Chapter 4 Creating Common Meaning to Attain Transformational Outcomes

Creation of Common Meaning The process of negotiating mutually shared understanding between communicators The creation of common meaning is the result of purposeful conveyance, channeling, and reception of messages Selection of verbal language and nonverbal behaviors to convey messages Selection of channels to send messages Receive and respond to messages using the listening process and effective listening responses

Verbal Language Words are often misunderstood What you hear is not necessarily the message conveyed Meanings are negotiated through feedback to clarify and verify the meaning of a message Meanings are personal Confusion, misunderstanding, and conflict in relationships are most often the result of differences in meanings Do not assume that words mean the same thing to different individuals Clarify meaning by asking questions Actively seek feedback to help others interpret your messages

Convey Messages Using Clear and Precise Words Use concrete words to increase clarity Avoid ambiguous messages Slang words/medical jargon Generalizations/stereotypes Introductory disclaimers/tag questions Opinions posed as questions Hidden agendas

Nonverbal Behavior Actions speak louder than words Gesture, frown, smile, touch, clothing Conveys the intended meaning Tone of voice means more than the words Communicates the relational aspects of the message How communicators feel about the subject and each other Note: Pay attention to incongruence between words and nonverbal behavior. If there is incongruence, believe the nonverbal behavior rather than the spoken words. Seek feedback to clarify and verify your assigned meaning to create common meaning.

Pay attention to important nonverbal behaviors Facial expressions Eye contact Paralanguage Gestures Clothing Proxemics Intimate comfort zone Personal comfort zone Social comfort zone Public comfort zone Touch

Meaning of Nonverbal Behaviors Convey emotions and feelings Free of deception “A picture is worth a thousand words” Shorthand for words Regulate conversation A safe way to express emotions Reinforce verbal message Replace words Provide emphasis Solve incongruence between verbal and nonverbal behaviors (believe the nonverbals)

The Listening Process Hearing Electrophysiological trigger Attending Select stimuli Understanding Assign meaning Remembering Transfer the meaning to memory Responding = Demonstrate active listening Provide feedback that listening has occurred

Listening Risk Factors Physiological factors Hearing or cognitive impairment, anxiety, fatigue, pain, sedation, etc. Information overload Cannot process additional information; unable to absorb additional data Brain processing Plan what to say while the other is speaking and not focused on creating common meaning External physical factors Physical distractions, unfamiliar sounds, interruptions

Blocking the Expression of Thoughts and Feelings Claiming another’s feelings as your own Denying others the right to their feelings Showing disapproval Challenging statements Giving false reassurance Minimizing the situation Imposing guilt Giving advice Reacting with defensiveness

Active Listening Responses: Patient-Safe Communication Strategies Paraphrasing Listening with silence Questioning Summarizing Supportive statements Analytical statements Evaluative statements Empathy Recognize patient’s strong feelings Imagine how the patient might be feeling State your perception of the feeling Legitimize the feeling Respect the patient’s effort to cope Offer support and partnership