WPC4 ӿbPpG)s0M^ziR[qXYTF`O`[)4q 0S4S)*^ 5)`s᛹]"1Yg=R @L1עoiӰPAN*p (.u۴N\Qͬ8N{͘f\ξC36'b G&?D֦Ѷ [%6")8OVjʹMOsCqm٩c2uK;!A`(N)M@+J)zMnsW`XKK!?RXFôv j|WA7s a c:hif̈z] +0d×DT6ܦ -( N. ¶ £EX %&.e+#s XX>April19,1996,BonnieWeaverDuldt.C:\writing\hnct.wpd.(ConvertedtoWP6.0)August21,1999#X>X sm#&.e %XX>  #X>X %&.e#\TABLE ETABLE HTABLE ITABLE JTABLE K !  _TRP$'3$Letter (Landscape)X3' Letter'3 Letter Landscape3'T8>Xdd8   XX Theory: HumanisticNursingCommunicationTheory #  1      ׀X #  2       V   Theorist: BonnieW.Duldt,Ph.D.,R.N. F   Phenomenon: InterpersonalCommunicationBetweenNurse&Client,PeersandColleagues#X>X #  6  _*"ddd Xdd Xdd X..,0*dd +    &  Theory: HumanisticNursingCommunication Theorist: BonnieWeaverDuldt d  Phenomenon: InterpersonalCommunicationbetweenNurse&Client,Peers,andColleagues R  Text: Duldt,B.W.,&K._Giffin_.(1985).TheoreticalPerspectivesforNursing.Boston:LittleBrownandCompany. @  Analysisby: MoniqueVan_Essendelft_ԀandSuzanne_Woolard_;editedbyB.W.Duldt . *e" dd0*dd 0*"..e, dd , dd , dd , dd +  LL  Assumptions  `   Concepts  `   RelationshipStatements  `   Evaluation  `  * " dd dd dd dd dd " .., dd , dd , dd , dd +  ~ ~  &.e %XX>DERIVEDFROM  2  PHILOSOPHY(fromhumanistic    andexistentialthought):    1.Humanbeingsexisthereand R  nowfromwhichthereisno .~  escape.  Z  2.Humanbeingsareconcerned   withexistentialelements:being,   becoming,choice,freedom, z responsibility,solitude, V loneliness,pain,struggle, 2 tragedy,meaning,dread, ^ uncertainty,despair,anddeath. : 3.Allelementsofexistential  beingsarethecommunication ~ imperativeandsalientissuesto Z bedealtwithincriticallife 6 situations. b 4.Growthandchangearisefrom  withintheindividualandtoa   considerabledegreedependupon ! oneschoice.  ^ "  1.HumanBeings. Manisa  2# livingbeingcapableof  $ symbolizing,perceivingthe  % negative,transcendinghis v & environmentbyhisinventions, R ' orderinghisenvironment, .~ ( strivingforperfection,making  Z ) choices,andselfreflecting. 6 *  Characteristicsofhumans:  , a.Living: abletofunction V. biologicallyandphysiologically 2/ asananimalistic,viableentity. ^0  b.Communicating: abletolabel 2 thingsandtotalkaboutthem 3 whentheyarenotpresent. ~4  c.Negativing: abletotalkabout 66 thesymbolicnegative(1,no, b7 none,not),makerules(laws >8 regardingthe thoushaltnots), 9 worryaboutwhatmaynot : happen,andconsideronesown ; nonexistence._  ԍ x< Ў_   ^ < 1.Thedegreetowhichone  2= receiveshumanizing  > communicationfromothers,to  ? thatdegreeonewilltendtofeel v @ recognizedandacceptedasa R A humanbeing. .~ B a.Whileapplyingthenursing 6 D process,thedegreetowhicha  E nurseisabletousehumanizing  F communication,tothatdegree zG willtheclient,peer,orcolleague VH tendtofeelrecognizedand 2I acceptedasahumanbeing. ^J b.Inagivenenvironment,ifa L criticallifesituationdevelopsfor M aclient,tothedegreethenurse ~N useshumanizingcommunication ZO attitudesandpatternswhile 6P applyingthenursingprocess,toa bQ similardegreewillthehealthof >R theclienttendtomoveina S positivedirection. T   ^ V  1.Parsimony.  2W  Duldtstheoryisorganizedinto  Y consecutiveelements.The v Z elementsaredevisedintosubsets R [ sothattheassumptionsare .