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PubMed2005

Communication and coping as predictors of fertility problem stress: cohort study of 816 participants who did not achieve a delivery after 12 months of fertility treatment.

BACKGROUND: We investigated coping strategies and communication strategies as predictors of fertility problem stress 12 months after start of fertility treatment. METHODS: We used a prospective, longitudinal cohort design including 2250 people beginning fertility treatment with a 12-month follow-up. Data were based on self-administered questionnaires measuring communication with partner and with other people, coping strategies: active-avoidance coping, active-confronting coping, passive-avoidance coping, meaning-based coping, and fertility problem stress. The study population included those participants (n = 816, men and women) who had not achieved pregnancy by assisted reproduction or delivery at follow-up. RESULTS: Among both men and women, difficulties in partner communication predicted high fertility problem stress (odds ratio for women, 3.47, 95% confidence interval 2.09-5.76; odds ratio for men, 3.69, 95% confidence interval 2.09-6.43). Active-avoidance coping (e.g. avoiding being with pregnant women or children, turning to work to take their mind off things) was a significant predictor of high fertility problem stress. Among men, high use of active-confronting coping (e.g. letting feelings out, asking other people for advice, seeking social support) predicted low fertility problem stress in the marital domain (odds ratio 0.53, 95% confidence interval 0.28-1.00). Among women, medium or high use of meaning-based coping significantly predicted low fertility problem stress in the personal and marital domain. CONCLUSION: The study provides information about where to intervene with fertility patients in order to reduce their stress after medically unsuccessful treatment.

Adaptation, Psychological↗
PubMed2004

Self-concept and adolescents' refusal of unprotected sex: a test of mediating mechanisms among African American girls.

During adolescence, girls form self-concepts that facilitate the transition to adulthood. This process may entail engaging in risky sexual behaviors resulting in STD infection and pregnancy. This study assessed the relation between self-concept and unwanted, unprotected sex refusal among 335 African American adolescent girls. The second aim was to determine whether attributes of partner communication about sex would act as a mediating mechanism on this hypothesized relationship. These assessments were made within the context of several theoretical models (social cognitive theory and theory of gender and power). Self-concept was composed of self-esteem, ethnic identity, and body image, whereas attributes of partner communication about sex was conceptualized as frequency of communication, fear of condom use negotiation, and self-efficacy of condom use negotiation. Structural equation modeling was used to analyze data. The results showed that self-concept was associated with partner communication attributes about sex, which in turn, was associated with frequency of unprotected sex refusal. The hypothesized mediating role of partner communication was also supported. STD-HIV preventive interventions for this population may be more effective if they target self-concept as opposed to only self-esteem, incorporate an Afrocentric approach, and focus on enhancing several attributes of partner communication about sex.

Adolescent↗
PubMed2001

The effects on significant others of providing a hearing aid to the hearing-impaired partner.

Communication is a shared experience which can be substantially affected by hearing impairment. Significant others may experience difficulties not only in direct communication but also in personal and social relationships. The present study was designed to investigate the impact on significant others of hearing loss in a partner and the benefits that accrued from the provision of personal amplification. The results suggested that before the provision of a hearing aid significant others experienced difficulties with person-to-person conversation, with group conversation and in viewing (listening to) television of the same order as did the hearing impaired individual. After appropriate intervention the difficulties were greatly reduced with resultant improvement in quality of life for both parties.

Affect↗
PubMed1995

Agencies & vendors. Friends, foes, or partners?

Communication is the key to making vendor-agency relationships work. This communication needs to start from the very beginning, with planning, and continue through installation, training, and support. With good communication, the change brought on by automation will be positive.

Ambulatory Care Information Systems↗
PubMed1985

Communication augmentation systems: quantification in natural settings.

Although observation in clinical settings of communication augmentation system use by severely physically handicapped nonspeaking persons is important, monitoring of such use in natural settings can yield valuable information about the system, communication frequency, and unique communication needs of the individual. This study was designed to evaluate the use of communication partners as data recorders. For nonspeaking, severely physically handicapped subjects were observed in the home, school or treatment settings by a trained observer and a minimally trained communication partner. Issues of partner training and length of time required to obtain a representative sample of communication arose as a result of this study. More work in the areas of automated data collection systems or use of communication partners as data collectors is required before claiming that accurate communication interactions can be recorded in natural settings.

Adolescent↗
PubMed2002

Behavioural awareness, interaction and counselling education in audiological rehabilitation: development of methods and application in a pilot study.

