SAC IHC Chapter 2 C

II.
Concepts that
Affect Midwifery
Care
JADE APPLE A. JACINTO, RM,
RN
ST . A L E X I U S COLLEGE
www.stalexiuscollege.edu.ph
II. Concepts that Affect Midwifery Care
D. Healthy Lifestyle
1. Elements of Healthy lifestyle
E. Communication
1. Principles underlying
communication
2. Types of communication
3. Elements of communication
OBJECTIVES: At the end of 2 hours lecture, the
students will:
• Know what is health according to WHO
• Define healthy lifestyle and identify the
elements of healthy lifestyle
• Identify the principles underlying
communication
• Discuss the types of communication
• Determine the elements of communication
HEALTH
“a state of complete physical, mental, and

social well-being and not merely the
absence of disease or infirmity” (WHO,
1948)
HEALTHY LIFESTYLE
A healthy lifestyle is a way of living that

lowers the risk of being seriously ill or dying
early. Not all diseases are preventable, but a
large proportion of deaths, particularly those
from coronary heart disease, and lung
cancer can be avoided.
HEALTHY LIFESTYLE
1. Balanced diet
2. Regular physical activity
3. Maintaining a regular sleep pattern
4. Stress management
5. Supplementation
COMMUNICATION
• Is any means of exchanging information or
feelings between two or more people.
• A basic component of human relationship
• Communication has various meanings.
• Exchange of thoughts or ideas
• Talking and listening, writing and reading
• Painting, dancing, and story telling is also a form
of communication
COMMUNICATION
• Communication is a process
• Its main purpose is to influence others and
obtain information
COMMUNICATION
• Midwives who communicate
effectively are:
• better able to collect assessment data
• initiate interventions
• evaluate outcomes of interventions
• initiate change that promotes health
PRINCIPLES OF COMMUNICATION :
1. Complete
The message must contain all facts needed for
the desired action
2. Clear
There must be clarity in terms of thought and
expression
3. Concise
The message must be to the point, and all
unnecessary words must be eliminated
PRINCIPLES OF COMMUNICATION :
4. Courtesy
One must communicate in a friendly and
polite manner
5. Correct
All facts, words, language, information of the
message must be accurate
6. Consideration
One must understand the emotions and
sentiment of the receiver.
TYPES OF COMMUNICATION:
1. Verbal communication
-Spoken way of communicating that is most
commonly used
2. Non- verbal communication

