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At least 1,207 records · Page 67Linked to original sources
PubMed2006

The effect of a therapy dog on the communication skills of an adult with aphasia.

UNLABELLED: Little evidence-based research has been published within the field of communication disorders on the role of dogs as catalysts for human communication. This single participant study, a point of entry into this realm of research, explores the effects of a therapy dog on the communication skills of a patient with aphasia receiving intensive speech and language therapy within a rehabilitation setting. The researchers conclude that the presence of the dog does have the potential to stimulate both overt social-verbal and social-nonverbal communication. LEARNING OUTCOMES: As a result of this activity the reader will be able to (1) describe the beneficial role of dogs to serve as catalysts for human communication (2) describe ways in which a person with aphasia may be assisted by a therapy dog and (3) become familiar with an animal-assisted therapy (AAT) program set-up for patients with communication disorders within a rehabilitation setting.

Affect↗
PubMed2006

Communication technology in trauma centers: a national survey.

The relationship between information and communication technology (ICT) and trauma work coordination has long been recognized. The purpose of the study was to investigate the type and frequency of use of various ICTs to activate and organize trauma teams in level I/II trauma centers. In a cross-sectional survey, questionnaires were mailed to trauma directors and clinicians in 457 trauma centers in the United States. Responses were received from 254 directors and 767 clinicians. Communication with pre-hospital care providers was conducted predominantly via shortwave radio (67.3%). The primary communication methods used to reach trauma surgeons were manual (56.7%) and computerized group page (36.6%). Computerized group page (53.7%) and regular telephone (49.8%) were cited as the most advantageous devices; e-mail (52.3%) and dry erase whiteboard (52.1%) were selected as the least advantageous. Attending surgeons preferred less overhead paging and more cellular phone communication than did emergency medicine physicians and nurses. Cellular phones have become an important part of hospital-field communication. In high-volume trauma centers, there is a need for more accurate methods of communicating with field personnel and among hospital care providers.

Analysis of Variance↗
PubMed2004

Cancer patient and caregiver experiences: communication and pain management issues.

This study examined facilitators and barriers to effective patient and caregiver communication with providers with emphasis on communication related to cancer pain management. Focus groups and personal interviews were conducted with cancer patients and family caregivers of patients. Communication experiences of subjects as well as suggestions for ways to improve the communication process were elicited. Twenty-two cancer patients and 16 family caregivers participated in the study. Seven themes emerged suggesting improvements that are needed in the communication process. These include: 1) improving the process of information exchange, 2) increasing active participation of patient and caregiver in the care process, 3) improving provider relationship-building skills, 4) overcoming time barriers, 5) addressing fears regarding use of pain management medications, 6) fostering appropriate involvement of family and caregivers in the communication process, and 7) improving coordination of care among providers. Specific suggestions and their practice implications for health care providers are highlighted.

Adult↗
PubMed2004

The context of health care communication in chronic illness.

Patient-professional communication is a critically important element of effective chronic illness care. However, the dynamics of health care communication in supporting self-care management and effective coping with various chronic diseases is not well understood. The present study examined health care communication from the perspective of 38 patients with four distinct chronic conditions: end-stage renal disease (ESRD), non-insulin dependent diabetes mellitus (NIDDM), multiple sclerosis (MS), and fibromyalgia (FM). Analysis revealed the dimensions of courtesy, respect, and engagement to be inherent in communication priorities across conditions. However, distinct "disease worlds" among and between these chronic conditions illuminated salient differences within these dimensions, thereby illustrating the way in which relevant variables such as legitimacy, the availability of conventional treatments, and lifestyle implications shape the meaning of health care communication. The findings enlarge upon patient-centered approaches to health care communication and inform further analysis of the interactional dynamics associated with chronic conditions.

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↗
PubMed2005

Chest pain: communication of symptoms and history in a London emergency department.

