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PubMedDate not supplied

Communication theory and the shift handover report.

The cooperation that makes human society possible is manifested most visibly within the organization and is almost entirely dependent upon the skill with which we communicate (Tortoriello et al, 1978). By understanding concepts related to communication theory, nurses may be better able to analyse areas of communication in their own practice. This article reviews the concepts of communication in terms of definition, function and purpose. The communication process model is examined and the hindrances to effective communication are explored. The shift handover report is analysed and related to group networking theory. Communication theory is then applied to the shift handover process and recommendations for practice are made.

Communication↗
PubMedDate not supplied

Community pharmacist-child medication communication: magnitude, influences, and content.

OBJECTIVE: To describe community pharmacist-child medication communication with respect to its magnitude, influences, and content. DESIGN: Cross-sectional descriptive study. SETTING: Indiana. PARTICIPANTS: 460 community pharmacists. INTERVENTION: Mailed questionnaire was used for data collection. Sections included: (1) pharmacists' practice of medication communication with children and with adults; (2) factors influencing the pharmacist's decision to communicate with children about medications; (3) elements of pharmacist-parent and pharmacist-child communication; and (4) demographics. MAIN OUTCOME MEASURE: Daily percentage of children to whom pharmacists talked directly about medications. RESULTS: Response rate was 44.7% with no indications of nonresponse bias. Most respondents were staff pharmacists in chain pharmacies. On average, pharmacists reported engaging in communications about medications with 20.7% of children and 57.0% of adults on a daily basis (t = 23.5, P < or = .0001). Experience as a preceptor and prescription volume significantly influenced the frequency of pharmacists' communication with either adults or children. Pharmacists provided more medication information to parents than to their children, and more medication information to older children than to younger children. Children of all ages were likely to be comforted and given information about the medicine's taste. CONCLUSION: Preliminary insights into the interaction between pharmacists and child patients are provided by this study. Considering the relatively low frequency of pharmacist-child communication, interventions aimed at influencing the child's and caregiver's motivation to seek information about the child's care, and improving pharmacist's knowledge about children's cognitive development at various ages may enhance the involvement of children in self-treatment.

Adult↗
PubMed1994

Self-esteem, family climate, and communication patterns in relation to deafness.

The purpose of the study presented in this article was to determine the effect that family communication patterns have on the self-esteem of deaf children. Deaf students at a southern residential school, ranging in age from 13 to 19, were administered the Modified Self-Esteem Inventory (MSEI) and the Subject Communication Questionnaire. The subjects' parents answered 10 questions about their communication patterns with their deaf child. The parents were not deaf themselves. Analysis of the data revealed that there is a positive relationship between the family's communication method and the deaf child's self-esteem such that parents who use total communication (speech, fingerspelling, and sign) have children whose self-esteem scores are higher than those of children whose parents use an oral-only method of communication (speech). The parents who were best able to communicate by using sign language had children whose self-esteem scores were higher than those of children whose parents were less skilled in sign language. Also, a positive relationship was found between student self-esteem and reading level.

Adolescent↗
PubMed2006

[How to follow communicative competence progress in nursing students].

This work is aimed at suggesting methodological foundations for following Nursing student's progress in communicative competence. Using qualitative methodology and theoretical reference of interpersonal communication, the research was developed through interviews with 13 professors with experience both in teaching activities and communication research in Nursing. Interviewees reported that they follow their students' progress in communicative competence through the observation of their communicative abilities with patients; by fostering moments for the expression of thoughts, feelings and perceptions; by giving feedback on the development of communicative abilities; by stimulating their communication abilities; by performing formative assessments and tutoring.

Communication↗
PubMed2005

[Current status of team communication considered from a questionnaire survey on the laboratory prescription card].

