COMMUNICATION
DOMINGO T. SO, JR.
COMMUNICATION
• Ongoing, dynamic series of events that
involves the transmission of meaning
from sender to receiver
DOMINGO T. SO, JR.
COMMUNICATION
PROCESS
DOMINGO T. SO, JR.
BASIC ELEMENTS
OF THE
COMMUNICATION
PROCESS
DOMINGO T. SO, JR.
COMMUNICATION PROCESS
REFERENT:
• Motivates one person to communicate with
other
• sights, sounds, odors, time schedules,
messages, objects, emotions, sensations,
perceptions, ideas, and other cues initiate
communication
DOMINGO T. SO, JR.
COMMUNICATION PROCESS
SENDER:
• The person who encodes and delivers the
message
RECEIVER:
• The person who receives & decodes the
message
DOMINGO T. SO, JR.
COMMUNICATION PROCESS
MESSAGE:
• The content of communication
• Contains verbal, non-verbal & symbolic
language
DOMINGO T. SO, JR.
COMMUNICATION PROCESS
CHANNELS:
• Means of conveying & receiving messages
thru visual, auditory & tactile senses
DOMINGO T. SO, JR.
COMMUNICATION PROCESS
FEEDBACK:
• The message the receiver returns
• Indicates whether the receiver understood
the meaning of the sender’s message
DOMINGO T. SO, JR.
COMMUNICATION PROCESS
INTERPERSONAL VARIABLES:
• Factors within both the sender and receiver
that influence communication
– Perception – Sociocultural
– Educational & backgrounds
developmental levels – Values & beliefs
– Gender – Emotions
– Physical health status
DOMINGO T. SO, JR.
– Roles & relationships
COMMUNICATION PROCESS
ENVIRONMENT:
• Setting for sender-receiver interaction
• need to meet participant needs for physical
& emotional comfort & safety
DOMINGO T. SO, JR.
OR M S
FMODES OF COMMUNICATION
FORMS / MODES
1. VERBAL
–Spoken or written word
2. NON-VERBAL
–Gestures,
DOMINGO T. SO, JR.
–facial expression
1. VERBAL
• CONSCIOUS
– people choose what they want to say
–It varies from :
•culture to culture,
•socioeconomic background
•Age
•education
DOMINGO T. SO, JR.
1. VERBAL
• Things to consider in verbal communication:
•Pace & intonation
•Simplicity
•Clarity & brevity
•Timing and relevance
•Adaptability
•Credibility & humor
DOMINGO T.•Humor
SO, JR.
PACE & INTONATION
It creates
• Manner of speech impact on
• Rate or rhythm and message
• Tone (express anger sadness…..)
DOMINGO T. SO, JR.
SIMPLICITY
•Use of commonly used words
–Convert Medical terms
•Brevity (briefness)
DOMINGO T. SO, JR.
CLARITY & BREVITY
•Direct & simple
–Saying precisely what it means
•Congruence and consistency
DOMINGO T. SO, JR.
TIMING & RELEVANCE
•Appropriateness
–Relate to person’s interest &
concerns
–sensitivity
DOMINGO T. SO, JR.
ADAPTABILITY
•Adjustments
•In accordance with behavioral
cues from the client
–responses
DOMINGO T. SO, JR.
CREDIBILITY
•Worthiness of belief
•Trustworthiness & reliability
–Being consistent, dependable &
honest
DOMINGO T. SO, JR.
HUMOR
•Promoting a sense of well-being
–Consider client’s perception of
what is considered humorous
–Timing
DOMINGO T. SO, JR.
2. NON-VERBAL
• PERSONAL APPEARANCE
• POSTURE & GAIT
• FACIAL EXPRESSION
• EYE CONTACT
• GESTURES
• SOUNDS
• TERRITORY & PERSONAL SPACE
DOMINGO T. SO, JR.
PERSONAL APPEARANCE
•CLOTHING
–Convey social & financial status,
culture, religion, group
association, self-concept
•grooming
DOMINGO T. SO, JR.
POSTURE & GAIT
•Carry one’s self
–Indicator of self-concept, mood,
health
DOMINGO T. SO, JR.
FACIAL EXPRESSION
•Emotions & status conveyed by
facial expression
–Convey universal meaning
–Express a person’s genuine
emotion
DOMINGO T. SO, JR.
EYE CONTACT
•Determine readiness to communicate
•Shows respect & willingness to listen
(caution to some cultures)
•Lack of eye contact may indicate
anxiety, defensiveness, discomfort,
lack of confidence
DOMINGO T. SO, JR.
