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PubMed2001

Communication between nurses and simulated patients with cancer: evaluation of a communication training programme.

In this paper the effect of a communication training programme on the instrumental and affective communication skills employed by ward nurses during the admittance interview with recently diagnosed cancer patients was investigated. The training focused on teaching nurses skills to discuss and handle patient emotions. For this purpose, 46 nurses participated in 92 videotaped admittance interviews with simulated patients. The study had a randomized pre-test-post-test design. Multi-level analysis was used to measure the effects of the training. The results revealed that the trained nurses significantly increased asking open-ended psychosocial questions, which indicates that they were actively exploring patients' feelings. Furthermore, the patients showed a significant increase in affective communication. In conclusion, the results of this study demonstrate that, although limited, training can induce favourable changes in the communication skills of nurses, and can even affect patient communication. Future studies should focus on the further evaluation of educational programmes to enhance communication skills.

Journal Article↗
PubMed1999

Interpersonal communication skills of deaf adolescents and their relationship to communication history.

As part of a longitudinal study, the conversational skills of 67 deaf adolescents were assessed in spoken English, simultaneous communication (SimCom) and American Sign Language (ASL). Two groups of students were identified on the basis of the communication used in their current educational program: a small group of 16 students in programs using spoken English (oral) and a larger group of 51 students in programs using sign communication (bimodal). Students in spoken English programs had good spoken English skills and limited ASL skills, whereas the reverse was true for students in bimodal programs. Most students demonstrated sufficient skill in one or more systems to meet basic interpersonal communications needs, but not those required for advanced academic discourse. In neither group was spoken English related to ASL skill. SimCom skills were strongly related to spoken English in the oral program group and to ASL in the bimodal program group. Spoken English in adolescence was highly predictable from spoken English in early childhood. Within the bimodal program group, students with deaf parents had better SimCom and ASL skills than those with hearing parents. Among bimodal program students with hearing parents, better SimCom skills (but not ASL skills) were associated with earlier introduction to sign communication in school and to mothers' use of sign communication.

Journal Article↗
PubMed2006

Developmental memory capacity resources of typical children retrieving picture communication symbols using direct selection and visual linear scanning with fixed communication displays.

PURPOSE: This study examined the cognitive demands of 2 selection techniques in augmentative and alternative communication (AAC), direct selection, and visual linear scanning, by determining the memory retrieval abilities of typically developing children when presented with fixed communication displays. METHOD: One hundred twenty typical children from kindergarten, 1st, and 3rd grades were randomly assigned to either a direct selection or visual linear scanning group. Memory retrieval was assessed through word span using Picture Communication Symbols (PCSs). Participants were presented various numbers and arrays of PCSs and asked to retrieve them by placing identical graphic symbols on fixed communication displays with grid layouts. RESULTS: The results revealed that participants were able to retrieve more PCSs during direct selection than scanning. Additionally, 3rd-grade children retrieved more PCSs than kindergarten and 1st-grade children. An analysis on the type of errors during retrieval indicated that children were more successful at retrieving the correct PCSs than the designated location of those symbols on fixed communication displays. CONCLUSIONS: AAC practitioners should consider using direct selection over scanning whenever possible and account for anticipatory monitoring and pulses when scanning is used in the service delivery of children with little or no functional speech. Also, researchers should continue to investigate AAC selection techniques in relationship to working memory resources.

Analysis of Variance↗
PubMed2006

A preliminary investigation of barriers to achieving patient-centered communication with patients who have stroke-related communication disorders.

This article reports on research investigating barriers to achieving patient-centered communication (PCC) with patients who have stroke-related communication disorders. A focus group, including people who had strokes and their family members, identified PCC issues they encounter when communicating with health care providers. The two key themes that emerged from this research were the desire to be treated with respect and the importance of allowing adequate time for a person with a speech disorder to communicate. Suggestions are given for improving PCC with people who have stroke-related communication disorders.

Communication Barriers↗
PubMed1992

[Communication with patients--the effect of verbal and nonverbal communication on the unconscious patient].

Communication, both verbal and non-verbal, is a greatly neglected skill at present. Two reasons given for this state of affairs are lack of time and lack of interest in others. Since it is difficult to separate verbal and non-verbal communication, the effects of both types were studied, whether or not they occurred simultaneously. Empirical evidence shows that unconscious patients are highly sensitive to the nature of communication, and that their intracranial pressures rise or fall concomitant in the way in which a conversation is being conducted within hearing distance. Music and touch seem to have similar consequences. The influence of communication is, however, not confined to intracranial pressure changes. The sympathetic and parasympathetic nervous systems are also affected, with associating changes in the heart rate. Messages of acceptance or rejection may be conveyed verbally or non-verbally. Communication with patients appears to be decisive, and should therefore warrant far greater attention than it receives at present.

