Family: Family communication patterns establish roles, identify
and enable the growth of individuals. Family dysfunction may
also be exhibited by communication patterns.
3. Romantic: Romantic relationships are defined in terms of the
concepts of passion, intimacy and commitment
4. Professional relationships: Professionalcommmunication
encompasses small group communication and interviewing
5. Casual relationships: The groups or individuals meet casually
without, any purpose, talk something in general. This relationship
may further deepen to friendship or it may extinguish.

PRINCIPLES OF INTERPERSONAL RELATIONSHIP:

Good interpersonal relationship can provide people with security and

belongingness, bring spiritual pleasure and satisfaction, facilitate
physical and mental health, therefore people all eager to establish a
good interpersonal relationship. However, many people can not
achieve this aim, and they even have a serious sense of failure.

I. Mutual Benefit Principle

In fact, interpersonal relationship is a kind of mental relationship

among people, and it reflects a mentality that individual or group
seeks for things to meet its social needs. Therefore, change and
development of interpersonal relationship is subject to satisfaction
degree of both parties’ needs. If during the communication, both
parties obtain their respective satisfaction of social needs, then close
mental relationship can occur and be maintained between them, which
display a friendly affection; at the opposite side, relationship between

45
them may be alienated. Interpersonal relationship of various levels
reflects the attraction degree of mutual needs among people.

II. Credit Principle

“Treat people with sincerity and insist on credit” is the guarantee for
extension and deepening of interpersonal communication. During the
communication process, only with a motivation and attitude of sincere
heart and kind intention can people mutually understand, receive, trust
and arise resonance in sentiment, so that the communication relation
can be consolidated and developed.

III. Respect Principle

Although due to the influence of subjective and objective factors,

people may vary in temperament, character, ability, knowledge, etc,
however, their personality is equal. Only through respecting oneself
and others can an equal position of each party in interpersonal
communication be maintained.

IV. Tolerance Principle

Tolerance displays that a person does not care much too minor
issues, he can treat others with tolerance, seek for common grounds
while putting aside differences and take revenge with lenience.
Tolerance helps to enlarge communication space, nourish
interpersonal relationship and eliminate interpersonal tension and
contradiction. During the interpersonal communication, contradiction
that occurs due to individual differences or unpredictable mistakes or
misunderstanding is inevitable. If someone pricks or hurts you, you
keep dwelling on it and hope to revenge, then it will necessarily lead to
a vicious circle. On the contrary, if you believe that people’s sentiment
can be induced, majority of people can be conscientious, open-minded
and tolerant, if “presenting a papaya” to others, then you will be
“returned for it a beautiful Ju-gem” sooner or later.
46
V. Moderation Principle

Time for communication shall be moderate. We shall be prevented

from inputting too much time and energy due to overemphasis of the
importance of communication.

Distance for communication shall be moderate. It is very necessary

for friends to keep a certain distance among them, however, the size of
distance can be differentiated to friends with different intimacy.

Frequency for communication shall be moderate. As for some

people’s communication principle, they are inseparable with their
friends when the interpersonal relationship is good; if their relationship
becomes disharmonious, they may mutually attack and is not willing to
communicate any more, and it is very disadvantageous for the mental
health of both parties and development of interpersonal relationship.
Degree of closeness shall be properly maintained in interpersonal
communication.

Other principles of interpersonal relationship:

 Learn everyones name and never address anyone by nick name.

 Respect everyones individuality.
 Donot impose anything on anybody.
 Keep emotions under control.
 Donot be aafraid to admit ignorance.
 Donot give and take personal favour.
 The team leader should not make any excuse regarding his/her
responsibility.
 Develop habits of listening and focus attention on the problem.
 Do not say anything that will disturb others faith.
 Be impartial to others and practice justice.
 The members of the team should be loyal, honest, dependable
and willimg to carry out the directions of the team leader.
47
  There should be “team spirit” or “we feeling” among the group
members.
 There should be mutual understanding between the members.
 There should be delegation of responsibility in a group and every
member should cary out his or her responsibility to the satisfaction
of the group.
 Teach the new comer about the job.
 The new comer should “feel at home” when he joins the group.
 Establish good rapport among the members in order to achieve
the aim.
 Every member should be familiar with the organization plan and
the policies of the group.
 Keep upto date with the information that are going around.
 Avoid arguments in the group.
 Talk in terms of other mans interest.
 Praise the slightest improvements made by [Link] words of
encouragement.
 Have a smiling face always.
 Prepare yourself mentally to accept the worst if necessary.

