Chapter I INTRODUCTION Nursing is a caring profession. It is also a profession that is more and more evidenced based in practice.

In as much as the scientific aspects of nursing is increasing due to the complex technological advancement of medicine and the machinery that is used at the patients bedside, the fact remains that the nurse is the first person that the client usually comes in contact with in any emergency or hospital setting. With caring comes the trained ability of the nurse to facilitate therapeutic communication. With therapeutic communication, the sender, or nurse seeks to illicit a response from the receiver, the patient that is beneficial to the patients mental and physical health. Just as stress has been proven to adversely affect the health of individuals, the therapeutic approach to communication can actually help. The nurse establishes and maintains this key relationship by using nursing knowledge and skills, as well as applying caring attitudes and behaviors. Therapeutic nursing services contribute to the clients health and well-being. The relationship is based on trust, respect, empathy and professional intimacy, and requires appropriate use of the power inherent in the care providers role. Nonverbal communication has a greater impact than verbal communication and yet not enough attention in nursing is focused on this area in communication training programs. (Krujiver et. al. 2000).

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Conscious of the fact that rendering therapeutic communication in different field of nursing, we could say that psychiatric field is more different rendering therapeutic communication from all other field. Communicating with a person you know that suffers from a mental illness can definitely be challenging. We also have encountered issues regarding the worst treatment of the staff nurses to their psychiatric patients. We would like to know if the staff nurses nowadays can provide a good quality of therapeutic communication. As a student nurse, we would like to learn how to render and apply therapeutic communication to this special area of nursing, psychiatric nursing. The therapeutic approach to communication can actually be a very good aid and in any given situation, communication is always utilized. People can make a big difference when they show sincere care to their patient in their movements and actions. It makes a huge in patients satisfaction and other outcomes such as compliance with treatment, participation in important treatment decisions, and even psychological adjustment. A good non-verbal skill will make patients think that a person is effective as caregiver and a communicator to them. (Baile, 2008)

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Review of Related Literature Therapeutic Communication Communication can be defined as "the process of transmitting messages and interpreting meaning" (Wilson and others, 1995 ). It is the act or reciprocal process of imparting or interchanging thoughts, attitudes, emotions, opinions, or information by speech, writing, or signs. Nurses can use this dynamic and interactive process to motivate, influence, educate, facilitate mutual support, and acquire essential information necessary for survival, growth, and an overall sense of well-being (Howells, 1975; Kleinman,

2004).Communication is essential for nurses to develop and maintain competent communication and interpersonal skills. Effective communication skills are required to facilitate therapeutic interactions, assess client need, and implement interventions that promote an optimal level of functioning. Early forms of communication and interactions with primary caregivers are the origin of trust, security and safety, and lifelong interpersonal relationships and communication patterns (Antai-Otong & Wasserman, 2003). Thus in the communication process, communication is defined as the exchange of thoughts, feeling, and other information. It is the interchange of information between two or more people; in other words the exchange of ideas or thoughts. It is where thoughts are conveyed to others not only by spoken or written words but also by gestures or body actions. It can be transmission of feelings or a more personal and social interaction between people.

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It is a basic component of human relationships. The intent of any communication is to elicit a response. It includes all the techniques by which an individual affects another. The two main purpose of communication are to influence others and to obtain information. In its simplest form, communication is a two way process involving the sending and the receiving of a message. The sender a person or groups who wish to convey a message to another can be considered the source-encoder. This term suggest that the person or group sending a message must have an idea or reason communicating (source) and must put the idea or feeling into a form that can be transmitted. Encoding involves the selection or specific signs or symbol (codes) to transmit the message such as which language and words to use how to arrange the words to use how to arrange the words and what tone of voice and gestures to use. The second component of the communication process is the message itself what is actually said or written the body language that accompanies the words and how the message is transmitted. The medium used to convey the message is the channel and it can target any of the receivers senses. It is important for them to be appropriate for the message and it should help make the intent of the message clearer. The receivers, the third component of the communication process, is the listener who must listen observe and attend. This person is the decoder who must perceive what the intended (interpretation). Perception uses all of the senses receive verbal and nonverbal messages. The fourth component of the communication process, the response, is the message that the receiver returns to the sender is

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also called feedback. Feedback can be either verbal or non verbal or both. Nonverbal examples are a nod of the head or a yawn. Either way feedback allows the sender to correct or record message (Kleinman, 2004).

According to the dyadic interpersonal communication model described by Berlo in 1960, communication is a dynamic interaction that consists of a source, who has a purpose that is understandable to another person, and an encoder, who is able to understand the meaning of the message. The message is processed and decoded and understood by the recipient, or decoder. In essence, people must convey clear messages if they expect the information to be understood. Two major modes of communication. There are two major modes of

communication. One is verbal communication which is largely conscious because people choose the words they use. The words used vary among individuals according to culture socioeconomic background, age, and education. As a result countless possibilities exist for the way ideas are exchange. An abundance of word can be used to form messages. In addition, a wide variety of feelings can be conveyed when people talk. When choosing words to say or write, nurses need to consider. Second is nonverbal communication which is sometimes called body language. It includes gestures body movements use of touch and physical appearance including adornment. Nonverbal communication often tells other more about what a person is felling than what is actually said because nonverbal behavior is

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controlled less consciously than verbal behavior. Nonverbal communication either reinforces or contradicts what is said verbally. Touch is one of the most universal nonverbal way to communicate, caring and much of nursing practices consist of using touch to carry out technical tasks. Touch is a key therapeutic tool. It is an adjunct to verbal psychotherapy (Suddan and Dullan, 2000).

Principles of Communication. Acceptance is one of the principles needed by the nurse to bear in mind, favorable reception of another person by implying a client has the right to exist, to live and to have somebody to care about. Second is interest, nurses communicate when they are genuinely curious and express a desire to know another person. Interest is conveyed by asking about those aspects of a clients life that others often reject. Another is show consideration for another by communicating their willingness to work with the client and accept the clients ideas, feelings, and rights. This is all conveyed with respect. Next is honesty, nurses must show consistency, open and frank. Nurses do not take refuge behind a professional mask but instead communicate with the client as an authentic person. Nurses must be honest and non-defensive about their thoughts and feelings that they discover through self-assessment. Also concreteness is one of the principles of therapeutic communication, being specific, to the point and clear when they communicate with the client should be practiced. Clients who speak in vague, general, unfocused ways are helped to be more specific and focused. And the sixth is assistance, nurses assist clients by committing

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time and energy to therapeutic relationships. They convey that they are present and available and have tangible aid to offer that will help the client to choose and develop more functional ways of living. Permission also is a principle; nurses communicate permission by conveying the massage that it is acceptable to try new ways of behaving. Often clients are afraid to choose freely and autonomously. They are bound by misconceived archaic rules and magical thinking and need to be given permission and encouragement to see and to things in new ways. Lastly the principle of protection, nurses protect clients by ensuring clients safety, and assumes responsibility of working with the client to anticipate trouble spots with new behavior and develop effective ways of dealing with anticipated or actual problems, thus maximizing the possibility of success (Haber et al., 2007). Barriers to Therapeutic Communication. Giving advice is a barrier to good therapeutic communication. The nurse offers solutions and advices the client about what course of action to take. This approach denies the clients ability to formulate solutions to problems and assume responsibility for direction of his/her life. Second is giving assurance, nurses offer information to the client that it is not based on fact and truth and differs from conveying information or giving realistic feedbacks. Reassurance denies the clients right to the feelings being experienced and closes off communication about them. Next is changing the subject. The nurse diverts the focus of the interaction at crucial times to something less threatening. Changing the subject usually occurs when the nurse is unwilling or unable to lessen the painful feelings being expressed by the client. Also being judgmental is a barrier to good therapeutic communication. The nurse respond to the client with value-laden

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judgments that come form the nurses value system. The fifth barrier is giving directions. The nurse approaches the client with specific directions to be followed and frequently lectures the client about advisability of following this course of action. Sixth is excessive questioning, on the part of the nurse it controls the nature of range of the clients responses. The nurse can be perceived by the clients as an interrogator who is demanding information with out respect for the clients ability or readiness to respond. Another one is using emotionally charged words. The nurse uses emotionally charged words with the client who cannot tolerate or accept such feelings. The client may withdraw physically and emotionally. Next is challenging, nurse sometimes feels that if the client is challenged to prove unrealistic ideas or perception, the client will realize that there is no proof to support such ideas and will be forced to acknowledge what is true. Making stereotypical comments is also a barrier.

Offering trite expressions and meaningless clithes as responses diminishes the value of the nurse-client interaction. The tenth barrier is self focusing behavior. It is characterized by the nurses excessive interest in or preoccupation with his/her own thoughts, feelings, or actions. And lastly is double-bind message. The nurse delivers two conflicting messages, one verbal, the other is nonverbal. The nonverbal message contradicts the verbal message. It is unclear which message is to be obeyed. Public Distance: 12 to 25 feet. It is important for the nurse to respect comfort zone and be aware of any boundary violations that may threaten ones safety.

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Therapeutic Techniques. The nurse can use collaborative interaction to assess the clients needs, formulate the client outcomes, and evaluate the effectiveness of interventions. Therapeutic techniques include: Active listening is the basis of all nurse client interactions. Listening is more than hearing. It is a dynamic and active process that requires enormous concentration and energy. It literally means using all the senses to assess verbal and nonverbal message. Active Listening conveys concern and respect for the client. It fosters

a trusting relationship that encourages the client to express feelings and share thought. Knowing the patient and encouraging her to tell their story. Students and nurse clinicians can enhance their communication skill by identifying barriers to active listening. The art of active listening requires perseverance and patience. Questioning is a valuable tool that nurse use to encourage the expression and feelings and self-disclosure and to gain insight into the meaning of present stressors. The basis of the client response depends on her level of trust and security or in the comfort with questions. Nurse can put their clients at ease by introducing themselves and calling them by name, making eye contact and shaking hands at the same time helps nurses connect with clients both verbally and nonverbally. This establishes a safe environment that promotes trust, care, and empathy. The nurse can use questioning as a tool to elicit pertinent information from the client. Clarifying techniques refers to the use of certain methods to clear up or make message understandable. Communication is complex, dynamic process that involves interaction between people. The likelihood of confusion exists in all human interactions. Specific clarifying techniques are paraphrasing or restatements.

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Paraphrasing involves listening to the client basic message and repeating them using similar words. This technique focuses on the content of the message. It affords the nurse with a clearer understanding of the client distress. Touching is another powerful, sometimes

controversial nonverbal communication. It is critical aspect of human relationships throughout the lifespan. Touching is the key to survival, particularly during infancy, because it conveys trust, safety, and love, and it nurtures neurobiological and psychosocial development. Therapeutic touch enables the client to experience trust, reassurance, and acceptance. Silence is a natural phenomenon; it is deliberate restraint from verbal expression. Therapeutic use of silence is another effective communication technique, but it requires practice and skill to master. Silence can be use to help clients explore the meaning of feelings and thoughts. Humor is important but underutilized therapeutic communication techniques. It values includes physiological, psychological, social, and cognitive benefits. Physiologically, it stimulates the circulatory and respiratory system, relaxes the muscle and increase the productions of endorphins. Humor helps client express their feeling, thereby reducing anxiety and tension or stress particularly during intense situations. Focusing refers to clarifying a perception or spotlighting certain aspects of communication. This technique is useful when clients are vague and need assistance with goal directed communication. Focusing is useful when clients don not express their feelings clearly, when they ramble, or when they discussed several issue at one time. Confrontation refers to an encounter or face-to-face meeting. Nurses often associate this term with conflict or angry discussion between opposing bodies. In reality, confrontation is necessary aspects of Nurse-

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clients interaction. Like other techniques, it is and art that involves pointing out contradictions or incongruities between feelings, thoughts, and behaviors. Summarizing is a communication tool that helps clients explores key points of a nurse-client interaction. This dynamic and collaborative process integrates perceptions from the nurse and client. Major points are reviewed and used to generate future client outcomes.

