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goals of verbal communication
establish rapport
obtain information
relay pertinent information
give instructions
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important factors for successful verbal communication
the way the material is presented
attitude of the speaker
tone & volume of the speakers voice
degree to which the speaker & receiver are ready & able to listen
- Vocabulary
- use/avoidance of jargon
- dependent on audience
clarity
organization of ideas
useful humor vs destructive humor
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7 levels of effective listening
- 1. analytical
- specific information & arranging into categories
- 2. directed
- to answer specific questions
- 3. attentive
- for general information to get overall picture
- 4. exploratory
- own interest in subject
- 5. appreciative
- aesthetic pleasure, ie music
- 7. passive
- overhearing, not attentive
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goals of the health professional
improve listening acuity-to hear accurately
learn to ascertain how accurately a patient has heard you
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sensory overloading
rate a which listener can process information varies
active listening requires undivided attention
too much sensory input can cause distraction
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Steps to more effective listening
1. selective listening
2. concentrate on central themes
3. judge content, as opposed to style of delivery
4. listen with an open mind rather than emotionally
5. summarize what you heard before speaking again
6. clarify before proceeding
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goals of the patient interview
procure information
provide information
therapy
persuasion to follow the course of therapy
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Parts of the interview
- introduction
- establish relationship
- closing
- confirm outcome for both parties
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verbal vs non-verbal communication
- social distance 4-12 feet
- more formal business,social
- public distance 12-25 ft
- no physical contact, little or no eye contact
- strangers
- pantomime and demonstration
- non-english
- speaking patient
- aphasia
- hearing impaired
- to supplement verbal instructions
- metacommunication
- gestures
- facial expressions
- physical appearance
- eye contact
- height
- establish authority or project submissiveness
body tension
posturing
physical appearance
- touch
- distance zones
- *intimate distance
- comforting/protecting
- *personal distance
- 1 1/2-4 ft personal interest
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responding to active listening
paraphrase
reflection of content-echoing
reflection of feelings
request of clarification
silence
summarization
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Lanaguage:
Sensitive Terminology
- EXAMPLE:
- he has a broken back, so he is confined to a wheelchair.
- John, who has a spinal cord injury, uses a wheelchair for mobility
- he is dependent on crutches
- He walks with crutches
- confined to a wheelchair; wheelchair bound
- oman who uses a wheelchair
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Lanaguage:
Sensitive Terminology
- Examples of some terms to avoid:
- victim, stricken, afflicted
- indicate unhealthy status
crippled-paints a picture of someone who cannot do anything
Epileptic-person who has epilepsy
Spastic-lack of coordination
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Language:
Sensitive terminology
words with strong negative overtones:
- imbecile
- moron
- feeble-minded
- deaf-mute
- dummy
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Lanaguage:
Sensitive Terminology
people have diseases, disabilities, impairments
people are not the sum product of all their medical conditions
- maintain person's self-esteem
- consider the persons 1st in your words & thoughts
- emphasize the person's abilities vs disability
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Teaching the Learning process (11)
1. Identify the needes of the learner
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teaching the learning process
2. Identify a level of learning or skill to be accimplished
specific knowledge or skill to be accomplished
does the learner have the prerequisite skills?
determine ways to provide the prerequisites
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Teaching the learning process
3. What is to be learned?
observable behavior
who will deomonstratre this behavior
conditions where the behavior will be domonstrated
minimal level of acceptable behavior
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teaching the learning process
4. make certain the learner understands the purpose of learning
tell the learner why the behavior is to be learned
relate the learning to past experiences and to future experiences
ask the learner to state what is to be learned
ask the learner why he needs to learn what is being taught
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Teaching the Learning Process
6. Demonstrate to the learner what is to be learned
use appropriate materials and examples
make the demonstration as similar as possible to the situation in which the learning is to be used
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Teaching the learning process
7. Provide the oppportunity to practice
make the practice situation similar to the actual situation
provide adequate practice
identify resources that asre available beyond the experience
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Teaching the Learning process
8. provide feedback on performance
indicate the extent the behavior has been learned
make suggestions for improvement
provide additional information, explanation or demonstration
assist the learner in identifying how he is learning
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Teaching the Learning process
9. Give some examples of the use of the behavior in everyday life
present several examples
present examples similar to the actual situations in the learner's life
incorporate principles and cues in the examples
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Teaching the Learning Process
10. Ask the learner to give examples of the use of the behavior
determine that the examples reflect actual, possible situations and understanding of the principles
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Teaching the Learning Process
11. Determine that the learner has learned what is taught
identify and implement an activity that will allow demonstration of learning
determine that the minimal level of acceptable performance has been met
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Types of nonverbal communication & importance
pantomine demonstration: It augment or substitute verbal communication
metacommunication: gestures, facial expressions, physical appearance, and other signs. It alters or supplements spoken words.
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areas in which pantomine & demonstration can almost always serve as complements to verbal communications
meeting someone: hand shake, nodding
expressing approval: toothy smile, round unblinking eyes
referring to oneself: pointing to oneself, thumping one's chest
expressing words when pointing & posturing cannot be conveyed: monosyllables
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How the aphasic patient can benefit from pantomime & demonstrations
if the patient is unable to interpret incoming verbal communication,pantomine & demonstration will be used as a substitute of verbal communication
if the patient is unable toform words, he/she may opt to use pantomime & demonstrations as a way tocommunicate with the health professional
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guidelines to follow in communicating by the nonverbal means of pantomime & demonstration
1. face the person so that he/she derives the benefit of facial expression, lip motion and posture
2. have light on your face rather than behind you, which can create shadows & confusion about the message you are sending
3. demonstrate while standing beside and in full view of the person because the effect of facing the patient directly is much the same as looking in the mirror-right & left are reversed
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Relationship of pantomime & demonstration to the idea of metacommunication
pantomime is an exaggered form of metacommunication: It brings to the surface those postures, facial expressions, and gestures that have understood meanings
actions that accompany words modify their meaning
metacommunication is used during any human interaction in which 2 people are in each other's presence
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components of metacommunication
1. facial expression
2. physical appearance
3. touch
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ways in which aq health professional conveys authority without saying anything
height
eye contact
distance
position
posture
gestures involving the extremities
dress
language
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pros & cons of wearing uniforms by health professionals
- pros: facilitates communications:
- quick mdeans of indentification,
- simple gain of admittance to a patient's room,
- comfort: designed for durability and movement;
- efficient & economical mode of dress
cons: creates unneccessary distance or gives a sense of undue authority to the health professional
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benefits & risks of being in a profession that involves touching a patient
- benefits:
- tools of communication,
- therapy and diagnoses procedures
- risks:
- invasion of private space, misunderstanding,
- inappropriateness
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Hall's 4 "distance zones"
1. intimate distance - direct contact
2. personal distance - 1 1/2 to 4 feet
3. social distance - 4-12 feet
4. public distance 12-25 feet
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examples of ways in which time awareness varies from culture to culture
USA-"punctuality communicates respect while tardiness is an insult"-Harrison
knowledge of time in other cultures :to arrive exactly in time is an insult"
is there an appropriate amount of tardiness?
length of professional services vs completion of treatment
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