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PubMed1985

Communication and contraceptive practices in adolescent couples.

This study presents a descriptive analysis of the content, frequency, and timing of couple communication regarding birth control among stable, sexually active adolescent couples, and the effect of communication on actual contraceptive practices. The sample consisted of 83 couples in which the female partner was 15-18 years old. All couples had been sexually active at least two months prior to the interview. The majority of couples had discussed birth control on at least one occasion, but discussions prior to first intercourse were atypical. Couples with good communication patterns were more likely to practice effective contraception. One-fourth of the respondents felt that contraception had not been adequately discussed, and these individuals were found to be most at risk to an unintended pregnancy.

Adolescent↗
PubMed1986

Suicidal communication of persons attempting suicide and responses of significant others.

Forty consecutively admitted suicide attempt patients in an intensive care unit, their therapists, and 70 significant others of 37 of the patients, were investigated by means of 300 semi-structured interviews. The patients belonged to three diagnostic groups: neurosis, alcohol and drug abuse, and prepsychosis/psychosis. Thirty-seven of the patients had communicated their suicidal intentions to people around them. All patients used protracted indirect verbal communication. Immediately before the suicide attempt, most of the neurotics continued often to indirect verbal communication, amplified by demanding behaviour. Drug and alcohol abusers, moreover, also employed direct verbal communication, and prepsychosis/psychosis patients indirect non-verbal communication. The majority of significant others understood the patients' suicidal communication and responded with near-total silence. Ambivalence about continuing the relationship characterised most partners of patients in all diagnostic groups, and also persons other than partners in the abuse group. Ambivalence about helping the patient, and aggression expressed by significant others were most prevalent in the abuse group.

Adult↗
PubMed1994

Planning for advanced EDI operations in materiel management--a case study.

Florida Hospital, a 1,462-bed organization in five locations in the central Florida area, wanted to implement an EDI system that would take redundancies, paper and FTEs out of their system. They hired a consultant to educate them about EDI and help them put together an EDI business plan. They decided to implement three initial transaction sets for a price catalog, purchase orders, and PO acknowledgments. Requesting departments will be able to order routine items directly from vendors via EDI. Future transaction sets will include advance ship notice with price (857) that will generate a receipt off of which the hospital will pay, and electronic funds transfer. Translation and communication software for their mainframe system was chosen to accommodate both the most and least electronically sophisticated trading partners, and negotiations/education on doing business with the hospital via EDI are ongoing.

Accounts Payable and Receivable↗
PubMedDate not supplied

["Soft" parameters and invisible resuscitation].

Caring for a patient implies performing technical interventions and caring for the whole person, recognising his/her personal life, habits, family, wills. The working experience of an intensive care unit of Bellinzona is described: the theoretical framework that led the health team to start this new approach to intensive care patients and its translation in everyday practice. Verbal and non verbal communication skills (with the patient and the team) are pivotal in this approach; relatives are considered partners in the care of the patient and an essential element of the caring environment. Nurses identified meaningful data (soft data) related to living experience of the patient, to the interaction with the healing environment, his/her patterns of communication, and their use in the intensive care unit is described.

Communication↗
PubMed2000

Tactile Contact by Deaf and Hearing Mothers During Face-to-Face Interactions With Their Infants.

Tactile contact with an infant plays an important role (though one largely overlooked by researchers until recently) in the development of synchronous interactive dialogues between caregiver and child. Dyads in which one or both partners are deaf present a unique opportunity to examine the use of touch as a means of optimizing or enhancing communication when the number of available sensory channels is restricted. Touch in these dyads may play an important role in eliciting visual attention, in alerting the infant that signed communication is forthcoming, in assisting the infant to achieve emotional regulation, or in simply maintaining contact even when the deaf child has looked away from the partner. The data presented here represent one attempt to investigate the role of touch in relation to deaf infants and deaf parents, for whom it may play a particularly salient role. Both deaf and hearing mothers were observed in videotaped face-to-face interactions with their infants (also either deaf or hearing); maternal behavior was coded for each event during which mothers initiated tactile contact with the infant and was classified according to intensity, location on the infant's body, and type of touch (e.g., active vs. passive). Results of this study indicate that deaf mothers may be especially responsive to the tactile needs of their deaf infants, as shown by qualitative differences in their behavioral interactions with 6- and 9-month-olds. However, hearing mothers with deaf infants also appear to be incorporating more active forms of touch in their interactions, although they tend to rely on longer durations of tactile contact than do the deaf mothers.

Journal Article↗
PubMed2005

[Women faced with the problem of erectile dysfunction: women's view on a male problem].

