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PubMed1988

Social communication patterns of attention-deficit-disordered boys.

This study was designed to compare the social communication patterns of attention-deficit-disordered (ADD) and normal boys. This was accomplished by employing a "TV Talk Show" social role-playing procedure in which the task required different strategies for the roles of "host" and "guest." Groups of ADD and normal elementary-age boys were formed, and each boy was paired with a normal class-mate. Measures of communication competence were coded from videotapes made of subject and partner social interactions while performing both roles. Results indicated that the ADD boys, in contrast to the control group, failed to modulate their social communication behaviors as task demands shifted. Additionally, the behavior of the ADD boys resulted in their normal partners' altering their response patterns in order to maintain the equilibrium in the dyadic interaction. These results suggest that the social behavior of ADD children is relatively independent of environmental requirements and may contribute to the inappropriate responding of others.

Attention Deficit Disorder with Hyperactivity↗
PubMed2005

The interpersonal process model of intimacy in marriage: a daily-diary and multilevel modeling approach.

This study used daily reports of interactions in marriage to examine predictions from the conceptualization of intimacy as the outcome of an interpersonal process. Both partners of 96 married couples completed daily diaries assessing self-disclosure, partner disclosure, perceived partner responsiveness, and intimacy on each of 42 consecutive days. Multivariate multilevel modeling revealed that self-disclosure and partner disclosure both significantly and uniquely contributed to the contemporaneous prediction of intimacy. Perceived partner responsiveness partially mediated the effects of self-disclosure and partner disclosure on intimacy. Global marital satisfaction, relationship intimacy, and demand-withdraw communication were related to daily levels of intimacy. Implications for the importance of perceived partner responsiveness in the intimacy process for married partners are discussed.

Adult↗
PubMed2001

Overcoming the barriers to disclosure and inquiry of partner abuse for women attending general practice.

OBJECTIVES: To determine the barriers to and rates of disclosure of partner abuse by women attending GPs. METHODS: In a qualitative study, abused Melbourne women were interviewed about their experiences with GPs. Following this, adult women attending a random sample of Brisbane general practices were surveyed. Multivariate analyses were conducted on the data, using levels of disclosure and GP inquiry adjusting for cluster effect to obtain prevalence rate ratios. RESULTS: Thirty-seven per cent of the survey participants (n=1836, response rate 78.5%) admitted to having ever experienced abuse in an adult intimate relationship. One-third (36.7%) of these abused women (n=674) had ever told a GP and 87.8% had never been asked by their GP about partner abuse. Women who disclosed were almost twice as likely than women who have not: to be middle aged, have experienced combined physical, emotional and sexual abuse and be afraid of their partner. They were more than twice as likely to have been asked about abuse. A GP's good communication skills facilitated disclosure. The main barriers to disclosure were that women saw the problem as their own i.e. internal barriers. The data from the qualitative study (n=20) are used to illustrate these findings. CONCLUSION: Educational interventions that improve GPs' communication skills might result in increased disclosure and early intervention in partner abuse. GPs need sensitive attitudes, greater skills, knowledge and support to manage the consequences of disclosure.

Adult↗
PubMed1988

[Russia and Halle reciprocity in medicine of the 18th century. Correspondence, scientific communication and reception].

In the history of the interrelations of Halle and Russia in medicine during the 18th century Francke's Foundations, the Faculty of Medicine and the Academia Naturae Curiosorum are important institutions. The correspondence of these three institutions with the partners in Russia became remarkable for the scientific communication and reception. The activities of the working teams which were embedded in these authoritative bodies were scarcely inferior in importance to the centres of enlightenment of that time working in other towns (for instance in Leipzig). In the field of medicine Halle occupied a leading position for the early knowledge about Russia.

Germany↗
PubMed1996

Conversational repair by individuals with dementia of the Alzheimer's type.