OBJECTIVE: To describe patient-provider interactions for patients in an emergency department with possible acute coronary syndrome (ACS) and to generate hypotheses about how communication might contribute to sociocultural disparities in cardiac care. METHODS: Qualitative analysis of observational data. Seventy-four consecutive patients presenting between 8 a.m. and 10 p.m. over a 4-month period. RESULTS: Participants were aged 40-85 years; 58% were male; 67% were white, 18% Afro-Caribbean, and 15% South East Asian. Observations revealed significant obstacles to communication for the majority of patients. The three most prominent impediments to effective communication were: the use of leading questions to define chest pain, patient-provider conflict as a result of, and contributor to, poor communication, and frank miscommunication due to language barriers and translational difficulties. CONCLUSION: This study documents aspects of the communication process that compromise the quality of the medical history obtained in emergency department patients with suspected ACS. Accurate diagnosis relies on an interaction that weaves both the patient's and the physician's perspective into a shared understanding of events that comprise a patient's history. When diagnostic short cuts are taken to overcome educational, cultural, or language barriers in the medical interview, they may contribute to health care disparities. PRACTICE IMPLICATIONS: Physicians should take a more attentive and careful approach to patient interviewing than was observed here and should be aware of the ways in which they shape the interview through their questions and focus. Good communication skills can be effectively taught at all levels of training and practice.

Adult↗
PubMed2006

Communication with patients during the prenatal testing procedure: an explorative qualitative study.

OBJECTIVE: While generally two phases of prenatal genetic counseling are distinguished, i.e. pre- and post-test counseling, we revealed a third form of communication during the testing procedure. The content of this intermediate communication was explored. METHODS: A secondary analysis was performed on data obtained in another observational study, which was focussed on how indefinite testing results are clarified. Thirteen testing trajectories in which communication with parents took place during the testing procedure were further analysed. RESULTS: In the majority of cases the content of intermediate communication was similar to the content of pre-test counseling. In four cases the content was different, because the communication involved the parents in decision-making about a testing result, which was still being processed. CONCLUSION: Communication in (prenatal) genetic testing is not always restricted to separate phases, but can be an ongoing process occurring parallel to, and sometimes even intertwined with, the testing process. The advocated model of shared decision-making might work better once it is determined if the decision concerns the area wherein the provider is the expert, or the patient. PRACTICE IMPLICATIONS: Further research into the process of continuing decision-making could clarify how providers' and patients' responsibilities regarding the diagnostic process are distributed. Meanwhile, the possible occurrence of continuous decision-making should be mentioned in (prenatal) genetic counseling.

Adaptation, Psychological↗
PubMed2006

Prior experiences associated with residents' scores on a communication and interpersonal skill OSCE.

OBJECTIVE: This exploratory study investigated whether prior task experience and comfort correlate with scores on an assessment of patient-centered communication. METHODS: A six-station standardized patient exam assessed patient-centered communication of 79 PGY2-3 residents in Internal Medicine and Family Medicine. A survey provided information on prior experiences. t-tests, correlations, and multi-factorial ANOVA explored relationship between scores and experiences. RESULTS: Experience with a task predicted comfort but did not predict communication scores. Comfort was moderately correlated with communication scores for some tasks; residents who were less comfortable were indeed less skilled, but greater comfort did not predict higher scores. Female gender and medical school experiences with standardized patients along with training in patient-centered interviewing were associated with higher scores. Residents without standardized patient experiences in medical school were almost five times more likely to be rejected by patients. CONCLUSIONS: Task experience alone does not guarantee better communication, and may instill a false sense of confidence. Experiences with standardized patients during medical school, especially in combination with interviewing courses, may provide an element of "deliberate practice" and have a long-term impact on communication skills. PRACTICE IMPLICATIONS: The combination of didactic courses and practice with standardized patients may promote a patient-centered approach.

Analysis of Variance↗
PubMed2006

Doctor-patient communications in the Aboriginal community: towards the development of educational programs.