FUNCTIONS OF INTERPERSONAL RELATIONSHIP

Interpersonal communication is important because of the functions its

achieves. Whenever we engage in communication with another person,
we seek to gain information about them. We also give off information
through a wide variety of verbal and nonverbal cues.

 Gaining Information:
One reason we engage in interpersonal communication is so that
we can gain knowledge about another individual. we attempt to gain
information about others so that we can interact with them more
effectively. We can better predict how they will think, feel, and act if
we know who they are. We gain this information passively, by
observing them; actively, by having others engage them; or

48
interactively, by engaging them ourselves. Self disclosure is often used
to get information from another person.

 Building a Context of Understanding:

We also engage in interpersonal communication to help us
better understand what someone says in a given context. The words
we say can mean very different things depending on how they are said
or in what context. Content Messages refer to the surface level
meaning of a message. Relationship Messages refer to how a message
is said. The two are sent simultaneously, but each affects the meaning
assigned to the communication.

 Establishing Identity:
Another reason we engage in interpersonal communication is to
establish an identity. The roles we play in our relationships help us
establish identity. So too does the face, the public self-image we
present to others. Both roles and face are constructed based on how
we interact with others.

 Interpersonal Needs:
we engage in interpersonal communication because we need to
express and receive interpersonal needs
William Schutz2 has identified three such needs:
Inclusion
Control
Affection
Inclusion is the need to establish identity with others.
Control is the need to exercise leadership and prove one's abilities.
Groups provide outlets for this need. Some individuals do not want to
be a leader. For them, groups provide the necessary control over
aspects of their lives.
Affection is the need to develop relationships with people. Groups are
an excellent way to make friends and establish relationship

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PHASES OF INTERPERSONAL RELATIONSHIP:

George Levinge, a Psychologist has developed a model on the

natural development of a relationship. This has five stages. They
are:
Acquaintance:
Becoming acquainted depends on previous relationships,
physical proximity, first impressions and a variety of other
factors. If two people begin to like each other, continued
interactions may lead to next stage.
Buildup:
During this stage, people begin to trust and care for each
other. The need for compatibility and such filtering agents a
common background and goals will influence whether or not the
interaction continues.
Continuation:
This stage follows a mutual commitment to a long term
friendship. It is relatively long relative stable period. Continued
growth and development occurs during this time. Mutual trust is
important for sustaining the relationship.
Deterioration:
Not all relationships deteriorate, but those that deteriorate
tend to show signs of trouble. Boredom, resentment and
dissatisfaction may occur, and individuals may communicate less
and avoid self disclosure, loss of trust and betrayals may take
place as the downward spiral continues.
Termination:
The final stage marks the end of the relationship, either by
death in case of a healthy relationship, or by separation.

BARRIERS OF INTERPERSONAL RELATIONSHIP:

A. Physical barriers:

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 There are many altered health states and human
responses that limit communication. Persons with hearing or visual
impairments have fewer channels to receive messages.
Different places, closed doors and people separated from each other
by physical distance. These barriers makes difficult for the people to
know each other and communicate in a free and easy manner.

B. Emotional Barriers:
Emotions also act as a barrier while people are
emotional, they don’t think clearly. This makes communication
difficult as one person might have mistrust, fear, suspicion or any
other emotion.

C. Developmental Barriers:
Aspects of growth and development also influence the
interaction.
Eg: An infants self expression is limited to crying, body movement
and facial expression whereas older children can express their
needs more directly.
The nurse can include the parents, child, or both as sources
of information about Childs health, depending on the child’s age.

D. Socio-cultural factors:
Cultural traits, religious beliefs, self care practices
influence th interpersonal relationship. Culture is a blue print for
thinking, feeling, behaving, and communicating.

To practice cultural sensitivity in communication, the nurse must

understand that persons of different culture uses different degrees of
eye contact, personal space, gestures, loudness of voice, pace of
speech, touch, silence, and meaning of language.

A. Gender:

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 Gender is considered as a barrier because people think
differently about communicating with men and women in relation
to logic and emotions. Male and female communication patterns
tend to differ, which can sometimes create barriers to effective
communication.
Males communicate to achieve goals, establish
individual status and authority and complete for attention and
power. They typically prefer to talk about topic that do not expose
personal feelings. Men tend to speak directly when giving criticism
or orders.
Females communicate to build connections with others,
include others, cooperate and respond, showing interest and
support. Women enjoy discussing feelings and personal issues and
find closeness in dialogue.

