1、第八章人际交流风格Chapter 8 Communication Styles【引言（2分钟）】Hello, every one. Nice to meet you again. Last class, we have learned Eriksons stages of psychosocial development .I think only when we finish assessing clients psychological crises, we may take measures accordingly to help them. Similarly, before we a
2、pply communication skills and strategies in the nurse-client relationship, we must acknowledge communication styles of clients. But what is communication style? How to explore it? Chapter 8 will give us some directions. Lets learn them together, ok? 【正文】【Outline（4分钟）】First, lets look at the outline.
3、 （对标“”单词做解释） Basic Concepts Metacommunication Verbal Communication Cultural Implications in Spoken Language English as a Second Language Slang and Jargon Pitch and Tone in Vocalization Gender Differences in Verbal Communication Nonverbal Communication Dynamic language on Nonverbal Communication Stat
4、ic language on Nonverbal Communication Interpreting Nonverbal Body Cues and Facial ExpressionsClothing as a Nonverbal Message Applications Knowing Your Own Communication Style Interpersonal Competence Style Factors Influencing Relationships Responsiveness of Participants Roles of Participants Valida
5、tion of Individual Worth Context of the Message Involvement in the Relationship Summary 【Objective（3分钟）】Because we have 3 classes today. So at the end of the chapter, we should be able to: 1. Describe the component systems of communication.2. Identify the influencing factors of verbal communication.
6、 3. Describe the components of dynamic language .4. Identify the components of static language .5.Define interpersonal competence 6.Identify five communication style factors that influence the nurse-client relationship说明目标中2、3、4是重点， 6是难点。【目标1】Describe the component systems of communication定义（2分钟）Com
7、munication is a complex composite of verbal and nonverbal behaviors integrated for the purpose of sharing information.It is easy to understand there are two component systems of communication. One is verbal system, the other nonverbal system. Also the two systems have their components or factors res
8、pectively. Just look at the figure9-1, you will find that.But in our book, there is a new concept ”metacommunication“. When I learn it,I really have some difficulties. Perhaps we can go deep into it through discussing together. Discussion（4分钟）Please read the content and the examples in the book. The
9、n tell me your opinion about the translation and meaning of the concept”metacommunication“. Metacommunication is broad term used to describe all of the factors that influence how the message is perceived (Fig.9-1) An example is the ”play fighting”observed in animals and children. Bateson noted that
10、for an organism（生物体） to play”at fighting ,it must both appear to be fighting and simultaneously appear not to be actually fighting but merely stimulating. This message about how to interpret what is going on is metacommunication (Mitchell,1991).Express respectively（6分钟）First, 学生发言.Then, 我的看法：Metacom
11、municated messages may be hidden within verbalizations or be conveyed as nonverbal gestures and expressions. According to the case example and the interpretation ,I think it may be translated as”潜交流 “in chinese. 这与我们平时说的“潜台词”十分相似。它可以通过语言的语音、语调、语气、文化涵义等，以及非语言中的身势语、眼神、表情、姿势等一切影响信息接收者对信息的理解的因素来反映。Metac
