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PubMed1990

[A study of factors affecting the communication ability of aphasics].

Standard Language Test of Aphasia (SLTA) may not represent sufficiently about communication ability of aphasic patients. Therefore authors studied factors affecting the communication ability of aphasic patients. Subjects were 66 aphasic patients treated in the Department of Communication Clinic, Atami General Hospital. These patients were divided into 2 groups; good communication (41 cases) and bad communication groups (25 cases) according to the result of communication ability test. Factors affecting the communication ability are then examined by quantitative analysis class 2. Nine factors, severity of aphasia, self-modification in speech, memorization disorder, disturbance of volition ability, the time elapsed since onset, disturbance of concentration and continuation ability, depressive state, shyness, positiveness are revealed to be greatly affecting the communication ability of aphasic patients.

Adult↗
PubMed1990

Cellular communication.

Generally, cellular-telephone communications seem to be a valuable means for the public to communicate that an accident has occurred on highways in metropolitan areas. Response time is reduced and congestion quickly relieved. This system could be improved by making a provision in emergency call boxes for the separation of vehicle problems from true emergency calls to ensure the proper response priority. Cellular-telephone communications are a valuable adjunct to EMS radio communications for biotelemetry, when channels are overcrowded or communications are needed in a "dead" area. A system of dedicated hospital-emergency-department lines and telephone numbers is needed. Cellular telephones shouldn't be used as a primary means of providing medical control. Advance planning should be undertaken to ensure immediate access to hospital emergency departments if cellular is used for secondary purposes. The amount of communication traffic at and surrounding a multi-casualty incident or disaster may overwhelm a local cell. Priority numbers providing immediate access and bumping of non-emergency calls for emergency responders are needed. All means of communication should be coordinated by an EMS communications MCI or disaster plan.

California↗
PubMed1997

The ABCs of effective communication.

Communication is affected by the aim of the communicators, their bias, and the climate in which they are communicating. It is also affected by their attitudes, their behaviors, and their self-concepts. Finally, before communicating, they should assess the communication situation, create a blueprint for the communication, and choose a communication style. In other words, they should practice the ABCs of communication.

Attitude↗
PubMed1999

Regulation of cell-cell communication in rat bone cells: the effect of phorbol esters.

The skin tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) is a potent inhibitor of gap junctional intercellular communication. In the present study, the inhibition of cell-cell communication by TPA has been investigated in primary bone cells from newborn rat calvaria, with an emphasis on the involvement of intracellular pH (pH(i)) and cytosolic calcium ([Ca(+2)](i)) in this process. The results show that TPA (5 x 10(-)(8) M) caused a complete inhibition of intercellular communication within 40-60 min. The intercellular communication was fully restored after overnight incubation in the presence of TPA. This effect was found to be associated with an elevation of pH(i). However, neither an increase of pH(i) alone nor exposure to TPA, under conditions preventing pH(i)-shift, were found to affect intercellular communication. It is suggested that the inhibition of intercellular communication, in the presence of TPA, depends on the pH(i)-shift itself rather than on the absolute value of pH(i). In addition, elevation of cytosolic calcium by ionomycin led to the termination of intercellular communication after 30 min. This inhibitory effect was abolished when the cells were incubated for overnight with TPA and then intracellular calcium was elevated by the addition of ionomycin. These results indicate that shift of pH(i) and the increase of intracellular calcium are involved in repression of intercellular communication by TPA.

Animals↗
PubMed1999

Evidence on patient-doctor communication.

This chapter covers important and well-studied aspects of patient-doctor communication. First the paper describes the lessons learned from studies about patients' satisfactions or dissatisfactions related to patient-doctor communication, making the point that complaints about doctors are usually due to communication problems and not technical competency issues. The next section of the chapter deals with time. It is often assumed that effective communication is inefficient. While this is not necessarily the case, the research results are complex and very interesting. The third part of the chapter covers communication in relation to patient adherence with the management plan recommended by the doctor. There is strong evidence that communication affects patient adherence and that there are four key aspects of communication that can enhance the patients' co-operation with the management plan. The final topic is patients' health. Twenty-two studies indicate the generally positive effect of key dimensions of communication on actual patient health outcomes such as pain, recovery from symptom, anxiety, functional status, and physiologic measures of blood pressure and blood glucose.

Attitude to Health↗
PubMed1999

The role of medical organizations in supporting doctor-patient communication.

