1. Chapter 4 Creating Common Meaning to Attain Transformational Outcomes

2. 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

3. 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

4. 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

5. 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.

6. 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

7. 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)

8. 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

9. 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

10. 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

11. 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