Conversational repair was examined in videotaped samples of spontaneous mealtime talk of 6 normal elderly adults, 5 subjects with early stage dementia of the Alzheimer's type (EDAT) and 5 subjects with middle stage DAT (MDAT) with a family member who acted as a conversational partner. The overall percentage of utterances involved in communication breakdown and repair and the specific proportions of utterances related to conversation problems, signals identifying problems, and repairs, were evaluated. Using the normal dyads as a control group, results showed the differential effects of DAT onset and progression on the conversational repair behavior of both subjects with DAT and their conversational partner. The percentage of conversation involved in repair was significantly higher for MDAT versus control and EDAT dyads. Despite the increase of conversational troubles with DAT onset and progression, the difficulties were repaired successfully the majority of the time. Subjects with EDAT produced more requests for repair than did their conversational partners. However, conversational partners of EDAT subjects used more elaboration repairs than did EDAT subjects. The opposite pattern was observed in the MDAT group where subjects with MDAT created and repaired more conversational problems than did their conversational partner. MDAT subjects produced more discourse trouble sources than did EDAT subjects. It was also observed that MDAT subjects and conversational partners frequently used nonspecific terms to signal misunderstandings. The findings have important implications for developing family caregiver communication enhancement strategies that are specific to the clinical stage of DAT.

Adult↗
PubMed1993

Condom use with primary partners among injecting drug users in Bangkok, Thailand and New York City, United States.

OBJECTIVE: To determine factors associated with likelihood or failure to use condoms with primary sexual partners among injecting drug users (IDU) in two cities. DESIGN AND METHODS: Interviews were conducted with 601 IDU in Bangkok in 1989 and with 957 IDU in New York City in 1990-1991. Subjects were recruited from drug-use treatment programs and a research storefront. Informed consent was obtained and a World Health Organization standardized questionnaire about AIDS risk behaviors administered by a trained interviewer. RESULTS: A substantial minority (37%) of IDU in Bangkok and a majority (55%) of IDU in New York City reported penetrative intercourse (vaginal, anal or oral) with a primary partner in the 6 months before the interview. Of those reporting penetrative intercourse with a primary partner, only 12% in Bangkok and 20% in New York reported that they always used condoms. Parallel bivariate and multiple logistic regression analyses were conducted to distinguish between subjects who reported always using condoms and subjects who reported unsafe sexual activity with primary partners. The same two factor--knowing that one is HIV-seropositive and talking about AIDS with sexual partners--were most strongly associated with always using condoms with primary partners in both cities. CONCLUSIONS: Programs to prevent sexual transmission of HIV among IDU should provide voluntary and confidential/anonymous HIV counseling and testing, and should facilitate discussions of AIDS and sexual transmission of HIV between IDU and their sexual partners. That the same two factors were associated with always using condoms with primary partners among IDU in these two cities suggests that these factors may also be important in other groups at high risk for HIV.

Adult↗
PubMed2000

Musculoskeletal examination teaching in rheumatoid arthritis education: trained patient educators compared to nonspecialist doctors.

OBJECTIVE: To assess whether students taught by trained patients acquire the same levels of competence in musculoskeletal examination skills as students taught by nonspecialist doctors. METHODS: Year 1 Graduate Medical Program (GMP) students (N = 25) at Hospital A were randomized to 8 tutorial groups, each comprising 3-4 students. Groups were taught hand and wrist examination skills by patient educators trained by the Searle Patient Partners in Arthritis program (patient partners). Students at Hospitals B and C (N = 12) remained in their normal tutorial groups, each comprising 3-4 students. Groups at Hospitals B and C were taught hand and wrist examination skills by doctors who had no specialized training in musculoskeletal medicine or orthopedics, with an untrained patient present. RESULTS: Students' mean self-ratings of examination skills before and students' patient partners, and consultants' mean ratings of students' examination skills after the tutorial were summed. Before the tutorial there were no significant differences in level of skill between students at Hospitals A, B, and C as measured by students' self-ratings. After the tutorial all students showed clear gains in levels of skill. Students taught by patient partners had higher levels of skill than those taught by doctors for 3 (p<0.01) and 4 (p<0.05) out of 14 examination skills and all 4 communication skills (p<0.05), as measured by both patient partners' and consultants' ratings. Students taught by doctors showed higher levels of skill for 2 observation skills, but these differences were not significant. CONCLUSION: Patient partners are either equal or superior to doctors not specifically trained in musculoskeletal medicine or orthopedics, in the teaching of musculoskeletal examination techniques and basic communication skills.

Arthritis, Rheumatoid↗
PubMed1995

Couple communication, sexual coercion and HIV risk reduction in Kigali, Rwanda.