The clinical competence of physicians depends largely on the education, accreditation, certification and licensing programs offered by the various Canadian medical organizations. In virtually all of these, doctor-patient communication is a required element. Educational programs at all levels are subject to accreditation by a number of different organizations including undergraduate medical programs (Committee on Accreditation of Canadian Medical Schools), residency training (College of Family Physicians of Canada and Royal College of Physicians and Surgeons of Canada) and continuing medical education (CFPC and RCPSC). Doctor-patient communication is a key element in teaching at all levels. The two colleges also emphasize communications in the certification process. The provincial licensing authorities are aware of the importance of effective communication between physicians and patients. Several of the them have physician assessment programs, and recently they have started to assess a model of mandatory performance review. Both of these approaches assess physician-patient communication. There is increasing pressure, with strong support from consumers, that some level of communication skills competency should be imposed by the licensing authorities. Most approaches to exposing physicians to communications focus on rewards rather than coercion but a number of possible schemes could be considered to promote communication skills.

Accreditation↗
PubMedDate not supplied

In context: physician-patient communication and managed care.

Communication between a physician and his or her patient is a critical component of medical care delivery. The quality of communication affects patient satisfaction and health outcomes. Managed care has heightened the awareness of communication because of the direct links among communication, outcomes, and malpractice liability. This article describes patient satisfaction, the relationship between communication and biological outcomes, the role that communication plays in malpractice prevention, the communication challenges present in the managed health care environment, and the need for communication skills training.

Communication↗
PubMed1999

Improving communication among health professionals through education: a pilot study.

Communication can be thought of as a message that is sent, received, and understood. Each discipline of the health profession has its own jargon and means of expressing ideas in shorthand. These separate forms of communicating are effective among those of the same background but are often at the root of misunderstandings between professional groups. This article reviews communication theory and traces the difficulties created when inter-disciplinary teams of healthcare try to work together and communicate. As multi-disciplinary teams are increasingly dealing with the complex problems of today's healthcare system, clear communication and understanding has never been more important. If educators could assist in creating an understanding of vocabulary used for decision processes, communication could improve. The authors of this study performed a multi-stage Delphi survey that grouped terms used by administrators and clinicians and produced a lexicon of corresponding terms. An expert panel then reviewed and modified the list. The result is a lexicon that can be useful to assist clinicians and administrators to communicate with each other. By utilizing clinical terminology, or vice versa, instead of management or clinical jargon, some of the translation done by administration or clinicians could be reduced. Examples of how the lexicon can be utilized are provided in the article. This includes using it in health administration education to demonstrate the variances in clinical/managerial terms. It could also be provided as a primer to physicians, nurses, and other health professionals who assume administrative positions to enhance their communication with administrators.

Communication↗
PubMedDate not supplied

Study of interspouse communication and adoption of family planning and immunization services in a rural block of Varanasi District.

Interspouse communication was studied in some pertinent areas which have an important bearing on day to day transactions. The level of such communication measured on a three-point scale was studied for its role on acceptance of family planning and immunization services. 200 currently married females residing with their husbands in a rural block of Varanasi, in the reproductive age group, with at least one child aged 1-3 years were selected and interviewed. Scores were ascribed for 12 selected items of conversation according to frequency of conversation on a three point scale based on which high, medium and low communicators were delineated. In this study high, medium and low communicators were found to be 14%, 40% and 45% respectively. Topics of importance which never featured in interspouse communication were menstrual problems (44%), when to have first child (82.5%) and birth spacing (48.5%). Interspouse communication was better in upper castes and joint families. Literacy status of both husband and wife and per capita income of the family revealed positive relationship with inter-spouse communication. Adoption and practice of family planning methods as well as full immunization coverage of the child in the family were observed to be higher among high and medium communicators as compared to low degree of communcators (p < 0.001).

Adult↗
PubMed2003

Dentists' and patients' communicative behaviour and their satisfaction with the dental encounter.

OBJECTIVE: The aim of this study was to examine the relations between patients' and dentists' communicative behaviour and their satisfaction with the dental encounter. PARTICIPANT: The sample consisted of 90 patients receiving emergency care from 13 different dentists. BASIC RESEARCH DESIGN: Consultations were videotaped in order to assess dentists' and patients' communicative behaviour. Dentists' behaviour was coded by means of the Communication in Dental Setting Scale (CDSS), scores for patients' behaviour included among other things, the number of questions asked during the consultation. MAIN OUTCOME MEASURES: After treatment, patients filled out a questionnaire that assessed their satisfaction with their own and their dentist's communicative behaviour. Dentists also filled out a satisfaction questionnaire after each consultation. RESULTS: Results showed that dentists' satisfaction could not be explained by patients' or dentists' communicative behaviour. Patients' satisfaction was mainly influenced by the communicative behaviour of the dentist. CONCLUSION: Not only is patients' satisfaction positively related to the communicative behaviour of dentists, but the principle of informed consent requires dentists also to inform their patients adequately enough for them to reach a well-informed decision about the treatment. Therefore, it remains important to train dentists in communicative skills.

