Babe Mhariel L.

Edles such as time, messages, noise, fields of experience,

frames of reference, meanings, shared systems of
HEALTH EDUCATION communicators and personal systems all pay a role
in the process of communication. Communicators
1. Principles of communication often participate simultaneously (sending,
receiving and interpreting). The unique
 Communication is a process;
interpretive and perceptual processes of
 Communication is not linear, individuals thus play an essential role in the
but circular; communication process.

 Communication is complex; 3. Purpose and Types of Communication

 Communication is The purpose of communication is to inquire,

irreversible; and inform, persuade, entertain, request and
investigate. A single message can have one or more
 Communication involves the of the following purposes:
total personality
To convey information/opinion, for example,
2. Communication Process “I went to the school” or “I am here to buy a gift for
my mom”.
Interaction between people is cyclic,
which means that what one person says and To request information/opinion/behavior, for
does evokes a reaction from the other person, example, “Are you scared of the dark?” or “Tell me
and this reaction again stimulates another more about how you saved that puppy”.
reaction from the first person.
To give social acknowledgement, for example,
They are 3 components of a “Good morning” or “Have a nice day”.
communication process, namely:
These three primary types of messages can be
 A sender; combined in many ways so that they form an
interaction (conversation). The goals of the
 A clear message; and interaction can be comprehensive. Nurses strive to
make all their communication with patients
 A receiver
therapeutic, that is, their communication is
The communication process may be explained by purposefully and consciously planned to promote
means of a linear model of communication, the patient’s health and wellbeing.
interactive model of communication or
 Types of communication
transactional model of communication.
Verbal and non-verbal communications are
A. Linear model of communication
the two main types of communication used by
Linear model of communication entails a human beings.
sender, a message, a receiver and noise.
 Verbal communication
B. Interactive model of communication
Verbal communication is associated with
Interactive model of communication gives a spoken words and is vitally important in the
slightly more complex explanation of the healthcare context. Members of the multi-
communication process. Communication is seen as disciplinary healthcare team communicate verbally
a process in which the listener gives feedback or with one another and with patients as well as
responds to a message after a process of family members.
interpretation. A communicator creates and
 Non- Verbal communication
interprets a message with a personal field of
expertise. Non-verbal communication is not reliant on
words. It is sent through the use of one’s body
C. Transactional model of communication
rather than through speech or writing. This kind of
Transactional model of communication communication, called body language, can tell a
acknowledges and gives emphasis to the dynamic great deal or can totally the wrong impression. It is
nature of interpersonal communication and the worth noting that body language may indicate a
multiple roles of the communicators. Features different meaning to what is spoken. As
approximately 60% of communication is non- understand the instructions from a nurse
verbal, non-verbal skills are essential for effective regarding the frequency of taking medication
communication. Often non-verbal messages send at home.
stronger signals than verbal messages.
 Cultural differences
Non-verbal communication is made up of:
Culture is another hindrance. The patient’s
o Accent culture may block effective nurse–patient
interactions because perceptions on health and
o Bodily contact
death are different between patients. The nurse
o Direction of gaze needs to be sensitive when dealing with a patient
from a different culture. What is acceptable for one
o Emotive tone in speech patient may not be acceptable for another. Given
the complexity of culture, no one can possibly
o Facial and gestural movements know the health beliefs and practices of every
culture. The nurse needs check with the patient
o Physical appearance whether he/she prefers to be addressed by first
name or surname. The use of eye contacts,
o Posture touching and personal space is different in various
cultures and rules about eye contact are usually
o Proximity
complex, varying according to race, social status
and gender. Physical contact between sexes is
o Speech errors
strictly forbidden in some cultures and can include
o Timing of speech handshakes, hugging or placing a hand on the arm
or shoulder. A ‘yes’ does not always mean ‘yes’. A
4. Effective communication skills and smile does not indicate happiness, recognition or
strategies agreement. Whenever people communicate, there
is a tendency to make value judgments regarding
Effective communication skills and strategies those perceived as being different. Past
are important for nurses. Clear experiences can change the meaning of the
communication means that information is message. Culture, background and bias can be
conveyed effectively between the nurse, good if they allow one to use past experiences to
patients, family members and colleagues. understand something new; it is when they change
However, it is recognized that such skills are meaning of the message that they interfere with
not always evident and nurses do not always the communication process. It is important for
communicate well with patients, family nurses to think about their own experiences when
members and colleagues. The message sent considering cultural differences in communication
may not be the message received. The meaning and how these can challenge health professionals
of a message depends on its literal meaning, and service users.
the non-verbal indicators accompanying it and
the context in which it is delivered. It is  Conflict
therefore; easy to misinterpret the message, or
Conflict is a common effect of two or more
to interpret it correctly, but to decide not to
parties not sharing common ground. Conflict can
pursue its hidden meaning this leads to
be healthy in that it offers alternative views and
obstruction to communication. Continuous
values. However, it becomes a barrier to
barriers to effective communication bring
communication when the emotional ‘noise’
about a gradual breakdown in relationships.
detracts from the task or purpose. Nurses aim for
The barriers to effective communication
collaborative relationships with patients, families
outlined below will help nurses to understand
and colleagues.
the challenges.
 Setting in which care is provided
5. Language barrier
The factors in care setting may lead to
Language differences between the patient
reduction in quality of nurse–patient
and the nurse are another preventive factor in
communication. Increased workload and time
effective communication. When the nurse and constraints restrict nurses from discussing their
the patient do not share a common language, patients concerns effectively. Nurses work in busy
interaction between them is strained and very environments where they are expected to complete
limited. Consequently, a patient may fail to a specific amount of work in a day and work with a
variety of other professionals, patients and their conversation. If patients are embarrassed or
families. The roles are hard, challenging and tiring. concerned that they will not be able to speak
There is a culture to get the work done. Some properly or control their mouth, they could be
nurses may consider colleagues who spend time reluctant to speak.
talking with patients to be avowing the ‘real’ work
and lazy. Nurses who might have been confident in  Noise
spending time with patients in an area where this
was valued, when faced with a task-orientated Equipment or environmental noise impedes
culture have the dilemma of fitting into the group clear communication. The sender and the receiver
or being outside the group and spending time must both be able to concentrate on the messages
engaging with patients. Lack of collaboration they send to each other without any distraction.
between the nurses and the doctors in information
sharing also hinder effective communication. This There are several points to be kept in mind
leads to inconsistencies in the information given to when communicating with patients. The first point
patients making comprehension difficult for the is that you are there to provide care and support to
patient and their families. the patient.

