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    This information pack will include a directory which explains the different forms of verbal and nonverbal communication and discusses the theories of communication.

    It will also include a series of case studies which will explain the different forms of communication which would enable residents, staff and volunteers to communicate with each other. Finally, it will also assess the role of effective communication and interpersonal interaction in health and social care with references to theories of communication. Directory of Key Words and Terms: Key word/term Explanation Example Verbal Communication It is the sharing of information between individuals using speech. Verbal communication includes talking, whispering, shouting etc. It uses words to give an idea, thought or a feeling.

    In a dental practice, the dentist is talking to a patient about using floss to keep their teeth clean from unwanted substances. The patient then asks the dentist how often she need to floss and the dentist explains and says she would need to floss after each meal. Braille It is a form of written language for people that have a poor or no vision at all. Braille consists of characters that are represented by patterns of raised dots that are then felt by the fingertips. In a pharmacy, a customer with poor vision asks for a certain medication that their doctor prescribed for him to use.

    After he pharmacist gave him the named medication, the customer then feels the Braille on the medication label to make sure that it is the right one the doctor prescribed for him. British Sign Language (BBS) Sign language is a visual means of communicating using gestures, facial expression and body language. It is mainly used by the deaf or people who have hearing impairments. BBS is Britain’s most common used Sign Language. In a primary school, a teacher’s assistant is communicating with a child who has a hearing impairment. She uses her fingers to show that there are 7 balls in a bag and the child nods as sign of understanding.

    The assistant then takes out two balls and the child then shows 5 fingers since there are now 5 balls left in the bag. Communication Passport Communication passports are personalized books containing information about a person’s style of communication. It helps the health & care worker to understand the needs of a person with communication difficulties. In an activity center, a young woman with communication difficulties is working with a care worker to set up her own communication passport. She uses drawings and photos of the things she likes and dislikes.

    The care worker now has a better understanding about her life, personality and her stories. Communication Cycle This is the most important communication which involves people sending and receiving ‘messages’. This cycle starts with an idea occurring from one person and ends with the message understood by another person In a care home, an elderly woman wants her lunch and asks the staff on what is available on the menu. The staff worker names the resident what’s on the menu loudly, slowly and carefully so she fully understands and won’t need to ask the worker to repeat herself as she has received, decoded and understood the message.

    Eye Contact It is the state in which two are aware of directly looking at each other’s eyes. It shows a sign of respect whilst you are communicating with another individual. In a nursing home, an old deaf man needs medical attention from the nurse. To make the resident feel appreciated, respected and valued, the nurse makes eye contact and smiles to him whilst assisting his medical needs. Facial Expression What we as humans do with our faces that represent a different kind of emotions. For example smiling means we are happy, raised eyebrows means we are shocked or surprised etc.

    In a GPO, the doctor smiles at the next patient ho enters the room. He kindly tells the patient to take a seat and asks what the patient how he could help her. This makes the patient feel comfortable and more willing to share her problem with the doctor. She then may make a sad face when she’s explaining her problems so the doctor tries to reassure her and make her less worried. Formal Communication This type of communication is usually between people who don’t know each other well. It is clear, correct and avoids misunderstanding. The language used is conventional.

    A doctor e-mails a patient to inform her about the changes she needs to make to her appointment. She starts off the e-mail using a formal greeting like ‘Dear Mrs.. Brown’ and ends with a formal ending like ‘Yours sincerely Dry. Smith’. Gestures This is the movement of the arm, hand or head that can help us understand what a person is saying. In a nursery, the teacher tries to tell a toddler to stop running by waving her finger and shaking her head. She then points at the chair so the toddler knows it is time to sit down. Group Communication Group communication refers to communication between 3 or more individuals.

    Effective group communication involves a facilitator and group members with sense of belonging, common goals and mutual respect. Both verbal and nonverbal communication are components of group communication. In an activity center for people with disabilities, a group of teenagers sit around a table and take turns to tell the rest of the group about their hobbies. Some share their likes and dislikes using speech while some use gestures and body language such as a ‘drawing’ gesture if what they enjoy is drawing. Informal Communication This type of communication is usually between individuals who know each other well, like friends and family.

    The language used is casual and more ‘open’. In a are home, two elderly residents, who are good friends, talk to each other about their childhood. They make jokes about some of the embarrassing things they may have done in the past and laugh about them. They also call each other by their first names since they know each other well. Megaton Megaton is a language programmer using signs and symbols to help people to communicate. It is designed to support spoken language and the signs and symbols are used with speech, in spoken word order.

