Friday, October 24, 2008

Therapeutic communication

Communication consists of several structural components the stimulus, the sender, the massage, the medium, the receiver, and feed back.

Communication is learned process influence by several factors, including the environment, the relationship between the sender and the receiver, the content of the massage and the context in which the massage takes place other factor include attitude, values, ethic background, socioeconomic status, family dynamic, life experience, knowledge level and the ability to relate to others experience, knowledge level and the ability to relate to other.

Therapeutic communication is foundation of psychiatric nursing and the psychiatric nurse’s single most importance tool. It is an interactive process that occurs between the nurse and the patient.The art of interacting therapeutically is a learned skill involving non verbal and verbal communication. The purpose of therapeutic communication is to enhance patient growth and intervention to promoting health to patient.

The effectiveness of therapeutic communication can be influence by trait of genuineness, positive regard respect, empathy, trustworthiness, clarity, responsibility and assertiveness. They incorporate verbal and nonverbal behavior as well attitudes, beliefs and feeling behind the communication all of this necessary for therapeutic communication to take place.

Genuineness.Is being consistent with both verbal and non verbal behavior. Consistent verbal and non verbal behavior shows that we are open, honest and sincere. Genuineness is importance to patient to develop trust in nurse or respect and acceptance. Nurses should shows that they view their client as worthy. For example sitting and listening to patient expressing concern about event affecting the patient and validating the patient feeling nurse also should shows positive regard by being nonjudgmental. Avoid harsh judgment of patient behavior and feelings both are real and cannot be argued with, discounted or criticize.

Empathy is the foundation of all therapeutic nurse client relationship and essential trait for nurses to have in order to meet their patient needs.It is difficult for client to trust their nurse if they do not believe the nurse has empathetic appreciation of themas individuals (McCabe, 2004: Reynolds,2000)and is therefore empathy or understanding is the nurse ability to see thing from patient view point and to communicate the ability to be sensitive and communicate understanding to the patient the ability to be sensitive to and communicate understanding of the patient feeling(May and Allygood, 2000)Empathy begins with awareness of another person's feelings. It would be easier to be aware of other people's emotions if they would simply tell us how they felt. But since most people do not, we must resort to asking questions, reading between the lines, guessing, and trying to interpret non-verbal cues. Emotionally expressive people are easiest to read because their eyes and faces are constantly letting us know how they are feeling.Once we have figured out how another person feels, we show empathy by acknowledging the emotion. We may say, for example,

I can see you are really uncomfortable about this.
- I can understand why you would be upset.
We can also show empathy through a simple sign of affection such as hug or a tender touch. Though empathy is usually used in reference to sensing someone else's painful feelings, it can also apply to someone's positive feelings of success, accomplishment, pride, achievement etc. In this case a "high five" would also be a sign of empathy.Empathy poses 2 stages if patient an importance and uncomfortable emotions first be receptive to understand the patient by putting your self in the patient place. Then be able to communicate understanding.

Trustworthy
is another essential characteristic of an effective nurse being trustworthy nurse keep commitment and promise and consistent their approach and respond to patient the trustworthy nurse respect the patient privacy, dignity and need for confidentiality.

Nurses need to communicated clearly to the patient who often have difficulty processing information or thinking clearly as a result as their mental disorder.
Problem will happen if instruction and information are given in highly technical manner. patient are embarrass to ask for clarification. Therefore nurse should make an effort to speak at the patient at level that patient can understand. Avoid abstract and lengthy explanation and use active rather than passive voice. Ensure all instruction are example: (Active voice): Take your medication 2 times per day (specific doses)
Passive voice ( Make sure your medication is taken as needed.
Responsibility.

Responsibility communication involves being accountable for the outcome of professional interactions. when communicating nurses have to make sure that patiet receive and interpret massages correctly. Nurses who communicate responsibly, strength growth in other. Responsible language involves the use of “I” statement when being assertive. Example “I feel hurt when you say that to me.Assertive communication is the ability to express thoughts and feeling comfortably and confidently in positive, honest, and open manner that demonstrates respect for self while respecting other (Balzer Riley,2004)
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