Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Communication Barriers”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMed2005

South Asians and epilepsy: exploring health experiences, needs and beliefs of communities in the north of England.

PURPOSE: To examine the beliefs and experiences of South Asians with epilepsy and the extent of provision of appropriate information and accessible services for them by health professionals. METHODS: Qualitative interviews with 30 South Asians with epilepsy, 16 carers and 10 health professionals. In addition, two focus groups were held with 16 South Asians without epilepsy recruited from community centers. The interview sample was divided by religious groupings (Hindus, Sikhs and Muslims). Fieldwork was conducted in Bradford and Leeds (England). RESULTS: Beliefs that epilepsy is caused by spirit possession (Muslims) or attributable to sins committed in a past life (Sikhs and Hindus) were reported as being widely held among South Asians living both in the UK and the Indian subcontinent, although few informants themselves subscribed to such views. Compliance with conventional medication was high; however, those who experienced seizures most often were most likely to turn to traditional South Asian therapies. Most informants used both treatments simultaneously. The main issues regarding the provision of services were: lack of appropriate information and advice; language and communication barriers; problems in interaction with health professionals. Also discussed were the potential merits of attending support groups. Greatest dissatisfaction was expressed in relation to primary care, whereas the highest praise was reserved for specialist epilepsy nurses. CONCLUSIONS: Our findings show both similarities and differences between participants' experiences, where gender, age or other aspects of personal biography can be as important as religion, culture or country of origin. Furthermore, the impact of being diagnosed with epilepsy can be exacerbated by structural impediments to accessing information and appropriate services.

Adolescent↗
PubMed1998

New insights into erectile dysfunction: a practical approach.

Erectile dysfunction (ED) is the most common sexual problem in men, after premature ejaculation, affecting up to 30 million in the United States. In a society in which sexuality is widely promoted, ED impacts on feelings of self-worth and self-confidence and may impair the quality of life of affected men and their partners. Damage to personal relationships can ensue; and the anger, depression, and anxiety engendered spill over into all aspects of life. Patients are often embarrassed or reluctant to discuss the matter with their primary care practitioners. Unfortunately, many physicians fail to take the opportunity to promote open discussion of sexual dysfunction. They too, may avoid the topic through personal embarrassment. Since the National Institutes of Health (NIH) Consensus Conference on Impotence in 1992, the inadequate level of public and professional understanding of ED has begun to be addressed. As a first step in breaking down the communication barriers between patients and practitioners, it is important that physicians have a thorough understanding of the wide variety of conditions associated with ED and how the different risk factors for ED may be readily identified. This review addresses the diagnosis of ED and identifies diagnostic tests that can be used by primary care physicians to determine the patients most at risk and the treatments most suited to meet the patients' and their partners' goal for therapy.

Erectile Dysfunction↗
PubMed1976

Interrelationships between orthodontics and periodontics.

At the present time, periodontists have no evidence to indicate that orthodontic treatment in the child will either enhance or detract from the periodontal health of the patient or that it will increase or decrease the longevity of the teeth. Many periodontists believe that much orthodontic treatment is undertaken on an esthetic or empirical basis. Proper emphasis on plaque control procedures prior to initial banding, altered and reinforced during the entire period of orthodontic treatment, may well minimize the inflammatory lesion often found during therapy. Gingival, periodontal, and mucogingival problems should be treated as soon as they are diagnosed. Limiting our orthodontic objectives in adult patients because of the possibility of inducing supporting alveolar bone loss and other problems that did not previously exist may be a worthwhile compromise. Orthodontic movement in periodontally healthy adults, and especially in those with periodontally involved teeth, constitutes a problem distinct from routine orthodontics. When periodontal disease has already produced significant destruction of supporting tissue and secondary occlusal trauma is a complicating factor, orthodontic treatment may possibly serve as another mode of treatment to reestablish the correct occlusal plane and alter bony deformities. Various methods can be used to try and place teeth into better bone. One should make certain that teeth are being moved into a greater volume of bone. The bite plane is of great value in allowing continuous eruption of the teeth and their supporting structures and in eliminating additional trauma by enabling the teeth to move into their correct cusp-fossa relationships unimpeded by the inclined planes of the opposing teeth. Since little is known about the interrelationships between orthodontic treatment and periodontal health and disease, there is still a great deal to learn. In spite of this lack of knowledge, the general practitioners and the various specialists of dentistry, each seeking a rationale for his preventive and therapeutic procedures, subject the patient to treatment based on concepts of the occlusion which have yet to be corroborated. In addition to the need for research in this field, a common language between the periodontist and the orthodontist must be established to eliminate the existing communications barrier. Once basic principles can be determined, elucidated, and applied correctly, the movement of teeth in periodontal cases will be limited only by the imagination of the operator.

