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Results for “Communication Barriers”

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PubMed2003

Barriers to patient information provision in primary care: patients' and general practitioners' experiences and expectations of information for low back pain.

BACKGROUND: As patient involvement in health-care increases, the role of information is crucial, especially in conditions where self-management is considered an integral part of care. However, the suitability and applicability of much patient information has not been appraised in terms of how far it meets patients' information needs. AIMS: To ascertain patients' and clinicians' experiences and expectations of information in low back pain in order to suggest a suitable 'patient-centred' content for a patient information pack to be used in a primary care setting. METHODS: A qualitative study using semi-structured interviews with General Practitioners (GPs) (n = 15) and focus groups comprising patients with low back pain (n = 37). RESULTS: Barriers to information-giving for low back pain in primary care exist. Patients are dissatisfied with the information they receive from their GPs, especially regarding diagnosis and treatment. Patients tend to access information from a variety of other sources, which is often contradictory, conflicts with research evidence and leads to unreasonable expectations. GPs have varying views regarding the value of patient information and are equivocal about their roles as information providers. Although The Back Book is generally acceptable as a patient information leaflet for low back pain, attention to the tone of the text is required. CONCLUSIONS: Barriers exist to patient information provision, both generally and for low back pain, which need to be addressed in order to close the gap between strategy and implementation. Improving clinician communication skills and involving patients in developing information materials which meet their needs are crucial to this process.

Attitude of Health Personnel↗
PubMed2001

Consumer participation in health policy decisions: empowerment or puffery?

Many consumers in today's society have increased access to information about health and medical care through books, videotapes, audiotapes, the Internet, and television programming. However, consumers often are excluded from involvement in health policy decision making because it is believed that they do not have the necessary expertise. In this paper, the following will be discussed: (1) the historic role of consumer involvement in health policy decision making, (2) an overview of major barriers that consumers have encountered in health policy decision making, and (3) strategies for overcoming these barriers so that consumer empowerment can be enhanced when they serve on health policy panels.

Communication Barriers↗
PubMed2006

Language barriers to health care access among Medicare beneficiaries.

This study examined language barriers to health care access among a population-based sample of Medicare seniors in California in 2001 and 2003. Results indicate that Medicare beneficiaries with limited English proficiency (LEP) had less access to a usual source of care and were less likely to receive preventive cancer screening tests. LEP Medicare beneficiaries who also were covered by Medicaid tended to fare better than those without Medicaid. This could be due to federal civil rights rules that require Medicaid health care providers to offer free language assistance, but exclude from these requirements physicians who provide only Medicare services. Findings suggest the federal government should take steps to reduce language barriers in Medicare.

Aged↗
PubMed2003

Barriers to collaboration between mental health professionals and families in the care of persons with serious mental illness.

Mental health professionals do not often collaborate with families when providing treatment to the mentally ill, even though research shows better patient outcomes with family involvement. The National Alliance for the Mentally Ill (NAMI) developed a course, Professional Provider Family Education Course (PP FEC), to educate mental health providers in outreach to families. This article reports the findings of a study which evaluated the PP FEC and identified barriers to collaboration between families and mental health professional providers.

Adult↗
PubMed2004

Medication practices among Chinese American older adults influences: a study of cultural.

The magnitude and intensity of medication use in older individuals have been widely discussed. Yet, a paucity of research data exists on medication practices among community-dwelling Chinese American older adults. This study examined factors associated with medication practices in community-dwelling Chinese American older adults. Data were collected through a descriptive survey. Chinese American older adults (n = 165) from the greater Boston area participated in the survey. The study revealed that ethnocultural barriers and a lack of health insurance significantly influenced medication practices among Chinese American older adults. The study suggested three important implications. First, more ethnoculturally appropriate health services are needed. Secondly, communication between clients and health providers must be improved. Finally, culturally sensitive medication management programs are needed.

Aged↗
PubMed1996

Educating the public about skin cancer prevention: a role for pharmacists.

