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PubMed1993

Attitudes towards and observations of nonverbal communication in a psychotherapeutic greeting situation: III. An interview study of outpatients.

An interview study of 50 Swedish nonpsychotic outpatients treated by some kind of psychotherapy was performed to investigate their attitudes towards and observations of nonverbal communication in a greeting situation according to the Questionnaire on Nonverbal Communication (psychotherapy patients' version) in relation to background factors such as gender, age, education, and profession, interest in psychological matters, "reading articles and books in psychology," duration of professional help for psychological troubles, number of occasions waiting for a new therapist, and number of therapeutic sessions before the interview. The greeting situation was the first time a patient and a therapist met in a waiting room. Test-retest reliability of the questionnaire was larger for items about observation of nonverbal communication than for those about attitudes. Face communication (eye contact and smile) was considered by the subjects to constitute the most important nonverbal communication in the greeting process. The importance of the face in communication was stressed when the patient believed that such communication corresponded to more than 50% of the total communication in general, was female, was elderly, or reported special interest in nonverbal communication in the greeting situation. Some effects of bias were discussed. The analyses also showed a considerable consciousness and observation in the greeting situation by many psychotherapeutic outpatients.

Adult↗
PubMed1993

The evaluation of intervention programmes for communicatively impaired elderly people.

A study is described which examined the efficacy of group intervention programmes using trained volunteers as agents of intervention with elderly nursing home residents with communication impairments. A series of intervention programmes, which consisted of six weekly sessions, was designed. Sessions were a combination of information giving, discussion and practical components where residents could practise newly acquired skills. Sessions covered a number of core components--the communication process, comprehension, expression and pragmatics, as well as information that was specific to the communication impairment. Volunteers were trained to administer the programme. Four groups of communicatively impaired elderly people were included in the study--a group of hearing-impaired residents, those with communication impairment subsequent to Parkinson's disease, those with communication impairment subsequent to cerebrovascular accident and those in varying stages of dementia. Results indicated that, although the residents studied responded very individually to the intervention strategies, with several subjects failing to demonstrate any gains in communicative competence from pre- to post-intervention, positive gains in communication skills and self-management of communicative impairment were observed for a number of subjects. Complicating factors such as general health and well-being are considered as uncontrollable variables in the measurement of performance in the elderly.

Aged↗
PubMed1998

[The history and current state of communication avoidance research].

The ability to communicate effectively has a profound impact on academic ability and social status in the United States. As such, communication avoidance may impart critical consequences on individuals who suffer from it. Within the communication discipline, communication avoidance is an extensive body of research with a relatively long history. Central to communication avoidance research is the concept of communication apprehension (CA). However, in comparison with research conducted in the United States, CA research in Japan remains in its genesis. This review thus focuses on communication apprehension and related constructs. Starting with an explanation of the magnitude of the problem of communication avoidance, a definition of CA is presented, and an overview of the related constructs of reticence, shyness, and other communication-related fears is introduced. Basic CA treatment programs and personality correlates of CA are also covered. The review closes by offering suggestions for future CA research in Japan.

Anxiety↗
PubMed2006

Teaching self-concept and self-esteem in a clinical communications course.

Effective interpersonal communication skills are needed for pharmacists to deliver patient-centered care. To achieve this outcome with pharmacists, communication skills are emphasized in pharmacy school in required coursework, such as a clinical communication course. One important concept to include in communication coursework is content on perceptions because perceptions influence communication interactions. Specific emphasis should include a focus on self-perceptions and self-concept, because related empirical literature demonstrates that accurate academic self-concepts predict academic success. These results were extrapolated to a pharmacy clinical communications course where a lecture and laboratory series was designed to emphasize self-concept and facilitate communication skills improvement. The instructional design of this series promoted the advancement of students' communication skills by using communication inventories, self-reflection activities, peer and class discussion, and lecture content. Class discussions, self-reflections, and baseline, and follow-up counseling activities throughout the semester provided evidence of improvements.

Communication↗
PubMed1999

Risk communication: clinicians' reported approaches and perceived values.