OBJECTIVE: To describe sexual interaction and HIV-related communication in Rwandan couples and to examine their relationship to HIV testing and condom use. STUDY DESIGN: Cross-sectional survey of a longitudinal cohort. METHODS: In 1988, women recruited for an epidemiological study of HIV, and interested male partners, received confidential HIV testing and counseling. Two years after enrollment, 876 women reporting one steady partner in the past year completed a questionnaire addressing sexual and HIV-related communication, sexual motivation and violence in the partnership. RESULTS: Men control sexual decision making, and coercive sex and violence between partners is not uncommon. HIV-positive women were more likely to report coercive sex and less likely to have discussed their test results with their partner. Women with HIV-positive partners were more likely to report being physically abused. Condom use was more common if the man had been previously tested, and if women reported discussing or negotiating condom use. HIV-negative women with untested or seronegative partners were the least likely to use condoms or to discuss or attempt to negotiate condom use. CONCLUSIONS: Participation of the male partner is crucial for successful HIV risk reduction in couples. HIV testing and counseling of couples has beneficial long term effects on condom use and HIV-related communication. Couple communication is associated with condom use, but only when the discussion is specific (sexually transmitted disease risks and using condoms). Seronegative women with untested partners are at increased risk for HIV as they are the least likely to discuss or attempt to negotiate condom use.

Coercion↗
PubMed1994

Heart transplantation: are there psychosocial predictors for clinical success of surgery?

50 adult patients were extensively psychosocially examined before undergoing heart transplantation. The data obtained and the clinical treatment data were compared with the clinical success of surgery (four groups ranging from excellent to unsatisfactory as determined by the surgeon one year after transplantation). Statistical evaluation by discriminant analysis resulted in the following predictors for successful surgery (all psychosocial): empathy, care and support by one partner (affective involvement), few demands for emotional communication (affective expression), self-control, ability to take stress, emotional stability, high frustration tolerance, low aggression level, and younger age. The following variables did not have predictive significance: schooling, occupation, social status, indication for transplantation, length of stay in intensive care and in hospital, extent of preoperative anxiety and depression, and the life-quality index according to Spitzer determined externally. The results show support by the partner to be the most significant psychosocial variable that can influence the clinical success of heart transplantation.

Adult↗
PubMed1989

Patient teaching in the ambulatory setting.

Tremendous growth in the ambulatory setting has made patient education an integral part of health care in that setting. Numerous factors can hinder the implementation of patient education. Institutional variables include time, environment, and money. Acuity, psychosocial issues, and available resources are patient-centered variables. In order to promote effective patient education in an ambulatory setting, nurses need to be involved actively in planning and presenting material and in evaluating patient learning. In addition, nurses should be knowledgeable about the content being presented. The type of environment in which the teaching occurs and the strategies utilized in patient education facilitate the information exchange. The nurse and client must develop trusting relationships built on effective communication skills by both client and nurse. The trend toward fostering the patient as an active partner in health care can be accomplished through the teaching of communication skills as well as prevention, management, and self-care skills.

Ambulatory Care↗
PubMedDate not supplied

Rehabilitation outcomes of long-term survivors treated for head and neck cancer.

BACKGROUND: Little is known about the rehabilitation outcomes of long-term survivors following treatment for head and neck cancer. There are, for example, no studies on physical and psychosocial rehabilitation outcomes of T1 glottic larynx carcinoma, despite the fact that these form the majority of head and neck cancer sites. Thus, this investigation afforded a unique opportunity for examining similarities and differences among T1 glottic larynx patients, laryngectomy patients, and those who had surgery for cancer of the oral cavity and/or oropharynx along a variety of physical and psychosocial dimensions. METHODS: To describe the impact of these three types of head and neck cancer and their treatment on the physical and psychosocial functioning of long-term survivors, a self-report questionnaire was completed by 110 patients treated between 2 and 6 years previously in a major cancer center. RESULTS: Data indicate that a higher percentage of patients treated with laryngectomy or commando procedures still experience severe psychosocial distress between 2 and 6 years after their last treatment than do patients treated with radiotherapy for a T1 carcinoma of the glottic larynx. Psychosocial and physical complaints are still reported by many laryngectomy patients, apparently the result of problems in effective communication with others. Many commando procedure patients experience problems with respect to food intake, and with disfigurement and its consequences. T1 larynx patients mainly experience a considerable number of physical complaints. The greater the time that had elapsed since treatment, the fewer the psychosocial problems associated with head and neck tumors. Open discussion of the illness in the family, social support, and perceptions of adequate information from the specialist are the most important predictors of positive rehabilitation outcomes. CONCLUSIONS: This study indicates that T1 larynx patients report many physical complaints even though several years had elapsed since treatment. Also, laryngectomy patients may need psychosocial guidance for a longer posttreatment period and that health care personnel must involve the partner as much as possible in all communications. Commando procedure patients in particular feel hindered by their disfigurement and its consequences. Future research with respect to validation of the specific head and neck modules is needed.