Clinical Nursing Research↗
PubMed1994

Personal cost, caring and communication: an analysis of communication between relatives and intensive care nurses.

Much of health care is seen as 'communication-centred' (Smith & Bass 1982) and the interpersonal nature of nursing gives this view particular relevance. The potential contribution to patient well-being which is offered by good communication is being recognised by professional service providers and consumers alike. Whilst relatives or 'significant others' have an important impact on patient well-being, recognition of their own needs is becoming more evident. This paper, therefore, is intended to focus attention on communication between nurses and patients' relatives in critical care settings. Needs of relatives are discussed along with an analysis of nurses' responses to these needs, and nurses' apparent reluctance to be involved is explored. A critical appraisal of the literature reveals compelling arguments for a decisive contribution by nurses to this area of care. Initiatives aimed at placing communication needs of relatives more firmly within a nursing remit are then explored. Whilst intensive care units (ICUs) may generally demonstrate good practice in relation to communicating with relatives it is suggested that exploration of concepts surrounding both the nature of nursing and caring may offer valuable insights into this aspect of critical care nurses' role.

Communication↗
PubMed2005

The double burden of communicable and non-communicable diseases in developing countries.

Now, at the dawn of the third millennium, non-communicable diseases are sweeping the entire globe. There is an increasing trend in developing countries, where the demographic and socio-economic transition imposes more constraints on dealing with the double burden of infectious and non-infectious diseases in a poor environment, characterized by ill-health systems. It is predicted that, by 2020, non-communicable diseases will cause seven out of every ten deaths in developing countries. Among non-communicable diseases, special attention is devoted to cardiovascular disease, diabetes, cancer and chronic pulmonary disease. The burden of these conditions affects countries worldwide but with a growing trend in developing countries. Preventative strategies must take into account the growing trend of risk factors correlated to these diseases. In parallel, despite the success of vaccination programmes for polio and some childhood diseases, other diseases like AIDS, tuberculosis, malaria and dengue are still out of control in many regions of the globe. This paper is a brief review of recent literature dealing with communicable and non-communicable diseases in developing countries. It gives a global view of the main diseases and their impact on populations living in low- and middle-income nations.

Cardiovascular Diseases↗
PubMed1990

Extended communication samples of augmented communicators. I: A comparison of individualized versus standard single-word vocabularies.

Vocabulary selection for linguistically intact augmented communicators is a growing clinical concern. The purpose of this study was to compare and contrast the relative benefits of word lists that were individualized for these augmented subjects to word lists selected from standard vocabulary sources. Communication samples were collected for 14 consecutive days from 10 subjects who used augmentative and alternative communication (AAC) devices. These samples were analyzed to determine the frequency of single word occurrence, and the results were compared with those obtained from analysis of standard vocabulary lists. The conclusions of the study were (a) that when vocabulary lists are individually created, based on the frequency of word occurrence in natural communication samples, relatively short lists can represent a large proportion of the total communication sample; (b) that individualized word lists are more efficient than standard vocabulary lists, if efficiency is defined as a large proportion of the total sample represented by a small list; and (c) that if used in their entirety, standard lists are not efficient because they contain a large number of words that are rarely used.

Adolescent↗
PubMed2002

The development of a scale to measure medical students' attitudes towards communication skills learning: the Communication Skills Attitude Scale (CSAS).

INTRODUCTION: There is little research identifying medical students' attitudes towards communication skills learning. This pilot study outlines the development of a new scale to measure attitudes towards communication skills learning. METHODS: First- and second-year medical students (n = 490) completed the 26-item Communication Skills Attitude Scale (CSAS) and 39 students completed the CSAS on a second occasion. Factor analysis was conducted to determine the factors underpinning the scale. The internal consistency of the subscales was determined using alpha coefficients. The test-retest reliability of the individual scale items were determined using weighted kappa coefficients and the test-retest reliability of the subscales were established using intraclass correlation coefficients. RESULTS: Maximum likelihood extraction with direct oblimin rotation resulted in a 2-factor scale with 13 items on each subscale. Factor I represented positive attitudes towards communication skills learning and factor II represented negative attitudes. Subscale I had an internal consistency of alpha=0.873 and an intraclass correlation of 0.646 (P < 0.001). Subscale II had an internal consistency of alpha=0.805 and an intraclass correlation of 0.771 (P < 0.001). The majority of items on the positive (n=9, 69.2%) and the negative attitude subscales (n=8, 61.5%) possessed moderate test-retest reliability. DISCUSSION: The development of a new and reliable scale to identify medical students' attitudes towards communication skills learning will enable researchers to explore the relationships between medical students' attitudes and their demographic and education-related characteristics. Further work is needed to validate this scale among a broader population of medical students.