Despite significant conceptual and empirical advances in research on the risk assessment of violence during the last decade, there has apparently been no empirical research in the related area of risk communication. After summarizing the major theoretical and practical justifications for studying risk communication, this article describes the results of two studies of clinicians' risk communication practices. In Study 1, practicing clinicians (psychiatrists and psychologists; n = 55) were surveyed. Only one clinician indicated that he employed numerical probability figures in communicating risk; a total of nine reasons for not using numerical probabilities were cited, in varying combinations, by participants. Risk communication practices that were reportedly employed included a total of 11 approaches, endorsed in varying combinations. In Study 2, a separate sample of clinicians (n = 59) rated (1) the importance of the Study 1 reasons against using numerical probability figures in risk communication and (2) the value of the different forms of risk communication derived in Study 1. These data apparently offer the first empirical description of how clinicians communicate the results of risk assessments of violence and their reasons for communicating in such ways.

Communication↗
PubMed2001

Physician-Nurse communication. Perceptions of Physicians in Riyadh.

OBJECTIVE: The need for communication between nurse and physician in clinical practice is undisputed. The objectives of this study were to describe doctors' perceptions of their communication with nurses, as related to the openness of the communication and the accuracy of the information communicated and to examine if specific sociodemographic characteristics concerning physicians were associated with perception of communication. METHODS: The sample consisted of 200 physicians selected randomly from 6 randomly selected hospitals representing both general and private. A modified Shortell's Intensive Care Unit physician-nurse communication subscale was used to measure the physician's perceptions of the degree to which openness and accuracy described their communication with nurses. Data was collected via a self-administered pilot questionnaire, which also included sociodemographic characteristics. RESULTS: The overall mean score for openness was 2.61 and 3.19 for accuracy out of a maximum score of 5. For openness the highest mean score was obtained for "listening to physician (4.31)" and the lowest mean score was obtained for "hospital environment (1.84)". For accuracy, the highest mean score was obtained for "use of medical language (4.37)" and the lowest mean score was for "feedback (1.84)". The results showed a significant difference for experience, age and gender for both types of hospitals. For specialization, title and nationality no significant difference was observed for both types of hospitals for openness and accuracy. Multivariate regression analysis showed that gender, age and experience were the predictor variables for openness and accuracy. With more experienced, older aged females, having the highest mean score. CONCLUSION: Communication between physician and nurses needs not remain only a researchable issue; its viability and vitality are crucial to the changing health care scene. Thus, the development of health delivery models that will enable effective multidisciplinary communication, cooperation and wiser use of limited resources in health care is essential.

Adult↗
PubMed2002

Cross-cultural communication with patients who use American Sign Language.

BACKGROUND: Although American Sign Language (ASL) is the third most commonly used primary language in the United States, physicians are often not adequately prepared for the challenges of conducting an interview with a deafpatient who signs. METHODS: A search of MEDLINE and PsychINFO databases for research on physician-patient communication and deaf people who use ASL was performed. Expert opinion helped guide discussion and recommendations. RESULTS: Few articles examined physician-patient communication involving ASL. Deaf people and their physicians report difficulties with physician-patient communication. Deaf people also report fear that their health care is substandard because of these difficulties. CONCLUSIONS: Preparing residents and medical students for working with patients and families who communicate in ASL presents many opportunities for teaching about physician-patient communication. ASL is quite different from English, and users of ASL often have sociocultural norms that differ from those of the majority culture. In addition to learning how to communicate with patients and families across languages and cultures, students and residents can learn how to collaborate with interpreters and how low literacy impacts physician-patient communication. Opportunities to teach about family dynamics, disability issues, and nonverbal communication also present themselves when working with families with Deaf members. Physician-patient communication involving ASL is an area that is ready for further research.

Communication↗
PubMedDate not supplied

Communication and the patient/physician relationship: a phenomenological inquiry.

All interaction between patient and medical team is mediated through communication. In working with advanced cancer patients, troubled communication between the patient and healthcare team is sometimes evident. The current study examined the perspective of seven advanced cancer patients on this communication. The patients were under the care of an urban cancer research center, and each had expressed, at least once, a desire for hastened death. Using a phenomenological form of inquiry, serial, "in-depth semistructured" interviews were conducted (mean = 3; range = 2-6) at a place convenient to the patient. The interviews were audiotaped, transcribed, coded, and organized into themes. The study findings suggest that the most important aspects of communication between the advanced cancer patient and medical team at an urban cancer research center are the extreme vulnerability of the patient to both style and content of the communication; the extreme sensitivity of the communication itself, because it concerns issues vital to the patient; and the complexity of the communication, encompassing and expressing both verbal and non-verbal messages, as well as intended and unintended messages. Conflict inherent in almost all communication between patient and medical team involved disagreement about goals of care and the participants' perception of not being treated with respect. Harm caused to the participant by communication missteps included loss of hope, a sense of abandonment, and diminished feelings of personal dignity and worth. The findings may not be representative of advanced cancer patients being cared for in a different treatment setting.

