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Results for “Communication Barriers”

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At least 919 records · Page 51Linked to original sources
PubMed1992

A short multilingual quality of life questionnaire--practicability, reliability and interlingual homogeneity.

International cooperative clinical trials require a multilingual quality of life questionnaire. The 'International Society for Chemo- and Immunotherapy' therefore designed a study to develop and test a 'health accentuated' quality of life questionnaire in the eight languages spoken in this society. The objective was to examine practicability, reliability and interlingual homogeneity. Versions of the questionnaire in Czech, German, Hungarian, Italian, Kroatian, Polish, Romanian and Slovakian have been prepared. The results are based on data of 1,104 adult patients. They demonstrate that the developed questionnaire is practicable. Patients need 10-15 min to answer it, usually without assistance. The proportion of missing values is for all but two questions less than 3%. The questionnaire also found high acceptance reflected by only 2.7% refusals. It is reasonably reliable in each language. Interlingual homogeneity could be shown by demonstration of strong structural similarities between the different versions using multidimensional scaling, factor analysis and comparison of mean profiles.

Adolescent↗
PubMed1997

Reliability of the ICD 10 version of the Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD).

The Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD) is a semi-structured clinical interview designed for use with respondents who have learning disability. The first version was based on the Present State Examination. The revised version was derived from the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), and makes ICD 10 diagnoses using the SCAN diagnostic program. This current version has a 4-point scale of severity, compared with the 3-point scale of the first version. It also has a new module relating to psychotic disorders. The sample consisted of 40 individuals representing a spectrum of neurotic, depressive and psychotic disorders. Videotapes of 40 PAS-ADD interviews were re-rated by trained interviewers who had not been involved in the original study in which the videotapes were produced. The mean Kappa across all individual item codes was 0.65, ranging from 0.94 to 0.35. The mean Kappa agreement on item groups was 0.66. Correlation between total symptom scores was 0.74. Agreement on index of definition was Kappa 0.70. We concluded that, agreement was generally lower than for the ICD 9 version. This was probably due mainly to the increase in the severity categories from three to four. However, the new items (most of which related to psychosis) were of comparable reliability to other items.

Adult↗
PubMed1997

Validity of the PAS-ADD for detecting psychiatric symptoms in adults with learning disability (mental retardation).

The Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD) is a semi-structured interview for use with respondents who have learning disability and for key informants. This report investigates the ability of the instrument to detect symptoms that had been found to exist during routine clinical assessment of the patients. Field trials involved 95 referred patients with learning disability and a key informant for each sample member. Clinical opinions of the referring psychiatrists were sought using a symptom checklist. Referrer checklist symptoms and PAS-ADD data were both factor analysed. Validity testing involved (a) computation of correlations between PAS-ADD factors and checklist data and (b) comparison of PAS-ADD and referrers' diagnoses. Results indicated good validity for the PAS-ADD in relation to psychotic symptoms and depressive symptoms. Anxiety symptom identification was not well validated, probably due to small numbers. Expansive mood identified by the referrers was not detected by the PAS-ADD because there is currently no corresponding section in the interview. Where the PAS-ADD produced a diagnosis (in 58 members of the sample), 44 were in agreement with the referrer. Probability of diagnosis by PAS-ADD increased with the number of relevant active symptoms identified by the referrer. The PAS-ADD has been shown in a previous report to have the sensitivity to detect mental disorders not known to psychiatric services. For psychotic and depressive conditions, our results showed that symptom detection was in good agreement with the information provided by the referring psychiatrists on their patients. The PAS-ADD needs a section on hypomania and further investigation of its detection of anxiety disorders.

Adolescent↗
PubMed1979

Problems of foreign born psychiatrists.

This paper describes problems incurred by those psychiatrists practicing in the United States who were born outside of the United States of America. It describes issues related to practice, politics, and understanding of a culture alien to them. It also focuses on some of the advantages of being a foreigner in the field. In conclusion, the paper recommends specific training to be incorporated in residency programs to address issues identified by the author.

