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ANALISA PROSES INTERAKSI

Inisial klien : …………………………………… Nama Mahasiswa : ……………………………..

Interaksi Ke :…………………………… Tanggal : ……………………………
Lingkungan : ………………………………………………………….. Waktu : ……………………………..
………………………………………………………….. Tempat : ……………………………
Deskripsi klien : …………………………………………………………..
…………………………………………………………..
Tujuan interaksi : ……………………………………………………………
……………………………………………………………

Komunikasi verbal Komunikasi non verbal Analisa berpusat pada Analisa berpusat pada klien Rasional
perawat
P : …………………………… P : …………………………. …………………………... ................................................
………………………….. ………………………………
K : ………………………… ………………………… ………………………………

K : …………………………… K : ………………………… ……………………………… ……………………………...

P : ………………………… ……………………………… ……………………………...
……………………………… ………………………………

Komunikasi verbal Komunikasi non verbal Analisa berpusat pada Analisa berpusat pada klien Landasan teoretis
perawat

KESAN :

………………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………………

RENCANA TINDAK LANJUT :

………………………………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………

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