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. Author manuscript; available in PMC: 2018 Jan 1.
Published in final edited form as: Nurse Educ. 2017 Jan-Feb;42(1):18–22. doi: 10.1097/NNE.0000000000000308

Table 2.

Definitions and Examples of Expressive, Conventional, and Rhetorical Message Design Logics

Message design logic Conceptual definition Operationalization Example
Expressive Direct expression of speaker’s thoughts and/or feelings
Inappropriate message delivery
Lack of the comprehension of the situation		 Mindless mirroring of patient’s disclosure
Irrelevant statements
Lack of any conventionally expected words of empathy or understanding
  • –

    [Student]: do you live with your parents?

  • –

    Tina Jones: I haven’t always lived at home–I moved back after Dad died.

  • –

    [Student]: any interests or hobbies?

  • –

    Tina Jones: I read a lot, especially since I bought one of those e-book readers. Oh, and there’s these free talks at church that I like to go to if I have time. […]

  • –

    **[Student]: That sounds very entertaining.
Conventional Targeting of social effects and focus on social conventions, expectations, and obligations Presence of statements that could be expected in general situations that call for the expression of empathy, understanding, or support
  • –

    [Student]: Is your father alive

  • –

    Tina Jones: No, Dad passed last year.

  • –

    **[Student]: I’m sorry to hear of your loss.
Rhetorical Focus on the importance of message receivers, their individuality, beliefs, and values
Negotiation and redefinition of social situations through communication		 Presence of a conventionally expected expression of empathy or support AND identification of an opportunity for the patient to find relief from or move beyond the disclosed situation
  • –

    [Student]: Have you ever felt depressed or anxious?

  • –

    Tina Jones: The closest I ever came to depression was after Dad died…I just felt sad all the time.

  • –

    **[Student]: I’m sorry to hear that your dad has passed.

  • –

    Tina Jones: Thanks.

  • –

    [Student]: Do you feel supported by your friends and family?

  • –

    Tina Jones: Yeah, definitely. We’re all pretty close. […] Mom and my sister and I all go to church, and eat together most of the time, the same as we always did.

  • –

    **[Student]: Its nice that you can keep up those traditions.
**

Statement identified as empathic by a nursing student.

Reprinted with permission from Shadow Health, Inc., Gainesville, FL. Permission granted on May 5, 2015.