Adult↗
PubMed1978

Evaluation of the professional communications of a pharmacist in a 45-bed rural hospital with comprehensive pharmaceutical services.

The professional communications of a pharmacist providing comprehensive services were studied to determine the accuracy of the information provided, its usefulness to patient care and the level of expertise needed to respond appropriately. Data were collected by a diary technique for a four-month period. Patient charts were reviewed to collect clinical data needed to evaluate the appropriateness of the pharmacist's responses and to ascertain evidence that the information provided was implemented. The analysis classified the communications as either "clinical" or "pharmaceutical" in content. Practitioner panels of pharmacists and a physician assessed the communications for accuracy, relevance to the patient episode and level of pharmacy expertise necessary to communicate. Most communications with physicians were "pharmaceutical" in content. The most frequent information asked concerned dose or dosage schedule. Approximately one-third of the "pharmaceutical" communications could have been handled adequately by a technician. Only one communication should have required an extensive literature search for the pharmacist to respond. Less than half of the pharmacist's communications were pertinent to the patient episode and of clinical importance. Information from half of the communications was implemented in patient care within 48 hours. There did not appear to be any relationship between accuracy of response and implementation of information. It is not known whether the deficiencies identified apply to a large number of pharmacists. Hence, the bearing of the study on the cost-benefit of clinical pharmacy services is not clear.

Communication↗
PubMed1983

Nutrition communication program: a direct mail approach.

A nutrition communication model (7) provided the framework for developing and evaluating a mass communication program for families with young children. A three-way interactive communication system via direct mail combined some of the attributes of interpersonal communication with the efficiency of mass-mediated communication. This interaction within the family and between the family and the nutrition communicator was expected to enhance the probability of improvement in nutritional knowledge, attitudes, and practices. The nutrition program took a holistic approach in order to develop an understanding of basic concepts important for making decisions about diet and food selection. Results from audience lists showed that the communication strategy led to desired interaction, particularly within the family reference group. Family discussion occurred frequently, and the amount of feedback was moderate. Attention paid to the messages was good for fathers and very good for mothers. As measured two weeks after program completion, nutrition knowledge increased significantly, and six of nine measured behaviors changed in the desired direction. In addition, one-third to one-half of the participants reported specific changes in food practices. The nutrition communication program was generally effective. The evidence of behavioral changes shows that it is possible to influence food practices with a mass communication program. These results support the belief that the limited effects of mass-mediated programs have been due at least in part to the way the channel has traditionally been used.

Communication↗
PubMed1980

Cell communication in breast cancer.

Direct intercellular communication is the transfer of ions and small molecules between cells in contact. Cells derived from human breast tissue have been examined to determine their pattern of direct communication, which was measured by the 3H-uridine nucleotide transfer method. The behaviour of mammary epithelium from normal and pathological sources has been compared with that of malignant mammary epithelium. Normal human mammary fibroblasts and epithelium demonstrate selectivity in direct communication. Thus although both transfer nucleotide to and from their own cell type, they do not transfer nucleotide between one another in heterologous co-culture. Further study of a variety of non-human fibroblasts and epithelium showed that cells may be functionally subdivided into selective communicators, non-selective communicators, and non-communicators. None of the malignant human breast cells examined showed selectivity in communication. Thus both primary cultures and established lines were either non-communicators or non-selective communicators. This loss of selectivity could favour the metastasis of malignant cells, enabling them either to ignore inhibitory growth control signals or alternatively to receive stimulatory signals from abnormal sources.

Breast↗
PubMed1995

Communication with deaf patients. Knowledge, beliefs, and practices of physicians.