    In a speech & language therapy, the therapist uses Megaton using gestures and symbols to a patient who has communication difficulties. Non Verbal This refers to the messages we send out to express ideas and opinions without talking. This might be through the use of body language, facial expressions, gestures, tone of voice, touch or contact, signs, symbols, pictures, objects and other visual aids. In a care home, an old resident who has lost the ability to speak, may use her hands to indicate that she needs something such as pointing at the remote on a table.

    She may smile or frown to show her expressions depending on how she is feeling. One to One Communication One-to-one means one person communicating with another person with no other people joining in. Two teenagers at a youth club may have a casual conversation with each other. Posture Posture is a particular position of the body. The way we sit or stand can send messages. A nurse is listening to a patient’s problem and to show that she is interested and is willing to listen and help, she leans forward as well as nodding her head. This creates a positive image and the patient feels the care and willingness the nurse is showing.

    Signs (use of signs) A sign is a gesture or action used to convey information or an instruction. A teacher waves at the children as they enter the classroom to say “hello” and the hillier automatically wave back at her. Symbols (use of symbols) A symbol is an object that represents a belief, action, image or suggests an idea. Touch (appropriate use of) This is the act of touching someone or something. It’s another way of communicating without the use of words. Touching another person can send messages of care, affection, power over them or sexual interest.

    A midwife is holding a patients hand to confront her and encourage her to not give up. She is making the woman feel valued and creates a sense of relief that someone is supporting her in her difficult time. Written This is a form of non-verbal communication through written word such as e- mails, letters , texts etc. A man’s dentist send him an automatic text message to remind him of an upcoming appointment. The man reads it and makes a note of it in his calendar so he does not forget. Case Study One Nurse and a Service user who is deaf This type of one to one interaction is formal.

    Formal conversations are ones in which we have in professional settings which in this case is at a hospital. It is usually between two people who do not know each other and often used when a professional person, such as a health or social are worker speaks to someone who is using the service. In this case study, the nurse is the professional and the deaf individual is the service user. The form of communication used in this case study is non-verbal due to the fact that the service user is deaf and cannot hear, so verbal communication would be ineffective. A form of effective non-verbal communication the two used could be Sign Language.

    This is effective because sign language is a popular and perfect way to communicate with people who are deaf or have a hearing impairment. The service user may feel more comfortable communicating by signing rather Han speaking. Hence, if the service user has this ability, another effective form of communication can be lip-reading. The service user can understand speech from observing the nurses lip movements. To make it most efficient, the nurse must make sure to speak in a normal tone; whispering or shouting will distort the lip movements, making it difficult for the deaf service user to understand.

    Another ineffective way to communicate is lack of eye-contact. If the nurse fails to give enough eye-contact to the service user, he or she may not realize that the nurse is talking, therefore loss of concentrating may occur and immunization loses its flow. Also, lack of eye-contact can make the deaf user feel unvalued and think that the nurse isn’t paying enough attention. A good posture is also important. In order to show willingness in listening to the deaf users problems, the nurse should use a good posture, such as leaning forward which shows respect and interest.

    If the nurse is leaning backwards or crossing his or her arms, the service user may feel disrespected or as if he or she is just bothering the nurse as not enough attention is given. In order for the nurse and the deaf user to communicate efficiently, they have to go through a process. This is called the communication cycle; a two way process in which each person tries to understand the other person. It is crucial for both to check that they are understanding each other, especially if one individual is deaf as it may be a little more difficult.

    Michael Argyle (1972) argued that interpersonal communication was a skill that could be learned and developed – like driving a car. Driving a car involves a constant cycle of watching what is happening, working out how to respond, making responses and repeating this cycle until you reach your destination. Argyle argued that since verbal and non-verbal communication isn’t straight award, an individual has to translate or ‘decode’ what other people are communicating and adapt their own behavior in order to maintain effective communication.

    The cycle involves 6 steps; ideas occur, message coded, message sent, message perceived, message decoded and message understood. In this case study, it is vital that effective communication and interpersonal interaction in the health and social care is properly carried out. Firstly, the idea occurs – the idea to communicate with each other. It can start with the nurse beginning the conversation, for example asking the service user if they need anything. Next, it is the message coded; the nurse must know decide how to say it.