In conventional audiological rehabilitation, the hearing therapist interacts with the hearing-impaired person and with significant others. In order to strengthen the personality and self-confidence of the hearing-impaired individual, a different strategy was designed and implemented whereby the pedagogic interaction was directed only towards the hearing-impaired individual, who in turn worked as a tutor/aid/counsellor to the communication partner. On the basis of an interactive communication model, new methods for rehabilitation of subjects with moderate hearing impairment were developed and evaluated in a pilot study on 13 men with noise-induced hearing loss. A course programme was developed with three main active components: (1) increased insight and knowledge; (2) education as counsellors with the ability to focus on the problems of the communication partner; and (3) motivation to change through group discussion and reflexive conversation. Increased insight and knowledge were obtained through test and training experiences in a sound environmental chamber, tutorials and discussions. The pedagogic training focused on helping the hearing-impaired subjects to become able communication counsellors in relation to their interlocutors. An act-react, offensive-defensive paradigm was used in conjunction with transactional analysis. Results of the pilot study were evaluated using questionnaires, interviews and a method of dialogue analysis. The results were evaluated for the hearing-impaired and the partner and in recordings of conversations in the home environment. There were clearly positive cognitive and emotional effects seen in the inquiries and interviews. The observations from the dialogue analysis indicated only small effects, with the exception of the two individuals with the most pronounced functional impairment, for whom dialogue was improved after the course. It was concluded that these new methods could contribute new possibilities in rehabilitation programmes, emphasizing the shared responsibility for communication and the unique competence and abilities of the hearing-impaired person.

Awareness↗
PubMed2004

Speech and language therapy to improve the communication skills of children with cerebral palsy.

BACKGROUND: The production of speech, language and gesture for communication is often affected by cerebral palsy. Communication difficulties associated with cerebral palsy can be multifactorial, arising from motor, intellectual and / or sensory impairments, and children with this diagnosis can experience mild to severe difficulties in expressing themselves. They are often referred to speech and language therapy (SLT) services, to maximise their communication skills and help them to take an independent a role as possible in interaction. This can include introducing augmentative and alternative communication (AAC) systems, such as symbol charts or speech synthesizers, as well treating children's natural forms of communication. Various strategies have been used to treat the communication disorders associated with cerebral palsy but evidence of their effectiveness is limited. OBJECTIVES: To determine the effectiveness of SLT that focuses on the child or their familiar communication partners, as measured by change in interaction patterns. To determine if individual types of SLT intervention are more effective than others in changing interaction patterns. SEARCH STRATEGY: Searches were conducted of MEDLINE, CINAHL, EMBASE, PSYCH INFO, LLBA, ERIC, WEB of SCIENCE, NRR, BEI, SIGLE up to December 2002. References from identified studies were examined and relevant journals and conference reports were hand-searched. SELECTION CRITERIA: Any experimental study containing an element of control was included in this review. This includes non-randomised group studies and single case experimental designs in which two interventions were compared or two communication processes were examined. DATA COLLECTION AND ANALYSIS: L Pennington searched for and selected studies for inclusion. J Goldbart and J Marshall independently assessed separate random samples each comprising 25% of all identified studies. Two reviewers independently abstracted data from each selected study. Disagreements were settled by discussion between the three reviewers. MAIN RESULTS: Eleven studies were included in the review. Seven studies evaluated treatment given directly to children, four investigated the effects of training for communication partners. Subjects in the studies varied widely in age, type and severity of cerebral palsy, cognitive and linguistic skills. Studies focusing directly on children suggest that this model of therapy delivery has been associated with increases in treated communication skills by individual children. However, methodological flaws prevent firm conclusions being made about the effectiveness of therapy. In addition, maintenance of these skills was not investigated thoroughly. The studies targeting communication partners describe small exploratory group projects which contain insufficient detail to allow replication, have very low power and cannot provide evidence of effectiveness of this type of treatment. REVIEWERS' CONCLUSIONS: Firm evidence of the positive effects of SLT for children with cerebral palsy has not been demonstrated by this review. However, positive trends in communication change were shown. No change in practice is recommended from this review. Further research is needed to describe this client group, and its possible clinical subgroups, and the methods of treatment currently used in SLT. Research is also needed to investigate the effectiveness of new and established interventions and their acceptability to families. Rigour in research practice needs to be extended to enable firm associations between therapy and communication change to be made.

Adolescent↗
PubMed1980

Nonvocal communication: performance evaluation.

With the increasing number of communication options available to severely dysarthric individuals, there is a growing need to develop techniques for the evaluation of nonvocal communication performance. A data collection and analysis system was developed in order to assess the performance of 2 nonvocal communicators. Records of entire messages were obtained along with durational measures of communication partner receiving time for each message, identity of the communication partner and location.