Watsons Ten Carative Factors Watsons ten carative factors form a framework for understanding nursing as the Science of caring. Watson (1985) uses the term carative instead of curative to distinguish between nursing and medicine. Whereas curative factors aim at curing the patient of disease, carative factors aim at the caring process that helps the person attain (or maintain) health or die a peaceful death (Watson, 1985). Nurses would use these carative factors in the delivery of health care to their clients. The Formation of a Humanistic- Altruistic System of Values . This begins developmentally at an early age with values shared with the parents. It is mediated through ones own life experiences, the learning one gains exposure to the humanities. It is also perceived as necessary to the nurses own maturation which then promotes altruistic behavior towards others.

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Installation of Faith-hope. Faith-hope is essential to both the carative and the curative processes. When modern science has nothing further to offer the person, the nurse can continue to use faith-hope to provide a sense of well-being through beliefs which are meaningful to the individual. The Cultivation of Sensitivity to Ones Self and to Others. Cultivation of sensitivity to ones self and to others explores the need of the nurse to begin to feel an emotion as it presents itself. Development of ones own feeling is needed to interact genuinely and sensitively with others. Striving to become sensitive, makes the nurse more authentic, which encourages self-growth and self-actualization, in both the nurse and those with whom the nurse interacts. The nurses promote health and higher level of functioning only when they form person to person relationship. The Development of a Helping-Trust Relationship. Establishing a helping-trust relationship is one of the strongest tool in the mode of communication, which establishes rapport and caring. Watson has defined the characteristics needed to in the helping-trust relationship. These are Congruence, Empathy and Warmth. Communication includes verbal, nonverbal and listening in a manner which connotes empathetic understanding. The promotion and acceptance of the expression of positive and negative feelings. The expression of feelings, both positive and negative . According to Watson, feelings alter thoughts and behavior need to be considered and allowed for in a caring relationship.

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She added that such expression improves ones level of awareness. Awareness of the feelings helps to understand the behavior it engenders. The Systematic Use of the Scientific Problem-Solving Method for Decision Making. According to Watson, the scientific problem- solving method is the only method that allows for control and prediction, and that permits self-correction. She also values the relative nature of nursing and supports the need to examine and develop the other methods of knowing to provide an holistic perspective. The science of caring should not be always neutral and objective. Promotion of Interpersonal Teaching-Learning. The caring nurse must focus on the learning process as much as the teaching process. Understanding the persons perception of the situation assist the nurse to prepare a cognitive plan. Provision for a supportive, protective and /or corrective mental, physical, socio-cultural and spiritual environment. Watson divides these into eternal and internal variables, which the nurse manipulates in order to provide support and protection for the persons mental and physical well-being. The external and internal environments are interdependent. Watson suggests that the nurse also must provide comfort, privacy and safety as a part of this carative factor. Assistance with the gratification of human needs. It is grounded in a hierarchy of need similar to that of the Maslows. She has created a hierarchy which she believes is relevant to the science of caring in nursing. According to her each need is equally important for quality nursing care and the promotion of optimal health. All the needs deserve to be attended to and valued.

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Allowance for Existential-Phenomenological Forces. Phenomenology is a way of understanding people from the way things appear to them, from their frame of reference. Existential psychology is the study of human existence using phenomenological analysis. This factor helps the nurse to reconcile and mediate the incongruity of viewing the person holistically while at the same time attending to the hierarchical ordering of needs.Thus the nurse assists the person to find the strength or courage to confront life or death. The Four Major Concepts of Watsons Theory Human Being. She adopts a view of the human being as: .. a valued person in and of him or herself to be cared for, respected, nurtured, understood and assisted; in general a philosophical view of a person as a fully functional integrated self. He, human, is viewed as greater than and different from, the sum of his or her parts. Health Watson believes that there are other factors that are needed to be included in the WHO definition of health. She adds the following three elements:A high level of overall physical, mental and social functioning. Environment/Society. According to Watson caring (and nursing) has existed in every society. A caring attitude is not transmitted from generation to generation. It is transmitted by the culture of the profession as a unique way of coping with its environment.

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Relationship-centered care reflects both knowing and feeling: thev knowledge that physician and patient bring from their respective domains of expertise, and the physician's and patient's experience, expression, and perception of emotions during the medical encounter. These processes are conveyed and reciprocated in the care process through verbal and nonverbal communication. We suggest that the emotional context of care is especially related to nonverbal communication and that emotionrelated communication skills, including sending and receiving nonverbal messages and emotional self-awareness, are critical elements of high-quality care. Although nonverbal behavior has received far less study than other care processes, the current review argues that it holds significance for the therapeutic relationship and influences important outcomes including satisfaction, adherence, and clinical outcomes of care. We define nonverbal behavior to include a variety of communicative behaviors that do not carry linguistic content.4 Briefly, these include (among others) facial expressivity, smiling, eye contact, head nodding, hand gestures, postural positions (open or closed body posture and forward to backward body lean); paralinguistic speech characteristics such as speech rate, loudness, pitch, pauses, and speech dysfluencies; and dialogic behaviors such as interruptions. Nonverbal behavior is widely recognized as conveying affective and emotional information, although it has other functions as well (such as regulating turn-taking in conversation). As examples, a frown may convey disapproval or a smile may convey approval or agreement. A blank expression may also convey an affective message to a

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perceiver, such as aloofness, boredom, or dismissal. Nonverbal behaviors often (although not always) accompany words and thereby give words meaning in context (e.g., by amplifying or contradicting the verbal message). So, the interpretation of a verbal message of agreement (Sure, that's fine) may be interpreted differently depending on whether the statement is accompanied by a frown or a smile or a blank expression(Deborah L. Roter Dr. PH Journal. 2006

In summary, this article focuses on the forms of touch described in the first category, therapeutic touch. That is, touch that is intentionally incorporated as part of verbal therapy and most often includes a hug, light touch, stroke of head, rubbing of a client's back, shoulder or arm, rocking or hand-holding. The intent of these forms of touch, which are an integrated aspect of therapy, is to increase the sense of connection and relatedness with clients and/or to calm, sooth or reassure clients. Communicating With Mentally Ill Person Communicating with a person that suffers from a mental illness can definitely be challenging. Fortunately, there are many tools that can be used that will help the mentally ill and their relatives understand each other.

The most important tool in communicating with anybody - mentally ill or not is respect; treating the other person nicely. When someone feels respected and heard, they

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are more likely to be respectful and consider what the other person has to say. Relaxing and staying calm by starting a conversation with the expectation that things will go smoothly, minimizing distractions, and listening and making an eye-contact (unless this is threatening) are recommended. Simplifying by discussing one topic at a time, using "I-statements" not "you-statements", and acknowledging what the other person says and how they feel, even if it is not acceptable counts a lot. Paraphrasing; engaging the person in the process by asking for opinions and suggestions, watching out for contradictory messages between verbal and non-verbal messages, looking for common ground, focusing on observable facts, honestly sharing ones own feelings can reduce defensiveness on both sides. However, starting a conversation expecting a confrontation or approaching a person with ones defenses up will likely make the communication difficult, Don't criticize, accuse or blame, Don't assume. Clarify by asking questions, Don't expect the other person to "just understand. Avoid bringing up the diagnosis, Don't raise voice or attempt to intimidate or "discipline" the person, Don't use general and loaded words such as "always" or "never". Use specific words instead, Don't use sarcasm and avoid humor in difficult situations, Avoid sounding patronizing or condescending. Thus, it is very important not to give up. Try a technique a few times and if it doesn't work try it in a different way or in combination with another one. Satisfying communication can take time and lots of practice, but will be rewarding and improve everybody's quality of life.

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Theoretical Framework The nurse-client relationship in Hildegard E. Peplaus Interpersonal Relations Model theory is essential to nursing practice. It is the nurse-client interaction that is toward enhancing the client's well-being, and the client may be an individual, a family, a group or a community. Peplau (1996) thought the basic element of the relationship is what goes on between the nurse and patient (Interpersonal Theory). The relationship depends on the interaction of thoughts, feelings, and actions of each person. The patient will experience better health when all their needs are fully considered in the relationship. Her theory has been described as drawing from developmental interpersonal and learning theories. Peplau has defined nursing as, "a significant, therapeutic, interpersonal process that aims to promote

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a patient's health in the direction of creative, constructive, productive, personal, and community living". She considered the relationship between nurse and client the key to the nursing process and conceptualized the nurse-client relationship as developing through phases: orientation, identification, exploitation, and resolution. The nurse and client have changing goals and roles as they pass through each phase. She further described the phases as "overlapping" and "interlocking" . For example, the nurse and client may return to an earlier phase. After initial issues have been resolved during exploitation they may return to problem identification to identify new issues to work on. Within this theory, awareness of the current stage of the-relationship is essential for the nurse to plan appropriate interventions. Conceptual Framework Staff nurses provide services & render care to the patient by using verbal therapeutic communication that minimizes feeling of pain, uplifts confidence through the use of encouraging words, decreases tension, promote trust and non-verbal communication that gives them time to reflect, increases self-confidence by the use of friendly gestures, smiling to the patient when approaching & light tapping on the back among others. Through the nurse-patient interaction, patients in Cavite Center for Mental Health elicit responses which shows the effect of therapeutic communication on different aspect of their specially on physical, mental, emotional & social dimensions

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VERBAL THERAPEUTIC COMMUNICATION

NON-VERBAL THERAPEUTIC COMMUNICATION

Figure 1. Conceptual Paradigm shows the relationship between the nurses and the patients perception on the effect of verbal and non-verbal communication to the patients

Statement of the problem This study aimed to determine the relationship between the nurses and patients perception on the effect of Verbal and Non Verbal Therapeutic Communication to the patients at Cavite Center for Mental Health. Specifically, it sought answer to the following questions:
1. What is the extent of the effects of Verbal Therapeutic Communication used by the

staff nurses at Cavite Center for mental Health on the physical, emotional, mental and social dimensions of the patients as perceived by: a. Nurses

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b. Patients 2. What is the extent of the effects of Non-Verbal Therapeutic Communication used by

the staff nurses at Cavite Center for mental Health on the physical, emotional, mental and social dimensions of the patients as perceived by: a. Nurses b. Patients
3. Is there a relationship between the nurses and patients perception on the effects of

Verbal Therapeutic Communication to the patients?

4. Is there a relationship between the nurses and patients perception on the effects of

Non- Verbal Therapeutic Communication to the patients?

Hypothesis

H01: There is no relationship between the nurses and the patients perception on the effect of Verbal Therapeutic Communication to the patients.

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H02: There is no relationship between the nurses and the patients perception on the effect of Non-Verbal Therapeutic Communication to the patients.

Definition of Terms The following terms are defined operationally for better understanding. Therapeutic Communication This includes both verbal and non-verbal communication employed by the nurse in dealing with the patient aimed at promoting trust, rapport, genuineness and empathy and developing the physical & well-being of the patient. Verbal Communication It is a mode of communication wherein the staff nurses communicates with their patients with the use of voice, sound, speaking & language.

Non-Verbal Communication It is a mode of communication wherein the staff nurses communicates with their patients through wordless messages. It can be communicated through gestures & touch.

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Cavite Center for Mental Health This refers to a health facility that cater to mentally-ill patients and it is located at Trece Martires, Cavite. Nurse Patient Relationship A series of interaction between a nurse and a client over a period of time with the nurse focusing on the needs and problem of a person, family or group. Physical Dimension This refers to the effect of the verbal and non-verbal therapeutic communication on the patient in terms of minimizing the feeling of pain. Emotional Dimension This pertains to such effects of verbal and non-verbal therapeutic communication on the patient as uplifting confidence, giving opportunity to express feelings, decreasing tension and uncertainty and promoting trust. Mental Dimension This includes such effects of verbal and non-verbal therapeutic communication on the patient as gaining new knowledge through health teaching, giving time to reflect and giving chance to clarify unclear information.

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Social Dimension This refers to such effects of verbal and non-verbal therapeutic communication on the patient as developing harmony, develops good nurse-patient relationship, improving confidence, and helping to cope effectively.

