Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Communication Barriers”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources
PubMed1999

A case of Capgras delusion following critical illness.

Hallucinations and paranoid delusions are recognised complications of critical illness. However, the occurrence of Capgras syndrome, in response to critical illness, where patients are convinced that doubles have replaced close family has not been described in the literature. There have been isolated case histories in the literature in response to medical procedures or illness but mostly in patients suffering from schizophrenia. A 42 year old woman was admitted to the intensive care unit (ICU) with pneumonia, following extensive surgery for a squamous cell carcinoma, secondary to Crohns disease. She had no history of previous head injury, cerebro-vascular problems or psychiatric disorder. She reported having memories of all her family, with the exception of her mother, being replaced by aliens while she was on the ICU. The delusion was only diagnosed once it had resolved and the patient was able to talk, and this highlights the difficulty of diagnosing delusions while patients are still intubated and unable to verbalise their concerns. It has been suggested that a defect in the ability to recognise the emotional significance of the face lies at the root of Capgras syndrome.

Adult↗
PubMed1999

The thought translation device: a neurophysiological approach to communication in total motor paralysis.

A thought translation device (TTD) for brain-computer communication is described. Three patients diagnosed with amyotrophic lateral sclerosis (ALS), with total motor paralysis, were trained for several months. In order to enable such patients to communicate without any motor activity, a technique was developed where subjects learn to control their slow cortical potentials (SCP) in a 2-s rhythm, producing either cortical negativity or positivity according to the task requirement. SCP differences between a baseline interval and an active control interval are transformed into vertical or horizontal cursor movements on a computer screen. Learning SCP self regulation followed an operant-conditioning paradigm with individualized shaping procedures. After prolonged training over more than 100 sessions, all patients achieved self-control, leading to a 70-80% accuracy for two patients. The learned cortical skill enabled the patients to select letters or words in a language-supporting program (LSP) developed for inter-personal communication. The results demonstrate that the fast and stable SCP self-control can be achieved with operant training and without mediation of any muscle activity. The acquired skill allows communication even in total locked-in states.

Adult↗
PubMed2005

[What does the language of Alzheimer patients have to do with the language of Paul Celan?].

Being in touch with severely demented patients requires a fundamental transformation in communication habits in medicine and in nursing. There is a need of reorientation away from an interpreting and often deficit-oriented aspect of communication towards attentive observance of unusual verbal and nonverbal signals and resources of the patient. Spontaneous and open communication with the patient outweighs the importance of a goal-oriented exchange of information and poses a significant challenge for all health and social professions. The well-being of persons with dementia depends mainly on the quality of communication and on the design of the milieu and the quality of everyday life. Interaction in nursing seems to be the crucial issue, including both spontaneity and creativity in the interaction partners, while respecting the personal boundaries of both the patient and the nurse in the necessary intimacy of the care environment. This essay shows important aspects and strategies of adequate communication with people with dementia from the perspective of medicine and of nursing. Ways to improve communication skills are shown, referring, among others, to the approaches by Kate Allan and John Killick (research fellows at Dementia Services Development Centre, University of Stirling).

Aged↗
PubMed2002

A patient database application for Hereditary Deafness Epidemiology and Clinical Research (H.E.A.R.): an effort for standardization in multiple languages.

One of the most challenging and neglected issues in medicine is the effective recording of the data obtained from the patients. The "European Work Group on the Genetics of Hearing Impairment," which has been working since 1996, proposed a few questionnaires to collect data regarding the phenotype, ENT findings, audiological examination findings and other special investigations. In this study, a computerized patient database application named "Izmir H.E.A.R version 1.0," written in Delphi 4.0 for Windows for recording the patients with hearing problems, is presented. The application consists of a modular form, including information about identity, genetic condition, proband query, audiology and vestibular tests, phenotype, pedigree and special examinations, which allows data entry on all these issues. It has been developed by using the guidelines of Hereditary Deafness Epidemiology and Clinical Research (H.E.A.R.) and by the experience gained within the last 10 years by the authors. The target population of the program is the ENT clinicians, audiologists, epidemiologists, geneticists and researchers in the field. The main idea is to create a program serving the needs of both the daily routine work and research purposes and to distribute this program to the above-mentioned specialists, to encourage them to try the first version and to find a standard and/or better way to collect data. For this reason, the program aims to be multilingual, and the currently available languages are English, German, Spanish and Turkish.

