Chapter 23

Communication

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 Communication and
Interpersonal Relationships
• Vehicle for establishing a therapeutic
relationship
• Means of influencing the behavior of
another to lead to successful
outcomes

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Levels of Communication

• Intrapersonal
• Interpersonal
• Transpersonal
• Small group
• Public

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 Basic Elements of
Communication
• Referent
• Sender and receiver
• Messages
• Channels
• Feedback
• Interpersonal variables
• Environment
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Forms of Communication

• Verbal
• Nonverbal
• Symbolic
• Metacommunication

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 Verbal Communication

• Vocabulary
• Denotative and connotative meaning
• Pacing
• Intonation
• Clarity and brevity
• Timing and relevance

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 Nonverbal Communication

• Personal appearance
• Posture and gait
• Facial expression
• Eye contact
• Gestures
• Sounds
• Territoriality and personal space
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 Zones of Personal Space

• Intimate zone: 0 to 18 inches

• Personal zone: 18 inches to 4 feet
• Social zone: 4 to 12 feet
• Public zone: 12 feet and beyond

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 Professional Helping
Relationships
• Nurse—client
• Nurse—family
• Nurse—health team
• Nurse—community

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 Elements of Professional
Communication
• Courtesy
• Use of names
• Privacy and confidentiality
• Trustworthiness
• Autonomy and responsibility
• Assertiveness

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 Communication in the
Nursing Process
• Assessment
– Physical and emotional factors
– Developmental factors
– Sociocultural factors
– Gender

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 Communication in the
Nursing Process (cont’d)
• Nursing diagnosis examples
– Impaired verbal communication
– Anxiety
– Social isolation
– Ineffective coping
– Impaired social interaction
– Powerlessness

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 Communication in the
Nursing Process (cont’d)

• Planning
– Goals and outcomes
– Priorities
– Continuity of care

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 Communication in the
Nursing Process (cont’d)

• Implementation
– Therapeutic communication techniques

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 Therapeutic Communication
Techniques
• Active listening (SOLER)
• Sharing observations
• Sharing empathy
• Sharing hope
• Sharing humor
• Sharing feelings

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 Therapeutic Communication
Techniques (cont’d)
• Using touch
• Using silence
• Providing information
• Clarifying
• Focusing
• Paraphrasing

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 Therapeutic Communication
Techniques (cont’d)
• Asking relevant questions
• Summarizing
• Self-disclosure
• Confrontation

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Nontherapeutic Communication
Techniques
• Asking personal questions
• Giving personal opinions
• Changing the subject
• Automatic responses
• False reassurance
• Sympathy

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Nontherapeutic Communication
Techniques (cont’d)
• Asking for explanations
• Approval or disapproval
• Defensive responses
• Passive or aggressive responses
• Arguing

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 Communication in the
Nursing Process
• Implementation
– Adapting communication techniques for
clients with special needs

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 Communication in the
Nursing Process (cont’d)
• Evaluation
– Analysis of communication patterns
– Process recordings

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