Team communication between dentists and dental technicians offers high-quality medical treatment for patients. When dentists and dental technicians understand dental treatments and laboratory procedures and talk to each other from an equal standpoint, good team communication between them can be established. However, undergraduate dental students do not sufficiently understand the content and processes of laboratory procedures because the subjects and hours in laboratory procedures have been reduced at present. Education on team communication between dentists and dental technicians is not sufficiently included in the training content of postgraduate training practice. It seems that at present, it is difficult for good team communication to be established between new graduate dentists and dental technicians. In view of this, the current status of the team communication between dentists and dental technicians in the present clinic was investigated, because a guideline for constructing team communications between dentists and dental technicians is given in the dental education before and after graduation. That is to say, the current status of the team communication of dentists and dental technicians was investigated by considering a questionnaire survey on the laboratory prescription card, which is the most important information means for connecting dentists with dental technicians in the dental clinic. The results were as follows: The entry items were insufficient on the laboratory prescription cards. Therefore, it is necessary to prepare such laboratory prescription cards that required items are entirely indicated as well as to enter them fully by dentists.

Communication↗
PubMed2005

Privacy vs usability: a qualitative exploration of patients' experiences with secure Internet communication with their general practitioner.

BACKGROUND: Direct electronic communication between patients and physicians has the potential to empower patients and improve health care services. Communication by regular email is, however, considered a security threat in many countries and is not recommended. Systems which offer secure communication have now emerged. Unlike regular email, secure systems require that users authenticate themselves. However, the authentication steps per se may become barriers that reduce use. OBJECTIVES: The objective was to study the experiences of patients who were using a secure electronic communication system. The focus of the study was the users' privacy versus the usability of the system. METHODS: Qualitative interviews were conducted with 15 patients who used a secure communication system (MedAxess) to exchange personal health information with their primary care physician. RESULTS: Six main themes were identified from the interviews: (1) supporting simple questions, (2) security issues, (3) aspects of written communication, (4) trust in the physician, (5) simplicity of MedAxess, and (6) trouble using the system. By using the system, about half of the patients (8/15) experienced easier access to their physician, with whom they tended to solve minor health problems and elaborate on more complex illness experiences. Two thirds of the respondents (10/15) found that their physician quickly responded to their MedAxess requests. As a result of the security barriers, the users felt that the system was secure. However, due to the same barriers, the patients considered the log-in procedure cumbersome, which had considerable negative impact on the actual use of the system. CONCLUSIONS: Despite a perceived need for secure electronic patient-physician communication systems, security barriers may diminish their overall usefulness. A dual approach is necessary to improve this situation: patients need to be better informed about security issues, and, at the same time, their experiences of using secure systems must be studied and used to improve user interfaces.

Communication↗
PubMed1988

Referential communication abilities of learning-disabled, language-learning-disabled, and normal school-age children.

Past research in referential communication has indicated normally developing children show developmental progression in ability to communicate a specific referent to a listener. In one paradigm subjects were given lists of word-pairs in which one member of each pair was designated as the referent. It was shown that communicating about referents found in word-pairs associated in some way was more difficult than communicating about referents in dissimilar word-pairs. The present study extended this methodology to learning-disabled children. Learning-disabled, language-learning-disabled, and normally achieving children were asked to communicate about 30 pictured referents on three different tasks. On Tasks 1 and 2 each subject was asked to give a clue for the referent that would distinguish it from the other picture. Stimuli for Task 1 were 30 pairs of pictures that were related in some way and the stimuli for Task 2 were 30 pairs of unrelated pictures. Task 3 required the subjects to evaluate the adequacy of the examiner's clues for Task 1 stimuli. The disabled subjects were matched to the normally achieving subjects on the basis of receptive vocabulary age. Few differences were noted among the groups' performances on these referential communication tasks. Implications include the importance of vocabulary and concept development to referential communication.

Adolescent↗
PubMed2003

Assessment of communicating systems on the basis of an ecological conceptual framework.

