Relationship Development and Therapeutic Communication

Question 1

therapeutic nurse-patient relationship

Answer 1

when each views the other as a unique human being; both participants have needs met by the relationship

Question 2

what are therapeutic relationships

Answer 2

goal-oriented and directed at learning and growth promotion

Question 3

what is the problem-solving method of achieving goals

Answer 3

identify the patient’s problem; promote discussion of desired changes; discuss aspects that cannot realistically eb changed and ways to cope with them more adaptively; discuss alternative strategies for creating changes that the patient desires to make

Question 4

goals and the problem-solving model

Answer 4

weigh benefits and consequences of each alternative; help each patient to implement the change; provide positive feedback for patient’s attempts to create change; help patient evaluate outcomes of the change and make modifications as required

Question 5

therapeutic use of self

Answer 5

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

Question 6

what do nurses need to understand to be therapeutic

Answer 6

self-awareness, self-understanding; and a philosophical belief about life, death, and the overall human condition

Question 7

what are some conditions essential to development of a therapeutic relationship

Answer 7

rapport; trust; respect; genuineness; empathy

Question 8

rapport characteristics

Answer 8

acceptance, warmth, friendliness, common interest, non-judgmental attitude

Question 9

trust characteristics

Answer 9

sincere desire to help, patient feels confidence with you, keeping promises, consistency

Question 10

respect characteristics

Answer 10

unconditional; call them by name, spend time with them

Question 11

genuineness characteristics

Answer 11

be real, honest, transparent

Question 12

empathy characteristics

Answer 12

being aware of patient’s feelings and help them explore and work through it

Question 13

what are the phases for the therapeutic nurse-patient relationship

Answer 13

pre-interaction phase; orientation phase; working phase; termination phase

Question 14

pre-interaction phase

Answer 14

obtain information about the patient from chart, significant others, or other health team members; examine your own thoughts

Question 15

orientation phase

Answer 15

create an environment for trust and rapport; establish contract for intervention; gather assessment data; identify patient’s strengths and limitations; formulate nursing diagnoses; set mutually agreeable goals; develop a realistic plan of action; explore feelings of both patient and nurse

Question 16

working phase

Answer 16

maintain trust and rapport; promote patient’s insight and perception of reality; use problem-solving model to work toward achievement of established goals; overcome resistance behaviors; continuously evaluate progress toward goal attainment

Question 17

transference

Answer 17

occurs when the patient unconsciously displaces (or “transfers”) to the nurse feelings formed toward a person from the past

Question 18

countertransference

Answer 18

refers to the nurse’s behavioral and emotional response to the patient

Question 19

termination phase

Answer 19

therapeutic conclusion of relationship occurs when: progress has been made toward attainment of the goals; a plan of action for more adaptive coping with future stressful situations has been established; feelings about termination of the relationship are recognized and explored

Question 20

types of boundaries in the nurse-patient relationship

Answer 20

material, social, personal, and professinal

Question 21

what are some professional boundaries to be put

Answer 21

self disclosure; gift-giving; touch; friendship/romantic association

Question 22

warning signs that indicate that professional boundaries of the nurse-patient relationship may be in jeopardy

Answer 22

favoring; keeping secrets; change in dress style; swapping assignments; giving special attention/treatment; spending free time with the patient; frequently thinking about the patient when away from work; sharing personal information; receiving gifts/continued communication with the patient after discharge

Question 23

interpersonal communcation

Answer 23

a transaction between the sender and receiver; both persons participate simultaneously

Question 24

transactional model of communication

Answer 24

both participants perceive each other, listen to each other, and simultaneously engage in the process of creating meaning in a relationship

Question 25

what are some impacting preexisting conditions

Answer 25

values, attitudes, and beliefs; culture and religion; social status; gender; age/developmental level

Question 26

different types of environments where a therapeutic relationship might take place

Answer 26

territoriality, density, distance

Question 27

four kinds of distance in interpersonal interactions

Answer 27

intimate, personal, social, public

Question 28

components of non-verbal communication

Answer 28

physical appearance and dress; body movement and posture; touch; facial expressions; eye behavior; vocal cues/paralanguage

Question 29

therapeutic communications techniques

Answer 29

using silence; accepting; giving recognition; offering self; giving broad openings; offering general leads; placing the vent in time or sequence; making observations; encouraging comparison; restating; reflecting; focusing; exploring; seeking clarification and validation; presenting reality; voicing doubt; verbalizing the implied; attempting to translate words into feelings; formulating plan of action

Question 30

nontherapeutic communication techniques

Answer 30

giving reassurance; rejecting; approving/disapproving; agreeing/disagreeing; giving advice; probing; defending; requesting an explanation; indicating the existence of an external source of power; belittling feelings expressed; making stereotyped comments, cliches, and trite expressions; using denial; interpreting; introducing an unrelated topic

Question 31

active listening

Answer 31

Sit, Observe, Lean forward, Eye contact, Relax

Question 32

motivational interviewing

Answer 32

evidence-based, patient centered style of communication that promotes behavior change by guiding patients to explore their own motivation for change and the advantages/disadvantages of their decisions

Question 33

what does it incorporate?

Answer 33

active listening and therapeutic communication techniques but focuses on what the patient wants to do; looks at how to motivate a patient to change their behavior

Question 34

process recordings

Answer 34

written reports of verbal interactions with patients; written by the nurse or students as a tool for improving communication techniques

Question 35

when is feedback useful

Answer 35

is descriptive rather than evaluative; specific rather than general; is directed toward behavior that the patient has the capacity to modify; imparts information rather than offers advice; well-timed