Adult↗
PubMed1999

The impact of a digital speaker on a teacher's interaction with a child with limited functional speech.

This paper describes the impact of the implementation of a digital speaker and teacher training on the quality of a teacher's interaction with an AAC user. The data was obtained by recording and analysing classroom story time interactions. The types of utterances directed at each child in the class, the types of questions used as well as the messages recorded onto the digital speaker were determined for each research phase. There were four major phases in the research, namely, a pre-implementation phase, a post-implementation phase, a post-training phase and a post-withdrawal phase. The results indicated that the implementation of the digital speaker and the training of the teacher resulted in certain changes in the way that the teacher interacted with the AAC user. Utterance types such as answering and imitating were used more frequently after the implementation of the device. There was also a much greater variety in the teacher's use of questions as well as in the messages that were recorded onto the digital speaker after the five training sessions were completed. This study highlighted the importance of formal training for the communication partners of the AAC user. One of the most important communication partners of the school-aged AAC user is the classroom teacher.

Amplifiers, Electronic↗
PubMed2006

Patient versus partner perception of voice handicap.

The primary purpose of this study was to compare patient's and communication partner's perceptions of handicap secondary to dysphonia. A secondary purpose was to compare patient health-related quality of life (HRQOL) to that of speakers with normal voice. Participants were 20 adults (mean age=69.15 years) with dysphonia and their communication partners. Patients completed the Voice Handicap Index (VHI), a questionnaire of self-perceived voice handicap, and the Short-Form 36 (SF-36), a general health questionnaire. Partners completed the Voice Handicap Index-Partner (VHI-P), a questionnaire derived from the VHI for this pilot study, to gauge partner perception of voice handicap. Patients in this study viewed themselves as only moderately handicapped by their dysphonia and their partners were in close agreement. Patients and their partners were also in close agreement on each of three VHI subscales (physical, functional, and emotional), and in all cases the physical domain was perceived by both patients and their partners to be most handicapped. Patients had lower SF-36 mean scores than those of persons with normal voice from the general U.S. population on scales assessing physical functioning, physical role, general health, vitality, social functioning, emotional role, and mental health. The results of this study are consistent with previous studies examining patient-partner agreement, which consider proxy ratings to be a useful alternative or collaborative source of patient's self-perception. Further research regarding the reliability of patient and partner agreement is necessary to most effectively assess and manage patients with dysphonia.

Adult↗
PubMed2006

Infertility and assisted reproduction in Denmark. Epidemiology and psychosocial consequences.