OBJECTIVES: The incidence of skin cancer is increasing at an alarming rate. This study aimed to assess pharmacists' willingness to counsel patients about skin cancer and factors which are predictive of this. METHODS: A 30 item survey assessing skin cancer prevention counselling attitudes and behaviours, personal skin cancer prevention behaviours, and willingness to counsel on skin cancer prevention, was mailed to 300 randomly selected San Diego County pharmacists. RESULTS: Data obtained from 128 pharmacists (43% response rate) indicated that the incidence of skin cancer prevention counselling was very low, with over one-third stating that they never counsel patients on this topic. Of those that did counsel, the percentage of patients counselled on skin cancer prevention was below 5%. Bivariate analyses indicated that pharmacists who counselled on this topic differed from those that did not on knowledge of skin cancer, attitudes and beliefs about counselling patients, pharmacy setting, services offered by their pharmacies, and their personal sun protective behaviours. Multivariate analysis indicated that two variables independently predicted skin cancer prevention counselling; whether the pharmacy where the respondent was employed offered this service, and attitude about counselling. Over 90% of respondents reported they were willing to counsel patients on skin cancer prevention and other health-related topics. CONCLUSIONS: Future studies should focus on skin cancer prevention counselling barriers and environmental prompts encouraging this type of interaction between pharmacists and patients.

Communication Barriers↗
PubMed1994

Lack of knowledge in health professionals: a barrier to providing information to patients?

OBJECTIVE: To assess obstetricians' and midwives' knowledge of routine prenatal screening tests for fetal abnormality and factors associated with such knowledge. DESIGN: Questionnaire assessment of antenatal clinic staff. SETTING: Six hospitals within the United Kingdom (four district general hospitals in London, one district general hospital in Wales, and one teaching hospital in Wales), offering routine prenatal screening tests. SUBJECTS: 29 obstetricians and 97 midwives were invited to participate, of whom 21 and 70 respectively responded to the questionnaire. MAIN MEASURES: Knowledge of prenatal tests, according to 19 item multiple choice questionnaire, reluctance to disclose uncertainty, and clinical experience. RESULTS: The overall response rate was 72% (91/126). In all, 43% of midwives and 14% of obstetricians obtained correct responses on fewer than half the items. Reluctance to disclose uncertainty to patients was associated in obstetricians with having less knowledge about prenatal testing (r = -0.50; p < 0.025, Pearson product moment correlation) and in midwives with more clinical experience (r = 0.43; p < 0.001). CONCLUSIONS: Lack of knowledge and greater clinical experience seem to be important barriers to providing patients with information about prenatal screening tests.

Communication Barriers↗
PubMed2006

Barriers to participation in the food stamp program among food pantry clients in Los Angeles.

Substantial numbers of food pantry clients are eligible for food stamps but do not receive them. Background characteristics of 14317 food pantry users in Los Angeles were analyzed to provide information helpful in food stamp outreach programs. Ninety percent of food pantry users were living well below poverty level, 59% were Hispanic, and 44% were homeless. Only 15% of the food pantry clients received food stamps, with homelessness and limited English language skills acting as barriers to food stamp program participation.

Adolescent↗
PubMed2000

Language barriers to informed consent and confidentiality: the impact on women's health.

Obtaining informed consent and maintaining confidentiality are critical to the way we practice medicine and remain a crucial part of our medicolegal responsibility to the patient and to society. Nevertheless, little attention has been paid to these topics in populations who may have limited English proficiency. Despite research suggesting that language barriers have direct effects on health and health care delivery, many health care settings do not provide professionally trained interpreters to patients who need them. This is clearly a challenge that will only grow as our nation becomes more diverse. Perhaps nowhere is this issue more significant than in women's health, given the very personal and sensitive nature of the medical exams and interventions. As health care providers, we must conduct and facilitate research on how language barriers compromise quality of care, and we must advocate for systems and policy change.

Adult↗
PubMedDate not supplied

Dementia in acute units: communication.

This is the second article in our series which looks in detail at one of the most pressing nursing problems of the age--coping with the behaviours of people with dementia in acute care units. The authors analyse the misunderstandings and misperceptions which conspire to build barriers to communication between nurses and people with dementia, and offer some practical advice on how to overcome them.

Communication↗
PubMed2005

Using research to inform health policy: barriers and strategies in developing countries.