Chapter 2 METHOD OF THE STUDY

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This chapter describes how the study was conducted. This includes the research design, the participants (population and samples), the setting, the measures (research

instruments/instrumentation), and the data gathering procedure. Research Design The study utilized descriptive correlational design to describe the relationship between the nurses and the patients perception on the effect of Verbal and Non-Verbal Therapeutic Communication to the patients. The data were gathered using questionnaires that we will use to evaluate the relationship between the effect of verbal and non-verbal therapeutic communication rendered by staff nurses at Cavite Center for Mental Health to the patients. Participants The study used purposive sampling. The researchers selected a total of 30 nurses composed of 6 male and 24 female currently working at Cavite Center for Mental Health and 20 patients who are in their rehabilitative stage - patients who are functional and able to regain or improve their coping abilitiy.

Setting

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The group selected Cavite Center for Mental Health located at Trece Martires, Cavite. The group has selected this location because it is a mental facility that caters to all kinds of patients with mental disorders. It is the only mental health facility in the entire province of Cavite. And also we have chosen this location because one of our group members, Jomachris Tejedor, has relative who is working here in the said located. Measures (Research Instruments/Instrumentation) The researchers used questionnaires to evaluate the relationship between the effect of verbal and non-verbal therapeutic communication rendered by staff nurses at Cavite Center for Mental Health to the patients. Two sets of questionnaires which were validated by Ms. Apolonia Reynoso, Mr. Rolando Daniel & Ms. Jocelyn Santos; were used in the study. The first set, set A. is for the staff nurses at Cavite Center for Mental Health and the other one, set B, is for the patients at the Rehab Department. Set A consists of two parts. Part I determined the staff nurses perception on the effect of verbal therapeutic communication while part II determined the staff nurses perception on the effect of non-verbal therapeutic communication to the patients. Set B also consists of two parts. Part I determined the patients perception on the effect of verbal therapeutic communication while part II determined the patients perception on the effect of non-verbal therapeutic communication to them. The questionnaires were translated to Filipino language for better understanding of the patients.

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The following scale were used to determine the extent of the effect of the of verbal and non-verbal therapeutic communication to the patients. Range 4.50 5.00 3.50 4.50 2.50 3.50 1.50 2.50 0.50 1.50 Qualitative Description -very high effect -high effect -moderate effect -limited effect -no effect

Procedure Data gathering period started from August 22-24, 2010. The evaluation tools were given to the Chief Nurse at Cavite Center for Mental Health who then distributed the questionnaires to the staff nurses involved in the study. On the other hand, the evaluation tools for the patients were distributed by the researchers themselves. They were given limited time to answer the questionnaires and divided them to five patients per batch to answer it. The reason behind this is that we cannot able to guard them all. The patients were given instructions on how to accomplish the evaluation tool. The respondents were assured of the confidentiality and anonymity of their responses.

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Chapter 3 RESULTS AND DISCUSSION

This chapter presents the data gathered from the participants. Analysis of the data provided answers to the problems raised in the study.

Perception on the Effect of Verbal Therapeutic Communication Verbal communication is largely conscious because people choose the words they use. The words used vary among individuals according to culture socioeconomic background, age, and education. As a result countless possibilities exist for the way ideas are exchange. An abundance of word can be used to form messages. In addition, a wide variety of feelings can be conveyed when people talk. When choosing words to say or write, nurses need to consider. Part I of the Perception Questionnaires for both the nurses and patients were used to determine the extent of the effects of Verbal Therapeutic Communication used by the staff nurses at Cavite Center for Mental Health on the physical, emotional, mental and social dimensions of the patients.

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Physical Dimension The effect of Verbal Therapeutic Communication on the patients physical dimension is measured in terms of minimizing the feeling of pain. Nurses perception is presented on Table 1. Four (4) out of thirty (30) nurses or 13% rated the item 5 which means very highly effective, thirteen (13) out of thirty (30) or 43% gave a rating of 4 which means highly effective, ten (10) out of thirty (30) or 33% gave an evaluation of 3 which means

moderately effective, three (3) out of thirty (30) or 10% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 3.60 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients physical dimension as measured in terms of minimizing the feeling of pain was highly effective. This implies that therapeutic conversation with the patient can alleviate if not diminish the pain experienced by the patient. On the other hand, the patients perception on the effect of Verbal Therapeutic Communication on the patients physical dimension as measured in terms of minimizing the feeling of pain is presented on Table 2. Twelve (12) out of twenty (20) nurses or 60% rated the item 5 which means very highly effective, two (2) out of twenty (20) or 10% gave a rating of 4 which means highly effective, three (3) out of twenty (20) or 15% gave an evaluation of 3 which means moderately effective, two (2) out of twenty (20) or 10% gave a rating of 2 which means limited effective, and one (1) out of twenty (20) or 5% gave a evaluation of 1 which means no effect. The mean rating of 4.1 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients physical

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dimension as measured in terms of minimizing the feeling of pain was highly effective. This implies that touch is a useful intervention to reduce the feeling of pain. According to Suddan and Dullan, touch is one of the most universal nonverbal way to communicate, caring and much of nursing practices consist of using touch to carry out technical tasks. Touch is a key therapeutic tool. It is an adjunct to verbal psychotherapy. As observed by Debra L. Roter, DrPH, finger pressure, grip, touches that feel good to the patient and to the other person produce sense of trust, excitement, and desire for closeness and psychologically transverse their negative feeling. Table 1 Nurses Perception on the Effect of Verbal Therapeutic Communication on the Patients (N = 30).
Dimension
Physical Emotional

Indicator/s 5
1. Minimizes the feeling of pain 1. Uplifts confidence 2. Gives opportunity to express feelings 3. Decreases tension 4. Decreases Uncertainty 5. Promotes trust 1. Gains new knowledge through health teachings 2. Gives time to reflect 4 (13%) 10 (33%) 15 (50%) 5 (17%) 11 (37%) 9 (30%) 12 (40%)

Frequency Rating 4 3 2
13 (43%) 15 (50%) 13 (43%) 20 (67%) 14 (47%) 17 (57%) 12 (40%) 10 (33%) 5 (17%) 2 (7%) 5 (17%) 4 (13%) 3 (10%) 5 (17%) 3 (10%) 0 (0%) 0 (0%) 0 (0%) 1 (3%) 1 (3%) 1 (3%)

Mean 1
0 (0%) 0 (0%) 0 (0%) 3.60 4.17 4.43

Qualitative Description
Highly Effective Highly Effective Highly Effective Highly Effective Highly Effective Highly Effective Highly Effective

0 (0%) 0 (0%) 0 (0% 0 (0%)

4.00 4.17 4.13 4.17

Mental

10 (33%)

13 (43%)

7 (23%)

0 (0%)

0 (0%)

4.10

Highly Effective

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Social

3. Gives a chance to clarify unclear information 1. Develops harmony 2. Develops good nursepatient relationship 3. Improves confidence 4. Helps to cope effectively

17 (57%)

10 (33%)

3 (10%)

0 (0%)

0 (0%)

4.87

Very Highly Effective

14 (47%) 15 (50%) 11 (37%) 11 (37%)

12 (40%) 13 (43%) 15 (50%) 17 (57%)

3 (10%) 2 (7%) 2 (7%) 2 (7%)

1 (3%) 0 (0%) 1 (3%) 0 (0%)

0 (0%) 0 (0%) 0 (0%) 0 (0%)

4.30 4.43

Highly Effective Highly Effective Highly Effective Highly Effective

4.10 4.30

Over-all

Table 2 Patients Perception on the Effect of Verbal Therapeutic Communication on the Patients (N = 20).
Dimension
Physical Emotional

Indicator/s 5
1. Minimizes the feeling of pain 1. Uplifts confidence 2. Gives opportunity to express feelings 3. Decreases tension 4. Decreases Uncertainty 5. Promotes trust 1. Gains new knowledge 12 (60%) 7 (35%) 8 (40%) 6 (30%) 8 (40%) 9 (45%) 8 (40%)

Frequency Rating 4 3 2
2 (10%) 7 (35%) 4 (20%) 4 (20%) 6 (30%) 3 (15%) 7 (35%) 3 (15%) 4 (20%) 7 (35%) 7 (35%) 4 (20%) 5 (25%) 3 (15%) 2 (10%) 2 (10%) 1 (5%) 0 (0%) 2 (10%) 2 (10%) 1 (5%)

Mean 1
1 (5%) 0 (0%) 0 (0%) 3 (15%) 0 (0%) 1 (5%) 1 (5%) 4.1 3.95 4

Qualitative Description
Highly Effective Highly Effective Highly Effective Moderately Effective Highly Effective Highly Effective Highly Effective

3.5 4 3.85 4

Mental

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Social

through health teachings 2. Gives time to reflect 3. Gives a chance to clarify unclear information 1. Develops harmony 2. Develops good nursepatient relationship 3. Improves confidence 4. Helps to cope effectively

7 (35%) 10 (50%)

3 (15%) 3 (15%)

7 (35%) 5 (25%)

1 (5%) 2 (10%)

2 (10%) 0 (0%)

3.6 4.05

Highly Effective Highly Effective

8 (40%) 11 (55%) 7 (35%) 8 (40%)

5 (25%) 3 (15%) 10 (50%) 3 (15%)

3 (15%) 5 (25%) 2 (10%) 8 (40%)

2 (10%) 0 (0%) 1 (5%) 1 (5%)

2 (10%) 1 (5%) 0 (0%) 0 (0%)

3.75 4.15

Highly Effective Highly Effective Highly Effective Highly Effective

4.15 3.9

Over-all

Emotional Dimension The effect of Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of uplifting the confidence of the patient by giving encouraging words. Nurses perception is presented on Table 1. Ten (10) out of thirty (30) nurses or 33% gave an assessment of 5 which means very highly effective, fifteen (15) out of thirty (30) or 50% gave a rating of 4 which means highly effective, five (5) out of thirty (30) or 17% gave an evaluation of 3 which means moderately effective, none or 0% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.17 shows that the nurses perceived that the effect of

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Verbal Therapeutic Communication on the patients physical dimension as measured in terms of minimizing the feeling of pain was highly effective. This implies that the use of verbal therapeutic communication through the use of encouraging words could uplift the confidence of the patient and help the patient become aware of the continuity in his life. Nurses maintain a caring attitude towards patients their way of speaking to the patient helps communicate their genuine concern. Meanwhile the patients perception on the effect of Verbal Therapeutic Communication on the patients physical dimension as measured in terms of uplifting the confidence of the patient by giving encouraging words is presented on Table 2. 7 out of 20 patients or 35% rated the indicator 5 which means very highly effective, 7 out of 20 or 35% gave a rating of 4 which means highly effective, 4 out of 20 or 20% gave an evaluation of 3 which means moderately effective, 2 out of 20 or 10% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 3.95 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of uplifting the confidence of the patient by giving encouraging words was highly effective. This implies that showing great interest and sincere care while performing nursing procedures are effective in encouraging patients to improve their health. According to Walter F. Baile, MD, you can make a big difference when you show your sincere care to your patient in your movements and actions. It makes a huge in patients

Page | 33

satisfaction and other outcomes such as compliance with treatment, participation in important treatment decisions, and even psychological adjustment. Certainly your patient is watching you. A good non-verbal skill will make your patients think that you are effective as caregiver and a communicator to them. The effect of Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of giving the patient the opportunity to express their feelings. Nurses perception is presented on Table 1. 15 or 30 nurses or 33% gave an assessment of 5 which means very highly effective, 13 out of 30 or 43% gave a rating of 4 which means highly effective, 2 out of 30 or 7% gave an evaluation of 3 which means moderately effective, none or 0% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.43 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients physical dimension as measured in terms of minimizing the feeling of pain was highly effective. This implies that through verbal communication, it can help the patient decrease tension by diverting his attention through having conversations especially with the nurse.

Meanwhile the patients perception on the effect of Verbal Therapeutic

Communication on the patients physical dimension as measured in terms of uplifting the confidence of the patient by giving encouraging words is presented on Table 2. 8 out of 20 patients or 40% gave an assessment of 5 which means very highly effective, 4 out of 20 or

Page | 34

20% gave a rating of 4 which means highly effective, 7 out of 20 or 35% gave an evaluation of 3 which means moderately effective, 1 out of 20 or 5% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.1 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of uplifting the confidence of the patient by giving encouraging words was highly effective. This implies that through verbal communication, it can help the patient decrease tension by diverting his attention through having conversations especially with the nurse. The effect of Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of decreasing uncertainty by sharing impression with the patient & seeking corrective feedback. Nurses perception is presented on Table 1. 11 or 30 nurses or 37% gave an assessment of 5 which means very highly effective, 14 out of 30 or 47% gave a rating of 4 which means highly effective, 4 out of 30 or 13% gave an evaluation of 3 which means moderately effective, 1 out of 30 or 3% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.17 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients emotional dimension as measured in terms of decreasing uncertainty by sharing impression with the patient & seeking corrective feedback. This implies that the patient could voice out what he is hinted at or suggested.