Adult↗
PubMed1992

A reconsideration of the factors affecting birth outcome in Pakistani Muslim families in Britain.

Over recent years, Bradford has had a consistently high perinatal mortality rate (PNMR), especially amongst its Asian population, 66% of whom originate from Pakistan. There is a high incidence of consanguineous marriages reported among Pakistani and Muslim couples. Often, this observation is used to explain their higher PNMR and congenital malformation rates. The factors affecting birth outcome in Pakistani women are complex and interrelated. Socioeconomic, genetic, biological and environmental factors all contribute to adverse birth outcome. In addition, these are complicated by discrimination, communication barriers and culture blaming. The aim of this paper is to challenge midwives and other health professionals to reconsider the overwhelming emphasis placed on consanguinity as a factor affecting birth outcome, and to recognise the impact and interplay of other confounding variables.

Confounding Factors, Epidemiologic↗
PubMed2000

Can tailored interventions increase mammography use among HMO women?

BACKGROUND: Telephone counseling and tailored print communications have emerged as promising methods for promoting mammography screening. However, there has been little research testing, within the same randomized field trial, of the efficacy of these two methods compared to a high-quality usual care system for enhancing screening. This study addressed the question: Compared to usual care, is tailored telephone counseling more effective than tailored print materials for promoting mammography screening? DESIGN: Three-year randomized field trial. PARTICIPANTS: One thousand ninety-nine women aged 50 and older recruited from a health maintenance organization in North Carolina. INTERVENTION: Women were randomized to 1 of 3 groups: (1) usual care, (2) tailored print communications, and (3) tailored telephone counseling. MAIN OUTCOME: Adherence to mammography screening based on self-reports obtained during 1995, 1996, and 1997. RESULTS: Compared to usual care alone, telephone counseling promoted a significantly higher proportion of women having mammograms on schedule (71% vs 61%) than did tailored print (67% vs 61%) but only after the first year of intervention (during 1996). Furthermore, compared to usual care, telephone counseling was more effective than tailored print materials at promoting being on schedule with screening during 1996 and 1997 among women who were off-schedule during the previous year. CONCLUSIONS: The effects of the intervention were most pronounced after the first intervention. Compared to usual care, telephone counseling seemed particularly effective at promoting change among nonadherent women, the group for whom the intervention was developed. These results suggest that telephone counseling, rather than tailored print, might be the preferred first-line intervention for getting nonadherent women on schedule for mammography screening. Many questions would have to be answered about why the tailored print intervention was not more powerful. Nevertheless, it is clear that additional interventions will be needed to maintain women's adherence to mammography. Medical Subject Headings (MeSH): mammography screening, telephone counseling, tailored print communications, barriers.

Cost-Benefit Analysis↗
PubMedDate not supplied

Emergent intubation and CT scan pathology of blunt trauma patients with Glasgow Coma Scale scores of 3-13.

