1 Communication In Health And Social Care

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1Communicationin health andsocial careUnit outlineCare workers require effective communication skills in order to work with thediverse range of people they meet in health and social care settings. This unitwill introduce you to:different forms of communicationfactors that affect communication in care settingsways of overcoming barriers to effective communication.You will have the opportunity to observe and discuss the communication skillsof others and to practise and refine your own communication skills.Learning outcomes1 Know different forms of communication.2 Understand barriers to effective communication.3 Be able to communicate effectively.Grading guideTo achieve a pass, you must showyou can:P1 Identify different forms ofcommunicationTo achieve a merit, you mustshow you can:To achieve a distinction, you mustshow you can:M1 Describe different forms ofcommunicationP2 Explain barriers to effectivecommunication within a healthand social care environmentP3 Take part in an effectiveone-to-one interactionP4 Take part in an effective groupinteractionM2 Describe the barriers to effectivecommunication in your twointeractionsD1 Assess the strengths andweaknesses of your twointeractions1

Topic 1.1Forms of communicationGetting startedThis topic introduces you to the forms of communication usedby health and social care workers and the contexts in whichthey are used. When you have completed this topic, you should: be able to describe and explain the communication cycle know about one-to-one, group, formal and informalcommunication in health and social care settings be able to describe a range of different forms ofcommunication used by health and social care workers.Key termsDecode: make sense of the information containedin a messageEmpathy: understanding and entering into anotherperson’s feelingsFormal communication: official or correct forms ofcommunicationInformal communication: doesn’t stick to the formalrules of communication (e.g. a casual, relaxedconversation, written note or text message)Makaton: a system of communication using simplehand signs, which is used by people with language andlearning difficultiesNon-verbal communication: forms of communicationthat do not use words (e.g. body language)Objects of reference: objects that have a particularmeaning for a person (e.g. a special ring or ornament)Symbol: an item or image that is used to representsomething elseVerbal communication: forms of communication thatuse words (e.g. conversation)The communication cycleCommunication is about making contact with others and beingunderstood. It involves people sending and receiving ‘messages’.We all communicate, or ‘send messages’, continuously. Figure 1.1describes the communication cycle. It shows that a communicationcycle occurs when:21 IdeaoccursMessagecodedMessage 3sent1. A person has an idea.2. They code their ‘message’ (using words or non-verbal means).3. They send their message to someone else (e.g. by speaking).4. A second person then receives the message (e.g. by hearingwhat has been said or by noticing non-verbal communication).5. The second person decodes the message.6. The message is understood.2Message6 understoodMessagedecoded5MessagereceivedFigure 1.1 The communication cycle4

1 Communication in health and social careOnce the original message has been understood, the cycle will be repeated if thesecond person replies or responds. Repetitions of the communication cycle are anessential part of our relationships, and occur every time we have a conversation.Case studyCharlie is 2 years of age. He enjoys helpinghis mum in the kitchen when she is makinga meal. When she says, ‘Can I get some fruitfor you Charlie?’, he puts his arms in the air,says ‘me, me’ and smiles at her. His mumresponds by picking him up and saying,‘Okay, you take something yourself thistime, Charlie’.1. How does Charlie’s mum communicate withhim in this example?2. How does Charlie communicate non-verballywith his mum in response to her question?3. Describe how a cycle of communicationoccurs in this example.Forms of communicationCare workers use different forms of communication during theirworking day (or night). These include the verbal communication skills oftalking and listening, and various forms of non-verbal communication,such as touch, eye contact and facial expression. A care worker has touse both of these forms of communication when they:give or receive information about the care that is being provided foran individualprovide emotional support to a individual or member of their familycarry out an assessment of an individual’s care needs.Verbal communicationVerbal communication occurs when one person speaks and anotherperson listens. Care workers need a range of verbal communicationskills to:respond to questionsfind out about an individual’s problems or needscontribute to team meetingsbreak bad newsprovide support to othersdeal with problems and complaints.The communication cycle demonstrates that effective verbalcommunication is a two-way process – speaking andlistening must occur. Listening is much harder than speaking andthere is more to this skill than just waiting for the other person tostop talking.Over to you!Are you a good listener? Think aboutwhat you do when you really listento another person. Try to identifythe skills and qualities needed foreffective listening.3

1.1 Forms of communicationNon-verbal communicationAs well as communicating through speech, people use a variety of forms ofnon-verbal communication. Some of these are referred to as body language.This is because they involve the individual using their body and appearance tocommunicate in some way. For example, a care worker’s behaviour, appearanceand attitude send ‘messages’ to people who receive care (as well as to colleagues)about what they think and feel. Similarly, a person’s body language may tell acare worker that they are uncomfortable or experiencing pain even when theysay, ‘I’m okay’. Non-verbal communication is a channel of communication thatis ‘always on’.Figure1.2Forms of non-verbal communicationNon-verbalcommunicationWhat does it involve?ExamplesFacial expressionMovements of the face thatexpress a person’s feelings Smiling FrowningTouch or contactPhysically touching or holdinga person Holding someone’s hand Placing a hand on a person’s arm or shoulder to reassurethemGesturesDeliberate movements of thehands to express meaning Thumbs-up gesture to show agreement or pleasure Shaking a fist to show anger or aggressionProximityThe physical closenessbetween people duringinteractions Being physically close to someone may be reassuring and may beseen as accepting the person. On the other hand, it might make the person feel uncomfortableand threatened. People need less personal space when they have a close, trustingrelationship.Eye contactLooking another persondirectly in the eyes Short or broken eye contact can express nervousness, shynessor mistrust. Long unbroken eye contact can express interest, attractionor hostility.Signs, symbols and objects of referenceCare organisations sometimes use signs and symbols to communicatewith the people who use their premises. Signs and symbols aregraphical ways of communicating essential information. Using imagesenables people who cannot speak or understand a spoken language,such as English, to communicate.Objects of reference are items such as toys, clothes, jewellery orother everyday objects that have a special meaning for somebody. For achild, a cuddly toy may represent comfort and safety. An older personmay treasure their photographs because they represent and providememories of family, friends and relatives. Objects of reference, such asphotos or toys might be used by a teacher to stimulate communicationand interaction with individuals with learning disabilities.4Over to you!When you have a chance, watch agroup of people talking or socialisingtogether. Observe the way they usetheir bodies to communicate. Tryto work out what they are ‘saying’non-verbally.

