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PubMed2003

Sex differences in intercultural communication apprehension, ethnocentrism, and intercultural willingness to communicate.

Communication predispositions influence interactions between individuals from different cultures. Three such predispositions have been found to affect behavior in intercultural contexts: Apprehension about intercultural communication, ethnocentrism, and intercultural willingness to communicate. This study examined differences between men (n = 130) and women (n = 175) on those three predispositions. The analysis showed that men reported experiencing higher apprehension about intercultural communication, being more ethnocentric than women, and being less willing to communicate interculturally than women. Implications of these findings are discussed.

Adolescent↗

PubMed1997

[Communication in the hospital. A qualitative study of the communication behavior within the nursing service between the wards of a psychiatric department of a general hospital].

In this project the behaviour of communication was examined of the nursing staff of a psychiatric clinic of a university hospital in Germany dealing with the staff of the other units. For this project qualitative methods of research with characteristics of the "Grounded Theory" have been used. The results show among others that communication barriers with regard to a cooperative communication process have existed in the past and are still showing some influence on todays' nursing staff. The interviewed nurses intend to realize a more cooperative communication and interaction on and between the units. A critical reflection of the "nursing conference", the "job rotation" or the "coaching of the team sessions by a neutral presenter" are examples of recommendations to improve and support the development of the communication process among the nurses.

Communication↗

PubMed2004

Enhancing socially adaptive communicative repairs of beginning communicators with disabilities.

Young children with significant disability often have limited communicative repertoires. The means they have available to communicate with others might include natural gesturing, vocalizing, and occasionally challenging behavior. These forms frequently are unconventional, ambiguous, and idiosyncratic and are therefore difficult for partners to understand. As a result of these compromised repertoires, communication breakdowns are the rule rather than the exception and the children's capacity to repair these breakdowns becomes critical. This article focuses on communication breakdowns and repairs by (a) identifying and defining their variations, (b) providing a rationale for their importance (especially for children with substantial language delays), and (c) developing a conceptual framework to facilitate their assessment and to assist in the design of interventions that are logically related to the assessment results. Guidelines for conducting the assessments and for implementing the interventions are provided.

Child↗

PubMed1998

An evidence-based approach to interactive health communication: a challenge to medicine in the information age. Science Panel on Interactive Communication and Health.

OBJECTIVE: To examine the current status of interactive health communication (IHC) and propose evidence-based approaches to improve the quality of such applications. PARTICIPANTS: The Science Panel on Interactive Communication and Health, a 14-member, nonfederal panel with expertise in clinical medicine and nursing, public health, media and instructional design, health systems engineering, decision sciences, computer and communication technologies, and health communication, convened by the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services. EVIDENCE: Published studies, online resources, expert panel opinions, and opinions from outside experts in fields related to IHC. CONSENSUS PROCESS: The panel met 9 times during more than 2 years. Government agencies and private-sector experts provided review and feedback on the panel's work. CONCLUSIONS: Interactive health communication applications have great potential to improve health, but they may also cause harm. To date, few applications have been adequately evaluated. Physicians and other health professionals should promote and participate in an evidence-based approach to the development and diffusion of IHC applications and endorse efforts to rigorously evaluate the safety, quality, and utility of these resources. A standardized reporting template is proposed to help developers and evaluators of IHC applications conduct evaluations and disclose their results and to help clinicians, purchasers, and consumers judge the quality of IHC applications.

Evidence-Based Medicine↗

PubMed2006

A randomized comparison of the effect of two prelinguistic communication interventions on the acquisition of spoken communication in preschoolers with ASD.