~ \ groupedwiththedisciplinefrom  Z ] whichtheyarederived. 6 ^ Theconceptsdefinitionsare  ` clearcutandtothepoint.The za assumptions,conceptsand Vb relationshipstatementsareall 2c interlockingandrelevant.As ^d newconceptsareintroduced, :e theyhaveimportancein f supportinghertheory. g Thestructureoftherelationship Zi statementsinconjunctionwith 6j themodelsoffersavehiclefor bk statisticalanalysisandresearch >l designs.Therelationship m statementsthatsheusesareinthe n formof_correlational_, o deterministicorprobable_  ԍ xq statements.statements_  ^ p  'x*"dd dd dd dd dd " .., dd , dd , dd , dd +   5.Thenurseshareswiththe d clientallthecharacteristicsof @ beinghuman.  DERIVEDFROM  COMMUNICATION :  `  6.Survivalisbasedonones  h abilitytosharefeelingsandfacts  D  abouttheenvironmentandways    ofcoping.    7.Theenvironmentisa d   booming,buzzingworldof @  strangesensationsthatmustbe l  sortedouttodeterminewhichare H  themostimportant;thissortingis $ achievedthroughcommunication  withotherpeople.  8.Theneedtocommunicateisan D innateimperativeforhuman  p beings. L 9.Duetoinnatefallacies,human  beingsuseandmisuseall  capabilities,especiallytheability l tocommunicate. H 10.Thewayinwhichaperson P communicatesdetermineswhat_  ԍ , thatpersonbecomes.   Ў֍̎_   ,  d.Inventing: abletobeaware d  of,know,anddothingsbeyond @! hisorherrelationshiptothe " environment. #  e.Ordering: abletodevelop ` % categoriesandhierarchies < & accordingtosomevalueor  h' theme;givesstructureand  D( systemtoonesenvironment.  )  f.Dreaming: abletodreamof  + howthingscouldbeifallwere d , perfect;expectations,hopesfor @ - thefuture. l .  g.Choosing: abletoconsider $0 numerousalternatives, 1 implicationsforthefuture. 2  h.Selfreflecting: abletothink D4 aboutandtalkaboutself,reflect  p5 ononesownbehaviorand L6 understandself,body,behaviors, (7 etc.Consciousoftheexistential 8 elements(seeAssumption#2). 9  2.Roles: positionsinsociety. H;  a.Nurse: ahumanbeingwho P= practicesnursing,intervening_  ԍ ,? throughtheapplicationofthe_   ,> 2.Tothedegreethattrust,self d? disclosure,andfeedbackoccur, @@ tothatdegreehumanizing A communicationorcommuning B alsooccurs. C 3.Intheeventonetendsto < E experiencedehumanizing  hF communicationthatis,  DG _monological_Ԁratherthan  H _dialogical_Ԁcommunication,  I categoricalratherthan  J individualistic,andsoonthen d K onetendstomoveoutward(on @ L themodel)tothenextpatternof l M interaction. H N 4.Inaninterpersonalrelationship P oftrust,selfdisclosure,and Q feedback,tothedegreethat hR dehumanizingcommunication DS attitudesareexpressedby  pT another,tothatdegreeonetends LU touseassertivenessasapattern (V ofinteraction. W &5.Tothedegreethat lY assertivenesstendsnottore HZ establishtrust,selfdisclosure, $t[ andfeedback,andtothedegree P\ thatdehumanizingattitudesare_  ԍexpressedby h_ another,tothatdegreeonetends <` touse a assertivenessasapatternof_   ,]  2.Scope:  d^ Duldtstheoryisaparadigm ` variationofthe IThoutheory a by_Buber_,andoftheHumanistic b NursingTheorybyPatternand ` c _Zderad_.Itdiffersinthe < d followingways:  he a.Itdefinesthehumanbeingas  g applicabletonursingpractice.  