GESTURES
•Hand gestures emphasize and
clarify spoken words
•Indicate particular feeling or sign
DOMINGO T. SO, JR.
SOUNDS
•Communicate feelings & thoughts
•Sighs, moans, groans, sobs
•Help clear messages (validate)–
combined with non-verbal comm
DOMINGO T. SO, JR.
TERRITORIALITY & PERSONAL SPACE
TERRITORIALITY:
• Need to gain, maintain, defend one’s right to
space
–Gives people sense of identity, security &
control
DOMINGO T. SO, JR.
TERRITORIALITY & PERSONAL SPACE
PERSONAL SPACE:
• Is invincible, personalized & travels with the
person
• When threatened, people respond
defensively & communicate less
• Nurse needs to convey confidence,
gentleness & respect for privacy
DOMINGO T. SO, JR.
THANK YOU
FACTORS AFFECTING COMMUNICATION
FACTORS AFFECTING COMMUNICATION
1. VALUES & PERCEPTION (through the
patient’s eyes)
2. PHYSICAL AND EMOTIONAL FACTORS
3. DEVELOPMENTAL FACTORS
4. SOCIO-CULTURAL FACTORS
5. GENDER
DOMINGO T. SO, JR.
FACTORS AFFECTING COMMUNICATION
1. VALUES & PERCEPTION (through the
patient’s eyes):
–Patient’s values, preferences & cultural,
ethnic and social backgrounds
DOMINGO T. SO, JR.
FACTORS AFFECTING COMMUNICATION
2. PHYSICAL & EMOTIONAL FACTORS:
–Altered health states & human responses
•Limits communication
▪ Hearing/visual impairments
▪ Endotracheal intubation
▪ Aphasia
▪ Alzheimer’s/mental illness
▪ medications
DOMINGO T. SO, JR.
FACTORS AFFECTING
COMMUNICAN
3. DEVELOPMENTAL
FACTORS:
•Infants, children have
different ways to express
needs
•Get parents involved
•Those with special needs
DOMINGO T. SO, JR.
FACTORS AFFECTING COMMUNICAN
4. SOCIO-CULTURAL
FACTORS:
•Culture influences
thinking, feeling,
behaving and
communicating
•Avoid stereo-typing,
patronizing, or making
fun
DOMINGO T. SO, JR.
FACTORS AFFECTING COMMUNICAN
5. GENDER:
–Men tend to use less verbal
communication but likely to initiate
one
•More direct
–Women tend to disclose more
personal info, and use more active
listening
DOMINGO T. SO, JR.
THERAPEUTIC
COMMUNICATION
TECHNIQUES
DOMINGO T. SO, JR.
THERAPEUTIC
COMMUNIATION
TECHNIQUES
• Specific responses that
encourage the expression
of feelings & ideas and
convey acceptance and
respect
DOMINGO T. SO, JR.
THERAPEUTIC COMM TECHNIQUES
1. ACTIVE LISTENING 10. CLARIFYING
2. SHARING OBSERVATIONS11. FOCUSING
3. SHARING EMPATHY 12. PARAPHRASING
4. SHARING HOPE 13. ASKING RELEVANT
5. SHARING HUMOR QUESTIONS
6. SHARING FEELINGS 14. SUMMARIZING
7. USING TOUCH 15. SELF-DISCLOSURE
8. USING SILENCE 16. CONFRONTATION
9. PROVIDING INFORMATION
DOMINGO T. SO, JR.
1. ACTIVE
LISTENING
• Being attentive to what a
patient is saying both verbally
& non-verbally
– Enhances trust, project
acceptance and respect for
patient
– Skills that facilitate active
listening:
•SOLER
DOMINGO T. SO, JR.
1. ACTIVE LISTENING • SENDS
MESSAGE OF
S IT FACING THE PATIENT INTEREST
• Open to what
O • WILLINGNESS
BSERVE AN OPEN POSTUREpatient says
• TO LISTEN
Close position
L • conveys
Conveys defensive
EAN TOWARDS THE PATIENT• Involved and
attitude
involvement &
E interested
•willingness
Being comfortable
STABLISH & MAINTAING EYE CONTACTto
with the patient
listen
R
ELAX
DOMINGO T. SO, JR.
2. SHARING OBSERVATIONS
• Make observation by commenting on how the
other person looks, sounds, or acts
• Help start a conversation
• Do not use observations that will embarrass or
anger the patient
– “you look good today….”, “you look tired….”