Clinically a couple is considered to be infertile after at least one year without contraception and without pregnancy. There was scant knowledge about the prevalences of infertility, involuntary childlessness and the seeking of fertility treatment and only few longitudinal studies about the psychosocial consequences of infertility and its treatment. This thesis is about the epidemiological aspects of infertility; the conceptualization and measurement of important psychosocial aspects of infertility; and a medical sociological analysis of the associations between these psychosocial variables among Danish women and men in fertility treatment. The thesis is based on nine papers. The three main purposes were: (i) to review critically, population based studies of infertility and medical care seeking in industrialised countries. Further, to examine these prevalences and subsequent motherhood among women in former assisted reproduction in a Danish population. (ii) To develop measures of psychosocial consequences of infertility: fertility problem stress, marital benefit, communication, coping strategies, attitudes to and evaluation of fertility treatment. (iii) To examine these phenomena and to analyse their interrelations among Danish women and men in fertility treatment. The thesis is based on four empirical studies: (i) The Women and Health Survey, a cross-sectional population-based study among 15-44 year old women (n=907, 25-44 year old) in Copenhagen County, 1989. (ii) The Psychosocial Infertility Interview Study, a qualitative interview study among 16 couples (n=2 participants) infertility treatment at The Fertility Clinic, Herlev University Hospital,1992. (iii) The Infertility Cohort, a longitudinal cohort study consecutively including all couples (n=250 participants) beginning anew fertility treatment period at one of four public (Braedstrup, Herlev, Odense, Rigshospitalet) and one private fertility clinic (Trianglen),2000-2002. (iv) The Communication and Stress Management Training Programme, an intervention study among couples(n=74 participants) in fertility treatment at The Fertility Clinic, The Juliane Marie Centre, Rigshospitalet, 2001-2003. Included is also a literature review of population-based infertility studies from industrialised countries. Data from (iii) and (iv) are studies from The Copenhagen Multi-centre Psychosocial Infertility (COMPI) Research Programme (www.compipro.dk). Epidemiological and demographic studies investigating the prevalences of infertility differed in how they defined the numerator (the infertile participants) and the denominator (the population at risk). It was important to calculate reliable estimates of the infertility prevalence by including only women who had tried to have at least one child in the population at risk, as a notable proportion of women in the fertile ages had not (yet) attempted to become a mother. The lifetime prevalence of infertility in the representative population-based study was 26.4%. In the age group 35 to 44 years 5.8% were primarily involuntarily in fecund (involuntarily childless). Even in a country with access to fertility treatment in a public health-care system without self-payment lower education was a predictor of lower treatment seeking. In the cohort study (2000-2002)of couples starting a new period of assisted reproduction treatment 62.6% reported a treatment-related pregnancy at the one-year follow-up. In total 32.4% reported a treatment-related delivery. In total 24.2% reported a current continuing pregnancy and spontaneous pregnancies accounted for 2.7% of these. We developed measures of fertility problem stress, marital benefit(that infertility has brought the partners closer together and strengthened their marriage), partner communication, infertility related communication, coping strategies, attitudes to fertility treatment and evaluation of care. The medical sociological analyses showed that the variables of psychosocial consequences of infertility and treatment are interwoven with each others in a complex pattern, a pattern that both differed and was similar when comparing women and men. The infertility-related communication strategy (secrecy, formal, open-minded)identified in the qualitative interviews was later confirmed in the COMPI Infertility Cohort. Using the formal strategy and not talking about the emotional aspects of infertility and its treatment suggested high fertility problem stress. The coping strategies studied showed significant social differences and active-avoidance coping was a significant predictor of high fertility problem stress. A positive effect of infertility on the marriage, marital benefit was common. Men using the secrecy communication strategy had increased risk of low marital benefit. Difficult partner communication was a significant predictor of high fertility problem stress and among men, of low marital benefit. The intervention study showed that it was possible for the participants to change their communication with partner and other people close to them and that participants achieved an increased awareness of what, how much and when to discuss with others. High fertility problem stress and high marital benefit were associated with high importance ratings of patient-centred care and intentions to use professional psychosocial services. Among women, high fertility problem stress was a predictor of lower satisfaction ratings with fertility treatment. High marital benefit was a predictor of high satisfaction ratings of both medical and patient-centred care. In conclusion, infertility is a common experience among couples attempting to become parents. Assisted reproduction in the public health-care system in Denmark has high success rates, i.e. pregnancies,deliveries and high patient satisfaction. A large minority of people in fertility treatment experience high fertility problem stress,and some use communication and coping strategies that predicts high stress. Developing and evaluating different psychosocial interventions are necessary to offer the psychosocial support needed for this minority of fertility patients.

Adaptation, Psychological↗
PubMed1990

Partner sensitivity to communication behavior of young children with developmental disabilities.

Aspects of partner sensitivity to communication behaviors of 24 presymbolic children with developmental disabilities were examined. The children were grouped according to their movement abilities (normal vs. abnormal patterns) and communication status (intentional vs. preintentional). Participating communication partners were those with whom the children interacted on a regular basis and included their mothers, early childhood special educators, and speech-language pathologists. Procedures were developed whereby the partners served as informants in order to provide information regarding (a) recognition of the children's communicative cues and (b) consistency of cue recognition and descriptions across partners. Results indicated wide individual variability in the partners' basic recognition abilities as well as their consistency with each other. Further, the observed variations could not be attributed to the children's movement and communication abilities. It was concluded that sensitivity, as measured in the present investigation, was highly partner-child specific, with some children likely to be exposed to more optimal interactions than others.

Child, Preschool↗
PubMedDate not supplied

Situational factors involved in college students' safer and risky sexual encounters.

OBJECTIVE: To ascertain the differences between the situational factors of risky and safer sexual encounters in college students. DESIGN: Descriptive. SETTING: Community-dwelling college students from a large Midwestern university. PARTICIPANTS: Participants were 84 college students ages 18 to 20 years. Fifty-five were female (67.5%), the majority (95.2%) were White, and all reported being heterosexual. MAIN OUTCOME MEASURE: Use of safer or risky practices in last or most memorable sexual encounter. RESULTS: Important situational characteristics of safer encounters were negative ambiance of the place, type of partner, unattractive qualities of the partner, communication with the partner, and having the encounter because of feeling desire. Important situational characteristics of risky encounters were a cozy ambiance, partner's attractiveness inducing desire, asking directly for the encounter, and encounters occurring after celebration or partying. CONCLUSIONS: Many characteristics were similar for both risk groups. However, practitioners can tailor interventions to make clients aware of factors that were more prevalent in risky sexual encounters, such as having the encounter with a boyfriend or girlfriend and having an encounter after drinking alcohol and partying.