A conceptual framework for auditory communication was constructed based on biological ecosystem theories. The framework was used to analyse and conceptualize the assessment of auditory communication and rehabilitation. Two different strategies for assessment are presented: analytical and holistic. It is observed that the application of the ecological concept preferendum (optimum) calls for both qualitative and quantitative assessment methods. The role of situation, the composition of the communicative system and the perspectives of the different actors were cornerstones of the analytical assessment. The holistic assessment can be approached in terms of matters such as satisfaction (ecological balance) and fatigue. Description of the communicative mass in the present framework, analogous to biomass in biological systems, was identified as a suitable endpoint of holistic assessment, formed from the total knowledge and positive emotions generated in the system. Communicative mass was described in three dimensions: the number of participants in the communicative system, time in communication, and flow of knowledge and emotion. The operationalization and application of this concept are discussed.

Audiology↗
PubMed2006

Building on existing models from human medical education to develop a communication curriculum in veterinary medicine.

Communication is a core clinical skill of veterinary medicine and one that needs to be taught and learned to the same degree as other clinical skills. To provide this education and essential expertise, veterinary schools in many countries, especially including North America, the United Kingdom, and Australia, have begun to develop programs and communication curricula. Human medical education, however, has 30 years' experience in developing communication curricula, and is thus an excellent resource upon which veterinary educators can build and shape their own communication programs. This article describes a skills-based communication course that has been successfully implemented for veterinary medical education at Ontario Veterinary College (OVC) and was based on the University of Calgary Faculty of Medicine's well-established program. The Calgary-Cambridge Guides and supporting textbooks provide the scaffolding for teaching, learning, and evaluation in both programs. Resources such as space and materials to support the OVC program were also patterned after Calgary's program. Communication skills, and the methods for teaching and learning them, are equally applicable for the needs of both human medicine and veterinary medicine. The research evidence from human medicine is also very applicable for veterinary medicine and provides it the leverage it needs to move forward. With this extensive base available, veterinary medicine is in a position to move communication skills training forward rapidly.

Animals↗
PubMedDate not supplied

Health literacy and cancer communication.

Health literacy is increasingly recognized as a critical factor affecting communication across the continuum of cancer care. We reviewed research on health literacy and examined its impact on cancer outcomes and communication. According to the National Adult Literacy Survey (NALS), considered the most accurate portrait of literacy in our society, about one in five American adults may lack the necessary literacy skills to function adequately in our society. As patients, such individuals are at a disadvantage in their capacity to obtain, process, and understand cancer information and services needed to make appropriate health care decisions. Patients with poor health literacy have a complex array of difficulties with written and oral communication that may limit their understanding of cancer screening and of symptoms of cancer, adversely affecting their stage at diagnosis. In addition, these barriers impair communication and discussion about risks and benefits of treatment options, and patient understanding of informed consent for routine procedures and clinical trials. More research is needed to identify successful methods for educating and communicating with patients who have limited health literacy. Based on our own experience, we offer practical communication aids that can help bridge the cancer communication gap.

Communication Barriers↗
PubMed2001

Effective communication in an intensive care setting: nurses' stories.

Effective communication has been long considered an important aspect of nurse-patient interactions. However, follow up of people who have been patients in intensive care units (ICUs) indicates that nurses' communication in this setting is at times unsatisfactory. Patients have described how they were left feeling frustrated and alienated by this failure in the communication process and unconscious patients report how they were aware of nurses' attempts at communication with them while unconscious (Lawrence, 1995). Because most of the research to date has focused on patients' perceptions of nurses' communication in an intensive care unit, this study sought to explore what nurses believed constituted effective communication in an intensive care setting. Therefore, a qualitative study was undertaken to explore nurses' perceptions of effective communication with patients in an intensive care setting. The stories of four intensive care nurses were utilized as the means of data collection. The analysed data revealed the following themes: nurses' perceptions, presencing and reassurance. The findings have relevance for nurses in many settings.

Communication↗
PubMedDate not supplied

Physician-patient communication: a lost art?