B. Perception:
It is a barrier because every one has their own views
about the world and things. So the difference of their
understanding and thinking can be a barrier.

C. Language:
It makes communication difficult, so there is a barrier for
interpersonal relations.
D. Defensive barriers:
 Lack of self confidence
 Fear of loss of status
 Fear of rejection
 Desire to be perfect in public opinion

DEVELOPMENT OF INTERPERSONAL RELATIONSHIP:

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 In general, people want to feel that they have been
understood, respected and treated fairly, regardless of what is being
communicated. The ability to listen respectfully can be effective in
many emotionally charged situations.

JOHARI WINDOW
A Johari window is a cognitive psychological tool created by Joseph
cuft and Harry Ingham in 1955 in united states, used to help people
better understand their interpersonal communication and
relationships. It is used primarily in self help groups and corporate
settings as a heuristic exercise.
When performing the exercise, the subject is given a list of 55
adjectives and she picks five or six adjectives that they feel describe
their own personality. Peers of the subject are then given the same list,
and each pick five or six adjectives that describe the subject. These
adjectives are mapped on to a grid.
Charles Handly calls this concept the Johari window. House with four
rooms or quadrants.
Room- 1 is the part of ourselves that we see and others see
Room- 2 is the aspect that others see but we are not aware of
Room- 3 is the most mysterious room in that the unconscious or
subconscious bit of us is seen by neither ourselves nor others
Room- 4 is our private space which we know but keep from others.

Quadrants:
 Adjectives that are selected by both the participant and his peers
are placed into the ARENA Quadrant. It represents traits of the
participant known to both of them.
 Adjectives selected only by the participant, but not by any of their
peers and placed into the FAÇADE Quadrant. These represent
information about the participant of which the peers are not

53
 aware. It is up to the participant whether or not to disclose the
information.
 Adjectives which were not selected by the participant but only by
their peers are placed into (BLIND SPOT) quadrant these represent
information of which the participant is not aware, but others are,
and they can decide whether and how to inform the individual
about these blind spots.
 Adjectives which were not selected by either the participant or
their peers remain in the unknown quadrant, representing the
participants behaviors or motives which are not recognized by
anyone participating. This may be because they Donot apply or
there is collective ignorance.

Known to self Not known to self

Known to others Open Blind

Not known to Hidden unknown

others

In new groups or teams the open free space for any team member is
small because shared awareness is relatively small. As the team
member becomes better established and known so the size of the
team member’s open free area quadrant increases.

sJohari window model of human interaction:

The process of enlarging the open quadrant is called self disclosure,
a give and take process between me and the people I interact with. As
a person shares some thing about himself (moving information from
hidden quadrant to the open) and
if the other party is interested ingesting to know about that person,
they will reciprocate, by similarly disclosing the information in their

54
hidden quadrant. Thus an interaction between two parties can be
modeled dynamically as two active Johari windows.
Disclosure helps in letting gout our feelings also. If a
person has to self disclose, he has to choose a person very carefully,
choose someone who will give him some insight into his problem like a
nurse.
Eg: the nurse educators must teach the student the importance of
confidentiality.

Advantages:

The Johari window model is a simple and useful tool for

 Illustrating and improving self awareness.
 Develop mutual understanding between individuals and with in a
group
 Can be used to assess and improve a group’s relationship with
other groups
 For inter group and interpersonal development
 Helps in mapping one’s personality
 Helps in employ counseling
 Useful in team building and training

GROUP DYNAMICS

INTRODUCTION:

55
 Group dynamics deals with the interactions and forces between
group members in a social institution. The study of influences which
determine the movement of the group is group dynamics. It is the
study of group behaviour to understand whether or and why the group
behaves as a whole. The manner of this communication is determined
by various factors.

DEFINITION:
The field of study or branches of social sciences concerned with
scientific methods to determine why groups behave the way they do is
group dynamics.