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Meanwhile the patients perception on the effect of Verbal Therapeutic

Communication on the patients physical dimension as measured in terms of decreasing uncertainty by sharing impression with the patient & seeking corrective feedback. is presented on Table 2. 8 out of 20 patients or 40% gave an assessment of 5 which means very highly effective, 6 out of 20 or 30% gave a rating of 4 which means highly effective, 4 out of 20 or 20% gave an evaluation of 3 which means moderately effective, 2 out of 20 or 10% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of decreasing uncertainty by sharing impression with the patient & seeking corrective feedback was highly effective. This implies that through verbal communication, it can help the patient decrease tension by diverting his attention through having conversations especially with the nurse. Lastly, the effect of Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of promoting trust towards the nurse by showing sensitivity. Nurses perception is presented on Table 1. Nine (9) or thirty (30) nurses or 30% gave an assessment of 5 which means very highly effective, seventeen (1) out of 30 or 57% gave a rating of 4 which means highly effective, three (3) or thirty (30) or 13% gave an evaluation of 3 which means moderately effective, one (1) or thirty (30) or 3% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.13 shows that the nurses perceived that the effect of Verbal Therapeutic

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Communication on the patients emotional dimension as measured in terms of decreasing uncertainty by sharing impression with the patient & seeking corrective feedback. It implies that through verbal therapeutic communication; it can stabilize rapport between the nurse and the patient thus, promoting trust. . Meanwhile the patients perception on the effect of Verbal Therapeutic

Communication on the patients emotional dimension as measured in terms of decreasing uncertainty by sharing impression with the patient & seeking corrective feedback. is presented on Table 2. 9 out of 20 patients or 45% gave an assessment of 5 which means very highly effective, 3 out of 20 or 15% gave a rating of 4 which means highly effective, 5 out of 20 or 25% gave an evaluation of 3 which means moderately effective, 2 out of 20 or 10% gave a rating of 2 which means limited effective, and 1 out of 20 or 5% gave a evaluation of 1 which means no effect. The mean rating of 3.85 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of decreasing uncertainty by sharing impression with the patient & seeking corrective feedback was highly effective. This implies that through verbal therapeutic communication it can stabilize rapport between the nurse and the patient thus, promoting trust. Mental Dimension The effect of Verbal Therapeutic Communication on the patients mental dimension is measured in terms of gaining new knowledge of the patient through health teachings.

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Nurses perception is presented on Table 1. 12 or 30 nurses or 40% gave an assessment of 5 which means very highly effective, 12 out of 30 or 40% gave a rating of 4 which means highly effective, 5 out of 30 or 17% gave an evaluation of 3 which means moderately effective, 1 out of 30 or 3% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.17 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients mental dimension as measured in terms of gaining new knowledge of the patient through health teachings. This implies that giving health teachings to the patient is effective for gaining new knowledge on the patients side. Meanwhile the patients perception on the effect of Verbal Therapeutic Communication on the patients mental dimension as measured in terms of gaining new knowledge of the patient through health teachings is presented on Table 2. 8 out of 20 patients or 40% gave an assessment of 5 which means very highly effective, 7 out of 20 or 35% gave a rating of 4 which means highly effective, 3 out of 20 or 15% gave an evaluation of 3 which means moderately effective, 1 out of 20 or 5% gave a rating of 2 which means limited effective, and 1 out of 20 or 5% gave a evaluation of 1 which means no effect. The mean rating of 4 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients mental dimension is measured in terms of gaining new knowledge of the patient through health teachings was highly effective. This implies that the nurse makes the facts available for the patients needs.

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According to Higgins S., health teaching is an essential component of nursing care and by giving a new knowledge through health teachings, a patient would be knowledgeable about his/her illness. And through this, patients would able to live life to the healthiest that is, to strive toward achieving ones maximum health potential. The effect of Verbal Therapeutic Communication on the patients mental dimension is measured in terms of giving the patient a time to reflect. Nurses perception is presented on Table 1. 10 or 30 nurses or 33% gave an assessment of 5 which means very highly effective, 13 out of 30 or 43% gave a rating of 4 which means highly effective, 7 out of 30 or 23% gave an evaluation of 3 which means moderately effective, none or 0% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.10 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients mental dimension as measured in terms of giving the patient a time to reflect. This implies that reflection encourages the patient to bring forth and accept as part of himself his own ideas and feelings. Meanwhile the patients perception on the effect of Verbal Therapeutic Communication on the patients mental dimension as measured in terms of giving the patient a time to reflect is presented on Table 2. 8 out of 20 patients or 40% gave an assessment of 5 which means very highly effective, 7 out of 20 or 35% gave a rating of 4 which means highly effective, 3 out of 20 or 15% gave an evaluation of 3 which means moderately effective, 1 out of 20 or 5% gave a rating of 2 which means limited effective, and 1 out of 20

Page | 39

or 5% gave a evaluation of 1 which means no effect. The mean rating of 4 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of giving the patient a time to reflect was highly effective. This implies that reflection encourages the patient to bring forth and accept as part of himself his own ideas and feelings. The effect of Verbal Therapeutic Communication on the patients mental dimension is measured in terms of giving the patient a chance to clarify unclear information. Nurses perception is presented on Table 1. 17 or 30 nurses or 57% gave an assessment of 5 which means very highly effective, 10 out of 30 or 33% gave a rating of 4 which means highly effective, 3 out of 30 or 10% gave an evaluation of 3 which means moderately effective, none or 0% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.38 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients mental dimension as measured in terms of giving the patient a chance to clarify unclear information. This implies that informing the patient of the facts when he asks questions or in other ways indicates the need for information builds up trust as well as gives the patient a greater body of knowledge from which to make decisions or come to realistic conclusions. Meanwhile the patients perception on the effect of Verbal Therapeutic Communication on the patients physical dimension as measured in terms of giving the patient a chance to clarify unclear information is presented on Table 2. 10 out of 20 patients

Page | 40

or 50% gave an assessment of 5 which means very highly effective, 3 out of 20 or 15% gave a rating of 4 which means highly effective, 5 out of 20 or 25% gave an evaluation of 3 which means moderately effective, 2 out of 20 or 10% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.05 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients mental dimension is measured in terms of giving the patient a chance to clarify unclear information was highly effective. This implies that informing the patient of the facts when he asks questions or in other ways indicates the need for information builds up trust as well as gives the patient a greater body of knowledge from which to make decisions or come to realistic conclusions. Social Dimension The effect of Verbal Therapeutic Communication on the patients social dimension is measured in terms of developing harmony. Nurses perception is presented on Table 1. 14 or 30 nurses or 47% gave an assessment of 5 which means very highly effective, 12 out of 30 or 40% gave a rating of 4 which means highly effective, 3 out of 30 or 10% gave an evaluation of 3 which means moderately effective, 1 out of 30 or 3% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.30 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients social dimension as measured

Page | 41

in terms of giving the patient a chance to clarify unclear information. This implies that when the patient is at ease and a strong rapport is developed, harmonious interaction Meanwhile the patients perception on the effect of Verbal Therapeutic Communication on the patients social dimension as measured in terms of developing harmony is presented on Table 2. 8 out of 20 patients or 40% gave an assessment of 5 which means very highly effective, 3 out of 20 or 25% gave a rating of 4 which means highly effective, 3 out of 20 or 15% gave an evaluation of 3 which means moderately effective, 2 out of 20 or 10% gave a rating of 2 which means limited effective, and 2 out of 20 or 10% gave a evaluation of 1 which means no effect. The mean rating of 4.05 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients mental dimension is measured in terms of giving the patient a chance to clarify unclear information was highly effective. This implies that that when the patient is at ease and a strong rapport is developed, harmonious interaction relationship occurs. The effect of Verbal Therapeutic Communication on the patients social dimension is measured in terms of developing good nurse-patient relationship by maintaining caring attitude towards the patient. Nurses perception is presented on Table 1. 15 or 30 nurses or 50% gave an assessment of 5 which means very highly effective, 13 out of 30 or 43% gave a rating of 4 which means highly effective, 2 out of 30 or 7% gave an evaluation of 3 which means moderately effective, none or 0% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The

Page | 42

mean rating of 4.43 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients social dimension as measured in terms of giving the patient a chance to clarify unclear information. This implies that having a good nurse-patient relationship there would be a continuity of care. Meanwhile the patients perception on the effect of Verbal Therapeutic Communication on the patients social dimension as measured in terms of developing good nurse-patient relationship by maintaining caring attitude towards the patient is presented on Table 2. 11 out of 20 patients or 55% gave an assessment of 5 which means very highly effective, 3 out of 20 or 15% gave a rating of 4 which means highly effective, 5 out of 20 or 25% gave an evaluation of 3 which means moderately effective, none or 0% gave a rating of 2 which means limited effective, and 1 out of 20 or 5% gave a evaluation of 1 which means no effect. The mean rating of 4.15 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients social dimension is measured in terms of giving the patient a chance to clarify unclear information was highly effective. This implies that that having a good nurse-patient relationship there would be a continuity of care.

The effect of Verbal Therapeutic Communication on the patients social dimension is measured in terms of improving confidence of the patient. Nurses perception is presented on Table 1. 11 or 30 nurses or 37% gave an assessment of 5 which means very highly

Page | 43

effective, 15 out of 30 or 50% gave a rating of 4 which means highly effective, 2 out of 30 or 7% gave an evaluation of 3 which means moderately effective, 1 out of 30 or 3% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.10 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients social dimension as measured in terms of improving confidence of the patient. . This implies that that it will allow the patient to take the initiative in introducing the topic. Meanwhile the patients perception on the effect of Verbal Therapeutic Communication on the patients social dimension as measured in terms of developing good nurse-patient relationship by maintaining caring attitude towards the patient is presented on Table 2. 7 out of 20 patients or 35% gave an assessment of 5 which means very highly effective, 10 out of 20 or 50% gave a rating of 4 which means highly effective, 2 out of 20 or 10% gave an evaluation of 3 which means moderately effective, 1 out of 20 or 5% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.15 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients social dimension is measured in terms of giving the patient a chance to clarify unclear information was highly effective. This implies that that having a good nurse-patient relationship there would be a continuity of care.

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The effect of Verbal Therapeutic Communication on the patients social dimension is measured in terms of helping the patient to cope effectively. Nurses perception is presented on Table 1. 11 or 30 nurses or 37% gave an assessment of 5 which means very highly effective, 17 out of 30 or 57% gave a rating of 4 which means highly effective, 2 out of 30 or 7% gave an evaluation of 3 which means moderately effective, 1 out of 30 or 3% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.30 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients social dimension as measured in terms of helping the patient to cope effectively. This implies that that the nurse seeks to offer the patient a relationship in which he can identify his problems in living with others, grow emotionally, and improve his ability to form satisfying relationships with others. Meanwhile the patients perception on the effect of Verbal Therapeutic Communication on the patients social dimension as measured in terms of helping the patient to cope effectively is presented on Table 2. 8 out of 20 patients or 40% gave an assessment of 5 which means very highly effective, 3 out of 20 or 15% gave a rating of 4 which means highly effective, 8 out of 20 or 40% gave an evaluation of 3 which means moderately effective, 1 out of 20 or 5% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 3.9 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients

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social dimension is measured in terms of helping the patient to cope effectively was highly effective. This implies that that having a good nurse-patient relationship there would be a continuity of care.

Perception on the Effect of Non- Verbal Therapeutic Communication

Nonverbal communication which is sometimes called body language includes gestures, body movements, use of touch and physical appearance including adornment. Nonverbal communication often tells other more about what a person is felling than what is actually said because nonverbal behavior is controlled less consciously than verbal behavior. Nonverbal communication either reinforces or contradicts what is said verbally. Part II of the Perception Questionnaires for both the nurses and patients were used to determine the extent of the effects of Non-Verbal Therapeutic Communication used by the staff nurses at Cavite Center for Mental Health on the physical, emotional, mental and social dimensions of the patients.