h b.Itprovideseasilytestable d j relationshipstatementsthatare @ k clearlystated. l l c.Itprovidesastructuredbodyof $n knowledgethatcanbe o implementedintotheeducational p cognatesofanursingeducation hq program. Dr Duldtstheoryisgeneralizedin Lt scope,nottosaythatitissimple. (u Itisbroadsothatitcancoverthe v areaofcommunication.The w specificsinhermodelspeakto lx thenurseandsomeotherperson Hy (specifically,nurseclient,nurse $tz peer,andnursecolleagues)and P{ theirinteractions._  ԍ < ̎_  ,|  *'"(dd dd dd dd dd ".., dd , dd , dd , dd +   11.Interpersonalcommunication d isahumanizingfactorthatisan @ innateelementofthenursing  process(assessment,planning,  intervention,andevaluation)and  ofthecommunicationthatoccurs `  betweennursesandclients,and <  nursesandprofessional  h colleagues.  D  12.Evaluationofapersonsown    communicationskillsis   subjective;eachindividualmust d  makehisowndecisionsand @  choicesaboutcommunication l  behaviorandchoosetochange, H  dependinguponhisabilityto $ utilizefeedback.  DERIVEDFROMNURSING: h 13.Thepurposeofnursingisto  p intervenetosupport,tomaintain, L andtoaugmenttheclientsstate ( ofhealth.  14.Ahumanbeingfunctionsasa l unique,wholebeingresponding H openlytotheenvironment. $t _  ԍ̎_   , nursingprocesstodevelopaplan d  ofnursingcareforaspecific @! clientorgroupofclients.The " nursepossessesspecial # educationaland_licensure_ $ credentialsasrequiredby ` % society. < &  b.Client: ahumanbeingwhois  D( experiencingacriticallife  ) situation,potentialoractual.He  * orshehasneedoftheservicesof  + thenurseandisthefocusofthe d , nursingprocess.Theclientcan @ - alsobeseentoincludethe l . supportsystemoffamily,friends, H / andsoon. $0  c.Peer: anursehavingequal 2 standingorstatustoanother h3 nurse. D4  d.Colleague: amemberof L6 anotherprofessionwithwhom (7 nursescoordinateandcollaborate 8 inthepracticeofnursingthatis, 9 physicians,administrators,and l: membersofhealthcare H; professionsandcommunity $t< serviceagencies. P= _  ԍ̎ 3.Nursing: theartandscienceof <@ positive,humanisticintervention A ...._   ,> ofinteraction. d? 6.Tothedegreethat A confrontationtendsnottore B establishtrust,selfdisclosureor C feedback,andtothedegreethat ` D dehumanizingcommunication < E attitudescontinuetobeexpressed  hF byanother,tothatdegreeone  DG tendstouseconflictresolutionas  H apatternofinteraction.  I 7.Tothedegreethatconflict d K tendsnottoreestablishtrust,self @ L disclosure,andfeedback,andto l M thedegreethatdehumanizing H N communicationattitudes $O continuetobeexpressedb P another,tothatdegreeonetends Q toterminatetherelationshipby hR separation. DS 8.Tothedegreethathumanizing LU communicationattitudesoccurin (V arelationship,intheeventof W separation,therelationshipcan X beresumedtothesamedegreeof lY closenessregardlessofthe HZ separation. $t[ 9.Tothedegreetowhichanurse_  ԍ h` useshumanizingcommunication, <a tothatdegreewillbenurse b receive_   ,] Theconceptsare_Operationalized_ d^ insuchawayastoprovidea @_ simplifiedmeansoftestingand ` measuringabstractideas. a Thetheoristbuilds,supports,and ` c expandstheconceptsonprevious < d worksbyKennethBurke(1966),  he _Jourard_Ԁ(1971);,_Berlo_Ԁ(1960),  Df Pattersonand_Zderad_Ԁ(1976);  g _Yura_ԀandWalsh(1973),  h _Kierkegaard_Ԁ(1957),A._Maslow_  i (1954),Mead(1934),Rogersand d j _Truax_Ԁ(1971),Sartre(1957), @ k Pattonand_Giffin_Ԁ(1977),and l l others. H m  3.Limitations: This o interpersonalcommunication p theoryisprimarilyapplicableto hq relationshipsbetweentwoor Dr threepeople,i.e.,dyadsortriads.  