MATERIAL AND METHODS: This study is based on an opinion survey conducted with the support of the Société d'Etudes Française Louis Harris, performed by telephone on a final sample of 507 women, representative of the population of French women between the ages of 20 and 65 years, interviewed about their sexuality. In particular we studied their perception and behaviour in relation to their partner's erection problems. RESULTS: 25% of women reported that they had experienced such problems, and although it was impossible to define a predictive profile pre-disposing to this problem, their attitude in relation to this event was found to be globally positive with an attitude designed to reassure and stimulate the partner experiencing erectile dysfunction (92%). In contrast, 66.4% of women considered that their partner's attitude tended to reinforce their sexual difficulties (insistence, withdrawal, avoidance, absence of dialogue). Erectile dysfunction (ED) does not affect the sexual satisfaction of the partner concerned (satisfied in 84% of cases), who report that they suffer much more from the lack of communication, frequent in this type of situation, well than from the absence of penetration (3%). CONCLUSION: Medical consultation is still relatively rare, and is essentially requested by the woman when her partner withdraws and refuses any assistance. It is often prevented by negative cognitions concerning the irreversibility of ED, for example when it is attributed to age. There is also a significant difference between women who say that they would encourage their partner to consult for this type of problem (87%), and those who actually encourage their partner to consult when specifically faced with this problem (8%). Women faced with the problem of ED are largely more in favour of the use of erectile drugs that those of the other group.

Adult↗
PubMed1992

Intercellular communication and cell-cell adhesion.

In developmental biology, binary cell-cell interactions often determine the fate of one or both cell partners. The two cells must adhere to one another to allow chemical signals to be transmitted in one or both directions across the regions of cell-cell contact. The molecular mechanisms of cell-cell adhesion and intercellular communication, even if they are mediated by different cell surface components, may be functionally integrated in several different ways. Studies of helper T cells with antigen-presenting B cells in culture have illuminated such binary interactions. The possible application of similar mechanisms to other binary developmental systems is briefly explored.

Animals↗
PubMed2002

Communication difficulties of healthcare professionals and family caregivers of HIV infected patients.

The family caregivers of HIV infected patients play a growing role in the support of the everyday life of their patient. Being more and more involved in different aspects of counselling and care-giving, they become the partner of the healthcare professionals who take care of the patient. It is nowadays well known that communication between healthcare professionals and patients is complex. So communication is between healthcare professionals and family caregivers, as our survey aims at demonstrating. Both the family caregivers and the healthcare professionals face difficulties and express needs and expectations that are important to meet in order to optimise the quality of care which is given to the patient.

Adult↗
PubMed1991

Is risk of Kaposi's sarcoma in AIDS patients in Britain increased if sexual partners came from United States or Africa?

OBJECTIVE: To determine whether the risk of Kaposi's sarcoma in patients with AIDS is increased by sexual contact with groups from abroad with a high incidence of Kaposi's sarcoma. DESIGN: Analysis of risk of Kaposi's sarcoma in patients with AIDS, according to country of origin of their sexual partners. SETTING: United Kingdom. PATIENTS: 2830 patients with AIDS reported to the Communicable Disease Surveillance Centre and the Communicable Disease (Scotland) Unit up to March 1990, of whom 566 had Kaposi's sarcoma. MAIN OUTCOME MEASURES: Percentage of patients with AIDS who had Kaposi's sarcoma. RESULTS: 537 of 2291 homosexual or bisexual men (23%) with AIDS had Kaposi's sarcoma; 10% (14/135) of the men and women who acquired HIV by heterosexual contact had Kaposi's sarcoma. None of the 316 subjects who acquired HIV through non-sexual routes had Kaposi's sarcoma. Kaposi's sarcoma was more common among homosexual men whose likely source of infection included the United States (171/551, 31%) or Africa (9/34, 26%) than among those infected in the United Kingdom (119/625, 19%) (p less than 0.05). CONCLUSION: The data suggest that Kaposi's sarcoma is caused by a sexually transmissible agent which was introduced into the British homosexual population mainly from the United States [corrected].

Acquired Immunodeficiency Syndrome↗
PubMed2004

A set of observational measures for rating support and participation in conversation between adults with aphasia and their conversation partners.

Conversation partners of individuals with aphasia, including health care professionals, families, and others, play a role that is as important for communication as the language disorder suffered by individuals with aphasia. Two complementary measures designed to capture elements of conversation between adults with aphasia and their speaking conversation partners have been developed. The first measure provides an index of the conversation partner's skill in providing conversational support. The second provides an index of the level of participation in conversation by the person with aphasia. This article describes the development of the measures, including preliminary psychometric data, and discusses applications.

Adult↗
PubMedDate not supplied

Openness to discuss cancer in the nuclear family: scale, development, and validation.

