Module 4: Cultural Appropriate

Communications that combine verbal and

and Competent Care Nursing
nonverbal elements
Approaches in ● Warmth
COMMUNICATION ● Humor

I. Communication
- comes from the Latin verb The Communication Process
communicāre, “to make common, Sender———— The person initiating
share, participate, or impart” the communication, or broadcasting the
- It implies and embraces the entire message
realm of human interaction and
behavior.
- All behavior, whether verbal or Message——— The specific set of words,
nonverbal, in the presence of another gestures, and images that the sender uses to
individual is a communication convey what he or she wants to say.
(Littlejohn & Foss, 2010;)
- Communication provides the means
by which people connect Channel——— The channel through which
- Communication is a continuous the message moves.
process by which one person may
affect another through written or oral
language, gestures, facial Receivers——- Receivers (or the audience
expressions, body language, space, for the message) - from whom the receiver
or other symbols. often expects a response

Types of Communication: Feedback——- The response from the

Verbal and Nonverbal Communication receiver to the sender.

Language or verbal communication Factors Influencing Communication

(Check canvas notes for definition) 1. Physical health and emotional
● Vocabulary well-being
● Grammatical structure 2. The situation being discussed and its
● Voice qualities meaning
● Intonation 3. Distractions to the communication
● Rhythm process
● Speed 4. Knowledge of the matter being
● Pronunciation discussed
● Silence 5. Skill at communicating
6. Attitudes toward the other person
Nonverbal communication and toward the subject being
● Touch discussed
● Facial expressions 7. Personal needs and interests
● Eye movement 8. Background, including cultural,
● Body posture social, and philosophical values
 9. The senses involved and their
functional ability
10. Personal tendency to make NON-VERBAL COMMUNICATION
judgements and be judgemental of (Meanings of Touch)
others
11. The environment in which the Touch may:
communication occurs.
12. Experiences that relate to the current 1. Connect one individual with another,
situation both literally and figuratively, by
indicating availability.

2. Provide affirmation and approval.

Linguistic isolation in the United States
- In the US, some 44.5 million adults 3. Be reassuring by providing empathy,
are linguistically isolated, do not interest, encouragement, nurturance,
speak English well, or speak a caring, trust, concern, gentleness, and
language other than English at home protection.
(U.S. Department of Commerce,
Bureau of the Census, American 4. Decrease loneliness by indicating a
Community Survey, 2017) relationship with another.

5. Share warmth, rapport, love, intimacy,

Spain 37, 458, 000 excitement, and happiness.
China 2, 896, 000 6. Provide stimulation by being a mode of
sensation, perception, and experience.
France 1, 253, 000
7. Increase self-concept.
Philippines 1, 613, 000
8. Communicate frustration, anger,
Vietnam 1, 399, 000
aggression, or punishment.
Germany 1, 066, 000
9. Invade personal space and privacy by
South Korea 1, 177, 000 physical and psychological assault or
intrusion.
Saudi Arabia 924, 000
10. Convey a negative type of relationship
Others 894, 000 with another.

Japan 449, 000 11. Cause sexual arousal.

12. Allow a person to perform a functional

or professional role, such as a physician,
barber, or tailor, and be devoid of personal
message.
 13. Reflect cordiality, such as a handshake ● Effective communication ensures
by business associates and among that important information is
strangers and acquaintances. properly conveyed between
healthcare professionals, and their
families.
II. Communication and Patient Safety ● When communication falls, patient
- The international Patient Safety safety is at risk.
Goals (PSG) are a set of guidelines ● Misunderstanding, inaccuracies, and
and objectives that aim to enhance incomplete information can lead to
patient safety and improve healthcare errors in diagnosis, medication
outcomes worldwide. These goals administration, and treatment plans.
were developed by The Joint ● To enhance patient safety, healthcare
Commission International (JCAHO) organizations must implement strong
in 2006. communication strategies.
● These strategies include clear and
- The International Patient Safety concise verbal communication,
Goals (IPSGs) provide a framework written communication that is easy
for healthcare providers to to understand, and the use of
implement safety measures and technology to improve
practices that are designed to reduce communication efficiency.
medical errors and prevent adverse
events. The goals cover a wide range
of areas including medication safety, III. Communication and Culture
infection prevention, patient - Communication and culture are
identification, and communication. closely intertwined.
- Communication is the means by
Joint Commission International and IPSG which culture is transmitted and
are two accredited organizations. preserved.