OBJECTIVE: Aboriginal people in Canada have poorer health than the rest of the population. Reasons for health disparities are many and include problems in communication between doctor and patient. The objective of this study was to understand doctor-patient communication in Aboriginal communities in order to design educational interventions for medical students based on the needs and experiences of patients. METHODS: Experiences of good and poor communication were studied by semi-structured interviews or focus groups with 22 Aboriginal community members, 2 community health representatives and 2 Aboriginal trainee physicians. Transcribed data were coded and subjected to thematic analysis. RESULTS: Positive and negative experiences of communicating with physicians fell into three broad and interrelated themes: their histories as First Nations citizens; the extent to which the physician was trusted; time in the medical interview. CONCLUSION: Aboriginal peoples' history affects their communication with physicians; barriers may be overcome when patients feel they have a voice and the time for it to be heard. PRACTICE IMPLICATIONS: Physicians can improve communication with Aboriginal patients by learning about their history, building trust and giving time.

Adult↗
PubMed2006

Parent-adolescent communication about sexuality: the role of adolescents' beliefs, subjective norm and perceived behavioral control.

OBJECTIVE: To examine to what extent adolescents' beliefs, subjective norm and perceived behavioral control predict the amount of parent-adolescent communication about sexuality. In addition, the role of adolescents' gender, ethnic background, religiosity and educational level on these relationships was assessed as well. METHODS: Data were collected from 481 students of four high schools in The Netherlands. A questionnaire assessed adolescents' beliefs, subjective norm, perceived behavioral control, and self-reported parent-adolescent communication about sexuality. Linear regression analyses were performed to identify predictors of parent-adolescent communication. To assess differences between subgroups, chi(2)-analyses, t-tests and analyses of variance were conducted. RESULTS: Being female and having positive beliefs about talking with parents about sexuality were positively related to amount of parent-adolescent communication. In addition, adolescents' perceived behavioral control and subjective norm were significant predictors as well. CONCLUSION: Adolescents' beliefs, subjective norm and perceived behavioral control, are all significant predictors of frequency of parent-adolescent sex communication, with beliefs being the most important. In addition, adolescents' gender predicted a significant amount as well. PRACTICE IMPLICATIONS: Interventions aimed to increase the amount of parent-adolescent communication should primarily target their efforts to changing adolescents' underlying beliefs about discussing sexuality with their parents. Our results furthermore suggest that it is important to take into consideration gender variations in these beliefs, by designing separate interventions for different groups of adolescents.

Adolescent↗
PubMedDate not supplied

Analysis of intentional communication in severely handicapped children with Cornelia-de-Lange syndrome.

UNLABELLED: Intentional communicative acts were assessed in 13 children with Cornelia-de-Lange syndrome (CdLS) with a severe mental disability and compared to a control group of Down and 5p (Cri-du-Chat (CdC)) syndrome children. The mean number of intentional communicative acts were significantly lower. Analysis of play behaviors revealed that the differences were specific for the communicative domain. They are part of a general behavioral characteristic of CdLS children with a severe mental disability which can be described as a lack of communication, emotional reactions and motility. A syndrome-specific low rate of communicative initiatives indicates a special problem for designing intervention programs which depend on opportunities for facilitating strategies. LEARNING OUTCOMES: The reader will learn about the behavioral phenotype of CdLS, distinctive communication problems and qualities of play behavior which are relevant for planning educational interventions in children with this syndrome.

Child↗
PubMed1999

Effects of obstetrician gender on communication and patient satisfaction.

OBJECTIVE: To describe patient-obstetrician communication during the first prenatal visit and its relationship to physician gender and patient satisfaction. METHODS: The first prenatal visit of 87 women with 21 obstetricians (11 male and ten female) was audiotaped and analyzed using the Roter Interaction Analysis System. Patient satisfaction was measured by postvisit questionnaire. RESULTS: Communication during first prenatal visits was largely biomedical, with little psychosocial or social discussion. Male physicians conducted longer visits than females (26 minutes versus 21.9 minutes, P < .05) and engaged in more facilitative communication (ie, making sure they were understood and providing direction and orientation) and explicit statements of concern and partnership (z > 1.96, P < .05). Female physicians devoted more communication to agreements, disagreements, and laughter than males (z > 1.96, P < .05). Satisfaction with physicians' emotional responsiveness and informational partnership was related to female physician gender and a variety of task-focused and affective communication variables. CONCLUSION: Communication and satisfaction between women and obstetricians during initial prenatal visits is related to physician gender and patient satisfaction. Male physicians conducted longer visits but women were more satisfied with female physicians.