OBJECTIVE: To describe the development and validation of a scale for assessing openness to discuss cancer in the family. METHOD: Two studies were conducted. Study 1 was a cross-sectional study designed to test the factor structure of the scale. Four hundred ninety-eight patients with either breast cancer or Hodgkin's disease were interviewed. In Study 2, a longitudinal study, 133 patients with cancer in the head and neck were tested at four points in time: just before treatment, 6 weeks, 13 weeks and 52 weeks after treatment. Study 2 aimed to confirm the factor structure established in Study 1, to test for construct validity in a new population, to test the psychometric properties of the Openness Scale, and to test the scale's sensitivity to change. RESULTS: In Study 1, a one-factor solution was revealed, resulting in a scale of eight items. In Study 2, the factor structure found in Study 1 was confirmed. In line with theoretical expectations, subjects who perceived their communication about cancer as more open showed more positive rehabilitation outcomes especially at 13 weeks after treatment (less uncertainty, fewer negative feelings, more control, higher self-esteem, fewer psychological and physical complaints). Furthermore, more open communication related with more support by family members and more discussion with the partner. The scale was found to be stable over time. CONCLUSIONS: The scale's construction and subsequent analysis show that open discussion of problems (related to cancer) in the family can be measured reliably with an eight-item instrument. Additional validation of the scale is indicated.

Adaptation, Psychological↗
PubMedDate not supplied

Profile of sterilized women in urban slums and evaluation of motivational strategies.

A study undertaken in hard core pockets having C.P.R. >50% of urban slums to sensitize target couples for encouraging spacing methods and sterilizations showed 55.4% coverage of 1820 unprotected eligible couples. This coverage is attributed to involvement of Aganwadi workers, Mahila Mandals and home visits. The motivational strategies such as sensitization of Mahila Mondals, provision of MCH services and inter personal communications were found to be effective. The reasons for non-acceptance, such as desire to have male and female child in 17.8%, post insertion bleeding due to Cu-T in 13.9% and refusal by male partners in 13.36% were noted in eligible couples. These reasons could be removed by continued inter personal communications. Illiteracy rate of 76.30% in living children of sterilized women indicates need of implementing literacy programme.

Adult↗
PubMed2004

Repeating the errors of our parents? Parental violence in men's family of origin and conflict management in dating couples.

Within a social learning model, family-of-origin violence places men at risk for developing negative communication in their adult relationships. Thirty young men exposed to family-of-origin violence (exposed group) and 30 unexposed young men were videotaped discussing a conflict topic with their female dating partners. Relative to the unexposed group, the exposed men and women reported higher relationship aggression and during discussion showed more negative communication, were more domineering, and the men reported more negative affect. There were no differences between the groups on cognition or heart rate. The conflict management deficits and aggression evident in the exposed group suggest that these partners are at high risk for future relationship aggression and distress.

Adaptation, Psychological↗
PubMed2000

Relationship of psychosocial factors to HIV risk among Haitian women.

This study describes the prevalence of HIV risk behaviors among low-income, Haitian women, identifies theoretically relevant mediating psychosocial HIV risk predictors, and provides formative data for developing culturally and gender sensitive interventions for this distinctive, high risk, and understudied population. Confidential interview surveys were administered to 101 women of Haitian descent while they awaited their medical appointments at a local low-income, community medical clinic. Moderately high levels of sexual risk behavior (i.e., unprotected sex with nonmonogamous partners; multiple lifetime partners) were reported. On average, these women reported a belief in their HIV susceptibility, relatively little HIV-related anxiety, somewhat inadequate levels of communication regarding safer sex practices, and lack of adequate confidence in their ability to negotiate safer behaviors in sexual encounters. Both personal and partner condom attitudes were unfavorable and these attitudes predicted condom use levels. It was concluded that interventions need to be developed for Haitian women to improve their attitudes toward condom use and their confidence in negotiating safer sexual practices. However, these interventions cannot be developed in a vacuum. Although it is crucial to consider the woman's individual attitudes and behaviors, it is also important to consider the male partner's attitudes toward sex and the woman's relationship with her male partner within the context of Haitian culture. Only by determining and targeting important potential motivations for safe sex within the cultural context can we most effectively reduce HIV sex risk behavior in Haitian women.

Adult↗
PubMed1997

Adolescent sexual strategies.