DOMINGO T. SO, JR.
3. SHARING EMPATHY
• empathy is the ability to
understand & accept another
person’s reality, accurately
perceiving feelings
• Be sensitive and imaginative
• neutral & non-judgmental &
help establish trust in difficult
situations
DOMINGO T. SO, JR.
4. SHARING HOPE
• Hope is essential for healing
–By commenting on positive aspects of
person’s behavior, performance or
responses
• Nurse to communicate “sense of possibility” to
others
• Important in fostering hope & self-confidence
DOMINGO T. SO, JR.
5. SHARING
HUMOR
• Any intervention that
promotes health &
wellness by stimulating
a playful discovery,
expression or
appreciation
• Humor provides
emotional support to
patients and humanizes
the illness experience
DOMINGO T. SO, JR.
• Help patient express
emotions by making
observations,
acknowledging
feelings,
encouraging
communication,
giving permission to
express negative
feelings & modeling
healthy emotional
6. SHARING FEELINGS self-expression
DOMINGO T. SO, JR.
7. USING TOUCH
• one of the most potent form of
communication
• Comfort touch (such as holding a
hand) is important for vulnerable
patients who are experiencing
severe illness
• Should be gentle, comforting,
non-threatening manner
DOMINGO T. SO, JR.
8. USING
SILENCE • Allow time for both patient and
nurse to observe one another, sort
out feelings, think about things to
say or how to say it
• Silence prompts some people to
DOMINGO T. SO, JR.
talk
9. PROVIDING INFORMATION
• Providing relevant info
tells people what they
need or want to know
–To make decisions
–Feel safe and secure
(removing anxiety)
DOMINGO T. SO, JR.
10. CLARIFYING
• Check if patient’s
understanding is
accurate
• Restate unclear or
ambiguous message to
clarify meaning
DOMINGO T. SO, JR.
11. FOCUSING
• Centers on the
key elements
or concepts of
a message
DOMINGO T. SO, JR.
12. PARAPHRASING
• Restating another’s
message more briefly
using one’s own words
DOMINGO T. SO, JR.
13. ASKING RELEVANT
QUESTIONS
• To seek information
needed for decision
making
– Ask one question at a
time
– Explore fully one topic
before moving to
another
– Be in logical sequence
DOMINGO T. SO, JR.
• A concise review of
key aspects of an
interaction
– Brings sense of
satisfaction and
closure to an
individual
conversation
– Helpful during
termination phase
of the
14. SUMMARIZING nurse-patient
relationship
DOMINGO T. SO, JR.
15. SELF-DISCLOSURE
• Subjectively true personal
experience about the self that
are intentionally revealed to
another person
–It shows the patient that the
nurse understands their
experiences
DOMINGO T. SO, JR.
16. CONFRONTATION
• Help person become more aware of
inconsistencies in his or her feelings,
attitudes, beliefs and behaviors
–Improves patient’s self-awareness
–Use of this technique only after nurse
established trust
DOMINGO T. SO, JR.
DOMINGO T. SO, JR.
DOMINGO T. SO, JR.
DOMINGO T. SO, JR.
NONTHERAPEUTIC
COMMUNICATION
(BARRIERS)
TECHNIQUES
DOMINGO T. SO, JR.
•Communication techniques that
hinder or damage professional
relationships
–Often causing patients to activate
defenses to avoid being hurt or
negatively affected
DOMINGO T. SO, JR.
NONTHERAPEUTIC COMM
1. Asking Personal 8. Approval or
questions disapproval
2. Giving personal opinions 9. Defensive responses
3. Changing the subject 10. Passive or aggressive
4. Automatic responses responses
5. False reassurance 11. Arguing
6. Sympathy
7. Asking for explanations
DOMINGO T. SO, JR.
1. ASKING PERSONAL QUESTIONS
• Asking personal questions
that are not relevant to the
situation
–Simply to satisfy curiosity
DOMINGO T. SO, JR.
2. GIVING PERSONAL OPINIONS
• Take decision-making away from the patient
• Inhibits spontaneity, creates doubt
• Differs from professional advise
DOMINGO T. SO, JR.
3. CHANGING THE SUBJECT
• Changing the subject when another is trying
to communicate their story is rude
• Tends to block further communication
• Thoughts are interrupted
DOMINGO T. SO, JR.
4. AUTOMATIC RESPONSES
• Stereotyping
–Generalized beliefs held about people
• Reflects poor nursing judgment & threatens
nurse-patient relationship
DOMINGO T. SO, JR.
