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Results for “Communication Barriers”

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PubMed2005

Barriers to effective communication across the primary/secondary interface: examples from the ovarian cancer patient journey (a qualitative study).

Effective communication across the primary/secondary interface is vital for the planning and delivery of appropriate patient care throughout the cancer patient journey. This study describes GPs' views of the communication issues across the primary/secondary interface in relation to ovarian cancer patients using qualitative interviews with purposively sampled general practitioners (GPs) and an audit of hospital medical records of 30 deceased ovarian cancer patients. Issues raised by the GPs related to the content and format of communications, but of most concern was the tardiness. The time lag between dictation and typing letters ranged from 0 to 27 days, with a delay of up to 8 days for signing before transit through various mail systems to the GP. Three stages in the patient journey were characterized by particular issues: (1) in the pre-diagnostic and diagnostic stage was a need for prompt information regarding the results of tests and diagnoses, and clearer guidance on the use of tests and fast-track referrals; (2) in the active treatment phase, when GPs could lose touch with their patients, they needed effective communication in order to provide moral support and crisis management; and (3) when oncology withdrew and the focus of care switched back to the community for the terminal phase, GPs needed information to enable them to pick up the baton of care. There is a need to develop and evaluate interventions aimed at improving the content and speed of communications between secondary and primary care. Such interventions are likely to be complex and might include the greater use of telephone or fax for more selected communications, a review of secretarial support, the use of email, the development of GP designed proformas, the feasibility of patient/carer letter delivery options, nurse-led communication, universal electronic patient records, or a revisiting of the patient-held record.

Communication Barriers↗
PubMedDate not supplied

Breaking down the barriers to effective communication.

Effective communication is central to working and helping clients in a health care setting. However, environmental factors can inhibit good communication. This paper encourages retention on factors that affect communication and how they might be overcome.

Communication Barriers↗
PubMedDate not supplied

Ethnicity and the effects of mapping-enhanced drug abuse counseling.

It was hypothesized that node-link mapping a tool for visually representing client issues during drug abuse counseling, would reduce communication barriers between counselors and their African American and Mexican American clients. Three hundred twenty daily opioid users participated in methadone maintenance treatment programs in three cities for 6 months or longer following random assignments to mapping-enhanced or standard counseling. Clients in the mapping condition had fewer drug-positive urines (with respect to opiates and cocaine), missed fewer scheduled counseling sessions, and were rated more positively by their counselors on rapport, motivation, and self-confidence during the first 6 months of treatment. Significant interactions involving ethnicity and counseling condition suggested that mapping is more effective for African Americans and Mexican Americans than for Whites. The use of mapping appears to help reduce cultural, racial, and class communication barriers by providing a visual supplement and a common language that enhances counselor-client interchanges.

Adult↗
PubMed2002

Patient-related barriers to fatigue communication: initial validation of the fatigue management barriers questionnaire.

Fatigue is a highly prevalent and distressing symptom of cancer and its treatment. However, cancer patients often fail to communicate with their oncologists about fatigue. In this study, we attempted to identify the patient-related barriers to communication about fatigue, as cited by patients. Two hundred patients were sampled across the Community Cancer Care, Inc. (CCC) network of Indiana using the Cancer Behavior Inventory-Brief scale (CBI-B), the Zung Self-Rating Depression Scale (ZSDS), the Functional Assessment of Cancer Inventory-Fatigue scale (FACT-F), and the Fatigue Management Barriers Questionnaire (FMBQ), a questionnaire devised by experts in the field of cancer-related fatigue. There were no significant correlations between the instrument scores and demographic variables. Scores on the instruments did not differ significantly based on whether the patient was from a rural or urban site. One hundred thirty-two patients (66%) reported that they had never spoken to their doctor about fatigue. The most frequently reported reasons for this lack of patient communication about fatigue included the doctor's failure to offer interventions (47%), patients' lack of awareness of effective treatments for fatigue (43%), a desire on the patient's part to treat fatigue without medications (40%), and not wanting to complain to the doctor (28%). Patients reported that medical staff offered a mean of 11.63 recommendations for dealing with fatigue. The FMBQ was found to correlate significantly with self-efficacy (CBI-B, r = -0.20, P < 0.01) and correlate weakly with the number of recommendations made (r = -0.15, P < 0.05). The FMBQ was noted to have acceptable internal consistency (alpha = 0.88) and validity and may prove to be a useful instrument for understanding why patients do not communicate about fatigue. Multiple barriers contribute to why cancer patients do not comment about fatigue but may be overcome if physicians screen and assess for this symptom.