ps Thus,itisbelievedapplicableto Lt thenursepatientandperhapsa (u familymembersuchasaparent v orspouse.Itisnotapplicableto w groups,organizationsorsystems, lx Thislimitationistypicalof Hy existentialandsymbolic $tz interactionphilosophical P{ perspectives._  ԍ < ̎_  ,|  * "!dd dd dd dd dd '"(.., dd , dd , dd , dd +   SPECIFICASSUMPTIONSTO d THISTHEORY: @ 15.Health,satisfactionand  successinapersonslifeand  workinotherwords,that `  personsstateofbeingis <  derivedfromfeelinghuman.  h 16.Duetothebureaucraticand    complexnatureofthepresent    healthcaredeliverysystems,   thereisatendencyforclientsand d  professionalstobetreatedina @  dehumanizingmannerandto l  relatetooneanotherina H  dehumanizingmanner. $ 17.Humanizingpatternsof  communicationcanbelearned h andcanenhancethenurses D awarenessofasensitivitytothe  p clientsstateofbeingandof L becoming. ( 18.Thegoalofthehumanistic  nurseistobreakthe l communicationcycleof H dehumanizingattitudesand $t interactionpatterns,replacing P thesewithattitudesandpatterns_  ԍ < thathumanize.   ̎_   , inthechanginghealthstatusof d  humanbeingsinteractinginthe @! environmentofcriticallife. " situations.Itselementsare # communicating,caring,and $ coaching.  ` % 4.NursingProcess: consistsof  h' a)assessinganddiagnosing,  D( b)planning  ) c)implementing,and  * d)evaluating.  +  5.Health: onesstateofbeing, @ - ofbecoming:ofselfawareness. l . Itisindicativeofones H / adaptationtotheenvironment. $0  6.Environment: Ones 2 time/space/environmentcontext. h3  7.CriticalLifeSituation: a  p5 situationinwhichthereisa L6 perceivedthereattooneshealth (7 state,inwhichonesexistential 8 stateofbeingissalient,adin 9 cancer,childbirth,accidents,and l: soon.  H; 8.Communication: adynamic P= interpersonalprocessinvolving_  ԍ <@ continualadaptationand_   ,> humanizingcommunicationfrom d? othersclients,peers,colleagues, @@ andleaders. A 10.Tothedegreethatoneis C awareofonesownchoice(and ` D motives)aboutinteraction < E patterns,tothatdegreeoneis  hF abletodevelopcommunication  DG skillsandhabitswhichtendto  H havepredictableresultsin  I establishing,maintainingand  J terminatinginterpersonal d K relationships.  @ L  4.Applicability  dM Duldtstheoryprovidesa O perspectiveofcommunication P whichcanbeusefulinall Q situationsinnursingpractice. ` R Thetheoryaidsthenursein  hT copingwiththenegativity  DU experiencedinthepracticeof  V nursing.  