-Along with spoken communication comes non-
verbal one
-Facial expression, gestures, and body
language
TYPES OF COMMUNICATION:
3. Visual communication
- Incorporating images in information exchange
process can make it clearer, more concise, and easier
to understand.
4. Written communication
- communication in more formal manner
are most of the time in written form
- most time and effort-demanding form of
communication
BASIC ELEMENTS OF COMMUNICATIONS:
1. Sender
- person or group who wishes to convey a
message to another
- Source-encoder
2. Message
– is the content of the communication.
- It may contain verbal, nonverbal, and
symbolic
language
3. Channel
- The medium used to convey the message
- can target any of the receiver’s senses
4. Receiver
– is the person who listens, observes, and attends
- is the person who must perceive what the sender
intend
- DECODER
5. Feedback
– response
- is the message returned by the receiver.
- It indicates whether the meaning of the
sender’s message was understood.
FACTORS AFFECTING
COMMUNICATION
1. Development
-Language, psychosocial, and intellectual
development move through stages across lifespan
- The use of dolls and games with simple language
may help explain the procedure to children.
- To adolescents who have abstract thinking skills, a
more detailed explanation can be given
FACTORS AFFECTING
COMMUNICATION
2. Gender
-females and males communicate differently
- Girls tend to use language to seek confirmation,
minimize differences, and establish intimacy.
- Boys use language to establish independence and
negotiate status within a group
FACTORS AFFECTING
COMMUNICATION
3. Values and perception
- Values are standards that influence behavior
- Perceptions are personal view of an event
- Each person has unique personal traits, values,
and life experiences, thus each one interprets
messages and experiences differently
FACTORS AFFECTING
COMMUNICATION
4. Personal space
- Is the distance people prefer in interactions with
others
- PROXEMICS is the study of distance between
people in their interactions
- Intimate: touching to 1 ½ feet
- Personal: 1 ½ to 4 feet
- Social: 4 to 12 feet
- Public: 12 to 15 feet
FACTORS AFFECTING
COMMUNICATION
5. Roles and relationship
- The roles and relationships between the sender
and receiver affect the communication process
- Choice of words, sentence structure, and tone of
voice vary considerably from role to role
- Student midwife and instructor
- Client and health care provider
- Parent and child
FACTORS AFFECTING
COMMUNICATION
6. Environment
- People usually communicate effectively in a
comfortable environment
- Temperature extremes, excessive noise, and
poorly ventilated environment can interfere with
communication
- Environmental distraction can impair
communication
FACTORS AFFECTING
COMMUNICATION
7. Congruence
- The verbal and non-verbal aspects of the
message match
- If there is incongruence, the body language
or nonverbal communication is usually the
one with true meaning
- Clients will trust the midwife when her
communication is congruent
FACTORS AFFECTING
COMMUNICATION
8. Interpersonal Attitude
- Attitudes conveys beliefs, thoughts, and
feelings about people and events
- Caring and warmth convey a feeling of emotional
closeness
- Warmth convey friendliness and consideration
shown by act of smiling and attention to physical
efforts
TECHNIQUES OF COMMUNICATION
TECHNIQUE DESCRIPTION EXAMPLE
Sitting quietly and

Accepting pauses or
waiting attentively until
silences or minutes
1. SILENCE the client is able to put
without interjecting any
thoughts and feelings
verbal response
into words
Use of statements and
“Can you tell me how
questions that:
is it for you?”
- Encourage the client
2. Providing
to verbalize
general “Where would you like
- Choose a topic of
leads to begin?”
conversation
- Facilitate continued
“And then?”
verbalization
“Rate your pain scale

Making statements that of 0-10.”
3. Being
are specific rather than (specific statement)
specific and
general, and tentative
tentative
rather than absolute “Are you in pain?”
(general statement)
“Tell me about…..”
Asking broad questions
“What brought you to
4. Using that lead or invite the
the health facility?”
open-ended client to explore
questions (elaborate, clarify,
“”I’d like to hear more
describe, or compare)
about that”
Providing appropriate
forms to touch to Putting an arm over
reinforce caring feelings. the clients shoulder.
5. Using
Tactile contacts vary Placing your hand
touch
considerably among over the client’s hand.
individuals, families, and
cultures.
Active listening to
C: “I couldn’t manage
client’s message and
to eat dinner last
6. Restating repeat the thoughts/
night.”
or feelings in similar words.
N: “You had difficulty
paraphrasing
eating yesterday”
It offers a clearer idea
on what they said.
-A method of making the

client’s overall meaning
“Would you please
of the message more
say that again?”
understandable.
7. Seeking
-Used when
clarification “I’m not sure I
paraphrasing is difficult
understand that”
or when the
communication is
rambling or garbled
“You trimmed your beard

and washed your hair.”
Giving recognition:
- in a non-judgmental way
8. “I noticed you keep
- Of a change in behavior
Acknowledging squinting your eyes. Are
- An effort the client has
you having difficulty
made
seeing?”
C: “My wife says she will look
after me, but I don’t think she
can, what with the children to
Helping the client take care of, and they’re always
expand on and after her about something-
9. Focusing
develop a topic of clothes, homework, what’s for
importance. dinner.”
M: “Sounds like you’re worried