International Patient Safety Goals IV. Implications for Nursing Care

Goal #1: Identify patients correctly - Nurses commonly relate to clients in
an interview setting. The nurse may
Goal #2: Improve effective communication also relate during the process of
client care orat a more informal level
Goal #3: Safety of high alert/risk medication in the hospital unit or in the clinic.
- Although cultural issues may cause
Goal #4: Ensure safe surgery the client to interpret the nurse’s
behavior to the following guidelines
Goal #5: Reduce the risk of Health will increase the likelihood that the
Associated Infections nurse-client relationship will be
positive.
Goal #6: Reduce the risk of patient harm
resulting from falls
1. Assess your personal beliefs
surrounding persons from different
How communication impacts patient safety?
 cultures. Review your personal • Respond in a reassuring manner in
beliefs and experiences. keeping with the patient’s cultural
orientation.
• Set aside any values, biases, ideas, and
attitudes that are judgmental and may • Be aware that in some cultural groups
negatively affect care. discussion with others concerning the
patient may be offensive and impede the
2. Assess communication variables nursing process.
from a cultural perspective.
Determine the ethnic identity of the 5. Understand that respect for the
patient, including generations in the patient and communicated needs is
United States. central to the therapeutic
relationship. Communicate respect
• Use the patient as a source of information by using a kind and attentive
when possible. approach.
• Assess cultural factors that may affect your • Learn how listening is communicated in
relationship with the patient and respond the patient’s culture.
appropriately.
• Use appropriate active listening
3. Plan care according to the techniques.
communicated needs and cultural
background. Learn as much as • Adopt an attitude of flexibility, respect,
possible about the patient’s cultural and interest to help bridge barriers imposed
customs and beliefs. by culture.

• Encourage the patient to reveal cultural 6. Communicate in a nonthreatening

interpretation of health, illness, and health manner. Conduct the interview in an
care. • Be sensitive to the uniqueness of the unhurried manner.
patient.
• Follow acceptable social and cultural
• Identify sources of discrepancy between amenities.
the patient’s and your own concepts of
health and illness. • Ask general questions during the
information-gathering stage.
• Communicate at the patient’s personal
level of functioning. • Be patient with a respondent who gives
information that may seem unrelated to the
• Evaluate effectiveness of nursing actions patient’s health problem.
and modify nursing care plan when
necessary. • Develop a trusting relationship by listening
carefully, allowing time, and giving the
4. Modify communication approaches patient your full attention.
to meet cultural needs. Be attentive
to signs of fear, anxiety, and 7. Use validating techniques in
confusion in the patient. communication. Be alert for
feedback that the patient is not
understanding.
• Do not assume meaning is interpreted
without distortion.

8. Be considerate of reluctance to talk

when the subject involves sexual
matters. Be aware that in some
cultures sexual matters are not
discussed freely with members of the
opposite sex.

9. Adopt special approaches when the

patient speaks a different language.
Use a caring tone of voice and facial
expression to help alleviate the
patient’s fears.

• Speak slowly and distinctly but not loudly.

• Use gestures, pictures, and play acting to

help the patient understand.

• Repeat the message in different ways if

necessary.

• Be alert to words the patient seems to

understand and use them frequently.

• Keep messages simple and repeat them

frequently.

• Avoid using medical terms and

abbreviations that the patient may not
understand.

• Use an appropriate language dictionary.

10. Use interpreters to improve

communication. Ask the interpreter
to translate the message, not just the
individual words.

• Obtain feedback to confirm understanding.

• Use an interpreter who is culturally

sensitive.