Contents Foreword Preface, |APTER 1 Review of the Communication Process Definitions of Communication Meaning of Communication... ess of Communication. . - _Elements of the Communication Process ‘Types of Communication... ~ Facilitators of Communication Batriers of Communication ... Methods to Overcome Barriers of Communication. Techniques of Effective Communication... Techniques of Therapeutic Communication _ PHAPTER 2 Interpersonal Relationships .... Definitions of Interpersonal Relationship Dynamics of Interpersonal Relationship. Purposes of Interpersonal Relationship ... ‘Types of Interpersonal Relationships. Phases of Interpersonal Relationship... Barriers of Interpersonal Relationships Methods to Overcome Barriers of Interpersonal Relationships... Johari Window ” Human Relations... Definitions of Human Relations .. Human Relations in Nursing Understanding Self...... Social Behaviour. Social Attitude .... Motivation. Individual and Groups .. Group Dynamics. Teamwork .. Guidance and Counsetting... Definitions of Guidance and Counselling. Definitions of Guidance. Definitions of Counselling. xiiixiv Contents CHAPTER 5 vw 16 Difference Between Guidance and Counselling Purposes of Guidance and Counselling Characteristics of Guidance and Counselling Scope of Guidance and Counselling Need of Guidance and Counselling Basic Principles of Guidance ‘Types/Areas of Guidance Services Organization of Counselling Service: ‘Types of Counselling Approaches . Role and Preparation of the Counsellor..... Counselling Process... a Tools and Techniques for the Counselling Process... Issues of Counselling in Nursing Managing Disciplinary Problems..... Management of Crisis and Referral Crisis Interventions. Principles and Philosophiestol of Education Meaning of Education. = Aims of Education... = Aims of Nursing Education. Factors Affecting Aims of Education Functions of Education Philosophies of Education “Philosophy, Education and their Interdependence. Classification of Educational Philosophies. ‘Traditional Educational Philosophies ~~ Contemporary Educational Philosophies... a \g—-Learning Process.Characteristics of Good Teaching Principles of Teaching Maxims of Teaching Formulation of Edu: Lesson Planning. Classroom Management CHAPTER 7 Methods of Teaching... Definition of Method of Teaching .#.... + Lecture Method... + Demonstration... aoe = Group Discussion... 4» Seminar re 2 Symposium... -e Panel Discussion. + Role-Play Si... -® Project Method. -eField Trip wet, # Workshop .. ¢ Exhibition i 4 Programmed Instructions ¢ Computer-Assisted Learnin; ‘¢ Application of Computers in Nursing“. ‘«Micro-Teaching «1. . Problem-Based Learning wl Si: . + Problem Solving as a Method of Teaching wf, . + Self-Directed Learning + Simulation. Clinical Teaching Methods Case Method/Case Study. Nursing Case Presentation lursing Rounds side Nursing Clinics ing Assignment...... yg Care Conference tional Objectives Conference ding Contents wvxvi Contents CHAPTER 8 Educational Media. Audiovisual Aids... “a \_-Graphical Teaching Aids. _Phree-Dimensional Audiovisual Aids Definitions of Audiovisual Aid Concept of Audiovisual Aids Importance of Audiovisual Aid Purposes of Audiovisual Aids.. Characteristics of a Good Audiovisual Ai Sources of Audiovisual Aids. Principles for using Audiovisual Aids Types of Audiovisual Aids. ~Chalkboard/Blackboard Flash Cards .. Flannel Board .. Bulletin Board Cartoons... Objects and Specimens. Video Cassette Recorder (VCR)/VCD Player Camera. Microscope .. LCD Projector Audio Educational Aids ‘Tape Recorder...Y Contents xvii Public Address Systems Computer abet . Guidelines for Effective use of Audiovisual Aids. CHAPTER 9 Assessment sehr " 356 Concepts of Measurement, Assessment and Evaluatio Meaning of Assessment/Evaluation Types of Assessment/Evaluation... Purposes of Assessment/Evaluation. Scope of Assessment/Evaluation .. Criteria for Selection of Assessment Techniques/Methods A Classification of Assessment Tools and Techniques: RA Essay Type Questions Short Answer Questions Multiple-Choice Questions. Ttem Analysis Observation Checklist. Rating Scale enn Practical Examination. Viva Voce ........ Objective Structured Clinical Examination (OSCE) Altitude Scales. Likert Seale = Semantic Differential Scale CHAPTER 10 Information, Education and Communication for Health. Health Behaviour. Health Education .. Planning for Health Education, é Health Education with Individual, Group and Communities ‘Communicating Health Message: ; Factors Contributing to the Successful Communication of Health Message ‘Methods and Media for Communicating the Health Message .. Using Mass Media... Appendix A: Lesson plan on course equivalency, transcript and credit system ...429 Appendix B: Comprehensive review (multiple- Index. aeReview of the communication process M pee singularly the most powerful force available fo humanity. We can choose to use tis