OTHERS!

• Factors that Affect Communication

  1. Personal factors
  2. Environmental factors
  3. Relationship factors
• Posture, body movement, gestures, gait

  Body behaviors
• The patient is slumped in a chair, puts her face in her hands and occasionally taps her right foot

  Body behaviors
• Frowns, smile, grimaces, raised eyebrows, purses lip, licking of lips, tongue movements

  Facial expressions
• The patient grimaces when speaking to the nurse; when alone he smiles and giggles to himself

  Facial expressions
• Angry, suspicious, accusatory looks

  Eye cast
• The patient eyes hardened with suspicious

  Eye cast
• Tone, pitch, level, intensity, infliction, stuttering, pauses, silences, fluency

  Voice-related behaviors
• The patient talks in a loud sing-song voice

  Voice-related behaviors
• Increase in respiration, diaphoresis, pupil dilatation, blushing, paleness

  Observable autonomic-physiological responses
• When the patient mentions discharge she becomes pale, her respirations increase, and her face becomes diaphoretic

  Observable autonomic-physiological responses
• Grooming, dress, hygiene

  Personal appearance
• The patient is dressed in wrinkled shirt and his pants are stained; his socks are dirty and he is unshaven

  Personal appearance
• Height, weight, physique, complexion

  Physical characteristics
• The patient appears grossly overweight and hsi muscles appear flubby

  Physical characteristics
• Is the study of distance between people during communication

  Proxemics
• (0-18 inches between people): This amount of space is comfortable for parents with young children, people who mutually desire personal contact, or people whispering. Invasion of this intimate zone by anyone else is threatening and produces anxiety

  Intimate zone
• (18-36 inches): The distance is comfortable between family and friends who are talking

  Personal zone
• (4-12 feet): The distance is acceptable for communication in social work, and business settings

  Social zone
• (12-25 feet): This is an acceptable distance between speaker and an audience, small groups, and other informal functions

  Public zone
• The therapeutic communication interaction is most comfortable when the nurse and client are (distance)

  3 to 6 feet apart
• Type of touch used in examinations or procedures such as when the nurse touches a client to assess skin turgor or a masseuse perform a massage

  Functional-professional touch
• Type of touch used in greeting, such as handshake and the "air kisses" some women use to greet acquaintances, or when a gentle hand guides someone in correct direction

  Social-polite touch
• Type of touch involves a hug in greeting, an arm thrown around the shoulder of a good friend, or the backslapping some men use to greet friends and relatives

  Friendship-warmth touch
• Type of touch involves tight hugs and kisses between lovers or close relatives

  Love-intimacy touch
• Used by lovers

  Sex-arousal touch
• Refraining from other internal mental activities and concentrating exclusively on what the client says

  Active listening
• Watching the speaker's nonverbal actions as he or she communicates

  Active observation
• Series of interaction between the nurse and the patient in which the nurse assists the patient to attain positive behavioral change

  Nurse patient relationship
• Characteristics of NPR

  G- goal oriented

  F- focused on the needs of the patient

  P- planned

  T- time limited

  P- professional
• Elements of NPR

  T- trust

  R- rapport

  U- unconditional

  S- setting limits

  T- therapeutic communication
• Trusting behaviors

  Trust is built in the nurse-client relationship when the nurse exhibits the following behaviors:

  Friendliness

  Caring

  Interest

  Understanding

  Consistency

  Treating other client as human being

  Suggesting without telling

  Approachability

  Listening

  Keeping promises

  Providing schedules of activities

  Honesty
• Phases of Trusting Behaviors

  1. Pre-interaction phase
  2. Orientation phase
  3. Working phase
  4. Termination phase
• When to terminate NPR

  1. When goals have been accomplished
  2. when the patient is emotionally stable
  3. When the patient exhibits greater independence
  4. When the patient able to cope with anxiety separation, fear and loss
• How to terminate

  1. Gradually decrease interaction
  2. Focus in future oriented topics
  3. Encourage expression of feelings
  4. Make the necessary referral
• Common Problems affecting NPR

  1. Transference
  2. Countertransference
  3. Resistance
• Level of intervention aimed at the promotion of mental health and lowering the rate of cases by altering the stressors

  Primary
• Health education, information dissemination, counseling

  Primary
• Level of intervention that limit the severity of a disorder

  Secondary
• 2 components of Secondary Intervention

  1. Case finding
  2. prompt treatment