1 Communication in health and social careTechnological aidsTechnological aids, such as electronic communicators, hearing aids andvideophones are designed to help disabled people who have difficulty sendingor receiving ‘messages’ as part of the communication cycle. Many non-disabledpeople now also use technology in the form of mobile phones, text messagingand emails to communicate with others. Websitessuch as Facebook, Twitter and Bebo are also examplesof technological aids that promote communicationbetween people.Human aidsThese include people who work as:interpreters, who listen to a person speak in onelanguage and then communicate what they havesaid to a second person in a different languagetranslators, who translate what is written in onelanguage into a second language (e.g. English toHindi)signers, who use forms of sign language tocommunicate what has been said or written intoa sign language, such as British Sign Language orMakaton.Alternative forms of communicationPeople who are unable to communicate in conventional ways sometimesuse alternative communication systems to send and receive messages.For example:People with visual impairments often use theirsense of touch to read documents written inBraille. This uses a series of indentations madeby a special stylus on one side of paper. Thecombinations of indentations represent letters thatcan be touch-read by people who understand theBraille system.People with hearing impairments or learningdisabilities sometimes use lip reading andsign language to communicate. Signlanguage systems include finger spelling(dactylography), British Sign Language andMakaton.A range of graphical signs and symbols arealso widely used in health and social care settingsto warn people of health and safety hazards,provide directions and give information to peoplewho are unable to speak or understand English.5

1.1 Forms of communicationContexts of communicationThe two main contexts in which health and social care workers use the communicationcycle are one-to-one and group communication.One-to-one communicationCare workers talk to work colleagues, to people who use care services and to theirrelatives on a one-to-one basis many times each day. Sometimes this involvesformal communication, at other times it involves informal communication,for example when the care worker speaks to a colleague who is also a friend, orwhen they have got to know a patient or relative very well. Effective one-to-onecommunication requires:listening skillsinformation-giving skillsquestioning skills.People who use care services, and their relatives, talk to care workers about awide variety of things that concern them. Care workers need to be able to helppeople talk about and express their concerns. They do this by:using open questions that give people a chance to talk at length rather than togive a one-word response (e.g. ‘How are you feeling today?’ is an open question)checking their understanding of what the person says to them by recapping,summarising or just asking questions like, ‘Can I just check that you meant ’using empathy to let the person know the care worker understands howthey feel and what they think.One-to-one communication skills are needed for basic everyday interactionsin health and social care settings. They are also needed to establish andmaintain supportive relationships with work colleagues and people who usecare services.GroupsPeople belong to a range of different groups including family, friendship andwork groups. Interaction in group situations is important for social, intellectualand emotional development. Health and social care workers communicate ingroup situations when they participate in:report or handover meetings where individuals’ needs are discussedcase conferences and discharge meetingstherapeutic and activity groupsmeetings with relatives and managers of care organisations.The communication skills we use in group contexts are slightly different fromthose we use in one-to-one situations. One of the main differences is that peoplehave to make compromises and must learn how and when to take turns atspeaking and listening. Communication in groups can sometimes feel challenging,competitive and negative where a few members of the group dominate.6ActivityRole-plays provide anopportunity for you todevelop and practise basiccommunication skills in asafe, simulated situation.With a class colleague orin a small group, role-playthe following situation:A parent approaches anursery nurse aboutobtaining a place for hischild at the nursery. Theparent wants to know whatthe nursery can offer, howthe child will be lookedafter and what the costswill be.The nursery nurse mustuse verbal and non-verbalcommunication skills toprovide appropriateinformation and reassurance.

1 Communication in health and social careHowever, groups can also be supportive, cooperative and productive when membersrespect each other, are inclusive and shareinformation. People who are effectivegroup members:make verbal contributions to the grouplisten to other group membersrespond positively to the group leaderare open about themselvesdon’t try to distract others or disruptthe main purpose of the grouphave a positive and constructiveapproach to other group membersarrive on time and stay until the end ofthe group’s meetings.Assessment activity 1.1 (P1, M1)You are working in a local day centre. The peoplewho attend have learning disabilities. The daycentre manager provides work experienceopportunities for local school and college students.She believes that effective communication skills areessential to work in a care environment like the daycentre. The manager has asked you to: Produce training materials that identify anddescribe forms of communication used withina health or care environment. Present your materials in the form of a leaflet,booklet or poster.Topic check1234Describe how the communication cycle works.Name two main forms of communication.What are the two

The two main contexts in which health and social care workers use the communication cycle are one-to-one and group communication. One-to-one communication Care workers talk to work colleagues, to people who use care services and to their relatives on a one-to-one basis many times each day. Sometimes this involves formal communication, at other times it involves informal communication, for .

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