force con- structively with words of encouragement, or destructively using words of despair. Words have energy and power with the abilty to help, to heal, to hinder, to hurt, to harm, to humiliate and to humble. Yehuda Berg LEARNING OBJECTIVES This chapter is designed to enable the reader to + Understand the meaning and concept of communication * Describe the process of communication * Classify the types of communication and recite relevant examples * Recognize the facilitators of communication + Appraise the barriers of communication and methods to overcome these barriers © Identify techniques of effective communication + Discuss the techniques of therapeutic communication KEY TERMS ‘Communication 03 — Formal communication 10 Referent 03 Informal communication 10 Sender 04 — ~ Therapeutic communication 10 Message 04 ~ Intrapersonal communication 10 Channel 04 Interpersonal communication 10 Receiver 05 ~ Public communication u Feedback 06 Organizational communication u Confounding elements 06 Barriers of communication 13 Verbal communication 06 Techniques of effective communication 18 Nonverbal communication 08 Techniques of therapeutic communication 20 INTRODUCTION “The term communication is derived from the Latin word, .2.eommon In general, com- munication refers to th ideas, facts, opinions, beliefs, feelings and ‘attitudes through. ‘two people or within a groupjof people. It can beSat dnp ape an ei he meek a cestyeacean nnn a a iy at eyo ta Broadly speak {Kline s a twosway proses of exchanging or sharing dea, ing, communicauon ree . Ieismore tan merely he shat ing infomation and men ping he ny forded ase wey providing ethers with norman fr achieving predccmincd gah, Cane a oe eae 's progress and is considered the uae eal eel communican hs ton nts mot poo ee an en oa eee a erceam ainoee ace Communion sd intention The a pp of coe eee a Adele inBox 11 (Waite ae aa Naring ie dcp that compli fetal te nculy we cmmune ng daytovdy due base vanes acne nay ike, Dr ida Wall he pomad ote teat oe ee ee ote waynes communica with tpn ar elisha ea esearch fags erga Fas Mill Therefore ars ant he ote ape oe Cn puters encom oder Unorency at aes te ee poor ‘communication ils and Tesmmead an phat oe preehi ae ae tring or mes (Sharma, 2009) Tolay. mune eed he poet nacrenheg Tce tomeral, writen so decor Comtmincatan cary au ee Poesioed eee oe an efficent maaner DEFINITIONS OF COMMUNICATION Communication i proce by which infomanon exchanged bnoen nt rough 2 ccomon gus of ulaeand sis agent — ete ietoay eommancaton i merchang of hs pies natn ach wig ris Communication isthe transmission and erange of facts, es figs or course of cto Comma Z -_ ideas and fetings i 1 mod of matali Communication is sharing of ideas and fel of = ‘CHAPTER 1 Review ofthe communication process patanding from one person 10 Commanication isthe proces of pasing information and unde von ‘md mating ons enero By OTE nae Is the proces of imparting eas MEANING OF COMMUNICATION Frm he dcaion and dente i the previous section, we can describe communication 1 proces hough which inviuals mutually exchange ter ess, valves, tought, flings and ons wit ne more people + Theatr of fcmation from he sender othe receivers this understood in the right context. 1 he proces of iitatng, transmit and receiving information. The means of making the tanser of information productive and goa oriented, +The process of sharing infomation, ideas and atiudes between individuals. PROCESS OF COMMUNICATION Tepe of conmaniaon complet oncingdymamic nd muliimensonl human interaction aedpiced in ig 1 is seamen the sede a the ipa of te message 0 {and has several components wich Pieeenetreoateon ee res ye nt and sending trove } ih epee tg eon em sender gw prin canal Te ee pone ema Te ee Koln cartes aes | ELEMENTS OF comMunicarion Process ‘Some important elements ofthe communication process are explained below: 1, Referen: § reset for receiver) to information! message, objccs, ‘um ene eles ews peyote sas, ns ee na ae ee Orcing Reto S| creme Ler] eure 1.1 = 3 :CHAPTER 1. Review of the communication process ‘communication skills of the sender. ostJetc. A bref classification and description of the channels Timepiece mag be 1 onan atc eg eh ent ey= Somm lunication and Educational Technology and is © ae ator aoe end of the communication process. He is expected to have the ability Ghatescaieca oe eons nteroet ho metiige ‘Some experts believe that the sender ang Saar et eee conned bot are essential and inseparable elements of the ore process. The sender and the receiver interact back and forth so spontaneously ang ‘aneously that mutual and reciprocal relation consistently exists for efficient communication, Depending on the purpose of communication, a receiver could be an individual, a homogenous group or a free group. 