Physical Dimension The effect of Non-Verbal Therapeutic Communication on the patients physical dimension is measured in terms of minimizing the feeling of pain. Nurses perception is presented on Table 3. Seven (7) out of thirty (30) nurses or 23% rated the item 5 which

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means very highly effective, Six (6) out of thirty (30) or 20% gave a rating of 4 which means highly effective, twelve (12) out of thirty (30) or 30% gave an evaluation of 3 which means moderately effective, three (3) out of thirty (30) or 10% gave a rating of 2 which means limited effective, and three (2) out of thirty (30) or 10% gave a evaluation of 1 which means no effect. The mean rating of 3.43 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients physical dimension as measured in terms of minimizing the feeling of pain was moderately effective. This implies that touch is a useful intervention to reduce the feeling of pain. On the other hand, the patients perception on the effect of Non-Verbal Therapeutic Communication on the patients physical dimension as measured in terms of minimizing the feeling of pain is presented on Table 4. Eleven (11) out of twenty (20) nurses or 55% rated the item 5 which means very highly effective, four (4) out of twenty (20) or 20% gave a rating of 4 which means highly effective, two (2) out of twenty (20) or 10% gave an evaluation of 3 which means moderately effective, one (1) out of twenty (20) or 5% gave a rating of 2 which means limited effective, and two (2) out of twenty (20) or 10% gave a evaluation of 1 which means no effect. The mean rating of 4.25 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients physical dimension as measured in terms of minimizing the feeling of pain was highly effective. This implies that touch is a useful intervention to reduce the feeling of pain.

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According to Debra L. Roter, Dr.PH, while you cannot always offer a care to your patients, you can offer comfort and comfort is one aspect in minimizing the feeling of pain and achieved at varying levels and different approaches. One of these approaches is through the use of non-verbal therapeutic touch like soft and rub touch since most of nursing intervention use touch.

The effect of Non-Verbal Therapeutic Communication on the patients physical dimension is measured in terms of encouraging them to improve health through the nurses evident sincere care while performing nursing procedure. Nurses perception is presented on Table 3. Five (5) out of thirty (30) nurses or 15% rated the item 5 which means very highly effective, Eighteen (18) out of thirty (30) or 60% gave a rating of 4 which means highly effective, Seven (7) out of thirty (30) or 23% gave an evaluation of 3 which means moderately effective, none or 0% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 3.9 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients physical dimension as measured in terms of encouraging them to improve health through the nurses evident sincere care while performing nursing procedure was highly effective. This implies that touch is a useful intervention to reduce the feeling of pain.

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As observed by Debra L. Roter, DrPH, finger pressure, grip, touches that feel good to the patient and to the other person produce sense of trust, excitement, and desire for closeness and psychologically transverse their negative feeling. Meanwhile, the patients perception on the effect of Non-Verbal Therapeutic Communication on the patients physical dimension as measured in terms of encouraging them to improve health through the nurses evident sincere care while performing nursing procedure is presented on Table 4. Eleven (11) out of twenty (20) nurses or 55% rated the item 5 which means very highly effective, four (4) out of twenty (20) or 20% gave a rating of 4 which means highly effective, two (2) out of twenty (20) or 10% gave an evaluation of 3 which means moderately effective, one (1) out of twenty (20) or 5% gave a rating of 2 which means limited effective, and two (2) out of twenty (20) or 10% gave a evaluation of 1 which means no effect. The mean rating of 4.1 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients physical dimension as measured in terms of encouraging them to improve health through the nurses evident sincere care while performing nursing procedure was highly effective. This implies that showing great interest and sincere care while performing nursing procedures are effective in encouraging patients to improve their health. According to Walter F. Baile, MD, you can make a big difference when you show your sincere care to your patient in your movements and actions. It makes a huge in patients satisfaction and other outcomes such as compliance with treatment, participation in

Page | 49

important treatment decisions, and even psychological adjustment. Certainly your patient is watching you. A good non-verbal skill will make your patients think that you are effective as caregiver and a communicator to them.

The effect of Non-Verbal Therapeutic Communication on the patients physical dimension is measured in terms of generating a feeling of security through promoting a safe environment. Nurses perception is presented on Table 13. Nine (9) out of thirty (30) nurses or 30% rated the item 5 which means very highly effective, Fourteen (14) out of thirty (30) or 47% gave a rating of 4 which means highly effective, Six (6) out of thirty (30) or 20% gave an evaluation of 3 which means moderately effective, one (1) out of thirty (30) or 3% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.03 shows that the nurses perceived that the effect of Non-Verbal Therapeutic Communication on the patients physical dimension as measured in terms of generating a feeling of security through promoting a safe environment was highly effective. This implies that therapeutic conversation with the patient can alleviate if not diminish the pain experienced by the patient. On the other hand, the patients perception on the effect of Non-Verbal Therapeutic Communication on the patients physical dimension as measured in terms of generating a feeling of security through promoting a safe environment is presented on Table 4. Seven (7) out of twenty (20) nurses or 35% rated the item 5 which means very highly effective, five

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(5) out of twenty (20) or 25% gave a rating of 4 which means highly effective, five (5) out of twenty (20) or 25% gave an evaluation of 3 which means moderately effective, three (3) out of twenty (20) or 15% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 3.8 shows that the nurses perceived that the effect of Non-Verbal Therapeutic Communication on the patients physical dimension as measured in terms of generating a feeling of security through promoting a safe environment was highly effective. This implies that upon admission in the chosen hospital the client gives full trust to the healthcare agency and the healthcare team that he/she will be taken care of. A contributing factor to that is providing a hazard free environment as well as the need to feel comfortable in everyway possible.

Table 3 Nurses Perception on the Effect of Non- Verbal Therapeutic Communication on the Patients (N = 30).
Dimension
Physical

Indicator/s 5
1. Minimizes 7

Frequency Rating 4 3 2
6 12 3

Mean 1
2 3.43

Qualitative Description
Moderate

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the feeling of pain 2. Encourage to improve health 3. Feels safe & secured

23% 5 16% 9 30%

20% 18 60% 14 47% 18 60% 16 53% 11 37% 14 47% 12 40%

30% 7 23% 6 20% 6 20% 6 20% 9 30% 9 30% 11 37%

10% 0 0% 1 3% 1 3% 1 3% 1 3% 1 3% 1 3%

7% 0 0% 0 0% 0 0% 0 0% 2 7% 1 3% 0 0% 3.93 4.03 3.9 3.97 3.67 3.7 3.77

effective Highly effective Highly effective Highly effective Highly effective Highly effective Highly effective Highly effective

Emotional

1. gives time to reflect 2. Feels relaxed & calm 3. Increased self confidence

5 17% 7 23% 7 23% 5 17% 6 20%

Mental

1. Gives time for

patients privacy 2. Gives new knowledge by showing the correct procedure

Social

1. Shows sincerity

9 30% 8 27%

13 43% 14 47%

8 27% 8 27%

0 0% 0 0%

0 0% 0 0%

4.03 4

Highly effective Highly effective

2. Uplifts confidence
by smiling

3. feels welcome by listening Over-all

12 40%

10 33%

8 27%

0 0%

0 0%

4.13

Highly effective

Table 4 Patients Perception on the Effect of Non-Verbal Therapeutic Communication on the Patients (N = 20).
Dimension Indicator/s 5 Frequency Rating 4 3 2 Mean 1 Qualitative

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Description
Physical 1. Minimizes the feeling of pain 2. encourage to improve health 3. feels safe and secured 1. gives time to reflect 2. Feels relaxed and calm 3. Increased self confidence 11 (55%) 10 (50%) 7 (35%) 9 (45%) 11 (55%) 10 (50%) 4 (20%) 3 (15%) 5 (25%) 5 (25%) 3 (15%) 3 (15%) 2 (10%) 4 (20%) 5 (25%) 4 (20%) 3 15%) 4 (20%) 1 (5%) 1 (5%) 3 (15%) 2 (10%) 1 5%) 3 (15%) 2 (10%) 2 (10%) 0 (0%) 0 (0%) 2 (10%0 0 (0%) 4.25 3.9 3.8 4.05 4 4 Highly effective Highly effective Highly effective Highly effective Highly effective Highly effective

Emotional

Mental

1. Gives time for patients privacy 2. Gives new knowledge by showing the correct procedures

8 (40) 8 (40%)

6 (30%) 7 (35%)

4 (20%) 3 (15%)

1 (5%) 2 (10%)

1 (5%) 0 (0%)

3.95

Highly effective Highly effective

4.05

Social

1. Shows sincerity 2. uplifts confidence by smiling 3. feels welcome by listening

7 (35%) 9 (45%) 10 (50%)

3 (15%) 7 (35%) 4 (20%)

6 (30%) 2 (10%) 3 (15%)

2 (10%) 2 (10%) 3 (15%)

2 (10%) 0 (0%) 0 (0%)

3.55 4.25 4.1

Highly effective Highly effexctive Highly effective

Over-all

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Emotional Dimension The effect of Non-Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of giving the patient time to reflect. Nurses perception is presented on Table 3. five (5) out of thirty (30) or 17% gave an assessment of 5 which means very highly effective, eighteen (18) out of thirty (30) or 60% gave a rating of 4 which means highly effective, six (6) out of thirty (30) or 20% gave an evaluation of 3 which means moderately effective, one (1) out of thirty (30) or 3% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.17 shows that the nurses perceived that the effect of Non-Verbal Therapeutic Communication on the patients physical dimension as measured in terms of giving the patient time to reflect was highly effective. This implies that the use of non-verbal therapeutic communication gives the patient a time to reflect, to think and gain insight on their status and problems. Meanwhile the patients perception on the effect of Non-Verbal Therapeutic Communication on the patients physical dimension as measured in terms of giving the patient time to reflect is presented on Table 4. 9 out of 20 patients or 45% rated the indicator 5 which means very highly effective, 5 out of 20 or 25% gave a rating of 4 which means highly effective, 4 out of 20 or 20% gave an evaluation of 3 which means moderately effective, 2 out of 20 or 10% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 3.95 shows that the

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patients perceived that the effect of Non-Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of giving the patient time to reflect was highly effective. This implies that the use of nonverbal therapeutic communication gives the patient a time to reflect, to think and gain insight on their status and problems. According to Walter F. Baile, MD, You might simply repeat what the patient has said, to give him time to mull it over or to encourage him to respond. Or, and often more effectively, you can reflect on what you think the patient is feeling. "It sounds like you're concerned about your family." or "I don't think you're very happy about this." By reflecting on his feelings, you may be encouraging him to talk about something he may have been hesitant to bring up himself. Or you may be helping the patient to identify his own feelings about something.

The effect of Non-Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of making the patient feel relaxed and calm through the maintenance of a steady and calm facial expression. Nurses perception is presented on Table 3. 15 or 30 nurses or 33% gave an assessment of 5 which means very highly effective, 13 out of 30 or 43% gave a rating of 4 which means highly effective, 2 out of 30 or 7% gave an evaluation of 3 which means moderately effective, none or 0% gave a rating of 2 which

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means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.43 shows that the nurses perceived that the effect of Non-Verbal Therapeutic Communication on the patients physical dimension as measured in terms of of making the patient feel relaxed and calm through the maintenance of a steady and calm facial expression was highly effective. This implies that through verbal communication, it can help the patient decrease tension by diverting his attention through having conversations especially with the nurse. . Meanwhile the patients perception on the effect of Non-Verbal Therapeutic

Communication on the patients physical dimension as measured in terms of uplifting the confidence of the patient by giving encouraging words is presented on Table 4. 8 out of 20 patients or 40% gave an assessment of 5 which means very highly effective, 4 out of 20 or 20% gave a rating of 4 which means highly effective, 7 out of 20 or 35% gave an evaluation of 3 which means moderately effective, 1 out of 20 or 5% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.1 shows that the patients perceived that the effect of Non-Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of making the patient feel relaxed and calm through the maintenance of a steady and calm facial expression was highly effective. This implies that presenting yourself in a calm manner, non-threatening gestures encourages the patient to be more comfortable with the nurse. It is determinant for the patient to be more open and relaxed with the nurse.