Adaptation, Psychological↗
PubMed2006

Racial differences in trust and lung cancer patients' perceptions of physician communication.

PURPOSE: Black patients report lower trust in physicians than white patients, but this difference is poorly studied. We examined whether racial differences in patient trust are associated with physician-patient communication about lung cancer treatment. PATIENTS AND METHODS: Data were obtained for 103 patients (22% black and 78% white) visiting thoracic surgery or oncology clinics in a large Southern Veterans Affairs hospital for initial treatment recommendation for suspicious pulmonary nodules or lung cancer. Questionnaires were used to determine patients' perceptions of the quality of the physicians' communication and were used to assess patients' previsit and postvisit trust in physician and trust in health care system. Patients responded on a 10-point scale. RESULTS: Previsit trust in physician was statistically similar in black and white patients (mean score, 8.2 v 8.3, respectively; P = .80), but black patients had lower postvisit trust in physician than white patients (8.0 v 9.3, respectively; P = .02). Black patients, compared with white patients, judged the physicians' communication as less informative (7.3 v 8.5, respectively; P = .03), less supportive (8.1 v 9.3, respectively; P = .03), and less partnering (6.4 v 8.2, respectively; P = .001). In mixed linear regression analysis, controlling for clustering of patients by physician, patients' perceptions of physicians' communication were statistically significant (P < .005) predictors of postvisit trust, although patient race, previsit trust, and patient and visit characteristics were not significant (P > .05) predictors. CONCLUSION: Perceptions that physician communication was less supportive, less partnering, and less informative accounted for black patients' lower trust in physicians. Our findings raise concern that black patients may have lower trust in their physicians in part because of poorer physician-patient communication.

Adult↗
PubMed1997

Temporal relationships between gaze and vocal behavior in prelinguistic and linguistic communication.

This work reports longitudinal evaluation of the temporal relationships between gaze and vocal behavior addressed to interactive partners (mother or experimenter) in a free-play situation. Thirteen children were observed at the ages of 1;0 and 1;8 during laboratory sessions, and video recordings of free-play interactions with mother and a female experimenter were coded separately for children's vocal behavior (vocalizations and words) and gaze toward their interactive partners. The difference between the observed and expected co-occurrence of these two communicative behaviors was evaluated by transformation into z-scores. The most important findings are related to differences in the temporal relationship observed at age 1;0 between gaze and vocalizations and at age 1;8 between gaze and words. At the earlier age, the infants who exhibited greater coordination between gaze and vocal behavior than was expected by chance (z-score > +1.96) preferred to look at the interlocutor at the beginning of the vocal turn. Instead, when they were older and began to produce words, they frequently looked at the interlocutor at the end of the vocal turn. These results are interpreted as referring to characteristics of conversational competence in the prelinguistic and lingustic periods. Moreover, looking at the interlocutor at the beginning of the vocal turn at age 1;0 was found to be related to language production at age 1;8, highlighting a significant relationship between conversational competence during the prelinguistic period and language acquisition.

Attention↗
PubMed2006

What makes a good midwife? An integrative review of methodologically-diverse research.

AIM: This paper reports an integrative review aimed at answering the question: 'What makes a good midwife?' BACKGROUND: A research-based definition of a good midwife which can be used as an operational definition in research and as a basis for curriculum development could not be found. Research in nursing has identified that patients and nurses may give different responses when asked about the most important aspects of nurses' contribution to care. It is also possible that views of how to define a good midwife might differ. METHODS: A four-stage systematic review process was used, consisting of protocol development, carrying out the search, appraisal/analysis of the papers retrieved, and synthesis of the information. The initial search covered the period from 1993 and used the keywords 'midwi*', 'nurse-midwi*' and 'good'. This was later extended to include the terms 'exemplary', 'excellent' and 'superb' as synonyms of 'good', and 'bad' as its antonym. The integrative review was descriptive and focussed on extracting from the papers the findings that contributed to answering the research question. FINDINGS: Thirty-three research-based papers were included in the review, and these had used a range of approaches and methods. Eight key concepts were derived from the data: attributes of a midwife, education, research, what a midwife does, care organization, other professionals, partners and an international perspective. CONCLUSION: Having good communication skills made the greatest contribution to being 'a good midwife', while being compassionate, kind, supportive (affective domain), knowledgeable (cognitive domain) and skilful (psychomotor domain) also made major contributions. Being involved in education and research were necessary requirements, and midwives' abilities to treat women as individuals, adopt a caring approach, and 'be there' for women were essential. A good midwife can compensate for poor management systems, but women should be able to choose who provides their care, and partners should be involved in this care.