[Link] Sheeba

A group is two or individuals who are connected to each other social

relationships

Anisha Maheshwari

FUNCTIONS OF GROUP:

 It must maintain a degree of group unity

 It needs to develop and modify its structure to improve its
effectiveness
 It must accomplish its goals

GROUP CHARACTERISTICS:

In order to understand the group behaviour the following

characteristics should be followed.
 Sense of unity
 Feeling of oneness
 Common interest
 Reciprocal relationships
 Similarity in behaviour

56
  Group regulations (rules)
 Identity

For the group to function harmoniously the following characteristic are

required:

 They have to be group conscious

 Sense of shared purpose
 A spirit of inter dependence and helplessness and selflessness.
 Frankness and sincerity of opinion and purpose
 Sense of freedom among the members to discuss matters
 Constant readiness to unite

TYPES OF HEALTH CARE GROUPS:

As a participant in a group, the nurse may be required to fulfill different

roles like member or leader, teacher or learner, advisor or advisee etc.
Common types of health care groups are:

Task groups:
The task group is one of the most common types of work related
groups to which the nurses belong.
Eg: Health care planning committees, nursing service committee,
hospital staff meetings etc.
The methods vary according to the task to be performed. The leader of
a group is called as Chair person, must be accepted by the group
members, and an expert in the area of task emphasis.

Role of the chairperson is:

 to identify the specific task,

 clarify communication
 assist in expressing opinions
 offering solutions

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member participation depends on the task. A target date for
termination of the group is set in advance.

Teaching Groups:
Purpose:
To impart information to the participants.
Eg: client health care groups, continuing education
Instruction to the family members about the follow up care for
discharged clients

Self help groups:

A self help group is a small, voluntary organization, composed of

individuals who share a similar health, social, or daily living problem.

The functions of the nurse in self help groups are:

 Help clients form such groups by identifying key people who can
act as facilitators
 Share expertise with clients and help them gain appropriate
knowledge and skills
 Inform client and support persons about existing self help groups
available to them
 Participate as a member of self help groups when it is
appropriate.
 Help out in times of crises

Self Awareness/ growth groups:

It develops interpersonal strengths. Its aim is to improve the person’s

functioning in the group to which they return family, job community.
Members are responsible for correcting inefficient patterns of relating
and communicating with each other.

Therapy groups:

58
 These groups work toward self understanding, more satisfactory
ways of handling stress.
Members of this group are referred as clients or patient. Duration of
therapy is not set. Termination date is decided by the therapist and
members.

Work related or social support groups:

Many nurses experience vocational stress. Various types of

group support can buffer such stress. Group members who know about
the work of others can encourage to be more active, creative about
their work and to achieve more. Members can share the joys of
success and frustration of failure through active listening without
giving advice or making judgments. It is given outside the work
environment.

ORGANIZATIONAL BEHAVIOUR

The study of Organizational Behaviour (OB) is very interesting and

challenging too. It is related to individuals, group of people working
together in teams. The study becomes more challenging when
situational factors interact. The study of organizational behaviour
relates to the expected behaviour of an individual in the organization

DEFINITIONS

“Organizational behaviour is a field of study that investigates the

impact that
individuals, groups and organizational structure have on behaviour
within the
organization, for the purpose of applying such knowledge towards
improving an
organizational effectiveness.”

59
 “The study and application of knowledge about human behaviour
related to other elements of an organization such as structure,
technology and social systems”

LM Prasad.

“Organizational behaviour as a systematic study of the actions and

attitudes that people exhibit within organizations.”

Stephen P Robins

ELEMENTS OF ORGANIZATIONAL BEHAVIOR :

 The organization's base rests on management's philosophy, values,

vision and goals.
 This drives the organizational culture which is composed of the
formal organization, informal organization, and the social
environment.
 The culture determines the type of leadership, communication, and
group dynamics within the organization.
 The workers perceive this as the quality of work life which directs
their degree of motivation.
 The final outcome are performance, individual satisfaction, and
personal growth and development.
 All these elements combine to build the model or framework that
the organization operates from.

MODELS OF ORGANIZATIONAL BEHAVIOR :

There are four major models of Organizational Behavior. They are:

1. Autocratic - The basis of this model is power with a managerial
orientation of authority. The employees in turn are oriented
towards obedience and dependence on the boss. The employee
need that is met is subsistence. The performance result is
minimal.

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 2. Custodial - The basis of this model is economic resources with a
managerial orientation of money. The employees in turn are
oriented towards security and benefits and dependence on the
organization. The employee need that is met is security. The
performance result is passive cooperation.

3. Supportive - The basis of this model is leadership with a

managerial orientation of support. The employees in turn are
oriented towards job performance and participation. The
employee need that is met is status and recognition. The
performance result is awakened drives.