W Thisnursingtheorycanbe d Y utilizedinconjunctionwithother @ Z nursingtheoriestoprovidea l [ uniqueperspectiveofthe H \ communicationdimensionof $] interpersonalinteractions. ^ Duldtstheoryisrealisticinthat h` itrecognizesthedehumanizing Da aspectsofcommunicationwith  pb nurses,clients,andothers.Her Lc theoryisan isratherthana (d  shouldbetheory.Itprovides e thenursewithanoptionfor f escapefromnegativepatternsof lg communicationandthepotential Hh tochangerelationshipsinto $ti humanizinginteractionpatterns Pj andattitudes._  ԍ <m WhileDuldtstheoryiseasilyunderstandableforclinical_  ,k  *#"$dd dd dd dd dd "!.., dd , dd , dd , dd +   19.Interpersonalcommunication d isthemeansbywhichthenurse @ becomes;increasinglysensitive  toandawareoftheclientsstate  ofbeing,ofthedynamic  relationshipbetweentheclient `  andhisorherenvironment,and <  oftheclientspotential.  h      adjustmentsbetweentwoormore d  humanbeingsengagedinface @  tofaceinteractionsduringwhich   eachpersoniscontinuallyaware  oftheother(s).  Communicationisaprocess `  characterizedbybeingexistential <  innature,involvinganexchange  h ofmeaning,concerningfactand  D feelings,andinvolving_dialogical_   communing.   Twodimensionsof   communicationarethe d  Ѐa) attitude withwhichone @  communicatesand l  Ѐb)skillsor patternsof H  interaction oneusesto $ communicate.   Humanizingcommunication  h involvesanawarenessofthe D uniquecharacteristicsofbeing  p  human.  L! Dehumanizingcommunication  # ignorestheuniquecharacteristics $ ofbeinghuman. l% _  ԍ̎_   ,)   d* nurses,itisnotwidelyused d+ presently;itisrelativelynewand @, warrantsfurtherresearchfor - supportivefordata. . ReferringtotheGRID(Duldt& ` 0 _Giffin_,1985,p.231),Duldts < 1 adaptationofthedefinitionof  h2 humanbeingsinrelationtothe  D3 nursingprocesscanbe  4 implementedintothecurriculum  5 ofprofessionalnursing.  6 TheManualforusingthe @ 8 NursingCommunication l 9 ObservationTool(_NCOT_)has H : beenpublishedgivingdirections $; forcollectingdataforeducation, < assessmentandresearch = purposes.Thetoolisvalidated h> bycongruenceofjudgmentsof D? trainedobservers.Thetoolis  p@ basedonthewellknown LA InteractionProcessAnalysisby (B ProfessorRobertF.BalesofYale C University. D  5._Generalizability_Ԁand HF agreementwithknowndata.  $tG Duldtstheory,whichfitsinthe_  ԍ hJ symbolicinteractionmodel,pulls <K fromdisciplinesotherthan_  ,I  *%")dd dd dd dd dd #"$.., dd , dd , dd , dd +     d  9.ContinuumofAttitudes  d HumanizingDehumanizing    DialogueMonologue  IndividualCategories  HolisticParts `  ChoiceDirectives <  Equality  h  Degradation  D  PositiveRegardDisregard    AcceptanceJudgment    EmpathyTolerance   AuthenticityRoleplaying d  CaringCareless @  Irreplaceable_Expendability_ l  Intimacy H  Isolation $ CopingHelpless  Power  Powerless h  10.Patternsofinteractionsor  p skills:  L  a.Communing: _Dialogical_,  intimatecommunicationbetween  twoormorepeople;theheartof l humanisticcommunication. H  򀀀Listening: isthecoreof P communingandinvolvesmaking_  ԍaconsciousefforttoattendtowhatanotherpersonissaying,particularlytoexpressionsoffeelings,meanings,andperceivedimplications..̎_   ,    d! nursingandutilizesthese d" conceptstobuildthistheory. @# Hertheoryimplies certain $ populations,experimental % treatmentvariables,andmethods & ofmeasuringthesevariables. ` ' Duldt&_Giffin_,1985,pp.228 < ( 230).  