INTRODUCTION: Widely accepted guidelines for use of pharmacologic agents for prehospital intubation have not been fully developed. Toward the goal of formulating specific guidelines, this study sought to determine how well the Glasgow Coma Scale (GCS) score stratifies the need for emergent intubation (within 30 minutes of emergency department arrival or in the prehospital setting). METHODS: A one-year, retrospective review of the charts of blunt trauma patients with presumed head injury who presented to the emergency department of a Level 1 trauma center with a GCS score of less than or equal to 13 was performed. A total of 120 patients met the inclusion and exclusion criteria. RESULTS: A significant number of patients presenting with a GCS score of less than or equal to 9 required emergent intubation. A significant minority of patients presenting with a GCS score of 10-13 required emergent intubation (20%) or had intracranial pathology on head CT scan (23%), and the majority of patients from this subgroup did not require subsequent intubation. Alcohol or substance intoxication and communication barriers such as deafness and language difficulties limited the clinical examination. CONCLUSIONS: Patients with a presenting GCS score of less than or equal to 9 represent candidates for the use of pharmacologic agents to facilitate aggressive airway control by well-trained and supervised emergency medical technicians (EMTs). Emergent intubation of patients with a GCS score of 10-13 is problematic. Patients with a presenting GCS score of 10-13 must be evaluated individually and closely monitored.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2002

[Attitude of cancer patients to fatigue: patient attitude in Switzerland and England].

UNLABELLED: In the course of a cancer trajectory, many patients suffer from distressing fatigue. In past years, research has shown that care givers tend to underestimate or even to ignore this frequent phenomenon. Despite increasing knowledge, fatigue seems to remain an orphan topic in symptom management. AIM: A qualitative research strategy was used to explore the perception of cancer patients regarding the awareness of fatigue in professionals and the way they deal with it. Patients also evaluated the usefulness of some currently available information material about fatigue. METHODS: The expert-opinion of cancer patients in Switzerland and England was analysed. Convenient sampling guided the selection process of seven patients in each country. A tape-recorded focus-group interview served as method to collect and transcribe data. Data were analysed according to the framework analyses by Richie & Spencer. RESULTS: Results were very similar in both countries. Patients stated a great need for more information regarding fatigue. They feel that care givers are not sufficiently aware of it and that a specific support is not part of current standard practice. The information material was well received and generally judged as very good and helpful. CONCLUSIONS: Communication barriers in professionals as well as in patients continue to exist. Patients wish to be better informed by care givers. The available information material serves well to support this information as they provide words for the unmentioned phenomenon. Far more professional fatigue education is needed to raise care givers' awareness.

Awareness↗
PubMed2004

Enhancing socially adaptive communicative repairs of beginning communicators with disabilities.

Young children with significant disability often have limited communicative repertoires. The means they have available to communicate with others might include natural gesturing, vocalizing, and occasionally challenging behavior. These forms frequently are unconventional, ambiguous, and idiosyncratic and are therefore difficult for partners to understand. As a result of these compromised repertoires, communication breakdowns are the rule rather than the exception and the children's capacity to repair these breakdowns becomes critical. This article focuses on communication breakdowns and repairs by (a) identifying and defining their variations, (b) providing a rationale for their importance (especially for children with substantial language delays), and (c) developing a conceptual framework to facilitate their assessment and to assist in the design of interventions that are logically related to the assessment results. Guidelines for conducting the assessments and for implementing the interventions are provided.

Child↗
PubMed2003

Translating clinical tools in nursing practice.

