COMMUNICATION Communication is an exchange of my world of meanings with your world of meanings.

It is a dynamic, on going process; a reason for existence and foundation of all course of relationship. Communication is critical to nursing practice because of the following:

Communication is the vehicle for establishing a therapeutic relationship. Communication is the means by which people influence the behavior of another, leading to the successful outcome of nursing intervention. Communication is the relationship itself because without it, a therapeutic nursepatient relationship is impossible.

Modes of Communication: I. Verbal - are spoken and written words. It has been estimated that 7% of meaning is transmitted by words. II. Non-Verbal - includes anything that does not involve the spoken or written word including all of the five senses. Often unconsciously motivated and may accurately indicate a person's meaning than the words being spoken. Truly reflective of one's thoughts and feelings because a person is less conscious of it. " Listen to what the other person is not saying " Types of Non-Verbal Communication 1.Kinesis or body cues - convey messages of intent and mood and can support or contradict a verbal message. Subtypes are: Facial Expression; Eye Contract; Gestures 2. Paralanguage or Paraverbal or Paralinguistic cues or vocal cues - vital cues of emotions and can be powerful conveyors of information. Subtypes are: Voice quality - tone of voice Non-language vocalization - such as crying, sobbing or moaning. 3. Proxemics - law of space relationship; gives a sense of their relationship or nature of relationship between two people; the way people perceive and the use of environment, social and personal space during interactions with each others. Subtypes are: Territoriality - permanent space that a person prevents from intrusion. Personal Space - temporary space that a person prevents from intrusion. Four types of personal spaces are: a.Intimate distance (6-18 inches) - allows interpersonal sensory stimulations. b.Personal distance (1 1/2-4 ft) - also known as Comfort Zone (Hall). Used for close relationships.Visual sensation is improved over the intimate range.The nearest distance for a client with Schizophrenia-paranoid is 4 ft.

c.Social distance (4-12 ft) - also known as consultative distance or business distance. This is less personal and less dependent, speech must be louder. d.Public distance (12 ft and more) - this is used in speech giving during gatherings. 4. Touch - most personal of the non-verbal messages (Smith et al 1997). First and most fundamental means of communication (Stuart and Laraia, 2005). This is a form of communication used almost daily by nurses providing direct physical care and support to clients. It can be a way of conveying concern, empathy or caring. However, like other forms of communication, touch may be interpreted in many ways. The therapeutic value of touch is dependent upon the client perceiving the intended message. The nurse must use it discreetly. Be reminded that touching the client must be preceded by a warning and never touch a client with Schizophrenia paranoid type. 5. Cultural Artifacts - are hair, clothing, fragrance, eyeglasses, beard, moustache.