Communication To Children

Communication to facilitate Health Assessment of The Child and Family By : Ns, Mardiyanti, S.Kep http://www.mosby.com/MERLIN/peds_wong_ncic

COMMUNICATION  Communication

is a complex process that includes the perceptions and judgments of all individual involved (Wong, 1999)  Many factor influence the process, to be successful communication must be appropriate to the situation, time and clearly delivered.  Pediatric’ nurse effective communication techniques quality of understanding

Verbal communication  Involve

language (words of choice) and its expression ( laughs, moans and squalls).  Influence the patient’s awareness of taking care of their self  E.g. cancer = tumor, cyst, malignancy, carcinoma  nurse recognize how patients and health professionals use language to change perception and to communicate effectively.

Verbal communication…  Avoidance

language alter reality, hide something (feeling), perpetuate the fears. nurse straightforward, precise, descriptive language allow the person to discuss fears or feeling

Verbal communication…  Distancing

language the use of impersonal words to shield from painful reality. (-) : the parents deny that the problem exist (+) : reduce the pain if the topic is too painful to discuss directly

Nonverbal communication  

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Body language : gestures, movements, facial expression, postures and reactions Paralanguage : pitch, pause, intonation, rate, volume, and stress in speech. Children respond attentively to a slow, even and steady voice In communication with children in all ages, the non verbal convey the most significant messages Confirming behaviors: direct eye contact, nodding the head, repeating/requesting clarification, comments Discomfirming behaviors: tapping fingger/foot, turning away, avoid eye contact, interrupting

Establishing a setting for communication  Appropriate

introduction  Role clarification and explanation of the interview  Preliminary acquaiantance  Assurance of privacy and confidentiality

Communication with family  Encouraging

the parent to talk  Directing the focus  Listening  Using silence  Being empathic  Defining the problem  Solving the problem  Providing anticipatory guidance  Avoiding blocks to communication  Communication with families through interpreter

Communication with children  Allow

children time to feel comfortable  Avoid sudden or rapid advance, broad smiles, extended eye contact, or other gestures that may be seen as threatening  Talk to the parent if child is initially shy  Communicate through transition objects: dolls or stuffed animals before questioning a young child directly. Talk to the doll first: “does your teddy bear have a special name?:  Give older children the opportunity to talk without the parents present

Communication with children…  Assume

a position that is at eye level with child  Speak in a quiet, unhurried and confident voice  Speak clearly, be specific, use simple words and short sentences  State directions and suggestions positively  Offer a choice only when one exists  Be honest with children  Allow children to express their concerns and fears  Use variety of communication techniques

Stages of social Communicative development in young children  Perlocutionary

stage (0-8-9 months)

unintentional communication behavior. child is reflexive to stimuli, increasing purpose in action

 illocutionary

stage (8-9-12-15 months)

true intent in communication efforts. communicates intentionally with signal and gestures

 Locutionary

stage (12-15-18-24 months)

intentional communication behaviors and use of symbols. communicates intentionally with gestures, vocalizations and verbalizations.

Communicate to infant  Infant

communicate their needs and feelings through nonverbal behavior and vocalizations  Infant smile and coo when content and cry when distressed.  Infants respond to adults’ nonverbal behaviors (cuddled, sound of voice even though they don’t understand)  Older infants’ attention are centered on themselves and their parents. Observe the position in which the parent hold the infant, in general upright position preferable than horizontal, also holds the infant so that they can see their parents.

Communicate to early childhood 

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Children under 5 years of age are egocentric, they see things only in relation to themselves and from their point of view tell them what they can do or how they will feel They Have not yet acquired sufficient language skills to express their feelings and wants, but they able to communicate effectively with their hands to transmits ideas without words. E.g ; push unwanted object away, pull another person to show something. Everything is direct and concrete to small children unable to work with abstractions, unable to separate fact from fantasy. (phantom, picture, etc)

Communicate to early childhood..  Use

simple, short sentences, repeat words that are familiar to the child and limit descriptions to concrete explanations  Nonverbal are consistent with words and actions don’t smile while doing something painful=you enjoy hurting them  Keep unfamiliar equipment out of view until it is needed  Allow them to touch and examine articles that will come in contact with them