In the face of rapid advances in technology, there has been a progressive deterioration of effective physician-patient communication. The American Academy of Orthopaedic Surgeons has identified that patients rate the orthopaedic profession as high in technical and low in communication skills. Poor communication, especially patient-interviewing skills, has been identified in medical students as well as in practicing physicians. Effective communication is associated with improved patient and physician satisfaction, better patient compliance, improved health outcomes, better-informed medical decisions, and reduced malpractice suits, and it likely contributes to reduced costs of care. Recognition of the importance of communication has influenced medical schools to revise curricula and to teach communication skills in residency training and continuing medical education programs. National certifying examinations also are being designed to incorporate these skills. Although written material is useful in increasing awareness of the importance of good physician-patient communication, behavioral change is more likely to occur in a workshop environment. The American Academy of Orthopaedic Surgeons is taking leadership in designing and implementing such an approach for its membership.

Adult↗
PubMed2003

Patient-centered communication, ratings of care, and concordance of patient and physician race.

BACKGROUND: African-American patients who visit physicians of the same race rate their medical visits as more satisfying and participatory than do those who see physicians of other races. Little research has investigated the communication process in race-concordant and race-discordant medical visits. OBJECTIVES: To compare patient-physician communication in race-concordant and race-discordant visits and examine whether communication behaviors explain differences in patient ratings of satisfaction and participatory decision making. DESIGN: Cohort study with follow-up using previsit and postvisit surveys and audiotape analysis. SETTING: 16 urban primary care practices. PATIENTS: 252 adults (142 African-American patients and 110 white patients) receiving care from 31 physicians (of whom 18 were African-American and 13 were white). MEASUREMENTS: Audiotape measures of patient-centeredness, patient ratings of physicians' participatory decision-making styles, and overall satisfaction. RESULTS: Race-concordant visits were longer (2.15 minutes [95% CI, 0.60 to 3.71]) and had higher ratings of patient positive affect (0.55 point, [95% CI, 0.04 to 1.05]) compared with race-discordant visits. Patients in race-concordant visits were more satisfied and rated their physicians as more participatory (8.42 points [95% CI, 3.23 to 13.60]). Audiotape measures of patient-centered communication behaviors did not explain differences in participatory decision making or satisfaction between race-concordant and race-discordant visits. CONCLUSIONS: Race-concordant visits are longer and characterized by more patient positive affect. Previous studies link similar communication findings to continuity of care. The association between race concordance and higher patient ratings of care is independent of patient-centered communication, suggesting that other factors, such as patient and physician attitudes, may mediate the relationship. Until more evidence is available regarding the mechanisms of this relationship and the effectiveness of intercultural communication skills programs, increasing ethnic diversity among physicians may be the most direct strategy to improve health care experiences for members of ethnic minority groups.

Adolescent↗
PubMed1998

[Communications difficulties during the medical interview].

The aims of medical interview are to obtain diagnostic information, to obtain an empathetic communication with the patient, to educate him about his disease and to establish a personal link allowing a lasting relationship. We analyze some features of communication with patients. Individualized communication, recognizing his identity and personal aspects, "looking from the patient". Context, a shared but not mentioned value, part of the world of emotions and ideas. An analog and digital language, the former precise in words and the latter more diffuse, with gestures, not verbal. Coherence, as the similitude between what we think, feel and say. If there is no coherence, communication is impaired. Emotions, always present, rending communication more valid and real. We need to recognize, express and respond to emotions. An emotionless patient becomes a distant and impersonal object, an "it". When emotions are incorporated the patient is a "him" with whom I share and dialog. Empathy is an emotional comprehension, a personal bond. It improves relationships and creates links. Compassion is a variation of empathy that includes spiritual aspects and values. Negative emotions as rage, frustration and aggression creates communicational difficulties. We must recognize, express and clarify them to improve the situation. Difficult patients with whom communication is difficult such as confuse, agitated, terminal, elder, manipulating or hypochondriac subjects. The idea of transference and counter transference in these complicated situations is analyzed.

Communication↗
PubMed2001

[Characteristics of communication of schizophrenic, neurotic, and healthy adolescents].