Clinical Competence↗
PubMed1995

Psychosocial factors influencing teenage sexual activity, use of contraception and unplanned pregnancy.

OBJECTIVE: to compare teenagers who become unintentionally pregnant and teenagers who have never been pregnant but are using contraception on matters related to family/partner stability, and communication with a parent or stable sexual partner about sexual matters. DESIGN: survey utilising self-completed questionnaire. SETTING: a hospital antenatal clinic and community-based family planning clinic. PARTICIPANTS: 30 teenagers with an unplanned pregnancy and 31 'never-pregnant' teenagers using contraception. FINDINGS: the two groups were similar on demographic factors, mean age at which sexual intercourse was first experienced, total number of sexual partnerships, the number of teenagers having a current, regular boyfriend and mean length of the interval between when the teenagers first started going out with their boyfriend and when first sexual intercourse took place. Teenagers in the family planning clinic group were more likely to be living with both natural parents and to be still at school or in higher education. The mean length of time pregnant teenagers had been going out with their boyfriend was longer, they were more likely to be cohabiting with him and to be unemployed. Participants from the antenatal clinic group communicated more with their mothers about sexual matters than those in the family planning clinic group, who were more likely to seek this information from books. The family planning clinic participants were more likely to discuss personal rules and values with friends than those in the antenatal clinic group. IMPLICATIONS FOR PRACTICE: to develop understanding of factors predisposing to unplanned pregnancy during adolescence and to implement measures to counter them, further studies to examine the influence of teenagers' perceptions of family relationships and future life prospects on contraception use and unplanned pregnancy were identified.

Adolescent↗
PubMed1996

Compliance issues in primary care.

Primary care medical practice is a broadly based medical discipline, emphasizing continuity of care in both sickness and health and effective doctor/patient communication and involving the patient as a partner in the provision of health care services. Against this background, there is troubling evidence that psychosocial (mental health) problems are not being adequately diagnosed and treated by physicians in general, and primary care practitioners in particular. This deficiency is the first step down the road to poor compliance. This author assumes that a goodly portion of the blame can be laid on the doorstep of the medical education establishment with its emphasis on the biomedical, reductionism, and high-tech tertiary care. Physicians exit the educational system with a predisposition to deal with problems from a biomedical perspective. They are unaware that, by the very nature of the doctor/patient relationship, they possess considerable ability to effectively intervene in the psychosocial area. Suggestions are given as to how primary care practitioners can improve on this dimension of their medical practice and deal with psychosocial issues. Available evidence would indicate that effectively dealing with these issues will improve patient compliance and outcomes.

Attitude to Health↗
PubMed2003

Challenges for communicable disease surveillance and control in southern Iraq, April-June 2003.

The recent war in Iraq presents significant challenges for the surveillance and control of communicable diseases. In early April 2003, the World Health Organization (WHO) sent a team of public health experts to Kuwait and a base was established in the southern Iraqi governorate of Basrah on May 3. We present the lessons learned from the communicable disease surveillance and control program implemented in the Basrah governorate in Iraq (population of 1.9 million) in April and May 2003, and we report communicable disease surveillance data through June 2003. Following the war, communicable disease control programs were disrupted, access to safe water was reduced, and public health facilities were looted. Rapid health assessments were carried out in health centers and hospitals to identify priorities for action. A Health Sector Coordination Group was organized with local and international health partners, and an early warning surveillance system for communicable disease was set up. In the first week of May 2003, physicians in hospitals in Basrah suspected cholera cases and WHO formed a cholera control committee. As of June 29, 2003, Iraqi hospital laboratories have confirmed 94 cases of cholera from 7 of the 8 districts of the Basrah governorate. To prevent the transmission of major communicable diseases, restoring basic public health and water/sanitation services is currently a top priority in Iraq. Lack of security continues to be a barrier for effective public health surveillance and response in Iraq.

Communicable Disease Control↗