This article examines the dissemination and uptake of health research into policy and program delivery in four developing countries. In-depth interviews were conducted with health researchers, policymakers, and practitioners at both the local and national level. The study highlights the similarities across the study countries in the barriers to effective dissemination and uptake of research results. A fundamental barrier to the uptake of research by decisionmakers is the lack of appreciation of the important contribution that research can make to policy and program development. A further barrier is researchers' lack of appropriate "packaging" of research findings that consider the needs of different policy audiences. Dissemination within academic circles also restricts access by decisionmakers nd practitioners. Overcoming the barriers requires effort on behalf of researchers, decisionmakers, and donor agencies. The strong presence of donor agencies in developing countries places them in a position both to enable and encourage dissemination activities and communication between researchers and policymakers or practitioners. Increased collaboration between all three parties is one of the key strategies toward increasing the uptake of research into health policy and program development.

Administrative Personnel↗
PubMed1993

New waves. Hospitals struggle to meet the challenge of multiculturalism now--and in the next generation.

Multiculturalism means different things to different people. For hospital executives, there are a number of major implications inherent in the rapidly expanding diversity of the United States. Beginning on page 23, we look at the ethnic diversity issues hospitals face as employers. A consensus has developed that more minority young people must be encouraged to enter health care administration and clinical care; but there are a variety of obstacles to be overcome. Then, beginning on page 29, we examine the many challenges hospitals struggle with as their patient populations become more and more diverse, and in many cases, change very quickly. Problems in dealing with an array of languages, cultures and backgrounds can put up major barriers to effective patient care. Providers must understand the cultural assumptions that patients bring with them.

Communication Barriers↗
PubMed1996

Practice environment for nurse practitioners in California. Identifying barriers.

Barriers exist that prevent nurse practitioners from using their primary health care knowledge and skills. We present the incidence of and specific barriers experienced by nurse practitioner respondents in California, the state with the largest number of nurse practitioners in the nation. A January 1995 survey was sent to all nurse practitioners certified in California to elicit their experiences regarding legal or social barriers in their practice, with space for an open-ended response. Of an estimated 3,895 nurse practitioners in California, 2,741 (70%) returned surveys. Most nurse practitioner (65%) respondents in California are providing primary care. Perceived barriers to practice are lack of prescriptive authority, lack of support from physicians, reimbursement difficulties, and lack of public awareness. Current barriers to nurse practitioner practice in California are similar to national barriers discovered in 1992 data. The development of interprofessional dialogue and the recognition of the contributions of all primary care professionals are some of the steps that can be taken to reduce these barriers and increase the use and effectiveness of nurse practitioners in primary care.

California↗
PubMed2006

Sexual communication skills in residency training: the Robert Wood Johnson model.

Few medical schools or residency programs offer adequate training in sexual medicine. Using the experience gained in our long-standing program in human sexuality for medical students, we have pilot tested a half-day intensive workshop curriculum for residents that focuses on sexual communication skills and management of sexual problems. Unlike our medical school program, this residency course was offered on an elective, one-day basis. The current report describes the successful implementation of our pilot program with 46 medical residents from subspecialty and primary care residency programs. Before the workshop, 22 (48%) residents indicated that they were uncomfortable with open discussion of sexual issues and would not feel comfortable in addressing the topic with their patients. A number of factors were identified as barriers to communication, including lack of time, inadequate training, and personal discomfort. After the workshop, the participants rated themselves as more comfortable with the topic and as more likely to address sexual issues with their patients. The participants evaluated the workshop positively overall and responded well to the interactive format and audience-response components. Most of the participants showed interest and willingness to participate in further training in sexual medicine skills. Our program offers a model for training of residents in communication skills and management of sexual problems. The difficulties in implementation and overcoming institutional barriers to curriculum reform are addressed.

Curriculum↗
PubMed2005

Children's protective services and law enforcement: fostering partnerships in investigations of child abuse.

Although collaboration in child abuse investigations has been emphasized since 1974, barriers, including role conflicts and organizational differences, have often been reported. This study describes the process of collaboration based on the perceptions of investigators working with a Child Advocacy Center. Telephone interviews were conducted with 290 child protective service workers and law enforcement officers from 28 child advocacy centers in 20 different states. Respondents identified barriers to the process of collaboration such as conflicts over case control and facilitators including co-housing and cross-training. Conditions that should contribute to successful collaboration are discussed.

Adult↗
PubMed1992

The philosopher in the health care setting: objections and replies.

This article presents a series of objections against having philosophers in the health care setting and rebuttals to these objections. These objections occur often enough to deal with them as characteristic criticisms. The rebuttals outline and advocate the positive--yet limited--function of the philosopher's presence in health care.

Attitude of Health Personnel↗