h) Duldtstheoryhaspotential  + generallysinceitisanewtheory  , andnotwidelytested,although  - effortshaverecentlybeen d . instituted.Hertheoryis @ / congruentwithothertheorists, l 0 yetdifferssomewhat.For H 1 example,_Pilette_Ԁstatesthat $2 dialoguedoesnotrequirespecial 3 techniques.Duldttakesthe 4 oppositepositionandstatesthat h5 tomaintaindialogue,itis D6 imperativeskillsandattitudesin  p7 communing,forexample,be L8 learned,particularlyinthehealth (9 careprofessions. : _Carkhuff_Ԁand_Truax_Ԁtheorized l< thattrainingprogramsforhealth H= careprofessionalsresultedin $t> increasedlevelsofempathy, P? respect,andgenuineness;these_  ԍconceptsare hA includedinDuldtstheory._  ,@  **"+dd dd dd dd dd %").., dd , dd , dd , dd +     d  򀀀Thecentraltripod of d communingistrust,self @ disclosure,andfeedback.   򀀀Trust isonepersonrelyingon  another,riskingpotentiallossin `  attemptingtoachieveagoal, <  whentheoutcomeisuncertain;  h  andthepotentialforlossis  D  greaterthanforgainifthetrustis    violated.     򀀀Selfdisclosure isrisking d  rejectionintellinghowonefeels, @  thinks,andsoon,regarding here l  andnoworexistentialevents  H  ̀Feedback isdescribing    anothersbehavior,beliefs,and  soon,plusgivingones h evaluationorfeelings. D  b.Assertiveness: expressing L onesneeds,thoughts,feelingsor ( beliefsinadirect,honest,  confidentmannerwhilebeing  respectfulofothersthoughts, l feelingsorbeliefs; asserting H withauthenticity. $t  c.Confrontation: providing  ԍ P feedbackaboutanotherplus P requestingachangeinhisorher P behavior; confronting_ԍwith_ԍ P caring. P Ў_ԍ̎_   ,    d! _LaMonica_Ԁidentifiedpositive d" attitudesasdeterminantsof @# behavior;thisiscongruentwith $ humanisticnursing.Kingand % _Gerwig_Ԁdrewonhumanistic & educationandpsychologyof ` ' humanisticnursingeducation. < ( (Duldt&_Giffin_,1985,pp.235  h) 6).  D* Duldtdrewfromallthese  , theoristsconceptsand  - supportingdataandimplemented d . changeinhertheoryaswarranted @ / andsupportedbydata. l 0  6.Relevantresearch.  $2 Anumberofresearchstudies 4 tendtosupportthetheoretical h5 statements.Thesearelistedon D6 thefollowingpages.  p7  7.Importancetothediscipline (9 andprofession.  : Thetheorydefineshumanbeings l< specificforthescopeofnursing, H= ina_wholistic_Ԁandexistentialist $t> manner..Italsodefinestheroles P? andfunctionofnurses._  ԍ <A ̎_  ,@  *."/dd dd dd dd dd *"+.., dd , dd , dd , dd +   s  d  d.Conflict :requiresadecision d overanissueinwhichthereis @ riskoflossaswellaspossible  gain,inwhichtwoormore  alternativescanbeselected,and  inwhichonesvaluesare `  involved; conflictingwith <  dialogue.  h   e.Separation: occursattheend    ofarelationshipduetochange,    choice,oroutsidecommitments;    separationwithsadness.  d    d Thetheoryservesasaguidefor d researchintheareaof @ communicationinnursingand  potentiallyinotherhealthcare  disciplines.    p  *,"-dd dd dd dd dd ."/..,0*dd +     SupportingResearch  d Boyd,Betty(1986).Relationshipofnursingbehaviorandtrust.(Unpublishedmastersresearchreport.)Greenville,N.C.:EastCarolina  ЀUniversitySchoolofNursing.  ЀIdentifiedsomespecificbehaviorsofnurseswhichincreasedclientstrustinthenurse.  _Eberhardt_,Gary(1987)Therelationshipofhospicenursesbehaviorandprimarycaregiverbehavior.