PURPOSE: This randomized group experiment compared the efficacy of 2 communication interventions (Responsive Education and Prelinguistic Milieu Teaching [RPMT] and the Picture Exchange Communication System [PECS]) on spoken communication in 36 preschoolers with autism spectrum disorders (ASD). METHOD: Each treatment was delivered to children for a maximum total of 24 hr over a 6-month period. Spoken communication was assessed in a rigorous test of generalization at pretreatment, posttreatment, and 6-month follow-up periods. RESULTS: PECS was more successful than RPMT in increasing the number of nonimitative spoken communication acts and the number of different nonimitative words used at the posttreatment period. Considering growth over all 3 measurement periods, an exploratory analysis showed that growth rate of the number of different nonimitative words was faster in the PECS group than in the RPMT group for children who began treatment with relatively high object exploration. In contrast, analogous slopes were steeper in the RPMT group than in the PECS group for children who began treatment with relatively low object exploration.

Autistic Disorder↗

PubMedDate not supplied

Children's Communication Checklist (CCC) scores in 11-year-old children with communication impairments.

BACKGROUND: The pragmatic skills of children with communication disorders and their assessment are currently an issue for speech and language therapy and educational placement. AIMS: To explore whether different subgroups of children with communication disorders score differently on the Children's Communication Checklist (CCC) and to study how they compare with published normative data. METHODS & PROCEDURES: A sample of 161 eleven-year-old children with a history of communication disorders was assessed using the CCC. The main use of this questionnaire was to establish whether pragmatic impairments were part of a child's communication difficulty. Although the checklist was originally designed for research purposes, normative data for this scale have been recently published as well as group data from a number of different clinical groups. Whilst the present CCC data have been previously reported descriptively for a wider sample, they have not been examined in terms of subgroups or compared directly with normative information and similarly diagnosed individuals from other studies. OUTCOMES & RESULTS: Of the children assessed, 52 (33%) scored in the normal range (within 1 SD) on the pragmatic scale, 40 (26%) fell between 1 and 2 SD below the normative mean, and 64 (41%) scored below 2 SD of the mean of typically developing children (aged 6-16 years). Thus, the majority (67%) scored out of the normal range for pragmatic skill at 11 years of age. The cohort was separated into four diagnostic subcategories: those with a definite diagnosis of autistic spectrum disorder (n=15); those with typical specific language impairment (n=82); generally impaired (n=37); and those with a clinical history of primary pragmatic language impairment (independent of CCC score, n=27). CONCLUSIONS: Findings show that those generally impaired and with specific language impairment were less impaired than the other groups on the CCC pragmatic scale. There was a significant trend for those with autistic spectrum disorders to score lowest through pragmatic language impairment, generally impairment to specific language impairment. It is argued that a cut-off of 140 may prove more useful at this age than the 132 level previously published for 8 year olds. Results suggest that the CCC can be used as a clinical tool, but in conjunction with other reliable measures.

Autistic Disorder↗

PubMed1998

Increasing communicative interactions of young children with autism using a voice output communication aid and naturalistic teaching.

We evaluated the effects of a voice output communication aid (VOCA) and naturalistic teaching procedures on the communicative interactions of young children with autism. A teacher and three assistants were taught to use naturalistic teaching strategies to provide opportunities for VOCA use in the context of regularly occurring classroom routines. Naturalistic teaching procedures and VOCA use were introduced in multiple probe fashion across 4 children and two classroom routines (snack and play). As the procedures were implemented, all children showed increases in communicative interactions using VOCAs. Also, there was no apparent reductive effect of VOCA use within the naturalistic teaching paradigm on other communicative behaviors. Teachers' ratings of children's VOCA communication, as well as ratings of a person unfamiliar with the children, supported the contextual appropriateness of the VOCA. Probes likewise indicated that the children used the VOCAs for a variety of different messages including requests, yes and no responses, statements, and social comments. Results are discussed in regard to the potential benefits of a VOCA when combined with naturalistic teaching procedures. Future research needs are also discussed, focusing on more precise identification of the attributes of VOCA use for children with autism, as well as for their support personnel.

Autistic Disorder↗

PubMed1978

[Anterior communicating artery aneurysms accompanied with anomalies or anterior communicating artery (author's transl) ].