Adolescent↗
PubMed2006

The effect of context on communication: a study of the language and communication skills of adults with acquired brain injury.

PRIMARY OBJECTIVE: To examine the effects of changing contexts on language and communication skills of adults with acquired brain injury. RESEARCH DESIGN: Repeated measures design. METHODS: Four adults with brain injury were observed in four contexts with pragmatic language and communication behaviours recorded. Contexts included baseline, two intervention phases (a 3-day camp and post-camp period) and 2-month follow-up. RESULTS: Participants demonstrated improvements in constructive language production during intervention phases. Results indicate structure, cueing and positive experiences created language which was observed to overcome the influence of organic damage. However, at follow-up, the language and communication levels returned to baseline levels. CONCLUSION: Clinically, these results have implications for the development of sustained interventions for language and communication skills in community-based rehabilitation programmes. Creating supporting contexts may serve as an effective means of improving language and communication behaviours, while also facilitating optimum community inclusion.

Adult↗
PubMed2006

Why communication is crucial: meta-analysis of the relationship between safer sexual communication and condom use.

The purpose of this study was to quantitatively synthesize the growing literature on the relationship between safer sexual communication (SSC) among sexual partners and condom use, and to systematically examine a number of conceptual and methodological moderators of this relationship. Data from 53 articles published in 27 journals met criteria for the study. Fifty-five independent effect sizes coded from samples totaling N=18,529 were meta-analyzed. Results indicate that the mean sample-size weighted effect size of the SSC-condom use relation was r=.22, and a number of conceptual variables were found to moderate this relationship. Specifically, communication about condom use (r=.25) and sexual history (r=.23) had significantly (p<.05) larger effect sizes than communication about safer sex (r=.18). In addition, SSC measures operationalized differently had significantly (p<.05) different effect sizes. From largest to smallest, these were behavioral format (r=.29), intentional format (r=.18), and self-efficacy format (r=.13). Measures that tried to assess persuasion attempts as compared with informational exchanges were not found to have significantly different effect sizes (p>.05). Further, methodological moderators tended to be unrelated to effect size. Implications for the future study of safer sexual communication as well as the importance of emphasizing communication skills in HIV preventive interventions are discussed.

Condoms↗
PubMedDate not supplied

Using a parental checklist to identify diagnostic groups in children with communication impairment: a validation of the Children's Communication Checklist--2.

BACKGROUND: The Children's Communication Checklist (CCC 1998) was revised in 2003 (CCC-2) to provide a general screen for communication disorder and to identify pragmatic/social interaction deficits. Two validation studies were conducted with different populations of children with language and communication impairments. METHODS & PROCEDURES: In Study 1, the questionnaire was given to families of 87 children attending full-time special education for specific language impairment, pragmatic language impairments or autistic spectrum disorders. In addition, the teachers of half the sample completed CCC-2 forms for the same children, providing evidence for interrater agreement. In Study 2, the sample was increased to include 24 children with similar diagnoses in educational contexts in Scotland and 27 children referred for clinical evaluation at a neurodevelopment centre. OUTCOMES & RESULTS: The CCC-2 distinguished children with communication impairments from non-impaired peers. Furthermore, the social-interaction deviance composite (SIDC) of the CCC-2 identified children with disproportionate pragmatic and social difficulties in relation to their structural language impairments. This measure also had good interrater agreement (r=0.79). CONCLUSIONS: CCC-2 provides a useful screening measure for communication impairment and can be helpful in identifying children who should be referred for more detailed assessment of possible autistic spectrum disorder. However, the present data highlight substantial overlap amongst groups with 'distinct' diagnoses. It is suggested that it is unrealistic to use the CCC-2 to make categorical distinctions on this continuum of disorder.

Child↗
PubMed1995

The use of deaf-aid communicators in a Salford Hospital: a failure of communication?

It is estimated that 7.5 million adults in the UK have varying degrees of hearing loss. People with hearing deficits often feel isolated, neglected and can be mistakenly labelled as confused. Responding to this need, ten deaf-aid communicators were purchased for our elderly-care wards. It however became apparent that the aids were being under-used, and to test this observation a survey of ten elderly-care wards was undertaken. Fifty-six nurses were questioned about their knowledge and use of the communicators. Only 32% knew the communicators were on their ward. Of these 32%, only 61% knew where the aids were kept and only five nurses had ever used the communicators. Only one original, functioning communicator was found and over 50% of the machines could not be recovered. The possible reasons for the failure of this initiative are discussed and lessons drawn. Similar surveys in other hospitals and general practice would be useful to determine the level of service offered to patients with hearing impairments and to provide a basis for future audit.