6. Feedback: Feedback is aretumimessage sent by the receiver to the sender. It is the element of the communication process as it shows that the receiver has understood the primary mes- sage seat by the sender and the communication process is now considered complete. * avecessil Communication must be a two-way process where theisender sends the message ark r-ocifea aaa ‘back from the receiver. This feedback could be A ‘or example, @ nurse receiving a phone message from the nursing superintendent to report for a morning meeting gives feedback that she will get there atthe earliest possible time. The loop as well asthe purpose of communication is considered complete after the sender receives feedback from the receiver 7. Confounding elements: These elements are not a direct part of the flow of the communication pro- coor bat influence the communication process significantly indirectly. These elements ‘sonal variables of the sender and the receiver and th yhere the communication process takes place. Interpersonal variables, such educational and “developmental levels, ‘emotions, gender, physical’ and mental health, etc., may significantly affect the communication process. For example, an Indian woman will be unable to communicate freely about her reproductive problems with a male nurse or a male gynaecologist. In this case, the sociocultural values of Indian women affect communication. Similarly, the environ- ment also plays a pivotal role in the communication process. The environment comprises of noise, temperature, destruction, lack of privacy or space, discomfort, etc. For example, it is difficult for a nurse to communicate with health care team members or a patient in a noisy ward. Nurses must, therefore, ensure a favourable environment for effective nurse-patient communication. TYPES OF COMMUNICATION “There is a lack of consistency about the types of communication in literature. To avoid such confusion and provide clarity, this book offers a clear, comprehensive and simple classification of the types of communication (Table 1.1). |. BASED ON THE MEANS OF DELIVERING THE MESSAGE Communication may be broadly categorized into verbal, nonverbal, symbolic and meta communication based on the means of delivering the message from the sender to the recipient. A. Verbal communication Verbal communication occurs through words is used and each word conveys @ convey factual informatis munication areCHAPTER 1 Review of the communication process Table 1.1 Types of Communication with a Brief Description | Based on the Means of Delivering the Message * Verbal communication = Spoken communication = Written communication = Telecommunication = Bectronic communication * Nonverbal communication © Symbolic communicatior ‘© Meta communication lt occurs through the medium of spoken or written words. Verbal ‘communication occurs directly and face to face using spoken words ‘r a telephonic device. It may also occur through written words using a paper and a pencil. Today, written words may be communicated using electronic means such as a computer and e-mail facility ‘This communication occurs without words, where the five senses and ‘a whole range of body movements, posture, gesture, facial expres- sions and silence are used for sending and receiving the message. It involves verbal as well as nonverbal symbols to convey a message (such as music) ‘The communication within the message is uncovered and understood in meta communication. For example, when someone says. ‘| am ok’, ‘meta communication helps in understanding i he or she is actually alright or not I. Based on the Purpose of Communication f ‘© Formal communication «Informal communication ‘© Therapeutic communication Ill. Based on the Levels of Communication . oe * Intrapersonal communication * Interpersonal communication * Transpersonal communication * Small-group communication * Public communication * Organizational communication |. Based on the Patterns of Communication * One-way communication Formal communication follows lines of authority such as organizational meetings. Informal communication does not follow ines of authority such as gossip. Itis a formal process where the patient and health care provider get an opportunity to learn about each other to modify the patient's Behaviour. ‘The communication that takes place within an individual (or sel-talk); crucial to understand oneseff. Where two or more people share ideas or messages with each other. The communication that takes place within a person's spiritual domain, e.g. communicating with one’s inner self-conscious. ‘Communication in a small-group, consisting of 3-4 people interacting face to face or using electronic means. Interaction of one or more people with a large audience, such as health education by a nurse (or nurses) to a group of people. It takes place when individuals and groups within an organization ‘communicate to achieve established organizational goals. sanrpererie % Itis a unidirectional process where the message