The investigation was carried out on arterial anomalies complicated with 296 cases of single aneurysm of anterior communicating artery and on the etiological significance of the anomalies in the development of cerebral aneurysms. Either the fenestration in anterior communicating artery or the presence of more than 2 anterior communicating arteries was observed in 17 cases (5.7%). As the anomaly was duplicated in some of these cases, the total number of cases with anomalies of anterior communicating artery became to be 26 cases (8.8%) out of 296 cases investigated. This occurrence rate was not higher than those observed in other cerebral aneurysmal cases and the control cases, which were reported previously. There was no significant difference as to the occurrence rate of hypoplasia of the A1 portion between the cases whose aneurysms of anterior communicating artery were complicated with arterial anomalies and the cases without the arterial anomalies.

Circle of Willis↗

PubMedDate not supplied

The meaning of communication: experiences with augmentative communication devices.

This study is a secondary analysis of data collected from end-users of Augmentative and Alternative Communication (AAC) devices as part of a project of the Rehabilitation Engineering Research Center on Technology Transfer (T2RERC). The original data, obtained from a Web-based focus group, were used to identify unmet consumer needs in existing AAC devices. The purpose of the secondary analysis was to give context to the original study through phenomenological interpretation of the narratives, thereby gaining an understanding of the common meanings and shared experiences and practices of people who use AAC technology. Underlying this study is the interpretive approach of Heideggerian hermeneutics; through reflective thinking, understanding of the human situation of AAC users in everyday life is uncovered or extended. Six themes and one constitutive pattern emerged to explain the participants' experiences with AAC devices: (a) maintaining effective communication, (b) interacting in various situations, (c) AAC device-imposing limitations, (d) wading through prepackaged technology, (e) AAC device giving more than a voice, (f) accepting the AAC device. The constitutive pattern was communication technology enables humanness. This information will make rehabilitation nurses aware of the value of the AAC device for the users and the limitations that the technology may impose on the users, as well as the need for others to accept the device. Nurses gaining this understanding may facilitate integration of AAC systems and the development of patient/nurse communication partnerships.

Adolescent↗

PubMed2026

Assessment and CommuniCation ExcelLEnce foR sAfe paTient outcomEs (ACCELERATE): A stepped-wedge cluster randomised trial evaluating the effectiveness of a nurse-led assessment and handover communication intervention on patient adverse events.

BACKGROUND: Patients continue to experience harm from undetected deterioration, falls and pressure injuries. We aimed to implement and evaluate an organisational, ward-level nurse-led assessment and communication intervention to proactively reduce patient adverse events. METHODS: A stepped-wedge cluster randomised Trial over 12-months was conducted at three metropolitan hospitals. Our intervention comprised a comprehensive, systematic patient assessment at shift commencement; a structured patient-centred bedside nurse-to-nurse clinical handover; and multidisciplinary communication consisting of nurse participation in medical ward rounds. Evidence-based implementation strategies informed intervention delivery to nine clusters (20-35 bed-wards with ≥70% permanent nurses) over three sequential 14-week steps. Routinely collected patient-level data were used to measure intervention effect. The primary outcome was a composite measure of medical emergency team calls, unplanned intensive care unit admissions, in-hospital falls; and stage 2-4 pressure injuries. Secondary outcomes were: individual measures of the primary outcome; nurse-reported perceptions of safety culture; organisational readiness to change; barriers to physical assessment; staff engagement; and patient-reported experience measures of safety and overall hospital experience. Analyses were adjusted for age, sex, hospital, pre/post intervention, and Trial step (fortnight), with random effects for ward and patient. RESULTS: There were 13,753 eligible admissions. No change was observed in the primary composite outcome measure (odds ratio (OR) [95% confidence interval (CI)]: 0.99 [0.77, 1.28]; p = 0.95). There was no significant difference in medical emergency team calls (OR [95% CI]: 1.02 [0.75, 1.39]; p = 0.91); unplanned intensive care unit admissions (OR [95% CI]: 1.35 [0.57, 3.20]; p = 0.50) and falls (OR [95% CI]: 1.53 [0.96, 2.45]; p = 0.07). However, stage 2-4 pressure injuries significantly decreased by 41% (OR [95% CI]: 0.59 [0.38, 0.93]; p = 0.02); a significant absolute effect improvement of 0.8% ([95% CI: 0.3%-1.3%], p < 0.01). There were statistically significant improvements in nurses' overall perceptions of Safety Attitudes (Pre: 74.6, Post: 79.7; p = 0.02), and the Organisational Readiness to Change subscales of, leader culture (Pre: 3.73, Post 3.91; p = 0.02), leadership behaviour (Pre: 3.85, Post: 4.11; p = 0.03), and general resources (Pre: 3.06, Post: 3.30; p = 0.03). A statistically significant decrease in Barriers to Physical Assessment (Pre: 2.48, Post: 2.24; p <0.001) and in six of seven sub-scales was observed. Patients' overall Measure of Safety remained high, but unchanged (Pre: 3.94 Post: 3.92; p = 0.07). CONCLUSION: The ACCELERATE Trial demonstrated that nurse-driven initiatives, emphasising structured physical assessments by nurses, patient-centred clinical handovers, and multidisciplinary communication, significantly: reduced pressure injuries; decreased nurses' perceived barriers to performing physical assessments; and improved leadership behaviour, communication, and ward safety culture perceptions. Results highlight the transformative potential of this approach, which now warrants testing at scale for broader implementation. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ID: ACTRN12621000265875.