BACKGROUND: The widespread use of clinical tools in nursing practice reflects their usefulness in guiding patient care, evaluating treatment effectiveness and conducting audit. Cultural awareness and the provision of culturally competent care is a high priority for nurses in the United Kingdom (UK), given patterns of increasing ethnic diversity. However, meeting the individual needs of patients can be difficult when language barriers hinder communication. One way to address these difficulties is to translate existing clinical tools. AIM: The aim of this paper is to appraise the potential for, and limitations of, translating clinical tools for use in nursing practice. DISCUSSION: Drawing on a range of studies from the disciplines of health and social science, this review describes and discusses some key considerations relevant to translating clinical tools in nursing. These considerations include the need to ensure cultural equivalence, lack of familiarity with clinical tool formats in some cultures and its impact on responses, and low literacy levels in some populations. CONCLUSION: Clinical tools provide benefits in identifying patients' problems, guiding patient care, and evaluating treatments and interventions. Translating these tools can help to bridge the language gap that hinders good communication between nurses and patients. Translated clinical tools can be of acceptable cultural equivalence and validity if high quality translation methodologies are employed, together with an awareness of culturally relevant issues when interpreting the information gained from the tools.

Communication Barriers↗
PubMed2003

Primary health care provision for adults with a learning disability.

BACKGROUND: During the last decade, primary care has been designated as the main provider of health care to people with learning disabilities. Practice nurses based in primary care teams are increasingly the first points of contact with health services. They make an important contribution to promoting good health, with health screening and illness prevention work being a significant part of their role. However, little is known about their views or involvement regarding the provision of primary care for people with learning disabilities. There is therefore a need to explore the nursing perspective, from within primary care, on the current provision of care for people with a learning disability. RESEARCH AIM: To inform the learning disability service of the role of primary care in current service provision for people with learning disabilities. RESEARCH METHOD: A survey of all practice nurses currently employed by Grampian Health Board in Aberdeen was conducted in June 2001. An initial pilot study was conducted in primary care and learning disability services. Data collection took place during June and July 2001. All practice nurses working in the geographical region of Grampian were invited to participate. RESULTS: Communication barriers exist, preventing access to health screening and treatment for some people with learning disabilities. Independent living skills, for example dietary management and budgeting, require additional community support. These conditions pose complex problems for practice nurses and other members of the primary care team. CONCLUSION: This study indicates a need for closer support and partnership with the learning disability service. The factors necessary for providing health care to people with learning disabilities extend beyond the domain of primary care teams. The findings of this survey have important implications for education and support to enable carers and professionals to provide a high standard of care.

Adult↗
PubMed2001

Paraplegia secondary to Burkholderia pseudomallei myelitis: a case report.

Bacterial infection is an uncommon cause of acute paraplegia. A 42-year-old Aboriginal man presented to a remote health clinic in northern Australia with myelitis associated with Burkholderia pseudomallei. He was treated with analgesia and intravenous flucloxacillin, ceftriaxone, and gentamicin and transferred to our hospital, where an urgent T12-L1 laminectomy and decompression was performed. Urine culture confirmed B. pseudomallei infection (melioidosis). Abdominopelvic computed tomography revealed left prostatic lobe and right periprostatic abscesses, which were managed conservatively. The patient was given intravenous ceftazidime (8g/d) for 2 months, followed by oral sulfamethoxazole (1600mg) and trimethoprim (320mg) twice daily for 8 weeks. Magnetic resonance imaging 3 weeks after his admission confirmed transverse myelitis. His rehabilitation was complicated by his difficulty in adjusting to disability, by urinary retention and fecal incontinence, by communication barriers, and his isolation from a culture familiar to him. He returned to his community after 15 weeks, free of infection, with T10-11 paraplegia and an indwelling catheter.

Adult↗
PubMed1997

Analysing discourse in the traumatic brain injury population: telephone interactions with different communication partners.