Biomedical Research↗
PubMed2001

Giving bad news: a GPs' narrative perspective.

The purpose of this study was to explore GPs' perspectives on giving bad news during consultations. To this end, 168 GPs were asked to recall, and record on the first page of a questionnaire, an occasion when they had given medically related bad news to a patient. The stories were analysed with a qualitative and interpretative approach. Two axes, each with a semantic polarity, were identified: a relational axis (semantic polarity: escape vs accompanying) and an ethical axis (semantic polarity: the doctor's choice vs the patient's choice). Furthermore, two main topics appeared to be common to almost all the narratives: the need to reassure the patient and the account of the doctor's emotions. Two different relational patterns appear to be described by doctors. A substantial number of GPs implicitly describe a disease- or doctor-centred consultation: in these cases the physicians refer to signs and symptoms, diagnosis and treatments; they decide for themselves whether to tell the truth or not. On the other hand, a smaller number describe consultations that could be defined as patient centred: these doctors consider that their duty of care for the individual ill person is paramount and try to respect the patient's right to decide. In both these relational patterns, GPs feel it is a fundamental professional duty to reassure the patient; furthermore, they feel the most difficult aspect is managing their own emotional responses.

Adult↗
PubMed2006

No matter how hard you try, your feet still get wet: insider and outsider perspectives on bridging diversity.

Research in which the researcher and the participants come from different contexts and communities always presents challenges. This paper is based on qualitative, community-based research carried out by a U.S. researcher in Pakistan and Afghanistan with an underground Afghan women's humanitarian and political organization. Written from the perspectives of two authors, one an organization insider and the other the outside researcher, it presents some unique examples of diversity challenges, while also illuminating issues that exist in subtle ways even in more common research experiences. Within the context of multiple diversities, two challenges to bridging diversity are discussed: (1) Can or should all diversities be bridged? and (2) Can narrow attention to diversity lead to ignoring similarities? We argue that the definitions of success and failure in bridging diversity are themselves relative terms, grounded in this very diversity. Further, even when research fails to bridge diversity it may, in fact, not only honor and respect that diversity, but ultimately lead to a better understanding of it.

Afghanistan↗
PubMed2006

Reflections on the evaluation of a Cambodian youth dance program.

Evaluating a youth program whose goals are to provide instruction in Cambodian dance, increase awareness and pride in Cambodian culture, promote healthy behaviors, and create linkages within the community has been a challenge. A primary source of conflict was incorporating evaluation methods that were required of all funded programs with our own specifically tailored measures. One of our concerns was that the required tools were not culturally appropriate for our participants. Our experiences reinforce the importance of forming partnerships that embrace principles of respect, equity, and empowerment among all involved before establishing a research agenda. The choices we made and did not make contributed to our struggles and frustration and also to the insight that was gained. Our analysis examines the importance of clear communication, cultural awareness, tailoring evaluation, and meaningful participation. We believe that the lessons we learned will help facilitate the conduct of culturally sensitive community-based research.

Adolescent↗
PubMed2006

Research reservations: response and responsibility in an American Indian community.

Community action research among the Assiniboine and Gros Ventre tribes of the Fort Belknap Indian reservation in Montana was undertaken to identify the cultural grounds for innovative mental health service delivery. As an enrolled tribal member investigating these matters in my "home" community, however, I encountered a series of challenges and limitations emerging from respondent reservations about sharing personal experiences of difficulty and distress, and the perceived means for redressing these. Focusing upon a difficult interview with a knowledgeable tribal elder, I enlist sociolinguistic analysis--the study of communicative norms governing who talks with whom about what (and under which conditions)--as one crucial means to making sense of this complex research encounter. Similar analyses would seem necessary to ensuring the cultural validity of research conclusions in cross-cultural action research more generally.