Humans↗

PubMed1992

Psychometric evaluation of a Swedish version of the communication strategies scale of the communication profile for the hearing impaired.

The Communication Strategies scale of the Communication Profile for the Hearing Impaired (CPHI) was translated into Swedish and used in several studies of people with hearing impairment (Hallberg & Carlsson, in press; Hallberg, Erlandsson, & Carlsson, 1991). In this study the scale was evaluated in terms of descriptive statistics, corrected item-total correlations, principal component analysis, and internal consistency reliability. Agreement with results from American studies is surprisingly good. Normative data based on three samples are presented: a general Swedish hearing-impaired sample with predominantly sensorineural hearing loss (N = 199), a subgroup of 105 younger subjects with noise-induced hearing loss, and a subgroup of 39 older subjects with sensorineural hearing loss due to heredity and/or old age. A significantly more frequent use of maladaptive behaviors (p less than .001) and verbal communication strategies (p less than .01) was reported by older subjects with age-related and/or hereditary hearing loss than by younger subjects with noise-induced hearing loss. The Communication Strategies scale seems to be an adequately reliable and clinically useful instrument for assessing adaptive and maladaptive strategies in hearing-impaired subjects.

Adaptation, Psychological↗

PubMed2001

Intercultural communication between patients and health care providers: an exploration of intercultural communication effectiveness, cultural sensitivity, stress, and anxiety.

Cultural diversity is becoming increasingly more important in the workplace. This is particularly true in health care organizations facing demographic shifts in the patients served and their families. This study serves to aid the development of intercultural communication training programs for health care providers by examining how cultural sensitivity and effective intercultural communication, besides helping patients, personally benefit health care providers by reducing their stress. Effective intercultural communication and cultural sensitivity were found to be related. Health care providers' levels of intercultural anxiety also were found to correlate with effective intercultural communication.

Clinical Competence↗

PubMed2002

Using the picture exchange communication system (PECS) with children with autism: assessment of PECS acquisition, speech, social-communicative behavior, and problem behavior.

The picture exchange communication system (PECS) is an augmentative communication system frequently used with children with autism (Bondy & Frost, 1994; Siegel, 2000; Yamall, 2000). Despite its common clinical use, no well-controlled empirical investigations have been conducted to test the effectiveness of PECS. Using a multiple baseline design, the present study examined the acquisition of PECS with 3 children with autism. In addition, the study examined the effects of PECS training on the emergence of speech in play and academic settings. Ancillary measures of social-communicative behaviors and problem behaviors were recorded. Results indicated that all 3 children met the learning criterion for PECS and showed concomitant increases in verbal speech. Ancillary gains were associated with increases in social-communicative behaviors and decreases in problem behaviors. The results are discussed in terms of the provision of empirical support for PECS as well as the concomitant positive side effects of its use.

