COMMUNICATION IN AN ELDERLY MEDICAL WARD

Communication In An Elderly Medical Ward

Communication In An Elderly Medical Ward

Introduction

Communication skills training is becoming an important aspect of nurse education. There has been a trend towards using models and methods of skills development, based on a variety of psychological approaches (French, 1982, Kagan, 1985 and Hussey, 1981). Our interest was in attempting to identify how nurses viewed their own communication competing. If communication skills training is to progress, it would seem vital that we first assess the levels of skills that nurses believe they have. It is one thing to prescribe skills and training methods and quite another to attempt to assess skill levels.

Six category intervention analysis

The conceptual framework known as Six Category Intervention Analysis was developed by John Heron, 1975 and Heron, 1986, building on the work of Blake and Mouton (1976). It was offered as a conceptual model for understanding communication relationships, and as an assessment tool for identifying a range of possible therapeutic interactions between two people.

The six categories in Heron's analysis are: prescriptive (offering advice), informative (offering information), confronting (challenging), cathartic (enabling the expression of pentup emotions), catalytic ('drawing out') and supportive (confirming or encouraging). The word 'intervention' is used to describe any statement that the practitioner may use. The word 'category' is used to denote a range of related interventions (Table 1).

Table 1: Authoritative and facilitative categories

Authoritative Categories

Facilitative Categories

1. Prescriptive

4. Cathartic

2. Informative

5. Catalytic

3. Confronting

6. Supportive

Heron (1986) calls the first three categories of intervention, (prescriptive, informative and confronting), 'authoritative' and suggests that in using these categories the practitioner retains control over the relationship. He calls the second three categories of intervention (cathartic, catalytic and supportive), 'facilitative' and suggests that these enable the client to retain control over the relationship. In other words, the first three are 'practitioner-centred' and the second three are 'client-centred'. Heron further argues that all six categories are of equal status and no one category is more important than any other. In contradiction, however, he also argues that catalytic interventions should form the 'bedrock' type of intervention on which effective communication communication could be developed.

On another occasion (Heron, 1977) offers the opinion that because we live in a 'non-cathartic society', where the open expression of emotion is not highly valued, the cathartic category will tend to be less skilfully used by many people. This is a debatable point and one worthy of considerable discussion though such discussion is beyond the remit of this paper.

Heron claims that his analysis should not be used to classify people's behaviours but should serve as a means of helping people to clarify their intentions in a therapeutic situation. Thus the present research aimed at asking people about their therapeutic intentions in clinical situations. The question remains, of course, as to the degree to which researchers can have access to people's intentions, after the event. On the other hand, it is equally difficult to ask people to assess their own behaviour after the event.

The Scenario

An accidental sample (Fink and Kosecoff, 1985) was ...