12、ommunication in the nurse-client conversation conveys messages about how to interpret meaning through both verbal and nonverbal clues. Understanding it needs an ability of observing. The congruence of verbal and nonverbal message will help us to convey our messages. For example, when we are communic
13、ating positive attitudes toward clients, the nonverbal message we can use is eye contact, body posture, head nodding at pivotal points in the conversation, and frequent smiling. So that messages will be accepted more easily. But when nonverbal cues are incongruent with the verbal information, messag
14、es are likely to be misinterpreted.【语言交流（15分钟）】学生主讲，完成目标2。【承上启下（1分钟）】 As we know, our communication forms are composed of verbal and nonverbal communication. So the first two objectives have been achieved. 语言符号是人类最重要、最便捷的沟通媒介，但不是唯一的沟通媒介。大家应该还记得说同样的一句“对不起”,会有好几种表达方式。其实这就是非语言符号所起的作用。【非语言交流】教师主讲，完成目标3。
15、【定义与作用（3分钟）】There are no fixed definitions in English （幻灯展示）* Nonverbal communication can be viewed as occurring whenever an individual communicates without the use of sounds.* Nonverbal communication is the study of facial expressions, touch, time, gestures, smell, eye behavior, and so on. *中文：非语言符
16、号是人类社会沟通的另一重要手段，它是以人的仪表、姿态、动作、神情、人际距离等作为沟通媒介，进行传递信息，表达感情的一种无声语言。美国专门研究非语言沟通的心理学家艾伯特梅热比曾提出一个公式：(请同学估计百分比)信息接受的全部效果 语言(7 %)体态语（55 %）语调(38 %)（插入饼图）以上公式证明，在人类沟通中互动双方所获得的信息有很大部分来自非语言沟通，它具有语言所不能替代的功能，如眉头一皱(frown)、手一扬（raise hand）等等，都是极敏捷、极微妙、极易领会的信息传递，可以起到很好的沟通作用。We need to understand that separating verba
17、l and nonverbal behavior into two separate and distinct categories is vertualy impossible. In many circumstances, we may say that through nonverbal behavior, our true emotion, attitude, personality, and even background are uncovered and overpower our verbal communication. 【非语言沟通的主要形式（2分钟）】关于非语言行为分类问
18、题，目前为大多数学者所接受的是三分法，即： 首语cephalic language 手势gestures 动态语 面部表情facial expression Dynamic language 触摸touch非语言行为 姿势posture静态语 空间效应proxemics Static language 服饰 clothing 辅助语言与类语言Paralanguage（Tone of voice, intensity, pitch, extent (drawl and clipping) speech rate, inflections, timing and pauses）（说明：辅助语言包括
19、声音的音调、音量、节奏、变音转调、停顿、沉默等，而类语言则是指那些有声而无固定意义的声音，是人们在运用语言时产生的，它把焦点放在理解信息时声音的作用上，如呻吟、叹息、叫喊；另外，人们说话时的不同语气和语调也可以表达不同的情感和态度。）【动态语】 首语（6分钟）首语指以头的动作来传情达意的体态语。它包括点头语和摇头语。nodding head means yes, but shaking head means no.在护理实践中，当某些病人不能用语言表达自己的意愿和要求时，护士可通过其点头或摇头去判断和理解病人的真正意愿和需要，从而提供恰当的护理，例如咽喉部手术、脑组织损伤等导致语言功能障碍的病
20、人以头的动作示意其需求。又如失语病人（aphasia），（插入视频1,解释后，插入视频2，请学生理解）。手势（5分钟） 手势是通过手和手指的动作来传情达意的体态语。手势是有声语言的延伸，是非语言行为中重要的表达方式。手势同眼神一样灵活多变，富有极强的表达功能，通常与口头语言同时使用。手势也可单独在人际沟通中使用，如聋哑人（deaf mute）的手语可以用来相互交换情绪、情感、思想、态度、观点。心理学家研究证明，手势是通过学习获得的，由于长期的生产生活实践，使手势形成了一些相对稳定的格式，如握紧拳头，常用于表示抗议报复或团结坚定的意思；仰手，即掌心朝上，五指自然伸屈，多用于表示欢迎、请求或一时没
21、有主意和没有办法的意思。但是，手势表情不仅有个体差异，而且由于社会文化、传统习惯的影响，手势又有民族或团体的差异。同一种手势，在不同的民族和国家中可用来表达不同的意思。 图1 Can you guess what the following gesture from Japan means?图2 Can you guess what the following gesture from France means? 图3 Can you guess what the following gesture from Iran means? ANSWERS: The Japanese gesture
22、means angry. The French gesture means I dont believe you. The Iran gesture is extremely obscene, and means roughly screw you. （骂人）面部表情（15分钟）幻灯：The face is a primary site for communication of emotional states; it reflects interpersonal attitudes; it provides nonverbal feedback on the comments of othe