Acculturation↗
PubMed1983

Utilization and evaluation of maternity care by American Indians in Arizona.

Drawing upon a statewide consumer survey conducted in 1979 by the Bureau of Maternal and Child Health, this report focuses on the health service utilization and evaluation of 110 American Indians. The data shows that Indians, in contrast to Anglos, have less prenatal care, a higher incidence of transport to special care facilities, a higher incidence of newborn problems, and unusually high rates of early and late discharge. The Indian women also reported a higher incidence of communication problems with their caretakers and were less satisfied with the care that they received. The discussion considers the problems of less continuity of care and personnel shortages as well as cultural differences for delivering the quality of care mandated by treaty and subsequent laws to this impoverished minority group.

Adolescent↗
PubMed1995

The politics of marginalization: the appropriation of AIDS prevention messages among injection drug users.

This essay addresses the space between a cultural critique and a class analysis of HIV transmission. It explores how injection drug users, as a disempowered group, resist hegemony through dissent. Distrust of the medical establishment and severe social and legal constraints force injection drug users to reconstruct the AIDS message. Economic and political survival inflates the need for trust and reciprocity within their social network. This makes the meaning of AIDS a continually ambiguous one for drug users. The ways in which dissent to domination is enacted and the effect this has on HIV prevention is explored.

Acquired Immunodeficiency Syndrome↗
PubMed1996

New rights for deaf patients; new responsibilities for mental hospitals.

In an era in which mental hospital administrators are confronted by shrinking budgets and cost containment strategies in order to survive, the recently enacted Americans with Disabilities Act requires their special attention. This article addresses the anticipated effect of the ADA upon inpatient psychiatric facilities. We assume that adminstrators should anticipate increased ligation and settlement costs associated with specialized services to deaf and other qualifying patients who seek equal access to psychiatric services provided in mental hospitals. It is our view that administrators can reduce the cost of implementing specialized services to deaf patient by developing a proactive plan of implementation. The authors analyze recent court consent decrees, and offer a three step plan for implementation.

Communication Barriers↗
PubMed1996

Prenatal care experiences and birth weight among Mexican immigrant women.

National studies indicate that Mexican immigrant women tend to have more positive birth outcomes than other groups, despite receiving relatively low levels of medical prenatal care. Our study-based on in-depth interviews with immigrant women who had recently given birth in Chicago-examines women's experiences seeking prenatal care. Qualitative findings contribute to understanding why many of these women received less than optimal care during pregnancy. The study also offers modest evidence that, despite overall positive birth outcomes and low levels of prenatal care, adequate prenatal care may make a difference in birth outcomes in this group. Suggestions are made concerning ways to improve access to adequate care, paying particular attention to the impact of migration and communication in prenatal care.

Adult↗
PubMed1996

The exclusion of non-English-speaking persons from research.

OBJECTIVE: We sought to determine how often non-English-speaking (NES) persons are excluded from medical research. DESIGN. Self-administered survey. PARTICIPANTS: A Medline search identified all original investigations on provider-patient relations published in major U.S. journals from 1989 through 1991, whose methodologies involved direct interaction between researcher and subject (N = 216). Each study's corresponding author was surveyed; 81% responded. MEASUREMENTS AND MAIN RESULTS: Of the 172 respondents, 22% included NES persons; among these includers, 16% had not considered the issue during the study design process, and 32% thought including the NES had affected their study results. Among the 40% who excluded the NES (excluders), the most common reason was not having thought of the issue (51%), followed by translation issues and recruitment of bilingual staff. The remaining 35% (others) indicated that there were no NES persons in their study areas. CONCLUSIONS: NES persons are commonly excluded from provider-patient communication studies appearing in influential journals, potentially limiting the generalizability of study findings. Because they are often excluded through overnight, heightened awareness among researchers and granting institutions, along with the development of valid instruments in varied languages, may increase representation of non-English-speaking subjects in research.

Communication Barriers↗
PubMed2000

Visual and acoustic communication in non-human animals: a comparison.