5. FALSE REASSURANCE
• Offering reassurance not supported by facts
• does more harm than good
DOMINGO T. SO, JR.
6. SYMPATHY
• Concern, sorrow or pity felt for patient
• Takes patient’s problems as if they were
his/her own
DOMINGO T. SO, JR.
7. ASKING FOR EXPLANATIONS
• Asks patient to explain why he/she believes,
feels or acts in certain ways
• “WHY” questions cause resentment,
insecurity, and mistrust
DOMINGO T. SO, JR.
8. Approval or disapproval
• People have the right to be themselves &
make their own decisions
• Judgmental responses contain: “should,
ought, bad, right”
• Implies that patient needs to meet nurse’s
expectations
DOMINGO T. SO, JR.
9. DEFENSIVE RESPONSES
• Patient’s concerns are ignored when nurse
focuses on the need for self-defense or
defense of others
DOMINGO T. SO, JR.
10. PASSIVE OR AGGRESSIVE RESPONSES
• Passive responses serve to avoid conflict or
issues
• Aggressive responses provoke
confrontation at the other’s expense
DOMINGO T. SO, JR.
11. ARGUING
• Challenging
• Arguing against patient
• denies that they are real or valid or truthful
DOMINGO T. SO, JR.
HELPING
RELATIONSHIP
DOMINGO T. SO, JR.
HELPING RELATIONSHIP
• Intellectual and emotional bond between the nurse
and client
– Focus on the client’s well-being
– Based on mutual trust, respect and acceptance
• Respecting client’s
– Individuality
– Confidentiality
DOMINGO T. SO, JR.
HELPING RELATIONSHIP
Growth facilitating process that strives to achieve:
1. Help clients manage their own problems in living
more effectively
2. Help clients become better at helping
themselves
3. Help clients develop an action-oriented
prevention mentality
DOMINGO T. SO, JR.
PHASES HELPING RELATIONSHIP
1. Preinteraction phase
2. Introductory phase
3. Working phase
4. Termination phase
DOMINGO T. SO, JR.
1. PREINTERACTION PHASE
• Similar to planning stage before an interview
– Gather information about the client before the
first face-to-face meeting
– Name, age, medical history,
DOMINGO T. SO, JR.
2. INTRODUCTORY PHASE
• Orientation phase
• Prehelping phase
• Sets the tone for the rest of the relationship
• Nurse and client observe each other & form
judgment about other’s behavior
• Nurse should develop trust and security
DOMINGO T. SO, JR.
2. INTRODUCTORY PHASE
• Resistive behavior
– Early part
– inhibit involvement, cooperation, or change
•an be overcome by conveying a caring attitude,
genuine interest in the client, and competence
DOMINGO T. SO, JR.
GOAL -INTRODUCTORY PHASE
• By the end of the phase, clients should begin to:
• Develop trust in the nurse.
• View the nurse as a competent professional capable of helping.
• View the nurse as honest, open, and concerned about their welfare.
• Believe the nurse will try to understand and respect their cultural values & beliefs.
• Believe the nurse will respect client confidentiality.
• Feel comfortable talking with the nurse about feelings & other sensitive issues.
• Understand the purpose of the relationship and the roles.
• Feel that they are active participants in developing a mutually agreeable plan of
care.
DOMINGO T. SO, JR.
3. WORKING PHASE
Nurse must have:
• Empathetic listening
• Nurse & client begins to view each other as unique
and responding
individuals • Respect
• Development of caring • • Client must
Genuineness make
decisions and take
• Concreteness
2 major stages: action to become more
• Confrontation
1. exploring and understanding thoughts
effective and
feelings • Nurse collaborates in
these decisions,
2. facilitating and taking action
provides support, and
may offer options or
DOMINGO T. SO, JR.
4. TERMINATION PHASE
• often expected to be difficult and filled with
ambivalence
Methods:
• Summarizing or reviewing the process
• express their feelings about termination openly and
honestly
• Follow-up phone calls or e-mails – help ease
client’s transition
DOMINGO T. SO, JR.
SBAR
DOMINGO T. SO, JR.
SBAR
• Situation, Background, Assessment,
Recommendations
• a standardized framework for communicating important
information.
– improve professional communication
USE IN:
• Docu about a change in a client’s condition, providing shift
reports, giving reports on clients being transferred within or
outside the health facility, and sending clients for procedures
DOMINGO T. SO, JR.
DOMINGO T. SO, JR.
DOMINGO T. SO, JR.
DOMINGO T. SO, JR.