flows from the sender to the recipient without feedback, such as in public speeches. where the message flows from the sender 7omy ‘Sonciseness, procisoness, comprehension. brevity, timing and relevance,-Verbal communication may be further classified into the ther methods existence. In spoken spoken c peeneures the exchange of facts, ideas and opin. tc hrou the best method of verbal communication exchange spoken words because of the ns, videoconferencing fa 5 on the sender and the recipient with the help of specific elee- with the av better communication, “Bleetronie communication: Electronic communication has become more popular recently because it is speedy, accurate and confidential and a large number of messages can be exchanged at a faster speed. This is why electronic mail (@-mail) éommunication has become a more popular means of communication. Electronic communication is usually accomplished through a computer and internet 8. Nonverbal communication werbal communication takes place without the use of spoken or written words. It includes all five. raised eye-brow, frown, st rate way of communi example, a gloomy faci Stuart and Laraia (2005) documented that 7% of a message is transmitted by words, 38% through voeal cues and 55% by body cues. Nonverbal communication may be accomplished by the following means: fluences. Factors such as age and sex also play an important role in individual meanings ated with touch, Desp s viewed as one of the most ways of expressing feelings such as comfort, love, affection, security, anger, sion and excitement. : Beers often begins with eye contact. Eye contact also. and keeps the communication open. Absence of eye contact often defensiveness or an avoidance of communication, In some cultures, however, adolescents are taught it is disrespectful to look an adult in the eyes. In others,CHAPTER 1 Review of the communication process avoid eye contact or not to make eye contact with elders. The eyes carry a large number of nonverbal messages that can easily be assessed on eye contact. + [Racial expression: The face is the most expressive part of the body. Facial expressions convey feel- ings such as anger, joy, suspicion, sadness and fear. Some people have an extremely expressive face whereas others are able to mask their feelings, making it difficult for others to determine what the person is really thinking. The way a person holds his or her body carries a nonverbal message. People’ in 00d")! “air and witha postive aioe wali hold their bodies in good alignment. Depressed or tired people are more likely to slouch. Posture also often provides nonverbal clues concerning s in and physical limitations. For example, MIRE a aceRCa Rc aRReNgoORTatkctay + Gait: A bouncy, purposeful walk usually carries a message of well-being. A less purposeful, shuffling gait is associated with illness. + (Gesture: A gesture using various parts of the body can carry numerous messages. For example, thumbs up means victory and a thumb down carries a negative implication. Kicking objects often expresses anger. Wringing hands or tapping a foot usually indicates anxiety or anger, and a waving hand signifies beckoning someone to come or leave. Gestures are used extensively when two people speaking different languages communicate with each other. ‘Physical appearance: }linesses result in an alteration in the general physical appearance. On the other hand, a person in good health tends to put it across through general physical appearance. + |Sound: Crying, moaning, gasping and sighing are oral but nonverbal forms of communication. Such sounds can be interpreted in numerous ways. For example, a person may cry because of sadness or joy. + \Silence:/A period of silence during a conversation often carries important nonverbal messages. For example, someone sitting silently in a group discussion suggests disinterest in the discussion or preoccupation with other thoughts. The nonverbal signal of friendly attitude may be understood from the findings reported by Argule (1992) in his qualitative study on the ways of nonverbal expression in a friendly attitude (Box 1.4). ii. BASED ON THE PURPOSE OF COMMUNICATION Communication may be categorized into formal, informal and therapeutic communication based on the purpose of communication. f ee ee) | Prosity Closer, leaning forward if seated directly but side nme imation. — r a | Facial expression Gestures Xt Ss10 Communication and Educational Tec hnology A. Formal communication Formal communication {GHG8 Hines OF muthority and is generally used in organizations to achieve organ. zational objectives. For example, the nursing superintendent of a hospital will communicate with staff nurges through assistant nursing superintendents, supervisors and ward-in-charge nurses. The channels of com. munication may be more formal and active through the use Ings in this method of communication. In