about how well she can manage.”
“During the past half hour we

Stating the main
talked about…”
points of a
10.
discussion to clarify
Summarizing “In a few days I will review what
the relevant points
you have learned about
discussed.
transcultural nursing”
MIDWIFE-CLIENT-INTERACTION
• Interpersonal relationship
• Therapeutic relationship
• Helping relationships
• An intellectual bond between the

midwife and the client and is focused on
the client
PHASES IN
I. Pre-interaction Phase
II. Introductory phase
III.Working Phase
IV.Termination Phase
PHASES IN
I. Pre-interaction Phase
- Similar to PLANNING STAGE
before an interview.
- The midwife has information about:
- Name, address, age, medical
history, social history, etc.
PHASES IN
II. Introductory Phase
- Orientation phase/ pre-helping
phase
- It sets tone for the rest of the
relationship
- The midwife and client observe each
other and form judgement about
ST . A L E X I U S C O L L E G E
PHASES IN
1. Opening the relationship
2. Clarifying the problem
3. Structuring and formulating the
contract
PHASES IN
- Getting to know each other and develop
a degree of trust
- RESISTIVE BAHAVIORS (behaviors that
inhibit involvement, cooperation, or
change)
PHASES IN
RESISTIVE BAHAVIORS
- Difficulty acknowledging a need for help
- Fear of exposing and facing feelings
- Anxiety about the discomfort involved in changing
problem- causing behavior patterns
- Fear and anxiety in response to midwife’s approach
“Caring attitude, genuine interest,

competence”
PHASES IN
- Clients should begin to:
- Develop trust in the midwife
- View midwife as competent
professional capable of helping
- View the midwife as honest, open,
and concerned about their welfare
PHASES IN
- Clients should begin to:
- Believe the midwife will try to
understand their culture and beliefs
- Feel comfortable talking to the
midwife
- Understand the purpose of
relationship and roles
PHASES IN
III. Working Phase
- The midwife and client begin
to care and view each other as
unique individuals
- When caring develops,
potential for empathy
increases
PHASES IN
III. Working Phase
1. Exploring and understanding
thoughts and feelings
- empathetic listening and
responding, respect, genuineness,
concreteness, confrontation
2. Facilitating and taking action
PHASES IN
IV. Termination Phase
- Often difficult and filled with
ambivalence
- The client begins to develop self-
reliance
- Methods involve:
- Summarizing, reviewing the
process, sharing reminiscences
ST . A L E X I U S C O L L E G E
(before and now), referrals,
Clarifications?
Reference:
Berman, A., Synder, S.J., (2011). Kozier & Erb’s

Fundamentals of Nursing. 9th Edition.
Assignment: Creative Video Presentation
 Make a 3-5 minutes video

presentation
 Apply all the concepts learned in
communication and transcultural care
nursing
 Each group is given a situation to
play
 Rubrics
ST . will
A L Ebe
X Igiven
US COLLEGE
Creative Video Presentation
Group1:
– Midwife conducting health education
to children about handwashing
Group 2:
– Midwife is on duty to a certain facility
and the family refused treatment of
their son because they cannot afford
hospitalization bills
Group 3:
– Midwife could not understand elderly
patient’s dialect seeking medical
help. (chief complain of occipital
headache for 1 month)- the elderly is
hypertensive
Group 4:
– Prenatal visit of teenage pregnant
client who shares her concerns about
her partner
ST . A L Ewho
X I Uleft
S C her
O L Land
E G Eher
Group 5:
– A father resistant of health services
because of his beliefs.

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II.

“a state of complete physical, mental, and

A healthy lifestyle is a way of living that

2. Non- verbal communication

Sitting quietly and

“Rate your pain scale

-A method of making the

“You trimmed your beard

M: “Sounds like you’re worried

“During the past half hour we

• An intellectual bond between the

“Caring attitude, genuine interest,

Berman, A., Synder, S.J., (2011). Kozier & Erb’s

 Make a 3-5 minutes video

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