OBJECTIVE: To assess physicians' knowledge and beliefs regarding communication with deaf people and compare their knowledge and beliefs with their methods of communicating with deaf patients in their practices. DESIGN: Survey. SETTING: University medical center. SUBJECTS: Attending physicians in an internal medicine department. INTERVENTIONS: Physicians were surveyed regarding prior contacts with deaf patients and with deaf people outside the medical setting, and regarding their knowledge and beliefs concerning methods of communicating with deaf people. Physicians were asked to estimate the fraction of encounters in which they communicated with deaf patients by lipreading, writing, translation by a relative or friend, a sign language interpreter, or other methods. RESULTS: Writing was the method used most frequently in communicating with deaf patients. Although 63% of physicians knew that signing should be the initial method of communicating with deaf patients who sign, only 22% used sign language interpreters more frequently than other methods in their practices. Past contact with deaf people (P = .05), belief that communication by signing was the best means of communication (P = .04), and knowledge of the inefficiency of lipreading (P = .04) were predictors of the use of sign language interpreters for deaf patients. Physicians who used sign language interpreters more frequently than other methods believed that much more time and effort were involved in caring for deaf than for hearing patients compared with those who used interpreters less frequently (P = .08). CONCLUSION: Although most physicians believed that use of sign language interpreters was preferable, only a minority used them in their practices. Greater recognition of the advantages of signing over other methods and greater availability of sign language interpreters should lead to more effective communication between deaf patients and physicians.

Adult↗
PubMed1995

Risk communication: a tool for behavior change.

This chapter presents some of the theories and models underpinning effective communication practice. It also emphasizes the central role of communication in achieving effective program implementation. Whether the communication is aimed at changing the attitudes and behavior of professionals, various segments of the public, or other target audiences, the basic approach is the same. The following checklist provides a guide to program planners (Arkin 1991): Commit adequate time, effort, and resources to communication planning and pretesting. Begin by singling out specific issues and specific target audiences. Then design messages based on the target audiences' values, needs, and interests. Conduct (or review existing) market research on the target audience to understand what will motivate them. Pretest messages and materials with the target audience to assure understanding and relevance to their needs and interests. Make sure that messages and materials appear where the target audience will pay attention to them (for sensitive issues, community and interpersonal channels that allow interactive discussion are very important). Produce public service announcements that are of high quality, community specific, marketed to stations, and targeted to audiences likely to see them when public service air time is available (such as fringe viewing times). Combine public service announcements with news and other uses of the mass media (e.g., building on related news) to increase exposure to issues. Use a combination of the mass media and community channels that will reach the target audience. Work collaboratively with other organizations, including drug treatment facilities, law enforcement and social service agencies, and other community organizations that have complementary strengths. Begin to coordinate efforts as early as possible in program planning. Use a multipronged communication strategy to focus on what an individual should do, how the individual can start to change, and factors that help reinforce individual change, such as peer approval and community support. Track progress and identify when, and what kind of, changes are needed in communications. Combine communications with other strategies needed to support change (e.g., access to treatment or positive alternatives to drug use). Set reasonable, short-term communication objectives to reach the long-term goal. Then, commit to communications as one program component over the long term. It is important to remember that one-shot campaigns are unlikely to have a lasting effect and that progress is incremental.

Behavior↗
PubMedDate not supplied

[Communication behavior between parents and their adolescent children and correlation with indicators of self concept].

Formats of communication within families are believed to be relevant contexts for children's development. Cultural values, norms, and interpretation patterns are transferred from parents to children within the family's specific communication framework. By the same token, skills to maintain the balance of living together or to realize one's own wishes are acquired within the scope of extant formats of exchange among family members. Puberty is a period, where a child strives for more autonomy and tends to dispute present parent-child relationships. The focus of the study is on links between formats of communication within the family and adolescents' estimations of the relationships with their parents and also adolescents' judgments about their self-esteem. 67 families with an adolescent child (between 11 and 12 years old at the beginning of data collection) participated in a longitudinal study, in which adolescents judged the quality of their relationship with parents as well as their self-esteem every six months over a period of three and a half years (8 waves). In addition, concrete communication behavior between parents and adolescents was observed and recorded during the first, fourth, sixth, and eight wave of data collection. Results point to considerable differences among adolescents' judgments concerning their quality of relationship with the parents and their self-esteem. Groups could be formed according to these differences. Data also show that adolescents show a high degree of constancy in their estimations over time. However, communication behaviors in parent-adolescent dyads showed divergent patterns of communication across the different groups on the one hand, and different degrees of variation of communication formats within groups over time on the other, dependent on whether adolescents belonged to the group of high quality relationship and self-esteem (considerable variation over time) or to the group of low quality relationship and self-esteem (less variation over time). Results are discussed under the perspective of adolescents' different experiences in family communication, and implications of possible links between development of self-esteem and adaptive or nonadaptive variations in family communication are considered.