 Internal noise, mental/emotional a. Be open, respectful and gracious in all your

distress interactions with the patient and keep his/her
cultural preferences in mind.
Internal noise has an impact on the
communication process. Fear and anxiety can b. Answer nurses’ bells promptly.
affect the person’s ability to listen to what the
c. Make sure you have the patients’ attention
nurse is saying. People with feelings of fear and
when communicating.
anger can find it difficult to hear. Illness and
distress can alter a person’s thought processes. d. Use words that are non-threatening – explain
Reducing the cause of anxiety, distress, and anger what you would like to do and do not give
would be the first step to improving orders to the patient.
communication.
e. Use simple, understandable phrases, not
 Perception medical terms as most patients do not
understand these terms.
If a healthcare professional feels that the
person is talking too fast, not fluently, or does not f. Speak clearly and courteously.
articulate clearly etc., he/she may dismiss the
person. Our preconceived attitudes affect our g. Use a pleasant and normal tone of voice to the
ability to listen. People tend to listen uncritically to hard of hearing.
people of high status and dismiss those of low
status. Difficulty with speech and hearing People h. Always stand so that the patient can see the
can experience difficulty in speech and hearing nurse’s face when communicating, as lip
following conditions like stroke or brain injury. reading is part of all normal hearing.
Stroke or trauma may affect brain areas that
i. Use body language that is appropriate.
normally enable the individual to comprehend and
produce speech, or the physiology that produces j. Explain facts and procedures before donning a
sound. These will present barriers to effective mask that covers the wearer’s mouth and
communication. lower face.
 Medication k. Be alert to the patient’s needs. Allow time for
answers to your requests and to answer
Medication can have a significant effect on
patient’s questions.
communication for example it may cause dry
mouth or excess salivation, nausea and
indigestion, all of which influence the person’s
ability and motivation to engage in