1. Communication It has various various meanings.
It is any means of exchanging information or feelings between two or more people.
It is a basic component of human relationships, including nursing.
It has two purposes:
1. To influence others
2. To obtain information

2. Communication Communication can occur on:
1. Intrapersonal level: within a single individuals (self-talk).
2. Interpersonal and group levels.

3. Communication Process
Sender
a person or group who wishes to convey a message to another (source-encoder).
Encoding: involves the selection of specific signs or symbols (codes) to transmit the message.

4. Communication Process
Message
Is what is actually said or written, the body language that accompanies the words, and how the message is transmitted.
The medium used to convey the message is the channel, and it can target any of the receiver's senses, e.g. talking face to face, telephoning, writing, recording on tape, or by radio or TV.

5. Communication Process
Receiver
The listener, who must listen, observe, and attend (decoder).
To decode means to relate the message perceived to the receiver’s storehouse of knowledge and experience and to sort out the meaning of the message (interpretation).

6. Communication Process
Response
Is the message that the receiver returns to the sender (feedback).

7. Modes of Communication
Verbal communication: uses spoken or written word.
Nonverbal communication: uses other forms, such as gestures or facial expressions, and touch.
Electronic communication: e.g.

8. Verbal Communication
Different according to culture, socioeconomic background, age, and education.
When choosing words to say or write, nurses need to consider the following:
1. Pace and intonation
2. Simplicity

9. Verbal Communication 3. Clarity and Brevity: clear with fewest words.
4. Timing and Relevance.
5. Adaptability.
6. Credibility.
7. Humor.

10. Nonverbal Communication
Is sometimes called body language, it includes:
1. Personal appearance
How a person dresses is often an indicator of how the person feels
Someone who is tired or ill may not have the energy or desire to maintain their normal grooming.

11. Nonverbal Communication
2. Posture and Gait
The way people walk is often an indicator of current mood and health.
e.g. erect posture suggest a feeling of well-being.
3. Facial Expression
Feelings of surprise, fear, anger, disgust, happiness, and sadness can be conveyed by facial expressions.
Clients are quick to notice the nurse’s facial expression.

12. Nonverbal Communication
4. Gestures
Hand and body gestures may emphasize and clarify the spoken words, or they may occur without words to indicate a particular feeling or to give a sign.

13. Electronic Communication
Advantages of fast, efficient way to communicate. Record the date and time of the message.
Disadvantages of risk of client confidentiality. Socioeconomic factors. Needs computer skills.

14. Electronic Communication
When not to use the
When the information is urgent.
Highly confidential information.
Abnormal lab data. if the information is confusing and could prompt many questions by the client.

15. Factors Influencing the Communication Process
1. Development
Knowledge of language, psychosocial, and intellectual development will allow the nurse to modify the message accordingly.
2. Gender
e.g. girls use language to establish intimacy. Boys use language to establish independence.
3. Values and Perceptions
Values are standards that influence behaviors.
Perceptions are the personal view of an event.

16. Factors Influencing the Communication Process
4. Personal Space
Is the distance people prefer in interactions with others.
A. Intimate distance: touching to 1 ½ feet. Heightened sensations of heat and smell, and vocalizations that are low. e.g positioning.
B. Personal distance: 1 ½ to 4 feet. Voice tones are moderate. Body heat and smell are less noticed. e.g. sitting with patient, giving medications, I.V.

17. Factors Influencing the Communication Process
C. Social distance: 4 to 12 feet. Clear visual perception of the whole person. Body heat and odor are imperceptible. eye contact is increased. Vocalizations are loud enough. e.g. nursing rounds.
D. Public distance: 12 to 15 feet. Loud and clear vocalizations.

18. Factors Influencing the Communication Process
5. Territoriality
Is a concept of the space and things that an individual considers as belonging to the self. e.g. patient territory.
6. Roles and Relationships
e.g. student and instructor, nurse and client, and parent and child affect the communication process.
Choices of words, sentences, and tone of voice vary from role to role.

19. Factors Influencing the Communication Process
7. Environment
To ensure effective communication, environment should be comfortable.
8. Congruence
In congruent communication, the verbal and nonverbal aspects of the message match. If not, not trust.
9. Interpersonal Attitudes
Attitudes such as:
A. Caring: involves giving feelings, thoughts, skills and knowledge.

20. Factors Influencing the Communication Process
B. Warmth: conveys friendliness and consideration.
C. Respect: a nurse respect by listening open-mindedly to others. Elderspeak is a speech that gives the message of dependence and incompetence.
D. Acceptance: accepting attitude allows client to express feelings. Don’t accept harmful behaviors of clients.

21. Therapeutic Communication
Promotes understanding and can help establish a constructive relationship between the nurse and and the client.
Is client and goal directed.
Nurses need to respond not only to the content of a client’s verbal message but also to the feelings expressed.
People need to deal with their feeling before they can cope with other matters.

22. Attentive Listening Is listening actively, using all the senses.
It is absorbing both the content and the feeling the person is conveying, without selectivity.

23. Physical Attending Actions of physical attending:
1. Face the other person squarely.
2. Adopt an open posture. e.g. nondefensive (no crossing).
3. Lean toward the person.
4. Maintain good eye contact.
5. Try to be relatively relaxed.