A range of discourse analyses are effective in identifying features which are aberrant following traumatic brain injury (TBI). We examined the exchanges of five traumatically brain-injured subjects and five matched controls across four speaking situations which included speaking to a therapist, to the bus timetable information service, to the police, and to their mothers on the telephone. Transcripts were analysed using the exchange structure analysis of systemic functional grammar. This analysis provided an indication of information giving (K1 moves per minute); information requesting and receiving (K2 moves per minute) and the amount of negotiation that was needed for the messages to be conveyed (dynamic moves per minute). Results indicated that the TBI subjects performed differently across the four conditions, and were differentiated from the matched controls on a number of measures. The role of different communication partners is also addressed. Communication partners were noted to interact differently with TBI subjects when compared with controls. This included increased information-giving to control subjects; more requests for information by police from TBI subjects and a greater use of dynamic moves by therapists with controls. The potential of exchange structure analysis is discussed as a useful way of examining the discourse of TBI subjects and their communication partners. Exchange structure analysis highlighted the dynamic nature of information exchange and the subtle ways speakers responded to familiarity and power imbalance in social interaction. This study has implications for family and community education regarding communication with people with TBI.

Adult↗
PubMed2004

Alcohol ignition interlock programs.

The alcohol ignition interlock is an in-vehicle DWI control device that prevents a car from starting until the operator provides a breath alcohol concentration (BAC) test below a set level, usually .02% (20 mg/dl) to .04% (40 mg/dl). The first interlock program was begun as a pilot test in California 18 years ago; today all but a few US states, and Canadian provinces have interlock enabling legislation. Sweden has recently implemented a nationwide interlock program. Other nations of the European Union and as well as several Australian states are testing it on a small scale or through pilot research. This article describes the interlock device and reviews the development and current status of interlock programs including their public safety benefit and the public practice impediments to more widespread adoption of these DWI control devices. Included in this review are (1) a discussion of the technological breakthroughs and certification standards that gave rise to the design features of equipment that is in widespread use today; (2) a commentary on the growing level of adoption of interlocks by governments despite the judicial and legislative practices that prevent more widespread use of them; (3) a brief overview of the extant literature documenting a high degree of interlock efficacy while installed, and the rapid loss of their preventative effect on repeat DWI once they are removed from the vehicles; (4) a discussion of the representativeness of subjects in the current research studies; (5) a discussion of research innovations, including motivational intervention efforts that may extend the controlling effect of the interlock, and data mining research that has uncovered ways to use the stored interlock data record of BAC tests in order to predict high risk drivers; and (6) a discussion of communication barriers and conceptual rigidities that may be preventing the alcohol ignition interlock from taking a more prominent role in the arsenal of tools used to control DWI. Whether interlock programs can help public policymakers achieve their expressed goals of substantially reducing the level of impaired driving will remain uncertain until procedural barriers and intransigent judiciary practices can be overcome that provide for more systematic routine use of interlock programs. Despite strong effectiveness evidence in all studies to date, the real potential of this technology to reduce the road toll cannot be estimated until they are more widely adopted.

Alcohol Drinking↗
PubMed2005

Hearing, deaf, and hard-of-hearing Israeli adolescents' evaluations of deaf men and deaf women's occupational competence.

This study examined 74 deaf and hard-of-hearing (D/HH) and 91 hearing high school students regarding their own occupational aspirations and their evaluations of occupational competence (EOCs) for deaf adults. In the EOC, participants rated the suitability of 25 occupations (varying according to prestige and required level of communication) for deaf men and women. The results showed that occupations requiring intensive communication levels, regardless of their prestige, were evaluated as much less suitable for deaf individuals than were those requiring less communication. D/HH adolescents did not find highly prestigious occupations as suitable for deaf adults even when communication barriers were irrelevant. Both D/HH and hearing participants expressed biased evaluations of deaf women's competence, but no further evidence emerged for stereotypic attitudes. Higher educational aspirations among hearing adolescents, especially hearing males, correlated with a higher EOC of deaf adults. No such associations emerged for D/HH participants. No gender effects emerged. Implications of these outcomes for career development, especially for females, were discussed.

Adolescent↗
PubMed1977

The effects of a cultural awareness program on the delivery of health care.

Provision of health care is frequently ineffective because providers of service do not understand the culture of the ethnic groups they are treating. The aim of the program described in this article was to break down cultural and communication barriers by teaching health care personnel about the attitudes, beliefs, and behaviors of various ethnic groups.