Communicate with school-age years  Scool-age

children need to know all the aspect of procedurs, objects and activities, why the objects exist, why it is used, how it works, and why it is being done to them specifically. E.g taking blood pressure, “ I want to see how far the silver goes up when the cuff squeezes your arm”  they have a heightened concern about body integrity lead to anxiety nurse have to provide reassurance and to implement activity that reduce anxiety. E.g : shy child dislikes being the center of attention talking to other children in family or group

Communicate with adolescence  Spend

time together  respect their views  Tolerate differences  Set a good example  Listen, listen and listen  Avoid judging or criticizing  confidentiality

Tehnik berkomunikasi creatif dengan anak

 Verbal

techniques

 Nonverbal

techniques

Tehnik Komunikasi Verbal “

I ” messages Nyatakan perasaan tentang perilaku dalam istilah “saya” hindari penggunaan istilah “anda” e.g: berkomunikasi pada pasien yg menolak pengobatan: “saya sangat perhatian terhadap jalannya pengobatanmu karena saya ingin kamu lebih baik” hindari “anda tidak kooperatif dalam menjalankan pengobatan anda

Tehnik komunikasi verbal..

 Third-person

technique

libatkan pengungkapan perasaan dalam istilah org ketiga ( ia, mereka ) “terkadang, jika seseorang sakit parah mereka merasa marah dan sedih karena tidak bisa bermain seperti biasa” diam sebentar utk mendapatkan respons atau dorong respon dengan pengulangan “Apakah kamu(nama pasien) pernah merasa demikian?”

Tehnik komunikasi verbal..

 Respon

fasilitatif

“kamu(nama pasien) merasa___karena__” contoh: bila anak berkata “saya benci datang ke RS dan disuntik” respon fasilitatif “kamu (np) merasa tidak senang terhadap semua yang dilakukan padamu di RS”

 Tiga

harapan

“bila kamu memiliki tiga permintaan, apa sajakah itu?”

 Bercerita tehnik paling sederhana adalah meminta anak menceritakan kejadian yg berhubungan, seperti “berada di rumah sakit”

Tehnik komunikasi verbal… pendekataan lain dlm bercerita: tunjukkan gambar tentang kejadian tertentu, seperti seorang anak di RS dengan perawat disebelahnya, dan minta mereka utk menggambarkannya

 saling

bercerita

saat anak bercerita, ikuti dengan cerita lain dengan situasi yg hampir sama contoh: cerita si anak adalah tentang seorang anak yg dirawat di RS dan tdk pernah melihat org tuanya. Cerita perawat adalah seorang anak dgn nama yg berbeda, di RS dgn org tua yg slalu berkunjung setiap sore setelah pulang kerja dan setelah sembuh, pulang bersama org tuanya.

Tehnik komunikasi verbal…

 Permainan

peringkat

angka 1-10, atau wajah sedih-senang. Contoh: utk menanyakan perasaan hari ini, perawat berkata “dgn nilai 1-10, dengan 10 adalah hari yg paling menyenangkan, saya ingin kamu (np) menilai tentang perasaan mu hari ini”

 Pro

dan kontra

dengan memilih topik “berada di RS” minta anak utk menyebutkan 5 hal yg baik dan 5 hal yg buruk mengenai topik tsb

Tehnik komunikasi verbal…

 Melengkapi

kalimat

libatkan anak utk melengkapi kalimat seperti: sesuatu yg paling (sedikit) saya sukai tentang orangtua saya adalah _____ sesuatu yg baik (buruk) tentang berada di RS adalah ____ yg paling (sedikit) saya sukai tentang diri saya sendiri adalah _____

 Permainan

Assosiasi kata

sebutkan satu kata kunci, dan minta anak mencari 3 kata lain yg berhubungan, contoh “operasi, penyakit, RS”

Tehnik Komunikasi Nonverbal  Menulis

buku harian, surat utk sahabat  Menggambar spontan atau dengan arahan  Bermain spontan atau dengan arahan

Terima kasih