Adolescent↗
PubMed1996

Nurse-physician communication: perceptions of nurses at an Army medical center.

The purposes of this study were to describe nurses' perceptions of their communication with physicians, as related to the openness of the communication, the accuracy of the information communicated, and the timeliness of the interaction; and further, to determine if specific demographic characteristics of nurses are associated with perceptions of positive communication. The sample (N = 112) consisted of professional nurses working on one of nine inpatient units at a major military medical center. Shortell's ICU Nurse-Physician Communication subscale was used to measure the nurses' perceptions of the degree to which openness, accuracy, and timeliness described their communication with physicians. Overall findings were that the nurses perceived a poor quality of communication between themselves and the physicians with whom they interacted. Results from this study further indicated that the perceived quality of nurse-physician communication was not related to a nurse's educational level, length of nursing experience, or length of time assigned to a specific unit. Finally, findings provided no evidence that perceived levels of nurse-physician communication were greater among permanent staff than temporary nursing staff, or in intensive care units versus general ward areas.

Communication↗
PubMed2005

Anatomical study of the communicating branches between the medial and lateral plantar nerves.

The plantar areas of the foot have specific biomechanical characteristics and play a distinct role in balance and standing. For the forefoot surgeon, knowledge of the variations in the anatomy of communicating branches is important for plantar reconstruction, local injection therapy and an excision of interdigital neuroma. The anatomy of the communicating branches of the plantar nerves between the fourth and third common plantar digital nerves in the foot were studied in 50 adult men cadaveric feet. A communicating branch was present between the third and fourth intermetatarsal spaces nerves in all eight left feet and in six right feet (overall, 28%), and absent in 36 (72%). A communicating branch was found in 14 ft. Ten of the 14 communications were from the lateral to the medial plantar nerve. The length of the communicating branch ranged from 8 to 56 mm (average 16.4 mm) and its diameter was 0.2-0.6 times of the fourth common plantar digital nerve. The angle of the communicating branch with the common plantar digital nerve from which it originated was less than 30 degrees in 11 ft, 30-59 degrees in 27 ft, 60-80 degrees in 8 ft, and more than 80 degrees in 4 ft. Classification of the branch is based on the branching pattern of the communicating branch and explains variations in plantar sensory innervations. We think that the perpendicular coursing communicating branch is at higher risk to be severed during surgery.

Adult↗
PubMed1997

A communication server for telemedicine applications.

The telemedicine applications, in some cases, need multipoint-to-multipoint communication. To meet the requirement of telemedicine communication, the development of a medical communication server is proposed in this paper. To make a working, as well as cost-effective, communication platform for the telemedicine applications, a specially designed communication server model is proposed in this work. This server is able to provide an effective multipoint-to-multipoint communication service for any level applications in telemedicine. The implementation program of this server is developed in a Windows'95 environment by using a winsocket. The trial application testing in a telemonitoring system is also presented to demonstrate the feasibility of taking such a structure with the server. By using the architecture of such a communication server in telemedicine applications, the multipoint-to-multipoint communication is easily managed and the communication processes are simplified and well controlled by the server.

Blood Pressure Monitoring, Ambulatory↗
PubMedDate not supplied

Communication during prosthodontic treatment--dentist, patient, and dental nurse.

PURPOSE: This study described and explored verbal communication during prosthodontic treatment. MATERIALS AND METHODS: Sixty-one patients and 15 dentists participated. Sixty-one prosthetic treatment periods, during which fixed tooth- or implant-supported prostheses were placed, were followed. One visit during each treatment period was audio recorded. The recorded verbal communication was analyzed with the Roter Interaction Analysis System-dental. The inter-rater reliability was 95% to 97% for utterance classification and kappa = 0.71 to 0.78 for categorization definition. RESULTS: There were 43,663 utterances available for analysis. Of those, 59% was dentist communication, 28% was patient communication, and 10% was dental nurse communication. Other persons, e.g., dental technicians, contributed with 3%. The dentist-patient communication contained more task-focused than socioemotional behaviors. Female patients used socioemotional talk to a greater extent than did the male patients. Dentists and patients of different genders communicated more overall, especially male dentists with female patients. The age difference between dentist and patient had no effect on the amount or type of communication. The dental nurse talked slightly more with male patients. CONCLUSION: When different genders met there was more communication, and the talk was more socioemotional when the patient was female.

Adult↗