THERAPEUTIC COMMUNICATION A    distinguishing    aspect    of    therapeutic communication is its application to long-term communi- cation  interactions. Therapeutic  communication  is defined as the face-to-face process of interacting that focuses   on   advancing   the   physical   and   emotional well-being of a patient.   This kind of communication has three general purposes:   collecting information to determine illness, assessing and modifying behavior, and providing health education.  By using therapeutic communication, we attempt to learn as much as we can about   the   patient   in   relation   to   his   illness. To accomplish  this  learning,  both  the  sender  and  the receiver  must  be  consciously  aware  of  the  con- fidentiality of the information disclosed and received during the communication process.  You must always have  a  therapeutic  reason  for  invading  a  patient’s privacy. When  used  to  collect  information,  therapeutic communication requires a great deal of sensitivity as well  as  expertise  in  using  interviewing  skills.     To ensure  the  identification  and  clarification  of  the patient’s thoughts and feelings, you, as the interviewer, must observe his behavior.   Listen to the patient and watch how he listens to you. Observe how he gives and receives both verbal and nonverbal responses.  Finally, interpret and record the data you have observed. As mentioned earlier, listening is one of the most difficult skills to master.  It requires you to maintain an open mind, eliminate both internal and external noise and distractions, and channel attention to all verbal and nonverbal messages.  Listening involves the ability to recognize pitch and tone of voice, evaluate vocabulary and  choice  of  words,  and  recognize  hesitancy  or intensity of speech as part of the total communication attempt.  The patient crying aloud for help after a fall is communicating a need for assistance. This cry for help sounds very different from the call for assistance you might  make  when  requesting  help  in  transcribing  a physician’s order. The  ability  to  recognize  and  interpret  nonverbal responses  depends  upon  consistent  development  of observation skills.  As you continue to mature in your role and responsibilities as a member of the healthcare team, both your clinical knowledge and understanding of human behavior will also grow. Your growth in both knowledge and understanding will contribute to your ability  to  recognize  and  interpret  many  kinds  of nonverbal   communication. Your   sensitivity   in listening with your eyes will become as refined as—if not better than—listening with your ears. The effectiveness of an interview is influenced by both  the  amount  of  information  and  the  degree  of motivation  possessed  by  the  patient  (interviewee). Factors that enhance the quality of an interview consist of  the  participant’s  knowledge  of  the  subject  under consideration;   his   patience,   temperament,   and listening skills; and your attention to both verbal and nonverbal   cues. Courtesy,   understanding,   and nonjudgmental attitudes must be mutual goals of both the interviewee and the interviewer. Finally, to function effectively in the therapeutic communication process, you must be an informed and skilled practitioner.  Your development of the required knowledge   and   skills   is   dependent   upon   your commitment   to   seeking   out   and   participating   in continuing education learning experiences across the entire spectrum of healthcare services. PATIENT EDUCATION LEARNING  OBJECTIVE:  Recognize  the importance of patient education. Patient (health) education is an essential part of the healthcare  delivery  system. In  the  Navy  Medical Department,   patient   education   is   defined   as   “the process  that  informs,  motivates,  and  helps  people adapt and maintain healthful practices and life styles.” Specifically, the goals of this process are to ·   assist individuals acquire knowledge and skills that  will  promote  their  ability  to  care  for themselves more adequately; ·   influence individual attitudinal changes from an orientation   that   emphasizes   disease   to   an orientation that emphasizes health; and ·   support  behavioral  changes  to  the  extent  that individuals are willing and able to maintain their health. All healthcare providers, whether they recognize it or not, are teaching almost constantly.   Teaching is a unique skill that is developed through the application of principles of learning.  Patient teaching begins with an  assessment  of  the  patient’s  knowledge.    Through this  assessment,  learning  needs  are  identified.     For example, a diabetic patient may have a need to learn how to self-administer an injection. After the learner’s 2-9