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According to Walter F. Baile, MD, before using communication skill techniques, remember that you must do what feels comfortable and natural to you. Even though you may have the best of intentions, if you do not sound sincere, the people will not be able to open up to you & never be comfortable to you. Also, keep in mind that your patients are individuals; if you sense that a particular patient may not respond well to a certain technique, you are probably right. Lastly, the effect of Non-Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of increasing the patients self confidence through the use of friendly gestures like soft touch, light tapping on the back etc. Nurses perception is presented on Table 3. Seven (7) out of thirty (30) or 23% gave an assessment of 5 which means very highly effective, Eleven (11) out of twenty (20) nurses or 55% gave a rating of 4 which means highly effective, nine (9) out of thirty (30) nurses or 30% gave an evaluation of 3 which means moderately effective, one (1) out of thirty (30) or 3% gave a rating of 2 which means limited effective, and two (2) out of twenty (20) or 10% gave a evaluation of 1 which means no effect. The mean rating of 3.67 shows that the nurses perceived that the effect of Non-Verbal Therapeutic Communication on the patients physical dimension as measured in terms of increasing the patients self confidence through the use of friendly gestures like soft touch, light tapping on the back etc was highly effective. This implies that using friendly gestures like soft touch, tapping on the back could increase the self confidence of the patient. It always says that actions speak louder than words. A person will generally pay more attention to what you do than what you say.

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Meanwhile the patients perception on the effect of Non-Verbal Therapeutic Communication on the patients physical dimension as measured in terms of uplifting the confidence of the patient by giving encouraging words is presented on Table 4. 10 out of 20 patients or 50% rated the indicator 5 which means very highly effective, 3 out of 20 or 15% gave a rating of 4 which means highly effective, 4 out of 20 or 20% gave an evaluation of 3 which means moderately effective, 3 out of 20 or 15% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4 shows that the patients perceived that the effect of Non-Verbal Therapeutic Communication on the patients emotional dimension is measured in terms of uplifting the confidence of the patient by giving encouraging words was highly effective. This implies that touch is a form of communication used nearly every day by nurses providing direct physical care and support clients. The value of touch is one of the characteristics of therapeutic communication. Also, facial expressions and gestures like nodding make the patient feel confident in performing self-care activities. According to Walter F. Baile, MD, the use of non verbal therapeutic communication is effective in increasing the patients self confidence. Facial expression and gestures like nodding make the patient feel confident in performing self care activities. Mental Dimension The effect of Non-Verbal Therapeutic Communication on the patients mental dimension is measured in terms of giving time for patients privacy. Nurses perception is

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presented on Table 3. 5 or 30 nurses or 17% gave an assessment of 5 which means very highly effective, 11 out of 30 or 37% gave a rating of 4 which means highly effective, 9 out of 30 or 30% gave an evaluation of 3 which means moderately effective, 1 out of 30 or 3% gave a rating of 2 which means limited effective, 1 out of 30 or 3% gave a evaluation of 1 which means no effect. The mean rating of 3.7 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients mental dimension as measured in terms of giving time for patients privacy is highly effective. This implies that giving time for patients privacy have been shown to be appreciated by the patients. Meanwhile the patients perception on the effect of Non-Verbal Therapeutic Communication on the patients mental dimension as measured in terms of gaining new knowledge of the patient through health teachings is presented on Table 4. 8 out of 20 patients or 40% gave an assessment of 5 which means very highly effective, 7 out of 20 or 35% gave a rating of 4 which means highly effective, 3 out of 20 or 15% gave an evaluation of 3 which means moderately effective, 1 out of 20 or 5% gave a rating of 2 which means limited effective, and 1 out of 20 or 5% gave a evaluation of 1 which means no effect. The mean rating of 4 shows that the patients perceived that the effect of Verbal Therapeutic Communication on the patients mental dimension is measured in terms of gaining new knowledge of the patient through health teachings was highly effective.

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This implies that giving the patient a time for privacy is effective. Drawing the curtains around the bed to maximize privacy and attempts at establishing privacy during an exam have been shown to be appreciated by patients. According to Debra L. Roter, Dr.PH. she also states that keeping the patients room quiet and private in setting facilities the patients privacy. The effect of Non-Verbal Therapeutic Communication on the patients mental dimension is measured in terms of gaining new knowledge through showing the correct nursing procedure to the patient. Nurses perception is presented on Table 3. 6 or 30 nurses or 20% gave an assessment of 5 which means very highly effective, 12 out of 30 or 40% gave a rating of 4 which means highly effective, 11 out of 30 or 37% gave an evaluation of 3 which means moderately effective, 1 out of 30 or 3% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 3.77 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients mental dimension as measured in terms of gaining new knowledge through showing the correct nursing procedure to the patient is highly effective. This implies that the nurse makes the facts available for the patients needs. Showing to the patient the correct nursing procedure is effective for gaining new knowledge on the patients side. Meanwhile the patients perception on the effect of Non-Verbal Therapeutic Communication on the patients mental dimension as measured in terms of new knowledge through showing the correct nursing procedure to the patient is presented on Table 4. 8 out

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of 20 patients or 40% gave an assessment of 5 which means very highly effective, 7 out of 20 or 35% gave a rating of 4 which means highly effective, 3 out of 20 or 15% gave an evaluation of 3 which means moderately effective, 2 out of 20 or 10% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.05 shows that the patients perceived that the effect of NonVerbal Therapeutic Communication on the patients emotional dimension is measured in terms of new knowledge through showing the correct nursing procedure to the patient was highly effective. This implies that showing to the patient the correct nursing procedure is effective for gaining new knowledge on the patients side. According to Higgins S., health teaching is an essential component of nursing care and by giving a new knowledge through health teachings, a patient would be knowledgeable about his/her illness. And through this, patients would able to live life to the healthiest that is, to strive toward achieving ones maximum health potential.

Social Dimension The effect of Non-Verbal Therapeutic Communication on the patients social dimension is measured in terms of showing sincerity through maintaining eye contact. Nurses perception is presented on Table 3. Nine (9) out of thirty (30) nurses or 30% gave an assessment of 5 which means very highly effective, thirteen (13) out of twenty (20) nurses or 43% gave a rating of 4 which means highly effective, eight (8) out of thirty (30) or 27% gave

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an evaluation of 3 which means moderately effective, none or 0% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.03 shows that the nurses perceived that the effect of Non-Verbal Therapeutic Communication on the patients social dimension as measured in terms of showing sincerity through maintaining eye contact is highly effective. This implies that it is generally agreed upon that eye contact communicates a positive message. Meanwhile the patients perception on the effect of Non-Verbal Therapeutic Communication on the patients social dimension as measured in terms of showing sincerity through maintaining eye contact is presented on Table 4. 7 out of 20 patients or 35% gave an assessment of 5 which means very highly effective, 3 out of 20 or 15% gave a rating of 4 which means highly effective, 6 out of 20 or 30% gave an evaluation of 3 which means moderately effective, 2 out of 20 or 10% gave a rating of 2 which means limited effective, and 2 out of 20 or 10% gave a evaluation of 1 which means no effect. The mean rating of 3.55 shows that the patients perceived that the effect of Non-Verbal Therapeutic Communication on the patients social dimension is measured in terms of showing sincerity through maintaining eye contact was highly effective. This implies by looking your patient in the eye and make eye contact both when you are speaking and (even more importantly) while youre listening to the patient could able to show sincerity to the patient.

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According to Higgins S., having an eye contact adds a comfort level to the interaction and lays the foundation for a good rapport. Other things which can ensure a nurse the optimum attention from a patient are checking out on their basic needs, avoiding distractions, etc. The effect of Non-Verbal Therapeutic Communication on the patients social dimension is measured in terms of uplifting the patients confidence through smiling. Nurses perception is presented on Table 3. 8 or 30 nurses or 27% gave an assessment of 5 which means very highly effective, 14 out of 30 or 47% gave a rating of 4 which means highly effective, 8 out of 30 or 27% gave an evaluation of 3 which means moderately effective, none or 0% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4 shows that the nurses perceived that the effect of Verbal Therapeutic Communication on the patients social dimension as measured in terms of giving the patient a chance to clarify unclear information was highly effective. This implies that smiling may convey approval or agreement. It is often accompanied by words and gives meaning in its context. Meanwhile the patients perception on the effect of Verbal Therapeutic Communication on the patients social dimension as measured in terms of uplifting the patients confidence through smiling is presented on Table 4. 9 out of 20 patients or 45% gave an assessment of 5 which means very highly effective, 3 out of 20 or 15% gave a rating of 4 which means highly effective, 6 out of 20 or 30% gave an evaluation of 3 which means

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moderately effective, 2 out of 20 or 10% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.25 shows that the patients perceived that the effect of Non-Verbal Therapeutic Communication on the patients social dimension is measured in terms of uplifting the patients confidence through smiling was highly effective. This implies that smiling to the patients can uplift patients confidence and also makes their day happy.

According to Steve Ford, smiling and cheerful is seen by some patients as an indicator of good nursing. Patients described nurses who were friendly, caring, compassionate, kind, and good listeners as nurses who were very skilled. A good bedside manner was how one patient described the skills and qualities of his ideal nurse, adding interested in me also as a person. Cheerful and happy and smiling were qualities several patients said gave them the impression that a nurse was skilled. A friendly nurse seems like they know everything were the words one patient used to describe the skill of the nurses who were the best at providing care. The effect of Non-Verbal Therapeutic Communication on the patients social dimension is measured in terms of making them feel welcome through listening. Nurses perception is presented on Table 3. 12 or 30 nurses or 40% gave an assessment of 5 which means very highly effective, 10 out of 30 or 30% gave a rating of 4 which means highly effective, 8 out of 30 or 27% gave an evaluation of 3 which means moderately effective, none or 0% gave a rating of 2 which means limited effective, and none or 0% gave a

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evaluation of 1 which means no effect. The mean rating of 4.13 shows that the nurses perceived that the effect of Non-Verbal Therapeutic Communication on the patients social dimension as measured in terms of making them feel welcome through listening. . This implies that that it will allow the patient to take the initiative in introducing the topic. Meanwhile the patients perception on the effect of Non-Verbal Therapeutic Communication on the patients social dimension as measured in terms of making them feel welcome through listening is presented on Table 4. 10 out of 20 patients or 50% gave an assessment of 5 which means very highly effective, 4 out of 20 or 20% gave a rating of 4 which means highly effective, 3 out of 20 or 11% gave an evaluation of 3 which means moderately effective, 3 out of 20 or 15% gave a rating of 2 which means limited effective, and none or 0% gave a evaluation of 1 which means no effect. The mean rating of 4.1 shows that the patients perceived that the effect of Non-Verbal Therapeutic Communication on the patients social dimension is measured in terms of making them feel welcome through listening was highly effective. This implies that that having a good nurse-patient relationship there would be a continuity of care.

According to Higgins S., as a patient speaks, think about what he must be feeling. Sometimes, as a listener, you must cut through layers of words to get to the real message. You must read between the lines. Practicing therapeutic communication is in many

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ways simply developing a good bedside manner. When your patient asks you a question or discusses something with you, be careful to respond in a helpful and caring manner. By encouraging the patient to speak up through listening, you are probably helping him/her to decrease his level of stress and thereby his recovery time. Relationship Between the Nurses and Patients Perception on the Effect of Verbal Therapeutic Communication The relationship between the nurses and the patients perception on the effect of verbal therapeutic communication is presented on Table 5.

Physical Dimension The relationship between the nurses and the patients perception on the effect of verbal therapeutic communication is measured in terms of physical aspect which is

presented on Table 5. The use of therapeutic communication is relative with an average weighted mean of 3.60 with the nurses and 4.1 with the patients in Cavite Center for Mental Health. This implies that therapeutic relationship can alleviate if not diminish pain by communicating relatively to the patient and family. It also implies that the pain felt by the patient can really be alleviated if not diminished when the nurse communicates relatively with the patient.

