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Results for “Communication Barriers”

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PubMed2002

Hmong immigrants' views on the education of their deaf and hard of hearing children.

The study investigated the attitudes, perceptions, and feelings of parents of 7 Hmong families that included a deaf or hard of hearing child attending a U.S. public school. The findings indicate that many Hmong parents value education and want to be involved in their deaf or hard of hearing child's learning. However, the parents in the study did not know how to become involved, and needed the support of the school. Although they accepted their deaf or hard of hearing children unconditionally, they had lower academic expectations of that child than of their hearing children. Most of the parents reported limited knowledge of the policies, procedures, practices, and organizational structures of special education, and all cited communication barriers as impediments to involvement in their child's education. Most of the parents expressed strong satisfaction with their child's educational program. The findings suggest several areas for further research.

Child↗
PubMed2002

Providing accessible services to minority ethnic deaf people: insights from a study in Alberta, Canada.

Evidence suggests that minority ethnic people in general and minority ethnic deaf people (MEDP) in particular face numerous formidable obstacles in their attempts to gain access to services in the community. Deaf people from minority ethnic groups who have no English and/or American Sign Language (ASL) skills have particular difficulty gaining access to services. The study therefore was concerned with identifying some of the special needs and difficulties of MEDP who are trying to gain access to services in multiethnic communities. Qualitative approaches were used in data gathering and analysis. The results indicated six areas of difficulty for MEDP in gaining access to services: (a) communication barriers, (b) a lack of recognition of the needs of MEDP, (c) inappropriate service delivery and a lack of information on available services, (d) insufficient cultural sensitivity on the part of service providers, (e) issues of user involvement, and (f) a lack of specific programs for MEDP.

Canada↗
PubMed2006

Software design to facilitate information transfer at hospital discharge.

Discharge communication between inpatient and outpatient physicians is often an inefficient and error-prone process. Adverse events result from poor communication at the time of discharge. The objective of this study was to describe development of discharge software to overcome communication barriers. The secondary objective was to assess factors that influence the time to complete tasks with the software. Methods were a performance improvement model and database analysis of 336 discharges. Software design specifications included computerised physician order entry, immediate utility, minimal development and deployment costs, acceptability to physician-users, and satisfaction of primary care physicians, patients and pharmacists. Design features included simple 'just-in-time' prompts and point-of-care prescribing resources. The dependent variable for analysis was physician time to complete discharge prescriptions and instructions while using the software. General linear and mixed-effects regression models adjusted for physician effects and other predictors. Results revealed that physician factors significantly affected the time to complete a discharge while using the software. As the number of accesses (log-ins) and free text typing increased, then time to complete the computerised discharge increased. Patient-related factors that increased physician time were discharge diagnoses, prescriptions and length of stay. In conclusion, discharge software can help inpatient physicians transfer timely, complete and legible information to outpatient physicians, pharmacists and patients. Physician and patient factors influence the time to complete discharges using the software.

Adolescent↗
PubMed2002

The language of schizophrenia and the world of delusion.

The bizarre language of schizophrenics is nowadays generally believed to be the meaningless breakdown product of a neurobiological disorder. The psychological significance of hallucinations and delusions also remains mysterious. Verbatim vignettes are presented from an advanced stage of a psychoanalytically informed treatment to illustrate that schizophrenics speak a meaningful language that is syntactically and morphologically similar to ordinary language, but is qualitatively different in terms of semantics and pragmatics. From a semantic perspective the ordinary distinctions between words, things, body states and actions are absent, creating words and sentences that are not representational or symbolic. It is a language of equivalence, immediacy and action as contrasted with a language of self-awareness, thoughtfulness, reflection and communication. From a pragmatic standpoint, because the language of schizophrenia makes no distinction between mind and world, it enables and supports delusional thinking. In order for the psychoanalyst to comprehend what the patient means, and couch interpretations in such a way as to convey the meaning he/she intends, analyst and patient must become aware of their inability to comprehend one another's languages and find a way to bridge the communication barrier.

Adult↗
PubMed2002

THE LANGUAGE OF SCHIZOPHRENIA AND THE WORLD OF DELUSION.

The bizarre language of schizophrenics is nowadays generally believed to be the meaningless breakdown product of a neurobiological disorder. The psychological significance of hallucinations and delusions also remains mysterious. Verbatim vignettes are presented from an advanced stage of a psychoanalytically informed treatment to illustrate that schizophrenics speak a meaningful language that is syntactically and morphologically similar to ordinary language, but is qualitatively different in terms of semantics and pragmatics. From a semantic perspective the ordinary distinctions between words, things, body states and actions are absent, creating words and sentences that are not representational or symbolic. It is a language of equivalence, immediacy and action as contrasted with a language of self-awareness, thoughtfulness, reflection and communication. From a pragmatic standpoint, because the language of schizophrenia makes no distinction between mind and world, it enables and supports delusional thinking. In order for the psychoanalyst to comprehend what the patient means, and couch interpretations in such a way as to convey the meaning he/she intends, analyst and patient must become aware of their inability to comprehend one another's languages and find a way to bridge the communication barrier.