Adolescent↗
PubMed1985

Predicting contraceptive behavior among college students: the role of communication, knowledge, sexual anxiety, and self-esteem.

Undergraduate students were surveyed about their sexual behavior and contraceptive behavior. In addition, measures of their self-esteem, knowledge about contraception, communication with their dating partners, communication about sexual matters with their sexual partners, and sexual anxiety were taken. Consistent with Byrne's (1983) model of effective contraception, it was found that general and sexual communication with one's partner were significant predictors of contraception use. Directional, but statistically weak, support was obtained for the predictions that knowledge about contraception and sexual anxiety would be related to contraception use. No support was found for the prediction that general self-esteem would be associated with contraceptive behavior.

Anxiety↗
PubMedDate not supplied

A randomized clinical trial of an HIV-risk-reduction intervention among low-income Latina women.

BACKGROUND: HIV infection has increased within the Latina community more than in any other ethnic or racial group within the United States. Latinas comprise only 13% of the U.S. population, yet they account for 20% of the cumulative reported cases of AIDS. OBJECTIVES: The purpose of the study was to evaluate a randomized culturally tailored intervention to prevent high-HIV-risk sexual behaviors for Latina women residing in urban areas. METHODS: Mexican and Puerto Rican women (18-44 years of age; N = 657) who were sexually active during the previous 3 months were recruited and randomized into intervention and control groups. The intervention, facilitated by bilingual, bicultural, trained Latina women, consisted of culturally tailored sessions on understanding their bodies, HIV/AIDS and sexually transmitted diseases, condoms (myths and use), negotiating safer sex practices, violence prevention, and partner communication. Bivariate and multivariate analyses assessed changes from baseline. RESULTS: The intervention improved HIV knowledge, partner communication, risk-reduction behavioral intentions, and condom use, and decreased perceived barriers to condom use. DISCUSSION: The efficacy of a culturally-sensitive intervention to reduce HIV/AIDS-risk behaviors in Latina women was demonstrated in the current study.

Acculturation↗
PubMed1996

A new perspective on the relationship between communication impairment and disempowerment following head injury in information exchanges.

Communication disorders following closed head injury (CHI) have been described in terms of the impairments that affect the individual's ability to produce words, sentences and discourse. Rather than focusing on impairments, this paper examines the disability experienced by one CHI subject. Comparison is made between M. R., who has sustained a severe CHI, and his brother, S. R. during four telephone calls to their mother, a therapist, the police and the bus timetable information service, using exchange structure analysis. Results indicated that social distance between communication partners, and the nature of the interaction, affected the language choices made by both subjects. The communication partner was found to have a profound impact on the way each subject was able to negotiate each interaction. Results are discussed in terms of the ways in which therapists and society in general view disability and how this shapes social encounters, which in turn affects the outcomes which are made possible for people with CHI.

Adaptation, Psychological↗
PubMedDate not supplied

Discourse sampling in the 21st century.

This paper examines the importance of evaluating discourse in individuals with a neurogenic language disorder. Discourse analysis is acknowledged as an important tool for speech-language pathologists, although it is often not the assessment tool of choice due to its apparent time-consuming nature and the overwhelming number of options available. The wide range of analyses available to clinicians such as the number of T-units and total words produced or Pragmatic Protocol checklists make it difficult to choose assessment measures. Even more difficult is the decision of where to direct treatment efforts. This paper aims to show that there are a number of levels of discourse analysis available to clinicians and that it is possible to sample a number of different genres in a clinical setting. The significance of the communication partner's contribution is discussed, particularly with regard to the limitations of the therapeutic interaction and the need to assess clients with a range of communication partners. The discourse opportunities we make available to people with communication problems will influence what is possible for them. To achieve this, the benefits of a theory of linguistic analysis, namely, Systemic Functional Linguistics (SFL) [Halliday, M. A. K. (1994). An introduction to functional grammar (2nd ed.). London: Edward Amold.] will be explored.

Brain↗
PubMed1995

Adult partner-augmented communication input to youth with mental retardation using the System for Augmenting Language (SAL).

The primary purpose of this study was to characterize the frequency and nature of augmented input that adult partners provided to 13 youth with mental retardation as they began to use the System for Augmenting Language (SAL). Analyses of youth-partner interactions revealed differences in the frequency with which home and school partners provided augmented input and in the manner and style of home and school partners' augmented input, particularly in directiveness and position of lexigram symbols within Utterances. Overall, partners naturally provided augmented input in a manner likely to promote youth's learning of the SAL.

Adolescent↗