Autistic Disorder↗

PubMed1996

Evaluating the impact of facilitated communication on the communicative competence of fourteen students with autism.

The purpose of this study was to evaluate facilitated communication (FC) as an augmentative or alternative communication system for 14 students attending the Eden Institute in Princeton, NJ. All participants had an independent diagnosis of autism and standardized testing revealed significant deficits in adaptive behavior across all developmental domains. A pretest-posttest design was utilized to (a) determine if any of the participants were immediately capable of communicating through FC (b) if necessary, instruct the participants in the use FC, and (c) determine if this instruction had any impact on their ability to use FC. At the end of 10 weeks of instruction, no participants were able to produce functional, typed communication. Findings are consistent with other quantitative studies that find no support for the cause-effect relationship proposed by FC proponents.

Adolescent↗

PubMed2003

Communication in context: new directions in communication research.

By focusing attention almost exclusively on a single encounter, researchers have adopted a rather restricted view on studying communication in health care. After all, communication does not take place in a vacuum but is influenced by the context in which it takes place. We would therefore strongly recommend to broaden the perspective of communication research. In this respect, four lines of investigation are proposed, each guided by different theories. In the first, context is determined by the goals or targets aimed at by both parties in the medical encounter. The second concerns the context of time, referring to the influence of previous and future medical encounters. The third is set up around the organizational context in which an interaction takes place and the last defines context by looking at a medical encounter as a meeting between two multifaceted parties. Studying a medical encounter in its broader context is expected to provide answers to intriguing questions such as why health care professionals do not always act in conformity with the general approved standards of high quality communication and how the factor time span can be used more effectively in the medical encounter. Eventually, a broader context view will bridge the existing gap between theory and practice.

Attitude of Health Personnel↗

PubMed2003

Centering families in cancer communication research: acknowledging the impact of support, culture and process on client/provider communication in cancer management.

Cancer management occurs within a system of relationships. Advancing a context based view of client provider communication, we first posit that family is central to client provider communication in cancer management. This premise is followed by three additional premises that emphasize the importance of culture, disease stage and communication styles, within this family-centered perspective. Supporting research questions are offered for each premise and implications of this approach for client, family, and provider communication and for client outcomes are offered.

Communication↗

PubMed2000

Effect of off-target verbosity on communication efficiency in a referential communication task.

The referential communication task was used to see if high off-target verbosity (OTV), defined as excessive speech that is lacking in focus, negatively affects communication of nonautobiographical information. The task required 1 individual (the director) to communicate descriptions of abstract figures to another (the matcher). Out of 455 adults aged 63 to 93 who were screened for OTV, 27 directors were drawn from each of the top and bottom 15% of the range of OTV scores and 26 directors and all 80 matchers from the middle 50%. High OTV directors were less efficient communicators about the figures and showed poorer inhibitory control but did not intrude personal information in their speech. The implications of the findings for the inhibitory deficit and pragmatic change explanations of OTV are discussed.

Age Factors↗

PubMed1989

The communicative effectiveness index: development and psychometric evaluation of a functional communication measure for adult aphasia.

Groups of aphasic patients and their spouses generated a series of communication situations that they felt were important in their day-to-day life. Using criteria to ensure that the situations were generalizable across people, times, and places, we reduced the number of situations to 36 and constructed an index that allowed the significant others of 11 recovering and 11 stable aphasic individuals to rate their partners' performance in the situations on two occasions 6 weeks apart. These data were then used to evaluate the psychometric properties of the Communicative Effectiveness Index (CETI) as a measure of change in functional communication ability. Further application of a generalization criterion reduced the final index to 16 situations. Results showed the CETI to be internally consistent and to have acceptable test-retest and interrater reliability. It was valid as a measure of functional communication according to the pattern of correlations found with other measures (Western Aphasia Battery, Speech Questionnaire, and global ratings). Finally, it was responsive to functionally important performance change between testings. Further research with the CETI and its usefulness for clinicians and researchers are discussed.

Aged↗