Table 5 Relationship Between the Nurses and Patients Perception on the Effect of Effect of

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Verbal Therapeutic Communication

Dimension Indicators Nurses Response Mean Qualitative Description
3.60 4.17 4.43 4 4.17 4.13 4.18 1. Gains new knowledge through health teachings 2. Gives time to reflect 4.17 4.10 4.87 highly effective highly effective highly effective highly effective highly effective highly effective highly effective highly effective highly effective Very highly effective Highly effective highly effective highly effective highly effective highly effective Highly effective

Patients Response Mean Qualitative Description

4.1 3.95 4 3.5 4 3.85 3.85 4 3.6 4.05 highly effective highly effective moderately effective moderately effective highly effective highly effective highly effective highly effective Highly effective highly effective

Physical Emotional

1.Minimizes the feeling of pain 1. Uplifts confidence 2. Gives the opportunity to express feelings 3. Decreases tension Decreases uncertainty Promotes trust

Over-all Mental

3.

Gives a chance to clarify unclear information

Over-all Social 1. Develops harmony 2. Develops good nursepatient relationship 3. Improves confidence 4. Helps to cope effectively Over-all

4.38 4.30 4.43 4.10 4.30 4.28

3.88 3.75 4.15 4.15 3.9 3.98

Highly effective highly effective highly effective highly effective Highly effective Highly effective

r=0.16 no or negligible relationship. There is no relationship in the verbal therapeutic communication between nurses and the patients

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Emotional Dimension The relationship between the nurses and the patients perception on the effect of verbal therapeutic communication is measured in terms of physical aspect which is

presented on Table 5. The use of therapeutic communication is relative with an average weighted mean of 4.18 with the nurses and 3.85 with patients in Cavite Center for Mental Health. This implies that nurses maintain a caring attitude towards the patients and their way of speaking can uplift the patients confidence, give opportunity to patients in expressing the feelings, can reduce tension, can decrease uncertainty and most importantly, it promotes trust. It also implies that the patient gave their trust to their nurses since the nurse maintains a caring attitude. Mental Dimension The relationship between the nurses and the patients perception on the effect of verbal therapeutic communication is measured in terms of physical aspect which is

presented on Table 5.The use of therapeutic communication is relative with an average weighted mean of 4.18 with the nurses and 3.85 with the patients. This implies that patient can gain new knowledge through health teachings, can reflect on their thoughts in a given time, and can seek clarification about a certain topic. It also implies that the patient gains or can gain knowledge from the nurses health teachings.

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Social Dimension The relationship between the nurses and the patients perception on the effect of verbal therapeutic communication is measured in terms of physical aspect which is

presented on Table 5.The use of therapeutic communication is relative with an average weighted mean of 4.28with the nurses and 3.98 with the patients. This implies that through verbal therapeutic communication, the nurse and patient creates an environment wherein they interact harmoniously which leads to a good nurse-patient relationship. Moreover, it can uplift the patients confidence can help him cope relatively during hospitalization. Among the four categories of verbal therapeutic communication used by staff nurses in Cavite Center for Mental Health, mental aspect has the highest total mean of 4.38 while the physical aspect has the lowest total mean of 3.60. The means that verbal therapeutic communication has a higher effect with the mental aspect and has a lower effect on the physical aspect of the nurses in Cavite Center for Mental Health. Among the four categories of verbal therapeutic communication used by staff nurses and received by the patients in Cavite Center for Mental Health, physical aspect has the highest total mean of 4.1 while the emotional aspect has the lowest total mean of 3.85. The means that verbal therapeutic communication has a higher effect with the physical aspect and has a lower effect on the emotional aspect of the patients in Cavite Center for Mental Health.

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Relationship Between the Nurses and Patients Perception on the Effect of Non-Verbal Therapeutic Communication The relationship between the nurses and the patients perception on the effect of non-verbal therapeutic communication is presented on Table 6.

Physical Dimension The relationship between the nurses and the patients perception on the effect of verbal therapeutic communication is measured in terms of physical aspect which is

presented on Table 5. The use of therapeutic communication is relative with the nurses with an average weighted mean of 3.80 and 3.98 with the patients. This implies that the non verbal therapeutic communication used by the staff nurses is relative in minimizing the pain felt by the client, in encouraging them to improve health and making the client feel safe and secured in a safe environment. It also implies that the patient's pain is minimized through the nurse's use of non verbal therapeutic communication. The patient's are also encouraged to improve their health and feels safe in a safe environment through the use of non verbal therapeutic communication of the nurses.

Table 6

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Relationship Between the Nurses and Patients Perception on the Effect of Effect of Non-Verbal Therapeutic Communication
Dimension Indicators Mean Nurses Perception Qualitative Description moderate effective moderate effective highly effective highly effective moderate effective moderate effective moderate effective highly effective moderate effective moderate effective Mean Students Perception Qualitative Description highly effective moderate effective moderate effective highly effective highly effective highly effective highly effective highly effective moderate effective highly effective

Physical

1. Minimizes the feeling of pain 2. Encourage to improve Health 3. Feels safe & secured

3.43 3.93 4.03 3.80

4.25 3.9 3.8 3.98 4.05 4 4 4.01 3.95 4.05

Emotional

1. Gives time to reflect 2. Feels relaxed & calm 3. Increased self Confidence

3.9 3.97 3.67 3.84

Mental

1. Give a time for patients privacy 2. Gives new knowledge by showing the correct procedures

3.7 3.77

3.75 Social 1. Shows sincerity 2. Uplifts confidence by Smiling 4.03 4.00 4.13

highly effective highly effective highly effective highly effective

4 3.55 4.25 4.1

highly effective moderate effective highly effective highly effective

3. Feels welcome by Listening

Overall

4.05

highly effective

3.97

highly effective

r=-0.38 moderately negative relationship low relationship. There is no moderate negative relationship in the non-verbal therapeutic communication between nurses and the patients

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Emotional Dimension The relationship between the nurses and the patients perception on the effect of verbal therapeutic communication is measured in terms of physical aspect which is

presented on Table 5.The use of non verbal therapeutic communication is relative with the nurses with an average weighted mean of 3.84 and 4.01 with the patients. This implies that the non verbal therapeutic communication used by the staff nurses is relative in giving the client time to reflect their feelings, making the client feel safe and relaxed and increasing their confidence. It also implies that the client's relatively reflect their feelings, feels safe and relaxed and has an increased confidence through the use of non verbal therapeutic communication of the nurses.

Mental Dimension The relationship between the nurses and the patients perception on the effect of verbal therapeutic communication is measured in terms of physical aspect which is

presented on Table 5.The use of non verbal therapeutic communication is relative with the nurses with an average weighted mean of 3.74 and 4.0 with the patient's. This implies that the non verbal therapeutic communication used by the staff nurses is relative in giving time for client's privacy and providing additional knowledge by showing correct nursing procedures to the patient. It also implies that the patient's are given their time for privacy

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and is provided with additional knowledge through the nurses way of showing correct nursing procedures.

Social Dimension The relationship between the nurses and the patients perception on the effect of verbal therapeutic communication is measured in terms of physical aspect which is

presented on Table 5.The use of non verbal therapeutic communication is relative with the nurses with an average weighted mean of 4.05 and 3.97 with the patient's. This implies that the non verbal therapeutic communication used by staff nurses is relative in showing sincerity, uplifting client's confidence by smiling and make the patient feel welcomed. It also implies that the non verbal therapeutic communication received by the patient's are relative in receiving sincerity from the nurses and has an uplifted confidence when the nurses smile and make them feel welcomed. Among the four (4) categories of non verbal therapeutic communication used by staff nurses in Cavite Center for Mental Health, social aspect has the highest mean of 4.05 while the mental aspect has the lowest mean of 3.74. These means that non verbal therapeutic communication has a higher effect on the social aspect and lesser on the mental aspect of nurses in Cavite Center for Mental Health.

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Among the four (4) categories of non verbal therapeutic communication used by staff nurses and received by the patients in Cavite Center for Mental Health, emotional aspect has the highest mean of 4.01 while the social aspect has the lowest mean of 3.97. These means that non verbal therapeutic communication has a higher effect on the emotional aspect and lesser on the social aspect of the patients in Cavite Center for Mental Health.

Chapter 4 SUMMARY AND CONCLUSIONS This chapter summarizes the study, by highlighting the research conducted in the patients' response on the use of verbal and non-verbal therapeutic communication. The conclusions given where drawn from the outcomes of the study, moreover recommendations were based from the findings and conclusions of the study. Summary of Findings

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The study measures the relationship of the responses of patients on the use of verbal and non verbal therapeutic communication used by staff nurses in Cavite Center for Mental Health. 1. The summary of findings for verbal therapeutic communication are as follows: a. In the physical aspect, the use of therapeutic communication is relative with an average weighted mean of 3.60 with the nurses and 4.1 with the patients in Cavite Center for Mental Health. This implies that therapeutic relationship can alleviate if not diminish pain by communicating relatively to the patient and family. It also implies that the pain felt by the patient can really be alleviated if not diminished when the nurse communicates relatively with the patient.
b. In the emotional aspect, the use of therapeutic communication is relative with an

average weighted mean of 4.18 with the nurses and 3.85 with patients in Cavite Center for Mental Health. This implies that nurses maintain a caring attitude towards the patients and their way of speaking can uplift the patients confidence, give opportunity to patients in expressing the feelings, can reduce tension, can decrease uncertainty and most importantly, it promotes trust. It also implies that the patient gave their trust to their nurses since the nurse maintains a caring attitude.

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c. In the mental aspect, the use of therapeutic communication is relative with an average weighted mean of 4.18 with the nurses and 3.85 with the patients. This implies that patient can gain new knowledge through health teachings, can reflect on their thoughts in a given time, and can seek clarification about a certain topic. It also implies that the patient gains or can gain knowledge from the nurses health teachings. d. In the social aspect, the use of therapeutic communication is relative with an average weighted mean of 4.28with the nurses and 3.98 with the patients. This implies that through verbal therapeutic communication, the nurse and patient creates an environment wherein they interact harmoniously which leads to a good nurse-patient relationship. Moreover, it can uplift the patients confidence can help him cope relatively during hospitalization. 2. The summary of findings for non verbal therapeutic communication are as follows:
a. In physical aspect, the use of therapeutic communication is relative with the

nurses with an average weighted mean of 3.80 and 3.98 with the patients. This implies that the non verbal therapeutic communication used by the staff nurses is relative in minimizing the pain felt by the client, in encouraging them to improve health and making the client feel safe and secured in a safe environment. It also implies that the patient's pain is minimized through the nurse's use of non verbal therapeutic communication. The patient's are also encouraged to improve their

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health and feels safe in a safe environment through the use of non verbal therapeutic communication of the nurses. b. In emotional aspect, the use of non verbal therapeutic communication is relative with the nurses with an average weighted mean of 3.84 and 4.01 with the patients. This implies that the non verbal therapeutic communication used by the staff nurses is relative in giving the client time to reflect their feelings, making the client feel safe and relaxed and increasing their confidence. It also implies that the client's relatively reflect their feelings, feels safe and relaxed and has an increased confidence through the use of non verbal therapeutic communication of the nurses. c. In mental aspect the use of non verbal therapeutic communication is relative with the nurses with an average weighted mean of 3.74 and 4.0 with the patient's. This implies that the non verbal therapeutic communication used by the staff nurses is relative in giving time for client's privacy and providing additional knowledge by showing correct nursing procedures to the patient. It also implies that the

patient's are given their time for privacy and is provided with additional knowledge through the nurses way of showing correct nursing procedures. d. In social aspect, the use of non verbal therapeutic communication is relative with the nurses with an average weighted mean of 4.05 and 3.97 with the patient's. This implies that the non verbal therapeutic communication used by staff nurses

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is relative in showing sincerity, uplifting client's confidence by smiling and make the patient feel welcomed. It also implies that the non verbal therapeutic communication received by the patient's are relative in receiving sincerity from the nurses and has an uplifted confidence when the nurses smile and make them feel welcomed.

