Therapeutic Communication

Question 1

Therapeutic relationship

Answer 1

An interaction between two people (usually a caregiver and a care receiver) in which input from both participants contributes to a climate of healing, growth promotion, and/or illness prevention
-goal oriented

Question 2

Hildegard Peplau

Answer 2

Referred the relationship to a patient as a human-to-human relationship and as a “mutually significant experience

Seeing patients beyond their illness or room number but rather as who they are as a person

Question 3

Therapeutic use of self

Answer 3

Ability to use ones personality consciously and in full awareness to establish relatedness and to structure nursing interventions

To use therapeutic use of self, nurses must possess self-awareness, self-understanding, and a philosophical belief about life, death, and overall human condition

Question 4

Therapeutic communication essentials

Answer 4

Rapport, trust, confidentiality, respect, genuineness, empathy (not sympathy)

Question 5

Boundaries in the nurse-patient relationship

Answer 5

Material: fences, boarders
Social: established within a culture
Personal: what we establish for ourselves including emotional and physical
Professional: spaces between a nurses power and the patients vulnerability

Question 6

Distance levels

Answer 6

Intimate distance
- 0-18”
- the closest distance that individuals allow between themselves and others
Personal distance
- 18-40”
- the distance for interactions that are personal in nature
Social distance
- 4-12’
- the distance for conversations with strangers or acquaintances
Public distance
-12’+
- the distance for speaking in public or yelling to someone some distance away

Question 7

Phases of a therapeutic relationship

Answer 7

1. Pre interaction phase
   - finding out info about the pt
   - examining ones own feelings and fears about working with a particular pt
2. Orientation
   - creating a therapeutic environment to create trust and rapport
   - identifying patient strengths and limitations
   - setting mutual goals and developing a plan to achieve
   - exploring feelings of both the pt and the nurse
3. Working
   - maintaining trust
   - the bulk of the work and problem solving
   - continuously evaluating progress toward goal
4. Termination
   - progress has been made toward achieving original goal
   - feelings about termination of the relationship are explored

Question 8

Transference

Answer 8

Occurs when the patient unconsciously displaces (or transfers) to the nurse feeling formed toward a person from the past

Question 9

Countertransference

Answer 9

Refers to the nurses behavioral and emotional response to the patient

Question 10

Interpersonal communication

Answer 10

We cannot NOT communicate
Transaction between the sender and the receiver. Both persons participate simultaneously

Question 11

Nonverbal communication

Answer 11

Component of nonverbal communication:
Physical appearance and dress
Body movement and posture
Touch
Facial expressions
Eye behaviors
Vocal cues or paralanguage

Question 12

Active listening

Answer 12

To listen actively is to be attentive to what patient is saying, both verbally and nonverbally

Question 13

Useful communication feedback

Answer 13

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

Question 14

Motivational interviewing

Answer 14

EBP, patient-centered style of communication that promotes behavior change by guiding patients to explore their own motivation for change and the advantages and disadvantages of their decisions
- incorporates active listening and therapeutic communication techniques but focuses on what the patient wants to do

Question 15

Process recordings

Answer 15

Written reports of verbal interactions with patients
They are written by the nurse or student as a tool for improving communication techniques