formal communication, i Organizational information with members in an organization to achieve specific organizational goals, 8. Informal communication Informal communicati Some examples of informal communication Informal communication is very fast and usually takes place in such as friends, family and peer groups. The main purpose of informal communication is socii s © Wadia infomation sth familiar people in a social group. C. Therapeutic communication Therapeutic communication takes place between a health care personpel and aipati with the purpose of modifying the patient’s behaviour. This is accomplished with sing certain es- ‘trust, empathy, tendemess, concern and a aia: sential attributes such as il. BASED ON THE LEVELS OF COMMUNICATION Communication may be categorized into intrapersonal, interpersonal, transpersonal, small-group, public and organizational communication based on the levels of communication. A. Intrapersonal communication Intrapersonal communication takes pl: we may also sa it is self-talke It is cru- cial because it provides a person with , before acting on it, ultimately affecting the person's behaviour. 8. Interpersonal communication Interpersonal communication takes place whenever two or more people interact and exchange messages ‘or ideas. This is also one of the most common forms of communication in our daily lives. Good inter- personal skills equip nurses with ; for patients more efficiently. Interpersonal communication may be further categorized int C. Transpersonal communication ‘Transpersonal communication takes place within communication is to realize selfhood, enhance spirituality and ; D. Small-group communicationCHAPTER 1 Review of the communication process 11 £. Public communication public is generally defined as a large group of people. Communication with such a large group of peopl js known as public communication. In health care, public communication becomes essential when a message needs to be disseminated to a large group at once. Public communication requires essential skills to influence people at large and media material to reach out to each member of the public clearly and loudly F Organizational communication Organizational communication takes place ‘hen india roaperaitpecempeai _ municate with each other to achieve established organizational goals. The success of an organization depends largely on the effectiveness of organizational communication iv. BASED ON THE PATTERN OF COMMUNICATION Communication may be categorized into one-way, two-way, one-to-one, one-to-many and many-to-one communication based on the levels of communication. A. One-way communication One-way communication takes place when messages are delivered to the audience from the communica- tor only aida oaasiaat Wedbeckd A common example of one-way communication is on ered in a classroom. There are plenty of drawbacks in one-way communication including th of ¢ constant feedback, the message being eee pa the receiver, the delivery of message being authorita-/ “tive and little participation of : B. Two-way communication ‘Two-way communication takes place when both the communicator and audience take part in the pro- cess. The audience may raise questions and be the subject. In two- way communication, the process of learning ii €. One-to-one communication ‘Communication between at one time is termed as one-to-one communica- tion. A nurse providing discharge information to a patient is an example of one-to-one communication. This method of communication is used when a more focused and individualized method of communica- tion is required. ‘it is termed as one-to-many ‘an example of one-to-many ‘opportunity to communicate cate with one person at the same ‘communication. This method ly at the same time.“ommunication and Educational Technology FACILITATORS OF COMMUNICATION tors help achieve smooth and hurdle-free communication between two or more people, The ‘ors of communication are discussed in this section. he seven Cs of communication are considered essential for effective written and oral communication (Fig. 1.2). These seven attributes are as follows: 1. Clarity: A clear message helps the receiver understand the message easily and appropriately ee misunderstandings. 2. Incomplete communication has no use; therefore, a message sent by the sender (or receiver) must be complete to achieve the desired purpose of communication. 3. Conciseness: Communication can be more effective if the message is as concise as possible so the “meaning is not lost in a large amount of content and can be easily understood by the receiver. This also makes communication less time-consuming and crystallized. 4. Concreteness:| Concrete communication is specific, clear and free from fuzziness. Concreteness makes communication more specific and meaningful. .) Correctness:Correct communication helps in having an error-free message or content in communica- ion. Correctness could be in reference to grammar or in the use of right words at the right place. © Gabo helps the senders/receivers express their politeness, empathy, enthusiasm, sin- cerity, etc., in communication. 