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Communication perceptions of older adults with sensory loss and their communication partners: implications for intervention.

INTRODUCTION: Vision and hearing loss are prevalent disorders in older adults although their effects on communication are not well documented. METHOD: The purpose of this study was to investigate the perceptions of older adults with sensory loss and their communication partners with regard to their communication, situational difficulties and conversational needs. RESULTS: Questionnaire results revealed that the sensory loss group experienced a range of functional vision and hearing difficulties. Over two-thirds of subjects reported frequent conversational difficulty, particularly in background noise and group conversations. Most subjects used clarification requests (mainly non-specific clarification and repetition requests) to overcome misunderstandings. By contrast, the communication partners reported few communication difficulties and claimed that they proactively eliminated or controlled environmental, speaker and listener variables to optimize conversation. The most frequently reported strategy was repetition. CONCLUSION: The findings suggest that older adults with sensory loss experience communication disruptions, which in many instances are not resolved. To optimize communication efficacy in this population, a communication training programme for people with sensory loss and their communication partners is highly recommended.

Adaptation, Psychological↗

[A study of family communication space (Part I)--A preliminary study on how family communication is actually practiced].

Housing science needs to concern itself with how to improve space for family communication because it plays an important role in human dwelling life. The purpose of this report (Parts I, II & III) is, hence, to elucidate various factors conditioning family communication, and spatial traits of the rooms where it is conducted, based on the survey of the households of students at women's junior colleges. Part I delves into what is specifically communicated within a family and how it is related with other living activities, by grasping how communication is practiced in everyday family life. A basic analysis is made as to how conscious a family members are of their mutual communication, and how rooms are used for it. It has become clear that family communication is closely related with meal-taking both behaviorally and spatially, and that different attitudes among a family members toward family communication cause different modes, and evaluations of it. It has proved to be necessary, for the further studies of family communication, to give an analytical perspective to an in-depth examination of how rooms in the target families are used and how every member views and evaluates their family communication.

Communication↗

Development of a communication aid to facilitate risk communication in consultations with unaffected women from high risk breast cancer families: a pilot study.

UNLABELLED: The literature on risk perception in women from high-risk breast cancer families reveals persistent over-estimation of risk, even after counseling. In this study, a communication aid was designed to facilitate discussion of risk between clinical geneticists and genetic counselors and women from this high-risk population. METHOD: Stage 1. The aid was developed by an expert panel of clinical geneticists, genetic counselors, psychologists, an epidemiologist, an oncologist, linguists and a consumer. It was guided by the international literature on risk communication and a large multi-centre Australian study of risk communication. The 13 page full-color communication aid used varying formats of words, numbers, graphs and pie-charts to address (a) the woman's subjective risk; (b) the population risk of breast cancer; c) the risk of inherited breast cancer; (d) the cumulative risk for women with BRCA1 and BRCA2 mutations; (e) family risk factors; (f) the woman's suitability for genetic testing; (h) screening and management recommendations, and (i) a re-assessment of the woman's subjective risk. Stage 2: A before-after pilot study of 38 women who were unaffected with breast cancer and were attending four Australian familial cancer clinics was undertaken. Baseline and follow-up questionnaires were completed by 27 women. Outcomes were compared to those observed in 107 similar women undergoing genetic counseling without the communication aid in 2001. RESULTS: The risk communication aid appears to be beneficial; breast cancer genetics knowledge improved in some areas and importantly, risk perceptions improved in the cohort receiving the communication aid. Psychological measures showed no difference in anxiety or depression between the group receiving the communication aid and the comparison cohort. Women and clinicians were very positive about the usefulness of the communication aid as an adjunct to the genetic counseling consultation.

Australia↗

Fax/modem board communications decrease preceptor communication costs.