Journal Article↗
PubMed2004

Gender differences in condom-related behaviors and attitudes among Mexican adolescents living on the U.S.-Mexico border.

Adolescents are at increasing risk for HIV infection in Mexico. Research on gender differences in risk behaviors and determinants is needed to develop effective HIV prevention interventions targeting Mexican adolescents. This study examined gender differences in the likelihood of unprotected sex and theoretical correlates among high school students in the border city of Tijuana. Three hundred seventy high-school students completed a face-to-face interview and a self-administered survey. Differences in sexual initiation, condom use, intentions to use condoms in the future, and attitudes towards condoms in this population were assessed. Although male students initiated sexual practices earlier than females, females were more likely to have unprotected sex. Females perceived themselves as more likely to avoid unprotected sex in the future and held more favorable attitudes about condoms. The results suggest that stereotypical gender roles and communication barriers place Tijuana female high school students at higher risk for HIV infection than their male peers.

Adolescent↗
PubMedDate not supplied

[Cultural dimensions of the childhood primary health care delivery from the mothers' perceptions in the Araucania-Chile].

OBJECTIVE: To explore the cultural dimensions of the childhood primary health care delivery process from the mothers' perceptions in the Araucania region of Chile. MATERIAL AND METHODS: Qualitative study performed in the year 2003 within the zone with the highest ethnicity rate of the country. Ninety four Mapuche and non-Mapuche mothers agreed to be in depth interviewed. RESULTS: The analysis drew three cultural dimensions: a) Explanatory models of disease were associated with cultural, political-economy, and environmental factors; b) The therapeutic itinerary blends indigenous, popular, and biomedical resources and; c) Health care delivery process lacks of cultural competence. CONCLUSIONS: The mothers explain their children diseases articulating religious, magic, and natural (hot, cold, humidity) causes. The main challenge of the primary healthcare delivery process is to overcome the communicational barriers due to the social and linguistic differences between mothers and health care providers.

Child↗
PubMed2005

An Internet-based patient-provider communication system: randomized controlled trial.

BACKGROUND: Internet-based interactive websites for patient communication (patient portals) may improve communication between patients and their clinics and physicians. OBJECTIVE: The aim of the study was to assess the impact of a patient portal on patients' satisfaction with access to their clinic and clinical care. Another aim was to analyze the content and volume of email messages and telephone calls from patients to their clinic. METHODS: This was a randomized controlled trial with 606 patients from an academic internal medicine practice. The intervention "portal" group used a patient portal to send secure messages directly to their physicians and to request appointments, prescription refills, and referrals. The control group received usual care. We assessed patient satisfaction at the end of the 6-month trial period and compared the content of telephone and portal communications. RESULTS: Portal group patients reported improved communication with the clinic (portal: 77/174 [44%] "a little better" or "a lot better;" control: 18/146 [12%]; chi2 = 38.8, df = 1, P < .001) and higher satisfaction with overall care (portal: 103/174 [59%] "very good" or "excellent;" control: 78/162 [48%]; chi2 = 4.1, df = 1, P = .04). Portal group patients also reported higher satisfaction with each of the portal's services. Physicians received 1 portal message per day for every 250 portal patients. Total telephone call volume was not affected. Patients were more likely to send informational and psychosocial messages by portal than by phone. Of all surveyed patients, 162/341 (48%) were willing to pay for online correspondence with their physician. Of those willing to pay, the median amount cited was 2 USD per message. CONCLUSIONS: Portal group patients demonstrated increased satisfaction with communication and overall care. Patients in the portal group particularly valued the portal's convenience, reduced communication barriers, and direct physician responses. More online messages from patients contained informational and psychosocial content compared to telephone calls, which may enhance the patient-physician relationship.

Colorado↗
PubMed1996

Communication difficulties of nursing home residents. How can staff help?

Recent studies have found a high prevalence of communication disorders in elderly residents of nursing homes. This study was undertaken to investigate staff attitudes to the communication problems and communicative needs of residents in their care. A questionnaire was administered to 32 staff members from one nursing home. Responses indicate little evidence of the negative staff attitudes previously reported in the literature. Staff wanted more time to spend communicating with residents and wanted to learn more about the residents' communication problems. Implications of the questionnaire responses for staff training are presented.