7. Consideration: Consideration helps in the understanding of others’ problems by stepping into others’ shoes. A message delivered following the principles of consideration is accepted by the recipient more openly and easily. Seven Cs of Effective Communication Concreteness FIGURE 1.2CHAPTER 1 Review of the communication process 13 In addition to the above attributes, communication can be facilitated by using the following strategies or general guidelines: + "Positive attitude? A positive attitude facilitates communication. Defensiveness interferes with ication. + Improving communication skills: Improving communication skills takes knowledge and work Increased awareness of the potential for improving communication is the first step for better communication. . skills: Including communication as a skill to be evaluated along with other skills facilitates communication. It helps other people improve their communication skills by helping them understand their communication problems, + Goal-oriented communication: Making communication goal-oriented boosts communication. Rela- tional goals come first and pave the way for other goals. When the sender and the receiver have a good relationship, they are much more likely to accomplish their communication goals. . Approaching communication as a creative process rather than simply as a part of the chore of working with people facilitates communication. Experimenting with communication alternatives (various channels, listening techniques and feedback techniques) is a good idea as what works with one person may not work well with another. + Minimizing negative impact: Accepting the reality of miscommunication helps in minimizing the impact of communication failure. The best communication may sometimes fail, so we should accept ‘miscommunication and work towards minimizing its negative impact. . : Good communication maintains qualities of warmth and friendliness throughout the communication process. + Openness and respect: An attitude of acceptance, frankness, respect and lack of prejudice helps in improving communication. + Empathy: Empathy is identifying with the way another person feels. An empathetic nurse is sensitive to the patient's feelings and problems but remains objective enough to help the patient achieve posi- tive outcomes. 1: A comfortable environment is one that is trustworthy and safe for communication to take place. BARRIERS OF COMMUNICATION Communication is not an easy process and can be hindered by several factors including personal, physiological, physical, environmental, psychological, social, cultural, semantic, and organizational and communication process-related barriers (Fig. 1.3). The barriers of communication are discussed in detail below (Table 1.2) |. PHYSIOLOGICAL BARRIERS * Poor retention due toTable 1.2 Barriers of Communication al ‘Categories of Description of Barriers ‘Bariers of Communication 2. Exwironmental Loud background noise bamers 3. Poychoiogical | Misperception and misunderstanding bares —«-|_ Distrust ‘and unhappy emotions Hist as Poor retention due to memory problems i Faas ervdely énd confused ti rang ind Methods of Overc coming the Barriers = ‘Sender and recipient must keep in re oc o> at must be ensured to facilitate nonverbal communication. ‘Comfortable gement must be provided for effective communication.CHAPTER 1 Review of the communication Process 15 Table 1.2 Barriers of Communication and Methods of Overcoming the Barriers—cont'd Categories of Description of Barriers Methods to Overcome the Barriers. Barriers ‘of Communication of Communication cial barriers. | Diffidence in social norms, values and Diffidence in social norms, Values ‘behaviour iv Ses aeee and behaviour must be given due Different social strata sender and recipient must be kept in mind while communicating 5. Cultural Ethnic, religious and cultural differences / Cultural difference barriers Cuttural traditions, values and behaviour Seo ee - be kept a + Hearing problems + Poor listening skills + Information overload Gender physiological differences + Loud background noise + Poor lighting + Uncomfortable setting + Unhygienic surroundings and bad odour + Very hot or cold room + Distance il. ENVIRONMENTAL BARRIERS lll. PSYCHOLOGICAL BARRIERS + Misperception and misunderstanding + Distrust and unhappy emotions + Emotional disturbances such as anger, jealousy and suspicion + Prejudice, resentment and antagonism -* Psychotic or neurotic illness + Worry and emotional disturbance + Fear, anxiety and confused thinking !V. SOCIAL BARRIERS + it cecenmes18 Communication and Educational Technology rr TECHNIQUES OF EFFECTIVE COMMUNICATION mes, the therapeutic