PURPOSE: The aim of this study has been to survey adolescents' strategies to promote sexual encounters and to compare those used by males and females. We examined the predictions that sexual strategies of young adolescents are fewer and less adult-like and that those of male adolescents are more coercive. We also examined the predictions from evolutionary psychology that suggest in sexual strategies, males communicate emotional involvement, long-term interest, and resource investment, whereas females communicate sexual availability and fertility. METHODS: The sample consisted of 153 African-American, white, Chinese-American, and Mexican-American adolescents. A strategy inventory was developed and mention of strategies by males and females were compared. RESULTS: Significant gender differences in mention of strategies were found. Males mentioned a higher percentage of coercive strategies such as pressuring and raping as well as a higher percentage of strategies such as lying and getting a partner drunk or high. Males and females both mentioned a higher percentage of strategies communicating commitment and investment. Females mentioned more strategies which signaled sexual availability. Adolescent strategies were fewer than those reported by adults and less focused on appearance enhancement and the intricacies of dating. CONCLUSIONS: Findings suggest the need for special targeting of coercive situations, use of sexual strategies as a prompt for counterstrategies aimed at abstinence, use of sexual strategies as a context for condom use promotion, and reinforcement of female preparatory strategies.

Adolescent↗
PubMedDate not supplied

The psychosocial impact of cervical cancer among affected women and their partners.

This study aimed to assess the range and intensity of psychosocial concerns experienced by women with cervical cancer and their male partners. A cross-sectional survey assessed 26 couples where the woman had invasive cervical cancer stage I-IV, up to 2 years posttreatment, using a concerns questionnaire and widely used psychosocial questionnaires. Respondents indicated their concerns about the impact of the disease and treatment as well as general psychosocial impact. Women with cervical cancer and their male partners expressed equal intensities of concern regarding the illness and its treatment, rating sexuality, prognosis, and communication with the treatment team most highly in terms of current concerns. Couples where the patient had a more advanced stage of cancer expressed higher concerns than those with earlier stage disease. Although women with cervical cancer reported more fatigue and illness intrusiveness than their male partners, both experienced disruptions in relationships, intimacy, and instrumental life domains. With increased time posttreatment, concerns differed subtly between affected women and their male partners. Effective psychosocial support for cervical cancer must be provided for both the affected woman and her male partner. Support and information should address the most salient concerns of patients and partners as these evolve over significant clinical milestones.

Adult↗
PubMed2005

Evaluation of a communication and stress management training programme for infertile couples.

OBJECTIVE: This study evaluates a patient education programme focussed on improving communication and stress management skills among couples in fertility treatment. METHODS: In total, 37 couples completed the intervention. Two teachers conducted all the five courses offered. The effectiveness regarding communication and infertility-related stress was assessed by questionnaires immediately before (time T1) and after the intervention (time T2). Seeking of information and professional support was assessed at a 12-month follow-up (time T3); response rates were: T1, 93.2%; T2, 85.1%; T3, 74.3%. Data were compared at baseline (T1) and at the 12-month follow-up (T3) with a prospective cohort of Danish people in fertility treatment. RESULTS: There were no differences in infertility-related stress at base line between the two groups studied. We estimated the bi-directional changes in communication, e.g., changes from talking often to talking less frequently and vice versa. More intervention participants started to talk often with their partner about infertility and its treatment after the intervention compared to those who stopped to talk often. Women and men changed occurrence, frequency and content of communication with close other people. Among women marital benefit increased significantly. Infertility-related stress was not reduced significantly. Significantly more intervention participants than in the comparison group had contacted support groups, a psychologist and/or agencies for adoption at the 12-month follow-up. CONCLUSION: The intervention resulted in important perceived improvement in the participants' competence to actively manage changes in marital communication and in communication in different social arenas. PRACTICE IMPLICATIONS: We recommend fertility clinics to develop and evaluate different interventions for those fertility couples who ask for more psychosocial support.

Adaptation, Psychological↗
PubMed1994

Orienting health care information systems toward quality: how Group Health Cooperative of Puget Sound did it.

BACKGROUND: Group Health Cooperative of Puget Sound (GHC), a large staff-model health maintenance organization based in Seattle, is redesigning its information systems to provide the systems and information needed to support its quality agenda. PLANNING PROCESS: Long-range planning for GHC's information resources was done in three phases. In assessment, interviews, surveys, and a benchmarking effort identified strengths and weaknesses of the existing information systems. We concluded that we needed to improve clinical care and patient management systems and enhance health plan applications. In direction setting, we developed six objectives (for example, approach information systems in a way that is consistent with quality improvement principles). Detailed planning was used to define projects, timing, and resource allocations. MAJOR EFFORTS: Some of the most important efforts in the resulting five-year plan include the development of (1) a computerized patient record; (2) a provider-based clinical workstation for access to patient information, order entry, results reporting, guidelines, and reminders; (3) a comprehensive set of patient management and service quality systems; (4) reengineered structures, policies, and processes within the health plan, supported by a complete set of integrated information systems; (5) a standardized, high-capacity communications network to provide linkages both within GHC and among its business partners; and (6) a revised oversight structure for information services, which forms partnerships with users. CONCLUSIONS: A quality focus ensured that each project not only produced its own benefits but also supported the larger organizational goals associated with "total" quality.

Health Maintenance Organizations↗