Table 2.
Definitions of communication types
| Communication behavior | Definition | Example |
|---|---|---|
| Influence | ||
| Argument | Factual statements made in support of a desired goal, often accompanied by evidence | May indicate experience/expertise (from what I’ve seen …), reference to value system (best interest to …), inference from evidence (lab result indicates …). |
| Refutation | Discounting information to something that has been said | Factual responses offered by provider in order to dispel myth(s) held by patient. |
| Altruism | Reference to helping others, being unselfish, or generous to secure a course of action | “Future patients will benefit from your participation.” |
| Esteem | Referencing others’ positive perceptions if the interactant complies | “I’m sure your husband would be happy if you….” |
| Guilt | Point out negative consequences of thoughts or actions; includes drawing attention to an existing inconsistency or past expressed thought or action | “That’s not a healthy attitude to take. You said you were going to be optimistic.” |
| Foot in the door | Small request followed by a larger one | “As long as you’re willing to accept palliative relief, then we can discuss hospice.” |
| Threat | Statement indicating negative consequences if one does not follow the other’s recommendation | “If you don’t quit smoking, this is just going to get worse.” |
| Relational Confirmation | ||
| Approval | Message indicating that other is doing the correct thing | “That’s a good idea”; “I appreciate you[r] being straightforward.” |
| Reassurance | Supportive response directed to expressed fears, concerns, or anxiety | “It will be OK”; “Don’t worry, I have faith in you.” |
| Clarification | Statements repeated or paraphrased to ensure understanding | “I’m not sure what you mean. Can you explain some more?”; “So what you’re saying is …” |
| Acknowledgement | Statement that expresses normalcy of beliefs or behaviors | “Lots of people would feel that way.” |
| Concern | Recognition of the other’s emotional state or other psychosocial issue; the spirit of identification with another is present | “I know this has been a long process for you”; “I realize that these options may sound confusing.” |
| Laughter (+) | Jokes or moments of laughter shared by interactants | |
| Apology | Expression of regret or nonverbal indication of compassion | “I’m sorry you’re burdened by this”; “I’m sorry, I didn’t mean to upset you.” |
| Offer of service | Provider offers service, above and beyond the normal scope of responsibility | Provider calls or arranges for social work rather than have nurse do it. |
| Disconfirmation | ||
| Disapproval | Communicated rejection of other’s values, beliefs, thoughts, or opinions, including sarcastic or defensive statements | “No, I don’t want to discuss it”; “It’s too soon to discuss this”; “You can’t be serious.” |
| Ambiguity | Unclear expression with more than one possible meaning | “Well it is and it isn’t”; “I agree 100%, but I must say …” |
| Indifference | Failure to respond appropriately to the other’s message by disconnecting from the topic verbally or nonverbally | Talk-overs, prolonged silence, overelaboration, monologue that doesn’t stop even with interruption, side conversations with others |
| Tangential | Recognition of an incidental piece of the previous communication, but misses or disconnects from the other’s main intent | “Yes, that’s interesting but what I want to focus on …”; “Sure, sure, now lets talk about …”; “Mm-hmm, that reminds me that we need to discuss …” [new topic] |
| Irrelevant | Incomplete, loose, or rambling responses, or complete disconnection from topic or other’s version of events | Topic switch without explanation or recognition |
| Disparaging | Demeaning remark or put down that focuses on the person rather than message | “Don’t be silly”; “You’re making this harder than you need to …” |
| Laughter (−) | Jokes or moments of laughter that are nervous, derisory, not shared | |