Chapter 9 Therapeutic Communication

Question 1

3 Types of Relationship

Answer 1

Intimate - emotional - mutual needs meet. not possible with nurse = nurse’s needs on the outside

Social - friendship

Therapeutic - nurse maximizes communication skills, focus on patient and goal to enhance patient’s growth

Question 2

Active Listening

Answer 2

focus on what the person is saying verbally and nonverbally
responds and remembers
enhances self-esteem and directs energy to a solution

Question 3

Clarifying Techniques

Answer 3

Paraphrasing - restate in different and fewer words “you seem to be saying…”
Restating - active listening strategy, use sparingly, uses patients key words - Your life is empty
Reflecting - help make patient aware of inner feelings. “what do you think about…” You look sad.
Exploring - examine ideas, experiences and relationships - “give me an example of what you think you did wrong.”

Question 4

Cultural filters

Answer 4

form of cultural bias or cultural prejudice that determines what we pay attention to and what we ignore.
acceptance and understanint

Question 5

debriefing

Answer 5

critical conversation and reflection regarding an experience that results in grown and learning.

Question 6

double-bind messages

Answer 6

2 or more mutually contradictory messages given by a person in power

eyes down and sad - but saying - you go out and have fun

Question 7

informative communication technology

Answer 7

electronic house calls
internet support group
virtual health exams

Question 8

Miracle Question

Answer 8

Goal setting question to help patient see what the future would be like if a problem were to vanish.

If you wanted a miracle to happen
what would it change?

Question 9

mobile medication applications (apps)

Answer 9

suicide safe
knowbullying
talk. they hear you.

Question 10

nontherapeutic communication

Answer 10

Excessive questioning - asking multiple questions consecutively or rapidly (interrogator)

GIving approval or disapproval approval might be misinterpreted

Giving Advice

Asking the WHY question.

Question 11

Nonverbal behaviors

Answer 11

It’s not what you said but how you said it

may define the real message

Question 12

nonverbal communication

Answer 12

Tone of voice
emphasis on words
manner of pacing speech
posture
appearance, 
eye contact
hand gestures, sighs
fidgeting
yawning
how close person is to you
Eyes  (focus with sadness, anger)) and mouth (focus when happy) biggest clues - eyes and mouth
fearful or neutral (focus on both eyes and mouth
Content = verbal. PROCESS = nonverbal

Question 13

patient-centered

Answer 13

patient is a full partner in care whose values and preferences are respected. therapeutic communication is center to it.

Question 14

Peplau’s nurse- patient relationship 2 parts

Answer 14

clarity - understood by both
continuity - connections

nondirective listening = reflective and nonjudgemental feedback

Question 15

Peplau’s Theory of INTERPERSONAL RELATIONSHIPS

Answer 15

Do note impose your bias

Nurse: values, culture, reace, beliefs, past experiences, expectations and preconceived ideas

Nurse/Patient relationship in the middle

Patient: Values, culture, race, beliefs, past experiences, expectations

Question 16

Projective Questions

Answer 16

What if…
helps to articulate, explore, and identify thoughts and feelings
“If you could go back and change how you acted what would you do?”

Question 17

Close ENDED QUESTIONS

Answer 17

Yes or no answer

Question 18

telehealth technologies

Answer 18

video conferencing
internet
phone consultation
counseling
image transmission
interactive video sessions

rural, chronically ill, homebound, and underserved.

Question 19

therapeutic communication techniques

Answer 19

Silence
Active Listening
Clarifying Techniques
Questions

Question 20

Therapeutic Relationship - 5 aspects

Answer 20

Therapeutic Relationship

1. Needs of Patient are identified and explored
2. Clear boundaries are established - what is personal space?
3. Alternate problem-solving approaches are taken - work together, kindness, mutual decision making
4. New coping skills developed
5. Behavior change encouraged

Question 21

OPEN ENDED QUESTIONS

Answer 21

OPEN ENDED
Not intrusive. Do not put on defensive
useful in the beginning to establish rapport

Question 22

Therapeutic Use of Self

Answer 22

The ability to use one’s personality consciously and in full awareness in an attempt to establish relatedness and to
structure nursing interventions.

Question 23

Therapeutic communication benefits?

Answer 23

Patient feels safe, protected
more satisfied with care
increased recovery rates
improved adherence to treatment

Restating
Encouraging description of perception
Summarizing

Question 24

THERAPEUTIC COMMUNICATION IS?

Answer 24

Patient-centered
Goal-directed
scientifically based.
communication

Question 25

Transactional model of communication

Answer 25

``` Communicator message channel (ie in person feedback encoding/decoding(determine meaning) context (social, relationship, cultural) environmental noise (physical, physiological, psychological) ```

Question 26

verbal communication

Question 27

What is the foundation for productive relationships and positive feelings?

Answer 27

Effective communication