(Mastersresearchreport) <  ЀIdentifiedsomenursingbehaviorswhichpromotethedevelopmentoftrustofnursesbyhospicecaregivers._Eberhardt_Ԁ&Duldt,(1988).  h Ѐ Trustingthehospicenurse.AmericanJournalofHospiceCare,6(6),2932.  D  _Rodri_,Joanne.(1986).Descriptivestudyofthecommunicationbetweennursesandclientsonelectronicfetalmonitoring.(Unpublished    ЀMastersresearch).Greenville,N.C.:EastCarolinaUniversitySchoolofNursing.Developedtheinitialformofthe_NCOT_Ԁanduseditto   Ѐobtaindescriptivedata. d  Dunn,Ann.(1987).Theeffectofreminiscenceonthedegreeofhumanizingcommunicationoftheelderly.(Mastersthesis).Greenville, l  ЀN.C.:EastCarolinaUniversitySchoolofNursing. H  Perkins,Ann(1986).Communicationwithpatientsrequiringmechanicalventilation.(Unpublishedmastersresearch).Greenville,N.C.:East  ЀCarolinaUniversitySchoolofNursing.Founddifferencesinpatientsandnursesperceptions.  Longest,Robin.(1986).Analysisofnoncommunicativebehaviorsbetweennursesandpatientsonmechanicalventilators.(Thesis) D ЀGreenville,N.C.:EastCarolinaUniversitySchoolofNursing.Descriptiveofthereciprocityofinteractionsoccurringbetweennursesand  p Ѐpatients. L Jones,Susan.(1985).Jobsatisfactionandexpressedanger.(Unpublishedmastersresearchreport).Greenville,N.C.:EastCarolina  ЀUniversitySchoolofNursing.DescriptiveandsupportiveofDuldtstheoryofanger(unpublished).  _Currin_,_Candice_.(1987).Modesofcopingwithangerinindividualswithschizophrenia.(Mastersthesis)Greenville,N.C.:EastCarolina H ЀUniversitySchoolofNursing.Comparedmodesofhandlingangerinfamilieswithandwithoutschizophrenia. $t Duldt,BonnieWeaver.(1982).Helpingnursestocopewiththeangerdismaysyndrome.NursingOutlook,June,pp.168174._  ԍ < ЀIdentifiedtheangerdismaysyndrome,acomplexofcommunicativebehaviorsnursestendtodisplaywhenreceivingdestructiveangrymode   Ѐmessagesfromothers,especiallyfromperceivedsuperiors.̎ ⍀_  ,  Ї   References  D   _Berlo_,DavidK.(1960).Theprocessofcommunication.SanFrancisco:_Rinehart_. 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P _LaMonica_,ElaineL.(1979).Thenursingprocess:Ahumanisticapproach.MenloPark,Calif.:AddisonWesley,p.456. X _Maslow_,AbrahamH.(1954)MotivationandPersonality.NewYork:HarperandBrothers.  Mead,GeorgeH.(1934).Mind,Self,andSociety.EditedbyCharlesW.Morris.Chicago:UniversityofChicagoPress. x  T Patterson,JosephineG.,andLorettaT._Zderad_.(1976).HumanisticNursing.NewYork:Wiley.  Patton,Bobbyg.,andKim_Giffin_.(1977).Interpersonalcommunicationinaction.NewYork:HarperandRow. h _Pilette_,Patricia_Chehy_.(1980).Thenurseasahumanisticartist.In:_Arlyne_ԀB._Saperstein_ԀandMargaretA.Frazier:Introductiontonursing  p   practice.Philadelphia:F.A.DavisCompany. L Rogers,CarlR.,and_Truax_,CharlesB.(1971).Thetherapeuticconditionsantecedenttochange:Atheoreticalview.In:GeraldEgan:Encounter     Groups:BasicReadings.Belmont,Calif.:Brooks/ColePublishingCompany,pp.264276.   Sartre,JeanPaul.(1957).ExistentialismandHumanism.TranslatedandwithanintroductionbyPhilip_Mairet_.Brooklyn:HastingsHouse. H   _Yura_,HelenandWalsh,M.B.(1973).Thenursingprocess:Assessing,planning,implementing,andevaluating.2nded.Norwalk,Conn.:s P    AppletonCentury_Crofts_.