Attitude to Death↗
PubMed2000

Sociodemographic factors and the assignment of do-not-resuscitate orders in patients with acute myocardial infarctions.

OBJECTIVES: This study examined the impact of sociodemographic and clinical factors, measured at the individual or ecological (zip code) level, on the assignment of do-not-resuscitate (DNR) orders. DESIGN: This was a retrospective study (analysis of secondary data). SUBJECTS: We used a probability sample of 974 patients admitted to 30 medium to large California hospitals with acute myocardial infarctions in 1990 to 1991; the sample was originally designed to validate risk adjustment with administrative data. METHODS: Multivariate logistic regression was used to adjust DNR assignment for age, gender, race, probability of death, functional impairments, payment source, hospital teaching status, and ecological measures of educational attainment, home ownership, and income. RESULTS: DNR assignment was inversely associated with black race and positively associated with age, probability of death, cognitive impairment, and poor nutritional status. When the probability of death was very low, DNR orders were assigned less frequently to men than to women (odds ratio [OR], 0.4; 95% confidence interval [CI], 0.2 to 0.7 at probability of death = 0.10). However, men were significantly more likely to receive a DNR order than women when the probability of death was very high (OR, 4.4; 95% CI, 1.2 to 16.3 at probability of death = 0.90). CONCLUSIONS: Older, white, sicker, or functionally impaired patients receive DNR orders more often than younger, black, healthier, or functionally intact patients do. Adjusting for these factors, DNR assignment is associated with gender through an interaction involving the probability of death. Future studies should reexamine the impact of these factors on DNR assignment and explore the role of patient values and patient-physician communication barriers.

Activities of Daily Living↗
PubMed2001

Differences in the kinds of problems consumers report in staff/group health maintenance organizations, independent practice association/network health maintenance organizations, and preferred provider organizations in California.

BACKGROUND: Little is known about the extent to which consumers have specific problems with their managed care organizations (MCOs) or whether these problems differ by type of MCO. OBJECTIVE: To estimate the prevalence at which consumers in managed care report specific problems and to assess whether rates in preferred provider organizations (PPOs), independent practice association (IPA)/network health maintenance organizations (HMOs), and staff/group HMOs differ. DESIGN: Random probability sample of insured adults weighted to reflect the underlying population in California. A computer-assisted telephone interview survey was conducted in September 1997. Logistic regression models estimate the adjusted odds of reporting each problem in the last year in IPA/network HMOs versus PPOs, IPA/network HMOs versus staff/group HMOs, and staff/group HMOs versus PPOs. SUBJECTS: One thousand two hundred one insured adults who had resided in California for > or = 12 months. MEASURES: Prevalence of 11 consumer problems in MCOs. RESULTS: Forty-two percent of adult Californians in managed care in our sample reported > or = 1 problem with their MCO in the last year. Adjusted odds that adults in IPA/ network or staff/group HMOs reported delays in getting needed care, not receiving the most appropriate or needed care, and being forced to change doctors were higher than for adults in PPOs. Adjusted odds that adults in IPA/network HMOs reported difficulty getting a referral to a specialist and difficulty selecting a doctor or hospital were higher than for adults in PPOs and staff/group HMOs. Adjusted odds that adults in staff/ group HMOs reported misunderstandings over benefits and coverage; important benefits not covered; and problems with claims, billing, or payments were lower than for adults in PPOs and IPA/network HMOs. Adjusted odds that consumers in HMOs in our sample reported any problem with their health plan was higher for those in IPA/network HMOs compared with staff/group HMOs. No differences were seen by MCO type in the rates at which consumers reported being denied care or treatment, forced to change medications, or language and communication barriers. CONCLUSIONS: Rates at which consumers report problems with managed care and the kinds of problems they report differ significantly across different types of MCOs. These findings have important implications for federal and state policy for consumer protections in managed care.

Adult↗