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Results for “Communication Barriers”

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PubMed1988

Communicating with patients who have psychiatric problems.

Psychiatric or emotional problems may become barriers to effective communication. These barriers may include factors that the physician cannot control, factors that can be controlled and factors that stem directly from psychopathology. External factors include language differences or hearing impairment. Internal factors generally stem from prejudices, maladaptive attitudes or misinformation on the part of the physician. All of these barriers must be surmounted in the interest of enhancing patient care.

Humans↗
PubMed2003

The truth about language barriers: one residency program's experience.

OBJECTIVE: To describe perceptions of how a lack of house staff Spanish proficiency adversely affects communication with Spanish-speaking families with limited English proficiency (LEP). METHODS: An anonymous, structured questionnaire was administered to the house staff an of urban, university-affiliated children's hospital that serves a population in which 10%-20% have LEP. RESULTS: Ninety-four percent (59 of 63) completed the questionnaire. Sixty-eight percent (40 of 59) reported that they spoke little or no Spanish (although 36 of 40 expressed a desire to learn Spanish). Fifty-three percent (21 of 40) of these nonproficient residents reported that they used their inadequate language skills in the care of patients "often" or "every day." Many of these residents believed that LEP families under their care "never" or only "sometimes" understood their child's diagnosis (21 of 40), medications (11 of 40), discharge instructions (17 of 40), or follow-up plan (16 of 40). Eighty percent (32 of 40) admitted to avoiding communication with such families. Although all (40 of 40) agreed that hospital interpreters were effective, 30 of 40 nonproficient residents reported use of hospital interpreters "never" or only "sometimes." Fifty-three percent (21 of 40) of these nonproficient residents reported calling on their proficient colleagues "often" or "every day" for assistance. Thirty-two percent (19 of 59) of residents described themselves as "fluent" or "proficient" in Spanish. Fifty-eight percent (11 of 19) reported that they were asked to interpret for fellow residents "often" or "every day." Proficient residents estimated that they spent a mean of 2.3 hours per week interpreting for other residents. CONCLUSIONS: Despite a perception that they are providing suboptimal communication, nonproficient residents rarely use professional interpreters. Instead, they tend to rely on their own inadequate language skills, impose on their proficient colleagues, or avoid communication with Spanish-speaking families with LEP.

Adolescent↗
PubMed2004

Psychosocial care for cancer patients in primary care? Recognition of opportunities for cancer care.

The paper outlines psychosocial problems experienced by cancer patients and the current barriers to service delivery. New models of psychosocial service provision are put forward, emphasizing information, communication and technology aids in an attempt to improve co-ordination of care. The management of cancer patients has evolved greatly over the past decades, and patients are well placed to benefit from the experiences of primary care professionals in the delivery of chronic illness disease management strategies.

Communication Barriers↗
PubMedDate not supplied

Assessing provider-patient-parent communication in the pediatric emergency department.

Patient-provider communication is related to the satisfaction with and process and outcome of emergency department care. Barriers to communication include noise, anxiety, confusion about process, and differences in language and expectations. In the emergency care setting, as in nonacute ambulatory settings, children tend to be left out of discussions of their own care. Both retrospective and real-time methods are available for studying communication during emergency department visits. Well-standardized generic communication assessment tools are applicable to emergency department communication, but assessment tools specific for emergency settings have yet to be developed and standardized. Although the emergency department poses some methodologic difficulties not present in other settings, studies of communications are feasible and likely to yield useful data.

Child↗
PubMed2004

Communicating about health care: observations from persons who are deaf or hard of hearing.

BACKGROUND: Achieving patient-centered care requires effective communication between physicians and patients. Persons who are deaf or hard of hearing face considerable barriers to communicating with physicians. OBJECTIVE: To understand perceptions of health care experiences and suggestions for improving care among deaf or hard-of-hearing individuals. DESIGN: 4 semistructured group interviews, 2 conducted in American Sign Language (for deaf individuals) and 2 using Communication Access Realtime Translation (for hard-of-hearing individuals). Men and women were interviewed separately. Tapes of interviews were transcribed verbatim for analysis. SETTING: Greater Boston, Massachusetts, and Washington, DC, in 2001. PARTICIPANTS: 14 deaf adults (23 to 51 years of age) and 12 hard-of-hearing adults (30 to 74 years of age). MEASUREMENTS: Commonly expressed themes or views organized around dimensions of communication. RESULTS: Concerns coalesced around 6 broad themes: conflicting views between physicians and patients about being deaf or hard of hearing; different perceptions about what constitutes effective communication (such as lip reading, writing notes, and sign language interpreter); medication safety and other risks posed by inadequate communication; communication problems during physical examinations and procedures; difficulties interacting with office staff, including in waiting rooms; and problems with telephone communication, such as lengthy message menus. Participants offered extensive suggestions for improvements, starting with clinicians' asking patients about their preferred communication approach. Having patients repeat critical health information (such as medication instructions) can identify potentially dangerous miscommunication. CONCLUSIONS: As the population ages, physicians will encounter many more persons with hearing limitations. Physicians are not reimbursed for making some accommodations, such as hiring sign language interpreters. However, ensuring effective communication is essential to safe, timely, efficient, and patient-centered care.

Adult↗
PubMed1996

Health promotion for Asian patients with CHD.

The British Asian community has a high incidence of coronary heart disease. Nurses should be aware of cultural barriers to health promotion and work to overcome them.

Communication Barriers↗
PubMed1996

Enactments: an evolving dyadic concept of acting out.

Unspoken actions between the therapist and the patient have major and often unconscious influences on the psychotherapeutic situation. Mutual transferences can bring about acting-out behaviors that portray transference wishes and defenses within both parties. Such actions tend to replace or overshadow verbalizing intrapsychic strife and in that sense can function as formidable resistance to therapeutic introspection. They also may represent behavioral attempts to communicate significant earlier experiences. Reflection on this dyadic interplay has led to contemporary treatment concepts. Enactment, actualization, and treatment misalliances are behavioral manifestations of urges, conflicts, and identifications and they appear most frequently during regressive periods in psychotherapy. Initially an enactment may include a component of the therapist's reciprocal behavior as a necessary feature of the process, prior to a fuller dynamic understanding and eventual definitive interpretation. Collusion by the therapist, through mutual and continuing acting out or through attempts to re-parent, will encourage antitherapeutic misalliances that can lead to continuing symptomatic behaviors and boundary violations. Continuing self-inquiry is essential to facilitate therapeutic change and we need to be aware that the principal analyzing device available to bring about positive change in our patients, is to be found within ourselves.

Acting Out↗
PubMed2000

Measurement of nonverbal receptive abilities in medical students.

Physicians have been reported to have difficulty in communicating with their patients. An element of this communication gap is proposed be related to the educational curriculum and the selection process of medical schools, in particular, with the emphasis on scientific methodology reducing exposure to humanistic values. This hypothesis was tested by measuring nonverbal receptive abilities in two groups. 30 medical students were compared with 30 college students who were not science majors but were age-, sex- and race-matched. The nonscience majors were better at perceiving nonverbal cues than medical students. Male nonscience majors had higher scores than male medical students while similar results were seen when female nonscience majors were compared with female medical students. Finally, medical students planning to practice as primary care specialists had higher scores than those interested in specialties which do not involve direct or prolonged patient care.

Adult↗