Aged↗
PubMed2005

Enacting appreciations: beyond the patient perspective.

The "patient perspective" serves as an analytical tool to present patients as knowing subjects in research, rather than as objects known by medicine. This paper analyses problems encountered with the concept of the patient perspective as applied to long-term mental health care. One problem is that "having a perspective" requires a perception of oneself as an individual and the ability to represent one's individual situation in language; this excludes from research patients who do not express themselves verbally. Another problem is that the idea of "talk" as a representation of the world ignores the fact that talk is also performative in the world: it requires, at least, the ability to deal with an interview situation. To think up alternative ways of including patients as subjects in research, I develop an approach that takes this performativity as a starting point. Analysing practical situations and activities, I argue that patients enact appreciations, making known what they like or dislike by verbal or non-verbal means in a given material environment, in situations that are co-produced by others. Thus, subjectivity is linked to situations and interactions, rather than just to individual characteristics; to "patient positions;" rather than "patient perspectives".

Attitude to Health↗
PubMed2006

Inhaler technique in Turkish people with poor English: a case of information discrimination?

OBJECTIVES: (a) To compare metered dose inhaler (MDI) technique in users with poor English and fluent English, (b) to evaluate two interventions: a translated patient information leaflet (PIL) plus support from an translator (PIL + verbal) and a multimedia touch screen system (MTS) using video clips and own-language instruction. METHODS: (a) Inhaler technique was videotaped and key steps rated blind for 105 fluent English-speakers (FE) and 69 Turkish-speakers with poor English (EP). (b) The EP group was randomised to receive information by MTS (n = 34) or PIL + verbal (n = 35). Inhaler technique was videotaped before and after information. MAIN OUTCOME MEASURES: (a) Global inhaler technique; (b) breathing-in time; (c) co-ordination of inspiration and inhaler actuation. RESULTS: Global technique, co-ordination and breath-holding were all significantly worse in MDI users with poor English. Only 17% of that group had adequate technique compared to over half (62%) of FE. The EP group were significantly less likely than the FE group to report ever seeing the practice nurse about their asthma. After information, global technique was rated as improved in 50% of the MTS group compared to 28% of those given a translated PIL. A further six people (17%) in the PIL group improved after subsequent verbal advice in their own language. Both information methods significantly increased inhaler shaking and mouthpiece checking, but co-ordination only improved in a small number of people. CONCLUSIONS: The study suggests that Turkish-speaking MDI users with poor English may be disadvantaged in terms of access to medicines information in the UK. The acceptability of pharmacy-based support services for this, and other specific language groups should be explored. Multimedia offers an alternative to a translator for brief explanations, particularly for first-time users, but improving poor co-ordination requires individualised "hands on" teaching from health professionals.

Administration, Inhalation↗
PubMed1983

Medical labels.

Explore the source record for details and available documents.

Communication Barriers↗
PubMed1993

Subjectivity and culpability in the constitution of nurse-patient relationships.

The development and implementation of new modes of organizing nursing work, such as primary nursing, stress the quality of interpersonal relationships between nurses and their patients. It is important to recognize, however, that such relationships are inherently problematic. This paper explores, from a sociological perspective, nurses' orientations to interpersonal relations with patients and examines some of the sources of their problematic features.

Attitude of Health Personnel↗
PubMed1979

Wives' evaluation of problems related to laryngectomy.

Previous questionnaire studies of problems after laryngectomy have been directed toward the patients. In this study, 45 wives of laryngectomees were surveyed regarding their prior understanding of laryngeal surgery. The wives were also asked questions pertaining to health and physical care, and financial and social problems encountered after the operation. The survey results indicate a need for improved family counseling both before and after surgery.

Adult↗