use of communication requires jues/skills are considered essen. Although we are involved in communication at all tin ary skills. The following techniql ion (Fig. 1.4). training and practice to develop nece: tial in ensuring effective communic: |, CONVERSATIONAL SKILLS Conversation or an exchange of verbal communi how to converse with others as children. The tec! verbal communi ion. + Focusing: Focusing is a central or to reality and builds trust between the two communicating jeri + Paraphrasing: Paraphrasing is restating another person'® ‘message more briefly using One'S'6wn “words, It helps individuals in sending reciprocal feedback showing they are keen to listen to and understand each other’s message. | interaction. As social beings, we lean ‘ed below may be used for effective ication is a soc! Jhniques discuss key element of communication. It helps individuals come down Focusing listening Paraphrasin eens, (Lise stence information Listening with Providing information, ‘Asking relevant questions Clarifying and ‘summarizing ‘Sharing humour FIGURE 1.4 Techniques of effective communication,CHAPTER 1 Review of the communication process 19 + Sharing information: Sharing information is a fundamental technique of effective communi It helps individuals to reciprocally understand each other + Providing information: The skills of providing information equip the individuals to deliver the information to other individual(s) without naming or causing undue anxiety and disturbance with an ease of relaxation, safe and secure with fellow members in loop of communication. + ‘Asking relevant questions: Asking relevant questions helps individuals in getting more appropriate and relevant information. This helps them collect and complete basic and specific information to take an appropriate decision on a particular matter. + Clarifying and summarizing: Clarifying is restating and seekii@ fUHHEF information about subject matter that is unclear and ambiguous, whereas summarizing is a concise review of the key aspects of interaction. Clarification helps individuals avoid invalid assumptions and misunderstandings. Summarizing helps provide a sense of satisfaction to individuals and aids in the termination of communication. | + Sharing humour: Humour is considered an important skill in communication. It is generally believed that using humour while conveying a message may help in establishing a cardinal rela- tionship between the interacting individuals. Furthermore, humour also helps in increasing the case of sending and receiving messages, by minimizing the likelihood of anxiety between the sender and the recipient. jon, i. LISTENING SKILLS Listening involves both hearing and interpreting what others say. It requires attention and concentration to sort out, evaluate and validate clues to better understand the true meaning of what is being said. The following recommended techniques may help improve listening skills: + \Aétive listening: Attentive and active listening is the key to effective communication. It enhances trust and understanding between the communicating individuals. + Using silence: Silence during communication can carry a variety of meanings. It provides an opportu- nity for the communicator to explore his or her inner thoughts or feelings comfortably. It can also promote patient exploration when he or she gets more opportunity to talk. + Listening with purpose: \t is said that one must not only hear but listen with a purpose during communication so that information may be appropriately received and understood. hghnemialgenent cf massagy Verbal or nonverbal acknowledgement helps individuals in the loop of communication show they are interested and keen to participate in the communication process. * ‘Giving feedback:)Providing feedback to the sender helps in completing one cycle of communication and it may further extend without any hindrance. Without feedback, the cycle of communication cannot be completed. ch includes using the single techniques, individuals translate20 Communication and Educational Technology * Using nonverbal cues: Nonverbal cues are important aspects of effective communication as they may help individuals develop a sense of reciprocal containment. + Sharing feelings: Thoughts of someone give rise to emotions and feelings that must be shared ang can help individuals understand the inner context of their thoughts. Individuals in the loop of communication observe how other people look, sound and act. The sharing of such observations helps individuals communicate without the need of questioning, focusing or clarification. * Sharing hope: Hope is essential to continuously move on in life. In health care, it is essential to ki the patient's hopes alive. It helps individuals utilize their positive aspects in terms of behaviour, Per- formance or response. Itis a technique used to convey to the individuals real