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Results for “Communication Barriers”

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PubMed2004

A survey of kidney disease and risk-factor information on the World Wide Web.

BACKGROUND: Chronic kidney disease (CKD) is epidemic, and informing those at risk is a national health priority. However, the discrepancy between the readability of health information and the literacy skills of those it targets is a recognized barrier to communicating health information that may promote good health outcomes. Because the World Wide Web has become one of the most important sources of health information, we sought to assess the readability of commonly available CKD information. METHODS: Twelve highly cited English-language, kidney disease Web sites were identified with 4 popular search engines. Each Web site was reviewed for the availability of 6 domains of information germane to CKD and risk-factor information. We estimated readability scores with the Flesch-Kincaid and Flesch Reading Ease Index methods. The deviation of readability scores for CKD information from readability appropriate to average literacy skills and the limited literacy skills of vulnerable populations (low socioeconomic status, health disparities, and elderly) were calculated. RESULTS: Eleven Web sites met the inclusion criteria. Six of 11 sites provided information on all 6 domains of CKD and risk-factor information. Mean readability scores for all 6 domains of CKD information exceeded national average literacy skills and far exceeded the fifth-grade-level readability desired for informing vulnerable populations. Information about CKD and diabetes consistently had higher readability scores. CONCLUSION: Information on the World Wide Web about CKD and its risk factors may not be readable for comprehension by the general public, especially by underserved minority populations with limited literacy skills. Barriers to health communication may be important contributors to the rising CKD epidemic and disparities in CKD health status experienced by minority populations.

Chronic Disease↗
PubMed2005

General practitioners (GPs) and palliative care: perceived tasks and barriers in daily practice.

BACKGROUND: General practitioners (GPs) play a crucial part in palliative care. The quality of care can be improved by investigating and addressing barriers perceived by GPs in daily practice. The aim of this study was to investigate GPs' task perception and barriers involved in palliative care. METHODS: Qualitative focus group study. We gathered together a group of GPs representing a broad range of experience in palliative care. Content analysis was performed to derive a comprehensive view of tasks and barriers in daily palliative care. RESULTS: GPs described their palliative care tasks as satisfactory and varied, but burdensome. Palliative care tasks included somatic and psychosocial care. Opinions differed with respect to whether the coordination of care belonged to the primary GP tasks. Barriers were classified according to three levels: (1) personal: barriers related to knowledge, skills, emotions; (2) relational: barriers concerning communication and collaboration; (3) organizational: barriers related to the organization of care and compartmentalization in healthcare. CONCLUSIONS: This study revealed a complex web of tasks and barriers. It may be possible to trace back a problem (lack of knowledge, for example) on the personal level to an isolated knowledge gap, but the problem may well have originated from communication or compartmentalization problems. To maintain GPs' feeling of being at ease with palliative care requires helping them acquire the appropriate balance between technical and organizational interventions and a compassionate orientation to their terminally ill patients.

Adult↗
PubMedDate not supplied

Family communication about positive BRCA1 and BRCA2 genetic test results.

PURPOSE: The identification of a BRCA1 or BRCA2 genetic mutation can provide important health information to individuals who receive this result, but it can also provide crucial cancer risk information to family members. Most of the research on communication of genetic test results has focused on first degree relatives. The purpose of this retrospective study was to examine the process of communicating a positive BRCA1 or BRCA2 genetic test result to male and female first, second, and third degree relatives. METHODS: Participants were 38 female mutation carriers who responded to a written survey assessing the number and relationship of relatives informed, methods used to inform relatives, topics discussed, and motivations and barriers for communication. RESULTS: Overall, 59% (470/803) of first, second, and third degree relatives were informed. The proportion of informed parents, siblings, and offspring was nearly twice that of more distant relatives including nieces, nephews, aunts, uncles, grandchildren, and cousins (88% versus 45%; P = 0.02). The method of communication differed by the gender of the relative, as did some of the topics discussed. The most important reasons for discussing the genetic test results were (1) to inform the relatives of their risk, (2) to suggest that they be tested, and (3) to fulfill a perceived duty to inform. The major barrier to communication was little contact and/or emotionally distant relationships. CONCLUSION: Female mutation carriers act on a perceived duty to inform close relatives of their positive test result; however, there is a need for genetic counseling strategies that address communication with more distant relatives.

Communication↗
PubMed2005

A descriptive study of barriers to enrollment in a collegiate Health Assessment Program.

This study identifies barriers to participation in a Health Assessment Program. Forty-seven students at an urban college were surveyed. The students were eligible for a Health Assessment Program, but chose not to participate in it. Students identified barriers to their involvement. They also identified what would be necessary for them to begin participation in the program. Barriers were examined in light of Rosenstock's Health Belief Model. Major barriers cited included time constraints, communication issues, fear, and not perceiving a need for participation.

Adolescent↗
PubMed1999

Asian-Islamic women and breast cancer screening: a socio-cultural analysis.

This article explores religious and socio-cultural issues relevant to breast cancer screening practices among older immigrant Asian-Islamic women in the U.S. Some of the Islamic tenets that facilitate breast cancer screening include cleanliness, prevention and individual responsibility in health promotion, diet and eating habits, and exercise, and those that hinder screening practice include gender and modesty considerations and patriarchal marital beliefs. Socio-cultural barriers include patient-physician communication and beliefs about cancer and cancer prevention. Recommendations to increase knowledge and practice of breast cancer screening within a religious and socio-cultural context are provided.