Conclusions The researchers were able to arrive at and concluded the following based on the findings of the study: 1. The verbal therapeutic communication rendered are: physically- minimizes the feeling of pain; emotionally: uplifts confidence, gives opportunity to express feelings, decrease tension, decrease uncertainty and promotes trust towards the nurse; mentally: gains new knowledge, gives time to reflect and gives a chance to clarify

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information; socially- develops harmony, develops a good nurse-patient relationship, improves confidence of the patient and help to cope effectively. 2. The non-verbal therapeutic communication rendered are: physically- minimizes the feeling of pain, encourages to improve health and feel safe and secured; emotionallygives a time to reflect, feels relaxed and calm and increases self confidence; mentally- gives a time for patients privacy and gains new knowledge; socially- shows sincerity, uplifts confidence and feels welcome. 3. There is no relationship in the Verbal therapeutic communication between the nurse and the patients at Cavite Center for Mental Health. 4. There is moderate negative relationship in the non-verbal therapeutic communication between the nurse and the patients at Cavite Center for Mental Health.

RECOMMENDATIONS After the analysis and interpretation of data, the following are recommended for: Staff Nurses They must improve the use of verbal and non-verbal therapeutic communication in nursing by developing their communication skills in interacting with mentally-ill patients.

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They must have utilize the use of verbal and non-verbal therapeutic communication & make it very effective to the patients with mental illness.

Nursing students They must have put into action their learning about the importance of therapeutic communication so that in time when they become nurses or psychiatric nurses, they would render efficient services to their patients especially in mentally-ill patients. They also must have to develop more techniques on the use of verbal and non-verbal therapeutic communication especially when it comes to dealing with mentally-ill patients.

Clinical Instructors: They must have to impart their knowledge and their share their experiences to their students and stress the importance of a therapeutic nurse-patient relationship especially whem you are dealing with the mentally-ill patients. Nursing administrators: They must have to improve the quality of psychiatric nurse through seminars and for the use of therapeutic communication as an effective tool in rendering care and service to the

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mentally-ill patient. Also they must have to train their staff nurses on the implementation of the therapeutic nurse-patient relationship.

BIBLIOGRAPHY Stop Walking on Eggshells: Taking your life back when someone you care about has borderline personnality disorder, Paul T. Manson & Randi Kreger, New Harbinger Publications, 1988. I Am Not Sick I Don't Need Help, Dr. Xavier Amador, Vida Press, 2nd ed, 2007. When Someone You Love Has a Mental Illness; A handbook for families, friends and caregivers, Rebecca Woolis, M.F.C.C., G.P. Putnam's Sons, New York, 2002.

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 Chamber Evans , Stelling & Goodwin, 1999 Haber et al., 2007 Krujiver, Kerkstra, Franke, Bensing, & Van de Wiel, 2000 Antai-Otong and Wasserman 2003 Larson, 1999; Rosenstein, 2002; Rosenstein & O Daniel, 2005

Boyle & Kochinda, 2004; Schmidt & Svarstad, 2002 Howells,; Kleinman, 2004 Fosshage, J. (2003)Contemporary Psychoanalysis Vol 39, No.3, 411-448, Hunter, M. & Struve, J. (2005) The Ethical Use of Touch in Psychotherary Montagu, A. (2001) Touching: The Human Significance of the Skin Glickauf- Hughs & Clance To Touch Or Not To Touch 2010 Wilison, B.G & Masson, R.L. (2006) Journal of Counseling and Development, 64, 497500 Miller, L.A. (2003) Nursing Forum, 18(3), 278-287 Cohen, S.S. (2004) The Magic of Touch Field, T. (2003) Touch Hernandez-Reif, M. Field, T., Krasnegor, J., Theakston, Z., & Burman, I. (2001) Journal of Bodywork and Movement Therapies, 4, 31-38 Downey, D.L. (2003) Psychotherapy, 36/1, 35-38

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APPENDIX A

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APPENDIX B

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APPENDIX C

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APPENDIX D

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APPENDIX E
Dear respondents, We are the group 7 of BSN 4F currently conducting a research on A Correlation Study Between Verbal & Non-Verbal Communication on the Nurse-Patient Therapeutic Relationship at Cavite Center for Mental Health, as a partial fulfillment on the course requirement in NPP 105 (Research in Nursing). We cordially ask for your time in answering questions and we assure you of the confidentiality and anonymity of the data that you will be enclosed. Thank you for your cooperation. The Researchers, __________________ Garcia, John Richard Group Representative

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Respondent No: Instruction: Please encircle the number that corresponds to your answer. 5 > very high effect 4 > High effect 3 > Moderate effect 2 > Limited effect 1 > No effect

A. Verbal Therapeutic Communication 1. Physical 1.1. Minimizes the feeling of pain through the use of therapeutic conversation Nababawasan ang sakit na nadarama ng pasyente 2. Emotional 2.1. Uplifts confidence by encouraging words Napapalakas ang loob 2.2. Gives the opportunity to express feelings. Nabibigyan ng pagkakataon na maipahayag ang nararamdaman 2.3. Decreases tension by starting the therapeutic conversation Nababawasan ang pag-aalala 2.4. Decrease uncertainty by sharing impression with the patient & seeking corrective feedback Nagiging panatag ang loob sa pamamagitan ng pagbabahagi sa pasyente at pag-aantay ng sagot 2.5. Promotes trust toward the nurse by showing sensitivity and display of positive regard towards the patient Nagkakaroon ng tiwala sa nars sa pamamagitan ng Pagiging sensitibo at positibong pagtangi sa pasyente 3. Mental 3.1. Gains new knowledge through health teachings Nakakakuha ng bagong kaalaman sa pamamagitan ng maayos at makabuluhang pagtuturo

5 5

4 4

3 3

2 2

1 1

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3.2. Gives time to reflect by pausing for a few seconds while in a conversation. Nagbibigay ng pagkakataon na makapagnilay-nilay sandali habang nakikipag-usap. 3.3. Gives a chance to clarify unclear information by answering questions asked. Nabibigyan ng pagkakataon para malinawan sa mga impormasyon sa pammagitan ng pagsagot sa tanong ng pasyente. 4. Social 4.1. Develops harmony by greeting with the use of therapeutic conversation. Nahuhubog ang mabuting pakikitungo sa isat-isa 4.2. Develops a good nurse-patient relationship by maintaining a caring attitude towards the client. Pagkakaroon ng magandang samahan sa pamamagitan ngmabuting pag-aaruga sa pasyente 4.3. Improves confidence of the patient by giving positive regard Nabubuo ang tiwala sa sarili sa maayos na pakikitungo ng nars 4.4 Helps to cope effectively by using therapeutic Conversation Nakakatulong sa kapanatagan ang epektibong pakikipag-usap sa pasyente

4 4

B. Non-verbal TherapeuticCommunication 1. Physical 1.1. Minimizes the feeling of pain with the use of therapeutic touch like soft touch or rub Nababawasan ang sakit ng nararamdaman tuwing ginagamitan ng haplos o masahe 5 4 3 2 1

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1.2. Encourages to improve health by showing great interest & sincere care while performing nursing procedure. 1.3. Feels safe & secured by promoting a safe environment & gives a sense of security. Randam ang kapanatagan at maayos na pangangalaga sa pamamagitan ng pagtataguyod sa ligtas na kapaligiran 2. Emotional 2.1. Gives time to reflect Nabibigyan ng panahon na makapagnilay-nilay 2.2 Feels relaxed & calm by maintaining steady & calm vocal cues Nakakaramdam ng kapanatagan kapag napanatili ang kahinahunan 2.3 Increases self confidence by the use of friendly gestures like soft touch, light tapping on the back etc. Nadadagdagan ang tiwala sa sarili tuwing hinahaplos at kinakalingabilang isang kaibigan 3. Mental 3.1. Gives time for patients privacy Naglalaan ng pribadong panahon sa pasyente 3.2. Gains new knowledge by showing the correct nursing procedure to the patient Nagkakaroon ng bagong kaalaman sa pamamagitan ng pagbibigay o pagpapakita ng tamang pamamaraan sa pag-aalaga 4. Social 4.1. Shows sincerity by maintaining an eye to eye contact Nagpapakita ang sensiridad sa pammagitan ng ugnayang mata sa mata 4.2 Uplifts confidence by smiling to the clients when approaching Naaangat ang moralidad sa pamamgitan ng pagngiti Sa tuwing nakikita ang pasyente

5 5

4 4

3 3

2 2

1 1

5 5

4 4

3 3

2 2

1 1

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4.3 Feels welcome by listening to what the patient tells or says Nagpaparamdam ang mainit na pagtanggap sa pamamgitan ng pakikinig sa anumang sinasab ng pasyente sa nars.

SET B: PATIENTS Bilang ng Respondent : Instruksyon: Pakibilugan po ang numero na sumasang-ayon sa inyong sagot.

5 > talagang totoong epektibo 4 > totoong epektibo 3 > epektibo 2 > hindi gaanong epektibo 1 > hindi epektibo

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A. Verbal Therapeutic Communication 1. Pisikal 1.1. Nababawasan ang sakit na nadarama kapag nakakausap ang nars 2. Emosyonal 2.1. Napapalakas ang loob sa tuwing napapayuhan ng nars 2.2. Nabibigyan ng pagkakataon na maipahayag ang nararamdaman kapag nakausap ng nars 5 4 3 2 1

5 5

4 4 4

3 3 3

2 2 2

1 1 1

2.3. Nababawasan ang pag-aalala o tensyon kapag nakakausap ang 5 nars 2.4. Nagiging panatag ang loob kapag nagbabahagi ng impormasyon ang nars 2.5. Nagkakaroon ng tiwala sa nars sa pamamagitan ng pagiging sensitibo at positibong pagtangi ng nars 3. Mental 3.1. Nakakakuha ng bagong kaalaman sa pamamagitan ng maayos at makabuluhang pagtuturo mula sa nars 3.2 Nagbibigay ng pagkakataon na makapagnilay-nilay sandali habang nakikipag-usap. 5 5

4 4

3 3

2 2

1 1

5 5

4 4

3 3

2 2

1 1

3.3. Nabibigyan ng pagkakataon na malinawan sa mga impormasyon sa pamamagitan ng pagtanong sa nars at pagsagot naman nito sa aking katanungan 4. Sosyal 4.1. Nahuhubog ang mabuting pakikitungo sa isat-isa

5 4

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4.2. Pagkakaroon ng magandang samahan sa pamamagitan ng mabuting pag-aaruga ng nars sa akin

4.3. Nabubuo ang tiwala sa sarili sa maayos na pakikitungo ng nars 4.4 Nakakatulong sa kapanatagan ko ang epektibong pakikipag-usap sa akin ng nars

B. Non-verbal TherapeuticCommunication 1. Pisikal 1.1. Nababawasan ang sakit ng nararamdaman tuwing ginagamitan ng haplos o masahe ng nars 5 4 3 2 1

1.2. Pinapalakas niya ang aking kalusugan sa pamamagitan ng pagpapakita sakin ng interes at sensiridad sa pag-aalaga habang ginagawa niya ang kanyang pamamaraan sa pag-aalaga 1.3. Nakakaramdam ako ng kapanatagan at maayos na pangangalaga dito sa loob ng ospital/institusyon 2. Emotional 2.1. Nabibigyan ako ng panahon na makapagnilay-nilay 2.2 Nakakaramdam ng kapanatagan kapag napanatili ang kahinahunan 2.3.Nadadagdagan ang tiwala ko sa sarili sa tuwing hinahaplos ng nars at kinakalinga bilang isang kaibigan

5 5

4 4

3 3

2 2

1 1

5 5

4 4

3 3

2 2

1 1

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3. Mental 3.1. Naglalaan ng pribadong oras o panahon sa akin 3.2. Nagkakaroon ng bagong kaalaman sa pamamagitan ng pagbibigay o pagpapakita ng tamang pamamaraan sa pag-aalaga

5 5

4 4

3 3

2 2

1 1

4. Sosyal 4.1. Naipadadama ang sensiridad sa pammagitan ng ugnayang mata sa mata 4.2 Naaangat ang moralidad ko sa pamamgitan ng pagngiti sakin ng nars sa tuwing nakikita niya ako

5 5

4 4

3 3

2 2

1 1

4.3 Feels welcome by listening to what the patient tells 5 or says Nakakaramdam ako ng mainit na pagtanggap sa nars sa pamamgitan ng pagkikinig niya sa anumang mga sinasabi ko

CURRICULUM VITAE

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