facts without confrontation, It helps individuals come down to reality and build further trust. * Sharing empathy: Empathy is the ability to understand and accept another person’s reality. It is the accurate perception of others’ feelings and communicating this understanding to others helps establish trust in difficult situations. IV. GENERAL SKILLS Individuals must keep the following essential points in mind for effective communication: + Control the tone of your voice,jso that you are conveying exactly what you mean and not a hidden message. + Be knowledgeable about the subject of conversation and have accurate information. + Be/flexiblesin adapting to the needs of the situation. + Be clear and concise while conveying the message. + Avoid words that may be interpreted differently. * Keep an open mind while receiving information; bias may lead to misunderstanding. * Take advantage of an available opportunity. Whenever possible, sitywith the person. While communicating, do not cross your arms or legs nveys a message of approaching the conversation with a closed mind. and take sufficient time to make the patient feel at ease during the conversation. * Keep the conversation as natural as possible and avoid being overly eager. . asian ‘appropriate, maintain eye contact With the person. * Indicate you are paying attention to what the patient is saying by usi i i i ee Pi ying by using appropriate facial expressions ° . fore giving feedback and ensure constant feedback. lo single technique is complete; one should use a combination of all of these techniques to ensure effective communication, because BeCHAPTER 1 Review of the communication process 21 Table 1.3 Techniques f Therapeutic Communication Listening Acknowledgement Feedback Mutual or congruence Clarification Focusing or refocusing Validation Reflection Open-ended questions Nonverbal encouragement Restatement Paraphrase ‘Neutral response incomplete sentences Minimum verbal activity Broad coining statements The process of consciously receiving another person's message. It includes ‘istening eagerly, actively, responsively and seriously Recognizing the other person without inserting your own values or judge- ents. Acknowledgement may be simple and with or without understanding. For example, in the response ‘I hear what you are saying’, the person pavnowedges a statement without agreeing with it. Acknowledgement may be verbal or nonverbal. qe process where the receiver relays the effect of the message to the fender, which either helps keep the sender on Course or alters his course. It TONES acknowledging, validating, Clarifying, extending and altering. Nurse's eedback to patient: “You did that well involves giving constructive informa- tion to patients about how the nurse Perceives and hears them. Harmony of verbal and nonverbal For example, is cryit a . » @ patient is crying and says, ‘I feel okay’. The nurse says. okay, Ging. Let's tak about whats going on’? =) YOU feel kay, but you are Pieces of checking out or making the intent or the hidden meaning of the message clear or of determining if the ‘sent was the message Treeneg: Nurse: "You said you feel funny. Can you describe what funny 1s? Picking up on central topics or ‘cues’ Given by the individual; concentrating attention on a single point. Nurse: "Ye hard i talk to your mothers Pom: Nurse: "You were teling me how hard it was to ‘The process of varying the accuracy of the sender’ message. Nurse: “Yes, it is confusing with so many people around ae Identifying and sending a message back acknowledging the feeling expressed or reflecting back the last few words of the messager directing question, feelings and ideas back to the patient (conveys acceptance and great understanding) Nurse: “You feel depressed?” or ‘Depressed?’ Asking questions that cannot be answered in a ‘yes’ or ‘no’ or ‘maybe’; generally requiring an answer of several words in order to broaden Conversational opportunities and to help the patient communicate. Do not ask ‘Did you have a good time on your pass?” rather ask, ‘How did your pass go?’ . Using body language to show interest, attention, understanding, support, caring and/or listening in order to promote data gathering. Nurse: ‘Nod appropriately as someone talks’. Restating what the patient says; repeating the main idea expressed. Nurse: “You said that you hear voices’. . ee ‘Summarizing or rewording what has been said. Nurse: ‘What saying is that you cat Wve comfortably at home : : jing interest and involvement without saying anything else. Nurse: "Yes... ‘Un hmm. . ‘ propper Encouraging the patient to continue. Nurse: ‘Then your ssettivsie : your owh verbalztion minimal and lting the patent ead the Keeping y« en 2 conversation. Nurse: ‘You feel . . . 4 eee Opening the communication by allowing the patient freedom to Tals focus on himself. Nurse: ‘How have you been feeing to talk about today?’ Se