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Health Promotion Ch4
The Therapeutic Relationship
| Question | Answer |
|---|---|
| Values | Qualities, principles, attitudes, or beliefs about worth; should be dynamic, not static |
| Cognitive values | Those a person ascribes to verbally and intellectually |
| Active values | Those a person physically acts out |
| Value clarification | A method for discovering one's values and importance of those values |
| 7 Steps of the Valuing Process | 1.Choosing freely, 2.Choosing from alternatives, 3.Choosing after careful consideration of potential outcomes, 4.Cherishing personal beliefs and action, 5.Affirming the choice in public, 6.Acting out the choice, 7.Repeatedly acting in pattern |
| Therapeutic Use of Self | Application of one's cognition, perceptions, and behaviors to create interpersonal encounters that promote health in others |
| Self-Concept | A mental picture of the self- characteristics, abilities, limitations, and aspirations |
| Self-Esteem | Refers to how individuals feel about the way that they see themselves |
| Johari Window- Four components of self | 1.Public self- known to self and others, 2.Semipublic self- known only to others, 3.Private self- known only to self, 4.Inner self- known neither to self or others |
| The goal of Self-Awareness | To increase the size of the Public self, while reducing the other three areas. |
| Steps in Self-Awareness | Listening to oneself, Listening to and learning from others, Self-disclosure, and Practical reflection |
| Listening to oneself | Pay attention to emotions, thoughts, memories and reactions. Self-reflection. |
| Listening to and learning from others | Asking and listening to feedback. Asking reflective questions |
| Self-Disclosure | Appropriate sharing aspects of self enhances self-knowledge and interpersonal life. Promotes reciprocal interaction- mutual exchange |
| Practical Reflection | Involves bouncing back one's own thoughts and recollections to understand and take needed corrective actions |
| Communication Process | Essential tool for health promotion interventions, basis for professional nurse/ patient relationship, patient centered communication important |
| Verbal Communication | Transmitting messages using words, spoken and written; Challenge- language differences |
| Nonverbal Communication | Involves gestures and facial expressions, vulnerable to misunderstanding, culturally and situation ally bound |
| Metacommunication | Refers to the meaning about a message, one type is a group process |
| Group Process | Relationship through communication of individuals in group settings |
| Effective Communication Steps | Firmly stating case, Clarifying the message, Seeking feedback, and Being receptive to received feedback |
| Firmly stating case | Need congruent content and metacommunication |
| Clarifying the message | Need complete message, important features and specifics should be stated and emphasized. Use of 'I' statements |
| Seeking Feedback | Provides validation and confirmation of communication |
| Being receptive to received feedback | Facilitates functional communication |
| Listening | Actively focusing attention on the message |
| Reciprocity | The patterning of similar activities within the same interval by two people |
| Flexibility | A balance between control and permissiveness |
| Silence | Can be therapeutic; can be perceived as a lack of interest or reflection or conveying support |
| Humor | Relieves tension, reduces aggression, create climate of sharing. However can block communication and inflicts emotional pain |
| Touch | Can express concern, may be inappropriate and threatening |
| Intimate Space | Up to 18 inches. Used for high interpersonal sensory stimulation |
| Personal Space | 18 inches to 4 feet. Appropriate for close relationship and good visualization is desired |
| Social-consultative Space | 9 to 12 feet. Less intimate and personal, requiring louder verbal communication |
| Public Space | 12 feet+. Used for formal gathering such as giving speeches |
| Space | Varies according to the type of communication, the setting, and the culture. |
| Proxemics | The use of space between communicators; four zones of space |
| Purposeful Communication | Focuses communication for a particular aim |
| Rapport | A harmony and an affinity between people in a relationship. Facilitated by genuine, open, concerned |
| Trust | The reliance on a person to carry out responsibilities and promises, based on sense of safety, honesty, and reliability. Facilitated by clear relationship definitions, being consistent |
| Empathy | The ability to understand another's feeling without losing personal identity and perspective. Personal understanding while maintaining boundaries |
| Goal Direction | Meet need or promote growth of recipient, goals measurable, focus on change, short- or long term, developed jointly |
| Focusing on individual | Person, not nurse, focus of interaction |
| Helping person to clarify content/meaning | Use of who, what, where, and when questions; Goal- helping the person to describe the problem and formulate solutions in partnership |
| Reflection | The restatement of what the individual has said in the same or different words. Goal: Emphasize, summarize, elicit information |
| Constructive confrontation | Identifies behavior and helps the person examine meanings/ consequences |
| Using nouns/ pronouns correctly | Promotes clear thinking/ communication |
| Silence | Allows person to communicate at own pace; time for reflection |
| Acceptance | Promotes feelings of safety, accept does not mean tolerance |
| Anxiety | Alters perception, distorts reality |
| Attitudes | Bias/ Stereotypes makes communication negativity and distorts perceptions |
| Gaps between the nurse and individual | Differences in gender, age, ethnicity, language. Causes difference in perception and blocks understanding |
| Resistance | Behavior to reduce anxiety (e.g., avoidance, anger, blocking). Nurse goal: identify, interpret, and understand behavior |
| Transference/Countertransference | Reacting to another as if the person is someone from the past; Goal: understand feelings/thoughts and remove distorted reality |
| Sensory Factors | Use other senses and obtain specialized assistance |
| Failure to address concerns/ needs | Arise from: inadequate assessment, lack of knowledge, inability to separate needs, and confusion from friendship and helping relationship |
| Setting | Control/ Alter disturbing environmental factors |
| Orientation or introductory phase | Establishing connection: Consistency, active listening, and concern/warmth |
| Working Phase | Nurse/ person partners in promoting health |
| Termination Phase | End of therapeutic contract, and can cause anxiety |
| Brief Interactions | Guidelines for 15-minute family interactions |
| Health Literacy | the capacity to read, comprehend, and follow thur on health info. Critical to health promotion |
| Combating low health literacy | Key clinical questions to teach ppl, safe/comfortable clinical environment, and therapeutic communication techniques |
Created by:
Futuredoctor09
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