The role of nursing is an essential element in any therapeutic process which allows the patient and their families also to have physical and psychological relief. This relief is provided through the practices implied by them. These practices are based on the psycho-social theories and effective communication which is considered to have the potential for having development in the therapeutic process. In this assignment I will explain how psycho-social theories and models of communication science supports the development of therapeutic, compassionate and effective relationships in nursing and social work practice. Also, I would aim to demonstrate the skills required to locate evidence to support nursing and social work theory and practice.
What is learning disability:
Learning disability affects someone from childhood it affects their ability to process information and this can significantly reduce his or her ability to carry out everyday task. Learning disability affects people in a diverse group with a wide range of abilities. There are people with mild learning disability these type of people may live on their own in a house or shared house. They can also work and raise children. They will need support and advice from time to time from family and support groups. Meanwhile, someone with profound or severe learning disability will need full support as he or she might be physically disabled or intellectually disabled.
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Learning disability can be assessed through a combination of intelligence tests and measures of flexible behaviour, by looking at a person’s ability to carry out everyday tasks. People with learning disability usually experience communication problem, they may have limited vocabulary and understanding of grammar or problems in articulating words. People with disability can also have chronic disorders, illness or disabilities in addition to their disorder. They are more at risk in acquiring injuries than people without learning disability because they have less capacity to assess risk.
Needs of Learning Disability People
Learning disability people are among the most disadvantaged groups in our society they can experience health inequalities when compared with those without disability. They can experience low life expectancy and a huge occurrence of health problems. However, most of their health conditions may go unrecognised or not managed properly. Also, it has been established that people with learning disability do not access preventive health care and health promotion programs that will be beneficial for them. Most LD people do not go for annual health check as they have difficulties recognising their illness or communicating their needs in a clear understood manner. Sometimes, they may find it hard and confusing when using health care services. Learning disability people die prematurely compared to people without any disability, reports shows that learning disability men will die 13 years earlier while women will die 20 years earlier. The healthcare services like GPs can help improve the health outcomes of people with learning disability by enhancing the acceptance of the annual health check for them.
However, there are people with mild learning disability who may need minimum support when accessing health care needs compared to those with profound multiple learning disabilities. Those with mild learning disability will require support understanding information in areas like health screening programmes, keeping up with their appointments. While those with PMLD may have complex health needs that may require varied help. Most people in this group are unable to walk or communicate they may have very limited understanding and can express themselves through nonverbal means or by using few unclear words or symbols. Communication challenges can be one of the challenging factors people with learning disability encounters especially if they have speech impairment or language difficulty. This will affect their access to healthcare and public services where they are required to provide history. This might lead to neglect of their health issuses and mistakes can occur which can result to death.
Therapeutic relationship helps to promote a positive relationship amongst nurse/social worker and the service user. Therapeutic nursing attempts to capture the atmosphere of the nurse-patient relationship, exploring not only the interpersonal but also the intrapersonal (Freshwater, 2002). Therapeutic relationship between nurse and patient can also be a helping relationship that is built on mutual trust and respect. This can be done through fostering of faith and hope, being sensitive to their plight and assisting fulfilment of your patient’s physical, emotional and spiritual needs through your knowledge and skill. This type of therapeutic relationship can develop when you and your patient come together in a moment, which results in harmony and healing. Carl Rodgers a famous Psychotherapist defines therapeutic relationship as a helping relationship whereby one party shows appreciation, more expression of more functional use of the concealed central resources of the individuals ( Rodgers 1961). Effective verbal and nonverbal communication is very vital in nurse patient interaction, and also provides care in a way that will allow your patient to be able to make a complete recovery.
Although, sometimes therapeutic relationship can be very trying for both nurses and patient in being open and trusting towards one another. This is because nurses can be under a lot of stress at work and patients worry about their illness. Building an honest relationship between nurse /patient is very important because patient usually like to be carried along when decisions are made about them. They like to ask questions and get an honest answer to their question, and when the nurse is not honest the patient might lose trust and respect for the nurse. Therapeutic relationship also promotes person centred care delivered from healthcare professionals to service users focusing on their needs and what matters. Person centred care helps service users to build knowledge, skills and confidence they need to virtually make informed decisions and be involved in their own healthcare. This ensures that their care is tailored to their needs so that they can make choices, manage their lives and live independent life.