Research on communication skills in psychotic patients demonstrates that in dialogues schizophrenics neglect the needs of the listener. There are only few linguistic studies which investigate the speech of schizophrenic children and adolescents. The verbal and non-verbal communication of schizophrenic, neurotic, and healthy adolescents during a problem solving situation was transcribed and compared by a content analysis. The transcripts were screened for dialogue control and communication disturbance of verbal/non-verbal activities of the speaker and listener: Dialogue control was defined by the variables signals of the speaker or signals of hearer and eye or body contact of the test person to the experimenter. Communication disturbance was defined as the amount of incomprehensible articulation and selections. Neurotic test persons produce the highest signals of speaker rate. In dialogues with neurotic and schizophrenic test persons the experimenter uses more signals of hearer than in dialogues with healthy test persons. In dialogues with neurotic test persons the experimenter shows more signals of the speaker than in dialogues with healthy test persons. Schizophrenics neglect more often the statements of the experimenter than in other dialogues and vice versa. Although the experimenter was instructed to restricted verbal behavior the communication intensified in the neurotic group. The communication in the schizophrenic group was characterized by frequent communication disturbance.

Adolescent↗
PubMed2001

Teaching senior nurses how to teach communication skills in oncology.

Many nurses acknowledge that their nursing practice is hampered by inadequate teaching about communication skills during their nursing education. Ineffective communication has negative effects on patient care and causes stress when nurses interact with each other, with medical colleagues, with patients and their relatives. Many senior nurses teach junior staff about communication and feel uncertain about their competence to do so despite recognition of its importance. This article reports data from a training initiative endorsed by the Royal College of Nursing in the United Kingdom (UK) aimed at helping senior nurses to identify their personal strengths and weaknesses when communicating, learn new teaching methods and encourage new teaching initiatives. A residential 2-day course, based on learner-centered methods was employed. One hundred and twenty nine nurses from UK cancer centers worked on personal communication problems via group discussions, video demonstrations, small group teaching exercises and role-plays with professional actors. Post-course, participants reported significantly greater confidence in handling 14 common communication problem areas in cancer (p < .0001) and in 8 different areas of teaching. Participants were very enthusiastic about the course overall and especially valued the training approach and teaching materials provided. Three months post-course 91% reported changing their own teaching practice and 85% had initiated new communication skills teaching.

Attitude of Health Personnel↗
PubMed2001

[Critical aspects of communication in intensive care].

The poor quality of interpersonal communication is the main reason for the dissatisfaction intensive care patients and their family members often experience. Yet interpersonal communication is considered an important means of conveying information, providing psychological support, and preventing conflicts which can arise when communication is ineffective and information is misunderstood. Good communication is, therefore, an essential part of therapy. This study examines the factors that can hinder communication between clinicians, patients and their family members and the strategies needed to overcome the obstacles to good communication. The results of the study showed that training in the development of relational skills and communicative competence within the intensive care setting should be directed towards the promotion of decision-making processes shared among medical personnel, patients and their family members. In this way, conflict can be reduced and the quality of medical care improved.

Communication↗
PubMed2003

[Psychological mechanisms of communication disorders in schizophrenics and their relatives].

The study aimed at searching for mechanisms of communicative impairments in patients with schizophrenia and their relatives. To evaluate a contribution of attention and memory to communication efficacy and to ability for understanding mental states of others, 100 patients with schizophrenia and schizoaffective psychosis, 150 their healthy relatives and 145 controls have been studied. The results confirmed a presence of communicative deviations in the patients with schizophrenia and their relatives. In these groups, communication deficit was determined by disturbance of 1 out of 4 communication principles--the principle of information quantity. Attention and memory did not exert any significant influence on communication efficacy in the patients and their relatives. Distinct deterioration of fulfilling the tasks demanding mentalizing ability was found only in the patients. However, no correlation was revealed between this deterioration and communication peculiarities.

Adult↗