Adult↗
PubMed1994

Health care professionals' characterizations of the system of care for long-term ventilator-dependent patients: a preliminary study.

The purpose of this study was to characterize, from multiple professional perspectives, current management approaches and systems of care for long-term ventilator-dependent patients. This study was preliminary in nature and served to generate questions to be explored with subsequent research. A focus group methodology was used. Three focus sessions were held, with participants representing nursing, social services, and respiratory therapy. Field notes were recorded by two independent observers. The primary themes arising from the narrative data were: (i) caregiver impact, (ii) system barriers to appropriate care, (iii) communication difficulties among professionals and between patients and professionals, (iv) ethical concerns, and (v) patient characteristics that influence medical management and patient outcomes. Implications include the need for systematic research regarding caregiver impact, ethical practice of health care professionals, and the epidemiology of ventilator dependency, as well as evaluative studies of different system approaches to caring for these patients.

Attitude of Health Personnel↗
PubMed2002

Lessons from east Arnhem land. Improving adherence to chronic disease treatments.

BACKGROUND: It is generally accepted that adherence or compliance to medical therapy can be poor in indigenous Australian communities. OBJECTIVE: This paper describes approaches and techniques to improve adherence that have been gleaned from four and a half years of clinical experience in the remote district of East Arnhem Land. DISCUSSION: First, the importance of gaining trust and credibility with a community is discussed. Approaches to gain that trust are then described. It is critical to overcome the considerable language and world view barriers that exist to good communication. The use of anatomical models and high quality illustrations combined with the development of 'key language concept' in the indigenous language have achieved some success in this area.

Australia↗
PubMedDate not supplied

Communication between physicians and cancer patients about complementary and alternative medicine: exploring patients' perspectives.

The aim of this paper is to identify barriers to communication between physicians and cancer patients regarding complementary and alternative medicine (CAM) by exploring the perspectives of patients. In face of the recent popularity of CAM use among cancer patients, the lack of communication is a serious problem. A number of CAM therapies may interfere with conventional treatments and thus impact patients' well-being and chances of survival. In addition, lack of communication is problematic in the health care context because the development of openness and trust between health care providers and clients is contingent upon effective interpersonal communication. We conducted semi-structured interviews with 143 cancer patients to explore their experiences with CAM use. Using a qualitative research method, we examined interview data from 93 CAM users who provided sufficient information about communication issues. As a result, three themes emerged describing barriers to unsuccessful communication as perceived from the patient's point of view: physicians' indifference or opposition toward CAM use, physicians' emphasis on scientific evidence, and patients' anticipation of a negative response from their physician. Increasing education about CAM and regular assessment of CAM use may help physicians to be more aware of their patients' CAM use. As a result, physicians may provide patients with information on risks and benefits of CAM use and refer patients to other services that may address unmet needs. Given a difference in epistemiologic beliefs about cancer and its treatment, the challenge is to find a common ground for an open discussion in which physicians consider that scientific evidence is not all that counts in the life of an individual facing a serious disease.

Adult↗
PubMedDate not supplied

Health literacy and cancer communication.

Health literacy is increasingly recognized as a critical factor affecting communication across the continuum of cancer care. We reviewed research on health literacy and examined its impact on cancer outcomes and communication. According to the National Adult Literacy Survey (NALS), considered the most accurate portrait of literacy in our society, about one in five American adults may lack the necessary literacy skills to function adequately in our society. As patients, such individuals are at a disadvantage in their capacity to obtain, process, and understand cancer information and services needed to make appropriate health care decisions. Patients with poor health literacy have a complex array of difficulties with written and oral communication that may limit their understanding of cancer screening and of symptoms of cancer, adversely affecting their stage at diagnosis. In addition, these barriers impair communication and discussion about risks and benefits of treatment options, and patient understanding of informed consent for routine procedures and clinical trials. More research is needed to identify successful methods for educating and communicating with patients who have limited health literacy. Based on our own experience, we offer practical communication aids that can help bridge the cancer communication gap.

Communication Barriers↗
PubMed2004

Practitioners' impressions of patients with Parkinson's disease: the social ecology of the expressive mask.

The expressive mask of Parkinson's disease, a reduced spontaneity, intensity, and fluidity of facial, bodily, and vocal expression, jeopardizes interpersonal interaction and quality of life. Observers have difficulty perceiving the "real" person behind the mask, leading to failed communication and misunderstanding. A social ecological explanation of this difficulty is that observers have learned in their daily social lives, and quite appropriately so, that expressive behavior reveals meaningful information about character. The premise of this study was that health practitioners, especially novices, would bring into the clinic their everyday perceptual tendencies related to deciphering character. The study examined novice and expert practitioners' impressions of the personality of patients with Parkinson's disease who were videotaped during a healthcare interview. It was found that practitioners, especially novices, appeared to be overly sensitive to expressive masking when forming impressions about patient extraversion. They incorrectly perceived patients with more masking to be less extraverted than patients with less masking. Novice practitioners were particularly inaccurate in their impressions of neuroticism compared to experts. Novices incorrectly perceived patients with more masking as being more neurotic, whereas experts tended to be sensitive to valid cues of neuroticism. Practitioners' impressions of patient conscientiousness were not sensitive to masking and were highly accurate.

Attitude of Health Personnel↗