    The nurse may use a small wave or a light touch on the shoulder to get the service user’s attention. After getting attention, the message is sent. The nurse may use sign language, Megaton or lip-reading to ask the service user “Good morning, how are you? Would you like me to bring you Thirdly, anything? ” Then, the message is perceived. The deaf service user will sense the message as he or she sees the nurse speaking or signing. The message is then decoded by the deaf service user which means it is interpreted but it is to always easy, as the service user may make assumptions about the nurse’s words or body language.

    Finally, the message is understood. If the nurse has made him or herself clear the first time, the message is taken in and understood, but, if not, the message would need to be repeated until the service user understands. Case Study Two Two service users who walking outside in the grounds This one to one interaction is informal. Informal communication is between friends and family and since these two service users who are chatting to each other while walking in the grounds, shows hey know each other and may be friends. The form of communication used is verbal.

    Non-verbal communication is the most effective form because it is a one to one interaction between these two individuals only. A form of effective communication would be for both service users to give each other eye-contact. Frequent eye contact would mean they are interested to talk to each other and it shows a sign of respect. If there was a lack of eye contact between the two, then the conversation would feel awkward because one or both of them may feel like they aren’t willing to talk and want to stop the talk. No eye contact also wows disrespect to the individual who is trying to talk, which will automatically make them feel offended.

    So a lack of eye contact would be an ineffective way to communicate. Another effective and important form of communication would be reflective listening. This plays a big role in the two service user’s communication because good listening ensures for them to understand each other’s thoughts. This type of skilled listening involved both service users to look interested and communicating to show they are ready to listen to each other. If there was no reflective listening, then the conversation would be pointless as no interest ND willingness to listen is shown. A massive non-effective way of communication would be long silences.

    Long pauses in their conversations may make them feel awkward or embarrassed. In order for them to communicate well and create a ‘flow’ they must only include short pauses if they want to think of what to say, but not long pauses as it makes the other service user to feel like they don’t want to talk anymore. The right tone of voice also plays an effective role in their communication. If for example, one service user is telling the other about a shocking experience they have had, the reaction should be a response like “Oh really? With a slightly higher tone of voice, to show the shock or surprise.

    If the response was a “Oh really” using a low voice, then it could show a rather sarcastic, uninterested or bored feeling which would make the conversation feel awkward and not fluent any longer. Lastly, another ineffective form is incorrect facial expressions. In order for them both to feel each other’s emotions as they speak, they should use correct facial expressions such as smiling if they are sharing a happy memory of their lives. If one of them doesn’t show any facial expressions then that may display a bored kind of feeling towards the other individual.

    This would then put the other person ‘off for talking to them since little or no interest is shown through their facial expressions. Like case study one, the two service users must go through the communication cycle. The reason for this because since they both are having a one to one conversation, they would need to work out what each other’s behaviors really mean and adapt their own behavior in order to communicate effectively. Michael Argyle theory of the communication cycle fits perfectly in this scenario as each individual has to ‘decode’ what the person they are talking to is saying, and respond in the erect manner.

    To start off this cycle, the first service user must think of an idea or a topic to talk about e. G. About their childhood memories. He or she makes eye-contact to show that they need their attention as they are about to start a conversation. Next he or she must think how they should say it, so in this case, verbally. After that, the message is sent. The service user may start with a happy tone of voice “Oh remember the good old days, when I was only 10 years old… “. Then the message is perceived by service user number two. They sense and hear the message that was put out to them.

    He or she analyzes he message and then decodes the message if it was clear enough. Finally, the message is understood and they would prepare for an response such as ‘Yeah I also remember, it was the best moments of my life! ” This cycle would keep repeating itself, which creates an effective conversation. Case Study Three Group meeting between Professionals – Social Worker, Nurse and Care Worker This type of group interaction is formal. Formal conversations are ones in which we have in professional settings with people who do not necessarily know each other well.

    In this case study, three professionals are having a meeting, so formal and high tankards must be maintained. Group communication is harder than one to one communication because it only works properly if everyone is able to be involved. In most groups there are people who speak a lot and others who speak rarely, if at all, because they feel uncomfortable speaking in front of a group of people or they are just not interested. Groups work best if there is a team leader when encourages everyone to have a say in turn, rather than everyone trying to speak at once.

    The type of communication used here is verbal. Professional people, which in this scenario is the nurse, care worker and social worker, often work within their win specialized language community. A language community is a community of people that has developed its own special ways of interacting that set it apart from other groups of people. Professionals working in health and social care must be aware of the need to translate technical language into everyday language when they are working or communicating with other professionals.