4. Collegial - The basis of this model is partnership with a

managerial orientation of teamwork. The employees in turn are
oriented towards responsible behavior and self-discipline. The
employee need that is met is self-actualization. The performance
result is moderate enthusiasm.

TYPES OF ORANIZATIONAL BEHAVIOR

Organizational behavior focuses on observable behaviors. It also

deals with internal actions, such as thinking, perceiving, and deciding,
that accompany visible [Link] studies the behavior of people both
as individuals and as members of larger social units. There are three
types of organizational behavior.

Micro organizational behavior:

It is concerned mainly with the behaviors of individuals
working alone. Three sub fields of psychology were the principal
contributors to the beginning of micro organizational behavior.
Experimental psychology provided theories of learning, motivation,
perception and stress. Clinical psychology furnished models of
personality and human development. Industrial psychology offered
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theories of employee selection, work place attitudes and performance
assessment.

Meso organizational behavior:

It is a middle ground, bridging the other two sub fields of
organizational behavior. It focuses mainly on understanding the
behaviors of people working together in groups and teams. It grew out
of research in in the fields of communication, social psychology. It
provides theories on socialization and group dynamics, etc…

Macro organizational behavior:

It focuses on understanding the behaviors of entire
organizations. The origins can be traced to four principal disciplines.
Sociology provided theories of

structure, social status, and institutional relations. Political science

offered theories of power, conflict bargaining and control.
Anthropology contributed theories of symbolism, cultural influence and
comparative analysis

DIFFERENT APPROACHES TO ORGANIZATIONAL BEHAVIOR

Taylorsim and Scientific Management Approach by Frederic

Winslow Taylor, (1856-1915) :
Taylor attempted to make a science for each element of
work and restrict behavioral alternatives facing worker. Taylor looked
at interaction of human characteristics, social environment, task, and
physical environment, capacity, speed, durability, and cost. The overall
goal was to remove human variability. This involved breaking down
each task to its smallest unit and to figure out the one best way to do
each job. Then the engineer, after analyzing the job should teach it to
the worker and make sure the worker does only those motions
essential to the task.

62
The Human Relations Approach by Elton Mayo :
The Human Relations Approach by Elton Mayo Elton Mayo
along with Roethlisberger and Dickinson conducted a study called as
Hawthorne Study in the Western Electric Cicero in 1920s, which
showed how work groups provide mutual support and effective
resistance to management schemes to increase output. The results of
the research led researchers to feel that they were dealing with socio-
psychological factors

Weber's Bureaucracy Approach :

Weber's Bureaucracy Approach German sociologist
Max Weber, observing the organizational innovations of the German
leader Bismarck, identified the core elements of the new kind of
organization. He called it bureaucracy. The Basic Elements of the
Bureaucratic Structure authority is rational and legal; authority should
be based on position, not on the person in the position authority stems
from the office and this authority has limits as defined by the office
positions are organized in a hierarchy of authority organizations are
governed by rules and regulations

SUMMARY
Communication is a process whereby information is enclosed
in a package and is channeled and imparted by a sender to a receiver
via some medium. The receiver then decodes the message and gives
the sender a feedback. All forms of communication require a sender, a
message, and an intended recipient, however the receiver need not be
present or aware of the sender's intent to communicate at the time of
communication in order for the act of communication to occur.

CONCLUSION
Communication is a process of interchange of information
between two [Link] is the only way one can express his thoughts,
feelings and emotions. So, as nurses we should develop the skills in

63
communicating with the client as well as with the health personnel in
health care settings. Communication also helps us in our normal life
situations.

SUBMITTED TO:
SUBMITTED BY:

[Link] Madam ,
K.K. Shiny john

64
Lecturer MSc(Nursing )
Iyr
MSc(Nursing),
EBMCON

BIBLIOGRAPHY

 Anisha Maheshwari, text book of communication, educational

technology for nurses, published by NR. Brothers, page No: 2-6,
30-53
 [Link] Sheeba text book of communication and educational
technology, frontline publications, page No:1-16
 [Link] text book of preventive and social medicine, published by
Banarsidas Bhanot, page No: 654,655
 Barbara Kozier, Glenora Erb, Audrey Berman, Shirley Snyder text
book of fundamentals of nursing concepts, process and practice
published by pearson education, page No:420-440.
 [Link] [Link]

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66