Therapeutic Communication in the Interview Process

1. Chapter 2The Interview and Therapeutic Dialogue

2. Communication Process • Complex, ongoing, interactive process • Always subject to interpretation • Communication ability, culture, and personal experience all influence the interpretation and decoding of messages • Culture • Perceptions about the relationship • Therapeutic communication • Caring and empathy

3. Nonverbal Communication Skills • Equally as, if not more, important as verbal communication • Physical appearance of the nurse • Eye level • Touch is an essential and dominant component of the physical examination

4. Verbal Communication Skills • Effective interviewing skills • Nurse’s speech • Patients with limited English

5. Active Listening • Ability to focus on patients and their perspectives • Talking about difficult feelings helps patients to heal

6. Other Techniques of Communication • Restatement relates to the content of the communication • Purpose is to ask patients to elaborate • Reflection is when the nurse summarizes the main themes of communication • Encouraging elaboration (facilitation) assists patients to more completely describe problems • Silence allows patients time to gather their thoughts and provide accurate answers

7. Other Techniques of Communication (cont.) • Focusing • Clarification • Summarizing

8. Nontherapeutic Responses • False reassurance • Sympathy • Unwanted advice • Biased questions • Changes of subject • Distractions • Technical or overwhelming language • Interrupting

9. Professional Expectations • Nonprofessional involvement • Sexual boundary violation

10. Question Tell whether the following statement is true or false. Therapeutic communication with a patient includes reflection. Reflection is when the nurse relates the content of the communication to the patient. Its purpose is to encourage the patient to elaborate.

11. Answer False Rationale: Reflection is similar to restatement; however, instead of simply restating comments, the nurse summarizes the main themes of communication.

12. Phases of the Interview Process • Nurse–patient relationship differs from social relationship • Preinteraction phase • Beginning phase • Working phase • Closed-ended or direct questions • Open-ended questions • Closing phase

13. Intercultural Communication • Cultural differences may exist related to group or ethnicity, region, age, degree of acculturation into Western society, or a combination of these factors • Communication etiquette • Limited English • Working with an interpreter • Gender and sexual orientation issues

14. Lifespan Issues • Children • Newborns and infants • Older children and adolescents • Older adults

15. Special Situations • Patients in health care settings • Hearing impaired • Low level of consciousness • Cognitive impairment • Mental health/illness • Anxiety • Crying

16. Special Situations (cont.) • Anger • Alcohol or drug use • Personal questions • Sexual aggression

17. Question • In what phase of the interview are open-ended questions used? A. Preinteraction B. Beginning C. Working D. Ending

18. Answer • C. Working • Rationale: During the working phase, the nurse collects data by asking specific questions. Two types of questions are closed-ended questions and open-ended questions. Each type has a purpose; the nurse chooses which type will help solicit the appropriate information.