Adolescent↗
PubMedDate not supplied

The dentist's communicative role in prosthodontic treatment.

PURPOSE: Dentist-patient verbal communication is important for patient satisfaction. The aim of this study was to investigate the dentist's role in the provider-patient relationship as to verbal communication and patient satisfaction with the treatment outcome in prosthetic dentistry. The dentist-specific properties were analyzed in random coefficient modeling. MATERIALS AND METHODS: Sixty-one dentist-patient pairs were followed through 61 prosthodontic treatment periods. The treatment performed was fixed prosthodontic restorations on teeth or implants. One encounter at the end of each treatment period was tape recorded. The verbal communication on the recordings was analyzed using an interaction analysis instrument. Various measures of communication were used, summarizing the variational pattern of verbal interaction. Two different aspects of the patient satisfaction concept were used as dependent variables: cure (overall patient satisfaction with prosthodontic treatment), and care (patient satisfaction with a particular dental encounter during the prosthodontic treatment period). RESULTS: In the multilevel model for care, the dentist variance was mostly explained by the communication variables. In the cure model, there was no dentist variance. The communication patterns used by the dentists thus influenced patient satisfaction in a short-term perspective but not in an intermediate perspective. CONCLUSION: Patient evaluation of the care during an encounter is dependent on the dentist's verbal communication activity during the encounter, but this communication has no impact on the patient evaluation of overall prosthetic treatment outcome in the intermediate time perspective.

Adult↗
PubMed2005

Patient-physician communication: why and how.

Patient-physician communication is an integral part of clinical practice. When done well, such communication produces a therapeutic effect for the patient, as has been validated in controlled studies. Formal training programs have been created to enhance and measure specific communication skills. Many of these efforts, however, focus on medical schools and early postgraduate years and, therefore, remain isolated in academic settings. Thus, the communication skills of the busy physician often remain poorly developed, and the need for established physicians to become better communicators continues. In this article, the authors briefly review the why and how of effective patient-physician communication. They begin by reviewing current data on the benefits of effective communication in the clinical context of physicians caring for patients. The authors then offer specific guidance on how to achieve effective communication in the patient-physician relationship.

Communication↗
PubMed2005

Effective communication with patients.

This brief article aims at heightening awareness about communication with various patients, including strategies to assist in improving communicative effectiveness. It assists us as health care professionals to go back to basics and reflect on how we communicate. Several researchers have provided insight into ways that communication may be enhanced. Walter, Bundy, and Donan (2005) suggested personally greeting the patient, introducing oneself, engaging in talk about clinical concerns, and then discussing next steps toward healthcare solutions. Schillinger (2003) implored that health related jargon be avoided and that all messages be clear and simple. Illustrations in the form of black-white line drawn pictures also tend to assist in patient comprehension. Lawton and Carroll (2005) suggested that effective communication requires assessing what the patient knows about their illness. Seidel's model (2004) stated that healthcare providers listen to the patient's story and elicit information through questioning with sufficient time allotted to provide answers. He also discussed the importance of providing a short summary of what the patient conveyed and giving additional information so they learn more about what is happening to them and can become an active participant in making decisions. It is important that patients understand what we as healthcare professionals say to them. Wisner (1999) further conveyed that it is not words alone that communicate. Body language, facial expressions, and tone of voice often provide additional clues influencing communicative effectiveness. Without a doubt, communication, directly impacts service delivery and quality of care in healthcare today. Listen to your patients, they have much to say.

Clinical Competence↗
PubMed2006

Effective improvement of doctor-patient communication: a randomised controlled trial.

