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 patients
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
patients 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
physicians 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 asif
not better thanlistening 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 participants 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 patients 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 learners
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