Aged↗
PubMed2005

[A marital-relationship enhancement program for couples: randomized controlled trial].

PURPOSE: This paper reports a randomized controlled trial to investigate the effects of a Marital-relationship enhancement program(MREP) for marital couples. METHODS: Volunteer couples from several well-being centers in Seoul were randomly assigned either to a treatment group (n=36), participating in a MREP based on Gottman's "sound marital house" theory, or to a control group (n=35) receiving no treatment. The content of the MREP was provided to the control group after the research was completed. Data was collected from December 2003 to May 2004 using modified versions of the inventories developed by Gottman on marital satisfaction, positive affect, conflict regulation, and communication barriers. RESULTS: Participants in the experimental group showed significant improvements in marital satisfaction, positive affects, conflict regulation, and communication-barrier scores compared to the control group. CONCLUSION: The present program for marital-relationship enhancement is helpful in enhancing marital relationships and regulating conflict between marital couples and, ultimately, may be useful to prevent divorce.

Adult↗
PubMedDate not supplied

Adaptive communication systems for patients with mobility disorders.

An adaptive communication system has been developed for individuals with mobility disorders. It uses specialized computer software and hardware that compensate for this disability. For an individual with a motor-control impairment who is not able to use a keyboard effectively, a computer voice-recognition technology now removes this communication barrier. Speech-recognition systems consist of three basic components: speech processing, speech recognition, and speech understanding. The new Dragon Dictate (Dragon Systems, Inc., Newton, Mass.) is the first large-vocabulary speech recognition system in the personal computer industry that interactively learns a user's vocabulary and mode of speaking and responds to natural language rather than to limited sets of words. This speech-recognition system requires a microprocessor, a display monitor, a printer, and specific software packages, including word-processing and enhanced memory-management software. Important considerations in the use of this speech-recognition system include microphone positioning and training of the system. With the advent of this new voice-recognition computer system, another communication barrier between the disabled and society has been overcome.

Communication Devices for People with Disabilities↗
PubMed2002

Effect of vital signs on triage decisions.

STUDY OBJECTIVE: We sought to determine whether knowledge of vital signs changes nurse triage designations (TDs). We also sought to determine whether patient age and ability to communicate modify the effect of vital signs on triage decisions. METHODS: We performed a prospective observational study, in 24 emergency departments, of nurse-assigned TDs of all ED patients undergoing triage. Nurses performed their typical triage routine, except that they chose 1 of 5 hypothetical TDs (call 911, ED <2 hours, physician's office 2 to 8 hours, physician's office 8 to 24 hours, or home care) before and after measurement of vital signs. The main outcome measure was the change of TD after knowledge of a patient's vital signs, with stratification on the basis of patient age and communication barriers. The secondary outcome was the final ED disposition. RESULTS: Six hundred twenty-five experienced triage nurses at 24 different EDs collected data on 14,285 patients. TDs were downgraded (decreased in urgency) in 2.4% of patients, and 5.5% were upgraded (increased in urgency) after vital signs were known. Changes were more likely to occur in the young (< or = 2 years old; 11.4%) and the elderly (> or = 75 years old; 9.9%) than in those 3 to 74 years of age (7.5%). When nurses reported a communication barrier, a change in post-vital signs TD was also more common (11.2% versus 7.7%). The post-vital signs TD better predicted patient ED disposition. CONCLUSION: In this sample, 92.1% of the nurses' TDs were not affected by the knowledge of patient vital signs. For the other 7.9%, including many patients from vulnerable populations, the vital signs changed the nurses' assessments of the patients' triage designation. Methods of triage that do not determine vital signs may not adequately reflect the urgency of the patient's presentation.

Data Collection↗
PubMedDate not supplied

Uniforms. Removing barriers to communication.

Nurses have engaged in debate over the advantages and disadvantages of the traditional uniform for many years, Stephen O'Connor and Martinne Wright describe an imaginative approach to attire which was adopted by nurses in a rehabilitation Results indicate that the particular needs of patients in this unit are better met in the less formal atmosphere which subsequently developed.

Clothing↗