23、rs; and some scholars say it is the primary source of information next to human speech. (Knapp & Hall, 1997).面部表情是指人们在社交中，由外部环境和内心机制的双重作用而引起眼部肌肉、颜面肌肉和口部肌肉的变化所表现出来的各种情绪状态，从而实现表情达意、感染他人的一种信息手段。人的面部表情是非常丰富的，可以通过口、眉、鼻及面部表情肌的不同排列组合，表示出人瞬间变化的内心世界（情绪与情感）。著名社会心理学家伯德惠斯戴尔说，光人的脸就能做出大约25万种不同的表情。（1）情绪与面部表情（请学生看图
24、说话）面部表情反应极为灵敏，能清楚地表明人的情绪，能迅速而真实地反映各种复杂的内心活动。因此，在人际沟通中，除了要用心倾听对方所说的话之外，还应该仔细观察他们的面部表情，也就是说要尽量去感知和理解话外音。（2）眼神交流Eye Contact (幻灯介绍a saying)Eye contact should be a positive form of nonverbal communication, but if it is not used correctly it can easily become negative. But how to take use of eye contact c
25、orrectly? The face shown has a shaded area that indicates the correct target zone for positive eye contact. That is looking anywhere within this shaded zone represents positive eye contact. Looking at someones face anywhere outside of the triangular target zone is likely to cause some degree of emba
26、rrassment. Zone A represents the intimate zone and by moving just a fraction below the base of the target triangle you will enter it. When this happens people typically react by feeling that the other person is staring at them, or that the observer looks shifty（老谋深算）.Zone B represents a dominant zon
27、e and by looking at the forehead of another person you are likely to invoke a reaction that you appear to be arrogant（自大）, that you are staring straight through them or more commonly that you are talking down at them.（指示）总结：在病人的心目中，医务人员无论年龄大小，都是他们的健康保护者，能从死神手里夺回他们的生命。因此，医护人员在与病人交谈时，应熟练运用目光表达不同的情感和意义
28、。例如表达安慰时，目光充满了关切；给予支持时，目光放射出力量；进行解释时，目光蕴含着智慧等。谈话时应以保护性的姿态，柔和的目光注视着病人的眼睛，使病人受到支持和鼓励，并且用眼神告诉他们：放心吧，我会照顾好你的。（插入视频，请同学思考。）另外，当医务人员与病人接触时，可能心情不愉快，但是绝不能将自己不良的心情通过眼神和面部表情流露出来，而影响病人的情绪。这一点应该引起医务人员的高度重视，要杜绝发生这种情况。触摸（10分钟）皮肤接触与心理状态有密切关系，是人体直接感知外界的重要媒介，是一种富有潜力的沟通方式。Most of you will be caregivers, so through to
29、uches you can communicate a great deal of information to your clients，such as a message of love and strong feeling of security . And you will enhance the quality of life for your clients. There are several physical and psychological benefits as follows: (幻灯)physical benefits: increase circulation; s
30、trengthen the immune system; aid in digestion; release stress(yours and your clients). psychological benefits: enhance bonding(the relationship between you); read nonverbal cues; allow some positives.(providing a nutrient touch will help you feel secure in your abilities to do something positive for
31、 your clients. )This time I will talk a little about benevolent touch. Benevolent Touch is a positive, gentle, nurturing touch provided to ensure someone that they are in a safe, secure and caring . It can be easily implemented by you to your clients. It can improve sleep patterns, it can increase r
32、elaxation, it also can make your communication much more efficient. There are three types of this touch.Type1: unstructured touch.接触所有你熟悉的人时，你可以通过 hugging ,giving your a hand to shake, putting a arm around someone, patting some one on the back, or just sitting with them.这是人类表达态度和情感最自然的方式。Type2: structural touch. It conceives some steps for you to do massage or relaxation techniques.它包括手按摩、背部慢推和按摩、