BACKGROUND: Doctor-patient communication is an essential component of general practice. Improvement of GPs' communication patterns is an important target of training programmes. Available studies have so far failed to provide conclusive evidence of the effectiveness of educational interventions to improve doctor-patient communication. AIM: To examine the effectiveness of a learner-centred approach that focuses on actual needs, to improve GPs' communication with patients. DESIGN OF STUDY: Randomised controlled trial. SETTING: One hundred volunteer GPs in the Netherlands. METHOD: The intervention identified individual GPs' deficiencies in communication skills by observing authentic consultations in their own surgery. This performance assessment was followed by structured activities in small group meetings, aimed at remedying the identified shortcomings. Outcomes were measured using videotaped consultations in the GPs' own surgery before and after the intervention. Communication skills were rated using the MAAS-Global, a validated checklist. RESULTS: The scores in the intervention group demonstrated a significant improvement compared with those of the control group (95% confidence interval = 0.04 to 0.75). The effect size was moderate to large (d-value = 0.66). The level of participation significantly contributed to the effectiveness. Largest improvement was found on patient-centred communication skills. CONCLUSION: The approach of structured individual improvement activities based on performance assessment is more effective in improving communication skills than current educational activities.

Communication↗
PubMed1989

The relationship between parent-sibling communication and coping of siblings with death experience.

Past studies have suggested that parents who can effectively communicate about subjects such as death and dying are most likely to help their child cope with illness and death. Most studies have focused on communication with the ill child and less attention has been paid to the sibling. As part of a larger study to investigate the effects of two types of terminal care on families of a child dying of cancer, this portion of the study focused on parent-sibling communication. It was hypothesized that increased communication would increase coping as manifested by fewer behavioral problems and more social competence in siblings. The tools used included the Child Behavior Check List (CBCL) and the Parent-Sibling Communication instrument. Measurements were taken before and at 2 weeks, 4 months, and 12 months after the death of the ill child. One positive and four negative correlations were found. Parent-sibling communication was positively related to Social Competence before the ill child's death, and was inversely related to Total Behavior Problems following the death. Parent-sibling communication was also inversely related to External Behavior Problems after the ill child's death, to Internal Behavior Problems after the ill child's death, and to Internal Behavior Problems at the 4-month point after the death. The positive relationship between parent-sibling communication and Social Competence scores may reflect the sensitivity of parents to siblings' needs.

Adaptation, Psychological↗
PubMed1988

Further evidence for the involvement of gap-junctional intercellular communication in induction and maintenance of transformed foci in BALB/c 3T3 cells.

In order to investigate further the role of gap-junctional intercellular communication in the process of cell transformation, we examined the effects of chemicals that modulate gap-junctional communication on the induction and maintenance of transformed foci in BALB/c 3T3 cells. When dibutyryl cyclic AMP, retinoic acid, fluocinolone acetonide, or dexamethasone was added during the induction of cell transformation by standard (3-methylcholanthrene alone) or two-stage (low dose of 3-methylcholanthrene plus phorbol ester) protocols, there was a significant decrease in the number of transformed foci. When BALB/c 3T3 cells are transformed, there is selective intercellular communication between transformed and between surrounding nontransformed cells: transformed cells communicate among themselves but not with surrounding normal cells. Addition of dibutyryl cyclic AMP, retinoic acid, fluocinolone acetonide, or dexamethasone to culture dishes in which transformed foci were present induced communication between transformed cells and surrounding normal cells. In the continuous presence of these chemicals, there was a clear decrease in the number of transformed foci. These chemicals therefore appear capable of reestablishing intercellular communication between transformed and nontransformed cells and of diminishing the number of transformed foci. However, when transformed cells were isolated and placed in culture dishes at clonal density in the presence of these chemicals, there was hardly any decrease in the number of transformed colonies, suggesting that the chemicals cannot revert the phenotype of transformed cells in the absence of normal cells. These results suggest that chemicals that modulate intercellular communication not only inhibit the induction of transformed foci but also revert transformed cells to the normal phenotypes by establishing intercellular communication with surrounding normal cells.

Animals↗
PubMed1986

Comparison and message-formulation skills in the referential communication of severely mentally retarded children.

The importance of comparison and message-formulation skills in referential communication was studied with severely mentally retarded children. A store game task was used that required the child to communicate a choice of one or two objects on a shelf. Comparison training taught the children to select the appropriate object when paired with a similar but inappropriate object. Message training taught the children to communicate by pointing and/or gesturing. Results indicated that combined comparison and message training produced higher communication accuracy than did comparison training alone. Comparison training, however, increased subjects' accuracy of communicating as compared to an untrained control group. A parallel pattern of results was found for communication frequency. The training groups either maintained or improved their communicative performance in a near-generalization task, suggesting that they learned communicative behavior and not merely task-specific behavior.

Activities of Daily Living↗
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↗