    Therefore, the language used is an effective way of communication. Hence, an ineffective form is the use of incorrect language between the three professionals. If they communicate using informal and unprofessional engage, then that will create the wrong atmosphere for a formal meeting. A second effective form of communication would be reflective listening. In order for each individual in the meeting to receive respect, they would need to be listened to well. Since this is a formal meeting, extra listening skills must be given.

    If their viewpoints and ideas aren’t listened to, then that would create a unprofessional and disrespectful image making the workers feel unvalued and uneasy. Also, a third effective form is a good posture coming from each individual in the meeting. In order to show interest in the topic they are discussing in the eating, they should display a correct posture. Slouching, leaning back or folding their arms could mean they aren’t interested or bored. Again, this is very unprofessional and can make the speaker feel disrespected.

    Finally, one ineffective form of communication is not facing each other while talking. It is very important for the speaker in the group to face everyone in the meeting so they all sense a feeling of involvement and really being part of a ‘group’. If this fails and the speaker only faces one person while they are talking, then that would be more similar to a one to one conversation ether than a group meeting and could cause the individual to feel left out and not valued to be part of the meeting. Bad seating and standing positions can also make communications harder.

    As mentioned earlier, a group communication or discussion is different from one to one communication and involves some additional issues. A man named TCPMAN came up with a theory in 1965 that suggested that group meetings go through certain stages to create an efficient group formation. These stages are forming, storming, morning and finally, performing. Firstly, the ‘forming’ stage involves meeting people for the first time and sharing information. The health and social care professionals may not know each other, but to act formal and professional, they must create the meeting by giving and sharing information. Storming’ involves barriers such as tensions and struggles the group may face. The individuals in the group may not necessarily straight away get on at first and go through some sort of struggle before they Secondly, unite. But the third stage, ‘morning’ sees the group merging and becoming together. The people in the meeting can finally agree on each their group values and keep the meeting going efficiently. Finally, if those three stages are correctly done, the fourth stage ‘performing’ is reached which is being an effective performing group, resulting in a successful meeting.

    Case Study Four Group discussion between 3 care workers during their lunch break This group interaction is informal. Informal communication is usually between people who know each other and because these 3 care workers are having lunch together, shows that they feel comfortable with each other, enough to share an informal discussion. The type of communication used between these three care workers is verbal. They could be having a normal chit-chat about how their day has been so far. There are certain forms of communication that can hinder or help their group discussion.

    One effective form of communication used in this discussion is ‘taking turns’. It is very important for each care worker to feel involved in the discussion that they are having. This means that there should be a group leader’ to start a topic to discuss and then looking around as well as lowering their tone of voice to signal another person’s turn to speak in the group. If this isn’t maintained then the care errors will fail to take turns in speaking, resulting in everybody to talk at once. An ineffective form would be lack of eye contact with every member in the group.

    If the speakers in the group make little or no eye contact with each member equally, then that could create a sense of disrespect to the rest. If the speaker only makes eye contact with one of the workers and not the other, the one that gets no eye contact may get a negative feeling of unvalued and a feeling of isolation in the discussion. Eye contact must be made to everyone equally to create a friendly, comfortable and respectful atmosphere. Secondly, another effective form of communication would be using the correct tone of voice.

    If the group discussion is located in a canteen then it is obvious that their tone of voice must be risen so each individual can hear. Also, a calm, soft voice with a varying tone can send a message of being friendly. However, if incorrect use of tone is used, the discussion may not go on as effectively. If one care worker is talking quickly in a loud voice while the other is talking too quietly, then that would create an awkward or uncomfortable atmosphere. So incorrect use of tone is an ineffective way to communicate in a group discussion.

    Use of space is another effective way that results in positive communication. If the care workers sit in a circle then everyone can see everyone else’s’ face. This is crucial as group feeling and turn taking often depend on people being able to understand the messages in each other’s faces. Lastly, an ineffective way of communicating would be inappropriate use of touch. If for example one care worker nudges the other to start a conversation or tell the rest of the group how their day went, may make the care worker to feel pressured. Instead, a friendly touch on the shoulder can create a more comfortable feeling.

    Communication in the group discussion can be influenced by the degree to which the care workers feel they belong together. When they first sit together to have their lunch break, the group goes through a group formation. Similarly to case study three, this involves Dustman’s (1965) theory of group formation which includes the four stages. ‘Forming’ involves the three care workers to meet up and start a casual group discussion. One care worker may start sharing information first for example how tiring their day was. The second stage is ‘storming’ which means any struggle or arguments the group may face with each other.

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