The visual and auditory systems are two major sensory modalities employed in communication. Although communication in these two sensory modalities can serve analogous functions and evolve in response to similar selection forces, the two systems also operate under different constraints imposed by the environment and the degree to which these sensory modalities are recruited for non-communication functions. Also, the research traditions in each tend to differ, with studies of mechanisms of acoustic communication tending to take a more reductionist tack often concentrating on single signal parameters, and studies of visual communication tending to be more concerned with multivariate signal arrays in natural environments and higher level processing of such signals. Each research tradition would benefit by being more expansive in its approach.

Acoustic Stimulation↗
PubMed2006

[The doctor-patient conversation: profession and art].

Communication errors between physician and patient are the most frequent cause of treatment errors. On the other hand, a structured dialogue expedites the diagnostic and therapeutic processes. It is based on understanding, perceiving emotions, clarifying the patient's wishes, expanding options, defining goals as well as the prompt preparation for possible setbacks.

Clinical Competence↗
PubMed2003

Conflict in the care of patients with prolonged stay in the ICU: types, sources, and predictors.

OBJECTIVE: To determine types, sources, and predictors of conflicts among patients with prolonged stay in the ICU. DESIGN AND SETTING: We prospectively identified conflicts by interviewing treating physicians and nurses at two stages during the patients' stays. We then classified conflicts by type and source and used a case-control design to identify predictors of team-family conflicts. DESIGN AND SETTING: Seven medical and surgical ICUs at four teaching hospitals in Boston, USA. PATIENTS: All patients admitted to the participating ICUs over an 11-month period whose stay exceeded the 85th percentile length of stay for their respective unit ( n=656). MEASUREMENTS AND RESULTS: Clinicians identified 248 conflicts involving 209 patients; hence, nearly one-third of patients had conflict associated with their care: 142 conflicts (57%) were team-family disputes, 76 (31%) were intrateam disputes, and 30 (12%) occurred among family members. Disagreements over life-sustaining treatment led to 63 team-family conflicts (44%). Other leading sources were poor communication (44%), the unavailability of family decision makers (15%), and the surrogates' (perceived) inability to make decisions (16%). Nurses detected all types of conflict more frequently than physicians, especially intrateam conflicts. The presence of a spouse reduced the probability of team-family conflict generally (odds ratio 0.64) and team-family disputes over life-sustaining treatment specifically (odds ratio 0.49). CONCLUSIONS: Conflict is common in the care of patients with prolonged stays in the ICU. However, efforts to improve the quality of care for critically ill patients that focus on team-family disagreements over life-sustaining treatment miss significant discord in a variety of other areas.

Adult↗
PubMed2004

Hidden evidence to the West: multicentre, randomised, controlled trials in sepsis and systemic inflammatory response syndrome in Japanese journals.

OBJECTIVE: To assess multicentre, randomised, controlled trials (MC-RCTs) of systemic inflammatory response syndrome (SIRS) and sepsis conducted in Japan, published in Japanese and not available to English-language medical databases. DESIGN: Methodological review. SUBJECTS: All Japanese RCTs relevant to SIRS and sepsis. INTERVENTION: Identification of manuscripts using a Japanese electronic library. Critical analysis of methodology and reporting quality using a modified Methodological Quality Assessment Score and the CONSORT group check list. MEASUREMENTS AND RESULTS: Three MC-RCTs were identified. In the first, 147 patients with septic shock were randomised to methylprednisolone (1000 mg i.v.) or placebo. In the second, 221 patients were randomised to 0.20 mg/kg per h or 0.004 mg/kg per h of sivelestat for acute lung injury with SIRS. In the third, 504 patients were randomised to immunoglobulin (5 g for 3 days) or to a control group. The average methodological quality score was higher than that of equivalent Western trials. The reporting quality (CONSORT checklist) was comparable to Western studies published during the same period. CONCLUSIONS: Despite sound methodology and quality, the information obtained from relatively large Japanese critical care trials is not widely available to English-speaking investigators and therefore might be ignored in meta-analyses.

Anti-Inflammatory Agents↗