BACKGROUND: Mail and the telephone are common communication links between departments of family medicine and their community-based preceptors. The availability of low-cost fax/modem boards offers the potential for new communication methods. This study compares the cost of personal computer-based fax/modem board communications with traditional mail and telephone linkages. METHODS: The department's community preceptor faculty served as the study population. Sixty-eight physicians (54%) had fax machines; these physicians received faxes instead of mailed communications. The remaining 59 physicians (46%) received mailed communications. All preceptors received standard telephone calls. Costs for telephone, mail, and fax/modem board communications were tracked over a 4-month period. RESULTS: Faxes were significantly less expensive and more efficient than either telephone or mail communications. Telephone communications were the most expensive. CONCLUSIONS: The study suggests that fax/modem boards offer a communication linkage with preceptors that is more economical than either mail or telephone.

Cost-Benefit Analysis↗

Verbal communication, nonverbal communication, and private speech in lower and middle socioeconomic status preschool children.

Three types of communication--verbal, nonverbal, and private speech--were investigated in 4- and 5-year-old children. Multiple analyses of variance (MANOVAs) without IQ controlled and multiple analyses of covariance (MANCOVAs) with IQ as a covariate were computed and followed by ANOVAs and ANCOVAs to determine the effects of sex, age, and socioeconomic status (SES) on each of these types of communication. The ANOVAs and the ANCOVAs yielded the same conclusions. Results indicated that age and SES, but not sex, influence the use of the three communication types. From age 4 to age 5, private speech decreased for middle SES children and remained the same for lower SES children. Although lower SES children had more nonverbal communication at both age levels than middle SES children, nonverbal communication decreased for middle SES children and increased for lower SES children between the ages of 4 and 5 years. Both lower and middle SES groups increased in verbal communication between the two ages. The middle SES 4-year-olds used more verbal communication than their lower SES counterparts, and the difference was maintained at age 5. Although IQ is related to verbal communication, statistically controlling for the effects of IQ did not change the conclusions.

Black or African American↗

The development of an automated method for analyzing communication rate in augmentative and alternative communication.

A significant barrier to evidence-based practice in Augmentative and Alternative Communication (AAC) is the lack of validated performance measures that can be used by speech-language pathologists and rehabilitation engineers to evaluate the communication and device use of AAC consumers. Recently an effort has been made to develop automated data-logging techniques to facilitate the transcription and analysis of the AAC speaker's device use. A major source of error for the automated measurement of communication rate is the presence of excessive Inter-Selection Intervals (ISIs) (i.e., pause times), for which no communicative activity is occurring. The goal of this study was to develop an automated technique to filter out extreme ISIs, while preserving true communication rate performance. AAC data log files were obtained from seven individuals participating in a 1-month field trial of an AAC technology. Two temporal filtering techniques (arbitrary and individual) were compared for their ability to eliminate excessive ISIs. Results indicated that use of an individualized temporal filter was more sensitive to performance variability than use of an arbitrary temporal filter. Further, the individualized temporal filter elevated the participants' communication rate (measured by words per minute) by a factor of 1.8 to 34.5 greater than that of the unfiltered communication rate estimate. In addition, the first AAC communication rate performance estimates taken from the field are presented. Implications for further research and the valid use of automated data logging and analysis are discussed.

Activities of Daily Living↗

Teaching communication in clinical clerkships: models from the macy initiative in health communications.

Medical educators have a responsibility to teach students to communicate effectively, yet ways to accomplish this are not well-defined. Sixty-five percent of medical schools teach communication skills, usually in the preclinical years; however, communication skills learned in the preclinical years may decline by graduation. To address these problems the New York University School of Medicine, Case Western Reserve University School of Medicine, and the University of Massachusetts Medical School collaborated to develop, establish, and evaluate a comprehensive communication skills curriculum. This work was funded by the Josiah P. Macy, Jr. Foundation and is therefore referred to as the Macy Initiative in Health Communication. The three schools use a variety of methods to teach third-year students in each school a set of effective clinical communication skills. In a controlled trial this cross-institutional curriculum project proved effective in improving communication skills of third-year students as measured by a comprehensive, multistation, objective structured clinical examination. In this paper the authors describe the development of this unique, collaborative initiative. Grounded in a three-school consensus on the core skills and critical components of a communication skills curriculum, this article illustrates how each school tailored the curriculum to its own needs. In addition, the authors discuss the lessons learned from conducting this collaborative project, which may provide guidance to others seeking to establish effective cross-disciplinary skills curricula.

Clinical Clerkship↗