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There are barriers in therapeutic relationship between nurse and service user/ patient this barriers can create obstacles in the end, and the health system as a whole (Sfoggia et al .., 2014). Some barriers can hinder building a good relationship amongst health professionals and patients. Language can be a barrier to communication when the nurse and patient can not communicate in one common language. This will result in the use of translator; some medical jargons can also be a barrier when health professionals make use of it. Some patients who have communication impairment like deafness, speech impairment can feel isolated and frustrated. Nurses can help by making enough time to describe any issues to such patient so that they do not feel left out.
Forms of Communications:
Communication is a way of making interaction between two or more persons it is much more then spoken words. It involves sending and receiving messages through various ways. If we cannot speak, understand words, or read and write very well, we are often excluded, unless others around us are prepared to change (Thurman, 2011). Communication is vital in healthcare field, nurses/social workers need to communicate often with patients about medical procedures, and daily care task. LD services and professionals should aim to have a communication strategy in place whereby various communication methods are used meaningfully across a range of services (Gates & Barr,2009). Good communication skills are very important in healthcare as it can help nurses create better outcomes for their patients by getting them to learn about their illness and how to manage it. There are many ways to communicate and healthcare professionals must know all forms of communication to help them at work. Effective communication skills for health professionals is about practical ways of enhancing communication between health professionals and their patients or clients and between colleagues (Burnard, 1997). Social works must make effort where possible to meet service users communication and language needs ( HCPC Code 2: 2;4 ).
There are many forms of communication, verbal and non-verbal. Verbal communication is by use of sound and words to express one’s self while nonverbal can be by the use of eye, hands, touch, and body language. Sometimes, most patients communicate through technology- aided equipment or device, they can use it to speak or hear. Another powerful way of communicating by disability people is by the use of Makaton and Braille language for those that are blind.
They use of signs and symbols is another form of communication that is very vital in health-care setting. In Leeds Teaching Hospital there are signs and symbols in all units that communicates to patients or visitors where to go, they also have information written in other languages like Arabic.
However, a breakdown in communication in healthcare can have huge impact to patients care and wellbeing. Communication breakdown is the major cause of medical errors, research by a number of surgeons shows that 43 percent of incidents were linked to communication breakdown. In 2013 the Francis inquiry report examined the cause of the failing in care at Staffordshire NHS foundation trust between 2005 -2009 under the 290 recommendations, it shows a massive break down in communication that occurred between many agencies that failed to share their knowledge of concerns. The systematic message indicates serious concern which was almost lacking in sharing information and their concerns in their findings.
Another common barrier maybe religious or cultural barrier in UK some people from ethnic minority group might find it difficult to discuss their illness to an opposite sex and some topics maybe completely off limits or taboo due to religious or cultural belief.
- Barr, O., & Gates, B. (2019). Oxford handbook of learning and intellectual disability nursing (second edition). Oxford: Oxford university press.
- Kraszewski, S., & McEwen, A. (2010). Communication skills for adult nurses. Maidenhead : open university press.
- Rungapadiachy, D. (1999). Interpersonal communication and Psychology for healthcare professionals: theory and practice. Edinburgh: Butterworth- Heinemann.
- Burnard, P. (1997). Effective communication skills for health professionals (2nd ed.). Stanley Thornes.
- Sheffied Hallam University (2018), Introduction to relationship centred care in nursing and social work science practice. (online e-lecture) from SHU Blackboard site Introduction to relationship centred care in nursing and social work science practice (2018/9). Last accessed 09/5/2019.
- www.nhs England.co.uk.
- Freshwater, D. (Ed). (2002). Therapeutic nursing: Improving patient care through self-a wareness and reflection_ Retrieved from https://ebook . proquest Com
- Thurman,S. (2011). Communicating effectively with people with a learning disability. Retrieved from https://ebook central. Proquest.com
- Hodgkinson, K. 2008. What is the psychosocial impact of cancer. Retrieved from Hodgkinson, K. and Gilchrist, J. Psychosocial care of cancer patients, chapter 1, p1-12.
- Sfoggia, A., Bassols, A., Laskoski, P., Severo, C., (2014), Psychiatry & Psychotherapy Article.
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