Aged↗
PubMed1997

Provider network replaces 'old way' of managed care.

The provider-sponsored Yellowstone Community Health Plan in Billings, MT, has discovered success by breaking many of the traditional rules in setting up a capitated insurance product. Key is to hold all parties accountable and to dissolve historic communication barriers.

Community Networks↗
PubMedDate not supplied

Chinese CLS sister school relationship.

OBJECTIVE: Establish a relationship with a Chinese CLS Program to foster cross-cultural diversity, provide for student and faculty cross-cultural exchange, scholarship, research, and improve the health care of both communities served by the colleges. DESIGN: Information needed to develop agreement strategy was gathered by literature review, personal interviews, and direct observation in China. Based upon literature review an original list of items for discussion was developed. Discussions were held between administrators of both schools and the teaching hospital. The Chief Laboratory Technologist of the associated Chinese teaching hospital was interviewed to establish the extent of CLS students' experiences. A form for the interview was developed and the results were used during the negotiation of the final agreement. SETTING/PARTICIPANTS: A CLS faculty team member from the U.S. traveled to the Jingmen School of Nursing and Allied Medical Sciences, Jingmen City, China, Hubei Province, P.R. China to establish an agreement. Tours of six cities in China, the School, and Jingmen hospitals provided for a better understanding of the Chinese culture and the Chinese CLS program. RESULTS/CONCLUSION: Three major concerns for success of the relationship (language barriers, communication vehicles, and socialization issues) were determined and addressed in a final agreement. The components of the agreement may provide some insight for others considering such a collaborative venture. Outcomes will be more fully addressed when exchanges begin.

China↗
PubMed2002

Supporting South Asian carers and those they care for: the role of the primary health care team.

BACKGROUND: Demographic and socioeconomic changes have increased policy interest in informal carers. However, despite the multicultural nature of British society, most research in this field has been in majority communities. AIM: To explore the role of the primary health care team (PHCT) in supporting carers from British South Asian communities. DESIGN OF STUDY: Qualitative study. SETTING: Four South Asian communities in Leicestershire and West Yorkshire. METHODS: Focus groups and in-depth interviews were used to assess male and female carers, supported by a literature review. RESULTS: Failure to recognise carers' needs, gaps in service provision, and communication and language issues compromised carers' ability to care. While some carers were positive about the PHCT role, the main weaknesses concerned poor consultation, PHCT attitudes towards carers, and access to appropriate services. CONCLUSION: South Asian carers' experiences largely parallel those of others, but there are some issues that are distinct, namely, language and communication barriers, culturally inappropriate services, and implicit or explicit racism. The multi-ethnic nature of Great Britain requires that professional practice enhances the ability of minority ethnic communities to provide informal care. The findings underline the important role of the PHCT in ensuring that carers' needs are taken seriously and that appropriate services reach them.

Asia↗
PubMed2003

Pain assessment and management in the critically ill: wizardry or science?

Assessment and management of patients' pain across practice settings have recently received the increased attention of providers, patients, patients' families, and regulatory agencies. Scientific advances in understanding pain mechanisms, multidimensional methods of pain assessment, and analgesic pharmacology have aided in the improvement of pain management practices. However, pain assessment and management for critical care patients, especially those with communication barriers, continue to present challenges to clinicians and researchers. The state of nursing science of pain in critically ill patients, including development and testing of pain assessment methods and clinical trials of pharmacological interventions, is described. Special emphasis is placed on results from the Thunder Project II, a major multisite investigation of procedural pain.

Critical Care↗
PubMed2003

Refugee health and medical student training.

BACKGROUND AND OBJECTIVES: Cultural awareness training is an increasingly important priority within medical curricula. This article describes an academic family practice-community partnership focusing on health care needs of refugees that became the model for a medical school selective on cultural sensitivity training. METHODS: The monthly Refugee Health Night program featured dinner with preceptors and patients, international sessions on special medical needs of refugees, and actual clinical encounters with patients. Students were not expected to become culturally competent experts but, rather, health care providers sensitive to and appreciative of cultural context, experience, and expectations. We worked with students to develop sensitive methods of inquiry about mental health, especially around issues of war and torture. We used problem-based cases to emphasize primary care continuity and the benefit of establishing trust over time. RESULTS: Over 2 years, 50 students and nearly 300 refugees (more than 73 families) participated. Students reported that their interactions with the refugees provided positive learning experiences, including expanded knowledge of diverse cultures and enhanced skills for overcoming communication barriers. Patients of refugee status were able to have emergent health care needs met in a timely fashion. CONCLUSIONS: Providing health care for refugee individuals and families presents many challenges as well as extraordinary opportunities for patients and practitioners to learn from one another.

Culture↗