Aged↗
PubMed2002

Circle communication: an old form of communication useful for 21st century leadership.

Circle communication is a form of group exchange that builds a network of relationships, a sense of community. Through practices of active listening, intentional speaking, and conscious self-monitoring, circle communication emphasizes individual contribution while building consensus to fulfill the purpose of the group. In this regard, circle communication supports a shared leadership in which all individual and unique perspectives are engaged to create the common ground for action. Circle communication emerges from a shared humanity, which can balance the "division of labor" and people only being known by their specific organizational roles. Both are needed to sustain an organization. By nurturing the human side, regardless of role and function, circle communication intersects with diversity or the uniqueness of each individual, storytelling, coaching, guiding, and mentoring, as well as discovering and responding to conflict.

Communication↗
PubMedDate not supplied

Nurses' death anxiety, comfort level during communication with patients and families regarding death, and exposure to communication education: a quantitative study.

The first purpose of this study was to determine if a nurse's death anxiety is related to the comfort level of the nurse during communication with patients and families regarding death. The second purpose was to explore whether nurses reported having been exposed to communication education regarding dealing with difficult subjects such as death and whether this exposure was related to comfort level of the nurse during communication with patients and families regarding death. Findings of this study benefit nurse educators and nurses involved in staff development because the results indicate that comfort level of the nurse during communication with patients and families is adversely affected by an increase in the nurse's own death anxiety, and positively affected by exposure to communication education. Thus, these results indicate a need for education in this area. The next step is to identify the most effective type, objectives, and content of this type of education.

Adult↗
PubMedDate not supplied

Communicating with alexithymic and non-alexithymic patients: an experimental study of the effect of psychosocial communication and empathy on patient satisfaction.

BACKGROUND: Previous studies have shown that alexithymia is associated with a wide range of somatic and psychiatric conditions. The aim of this study was to investigate experimentally how psychosocial communication and empathic response from the physician affects satisfaction in alexithymic and non-alexithymic patients. METHOD: Seven physicians and 65 female patients from a fibromyalgia patient association participated in the study. The Toronto Alexithymia Scale (TAS-20) was used to categorise patients as alexithymic or non-alexithymic. Patients also completed questionnaires regarding trait anxiety and satisfaction with their consultation. Physicians were instructed to differentiate their communication in terms of both psychosocial matters and empathic response. The content of the consultation was analysed using the Roter Interactional Analysis System. RESULTS: Regression analyses revealed that alexithymic patients were significantly more satisfied when they received a greater empathic response from the physician. Non-alexithymic patients, however, were more satisfied when the consultation was of longer duration. Psychosocial communication did not have any statistically significant effect on satisfaction in either of the two subgroups. CONCLUSIONS: Verbalised empathic response from the physician may be crucial for the alexithymic patient's post-consultation satisfaction and may thereby become the basis for a solid treatment alliance. The validity of this hypothesis should be tested in different clinical settings and with different patient populations. Future research on alexithymic patients' response to psychosocial communication may benefit from determining to what extent this communication is concerned with general distress or more complex emotional phenomena.

Adult↗
PubMed2001

Communication challenges for experienced clinicians: topics for an advanced communication curriculum.

We asked 111 experienced clinicians (MDs, RNs, PhDs, DMins) attending a conference on medical interviewing for descriptions of communication challenges they encountered while practicing in clinical health care settings. Eighty-one provided accounts analyzed in this study. Using narrative analysis, we found that most of the accounts focused on conflicts between clinicians and patients based on differing beliefs about the nature and treatment of illness and contrasting expectations about the doctor-patient relationship. This article traces the clinician-narrators' use of plot, characterization, cause-effect relationships, and idealized images to make sense of challenging communication encounters. The results of our analysis point to several communication competencies that experienced clinicians found they lacked, even af ter receiving communication training and developing an awareness of the literature on teaching health communication skills. Building skills in the identified areas could reduce clinician frustration and enrich the practice of medicine.

Adult↗
PubMed2004

Perceptions of health care providers' communication: relationships between patient-centered communication and satisfaction.

Specific communication practices of multiple professionals in health care settings can impact patient outcomes. This study, conducted at a large Children's Hospital, sought to determine the extent to which patient-centered communication (PCC) affected satisfaction with communication and with care itself. Parents of child patients (N = 195) reported on the communication practices of physicians, nurses, and hospital staff members during their most recent stay in the hospital. Surveys were completed on site. Health care providers' use of PCC behaviors, especially immediacy and perceived listening, was positively associated with satisfaction with care and with communication. In addition, PCC behaviors were perceived to be used more frequently with children in better health than with children with poorer health status.

Adult↗