Adult↗
PubMed2003

Communication of prenatal screening and diagnosis results to primary-care health professionals.

OBJECTIVE: To describe how prenatal screening and diagnostic test results are communicated to primary care health professionals. DESIGN: Postal questionnaire. SETTING: Primary care practices across London, East Anglia, the Southeast and Southwest of England. PARTICIPANTS: 714 community-based health professionals (GPs, midwives and health visitors) identified by 247 women (participants in a study of experiences after a positive prenatal diagnosis) as members of their primary care team. MAIN OUTCOME MEASURES: Description of how information about prenatal screening and diagnostic test results is communicated to health professionals working in the primary care team. Participants' views about the timeliness and sufficiency of the information they are given. RESULTS: 131 GPs, 143 midwives and 151 health visitors returned questionnaires, an overall response rate of 60.4%. Sixteen percent of primary care professionals reported that they were not usually informed of high-risk results after serum screening for Down's syndrome. Twenty eight percent were either not usually told about the possibility of abnormalities detected on ultrasound or only heard of such abnormalities from the woman herself. Even when informed, 28% of midwives and GPs did not know what action they were expected to take. Information about confirmed abnormalities is not always communicated to primary care. Only 29% were told soon enough about diagnosed abnormalities and only 17% of health professionals reported that the information they were given was always sufficient to allow them to discuss issues with their patients. The presence of specialist screening coordinators was perceived to be helpful by 76% of health professionals. Improvements in how they were told about abnormalities were suggested and these included the need for systems and protocols that ensured that quality information was communicated quickly. CONCLUSIONS: The frequent absence of means of effective communication between primary and secondary care about diagnosed abnormalities, and health professionals' uncertainties about their role has implications for the quality of care given to women who receive positive results after prenatal screening or diagnosis. There is a need for standards to be established concerning the communication of information to the health professionals responsible for the community-based care of pregnant women after a positive test result.

Communication↗
PubMed1995

Gap junctional communication in primary culture of cells derived from human aortic intima.

Intercellular communication via gap junctions plays an important role in the regulation and homeostasis. The presence of gap junctions and the efficiency of their function directly correlates with the degree of cell differentiation in a tissue. In the present study, gap junctional communication has been investigated in a primary culture of highly differentiated mesenchymal cells (subendothelial smooth muscle cells isolated from grossly normal and atherosclerotic areas of human aorta) and in poorly differentiated cells of mesenchymal origin (adult human skin fibroblasts as well as skin fibroblasts and aortic smooth muscle cells, derived from human fetus). The fluorescent dye transfer technique was used in this study. In cell cultures isolated from grossly normal and atherosclerotic aorta, the number of cells coupled via gap junctions increased with cell density and reached a plateau at a cell density of 50 to 70 cells/mm2. In cultures of normal aortic cells the number of coupled cells was 23.0 +/- 4.1 per injected cell and was significantly higher than in cultures of atherosclerotic cells (16.4 +/- 2.1, p < 0.05). Gap junctional communication between cells loaded with lipid inclusions was 2.4-fold lower than between cells free of excess intracellular lipids. In cultures of human skin fibroblasts the rate of intercellular communication was lower than in cultures of normal aortic cells and was comparable to that in cultures of atherosclerotic cells. There was practically no cell-to-cell communication in cultures of fetal cells. It is hypothesized that the reduced gap junctional communication in atherosclerotic human aorta is associated with the alterations in the degree of smooth muscle cell differentiation and impairs the function of the intima in atherosclerosis.

Aorta↗
PubMed2002

Evolutionary aspects of cellular communication in the vertebrate hypothalamo-hypophysio-gonadal axis.

This review emphasizes the comparative approach for developing insight into knowledge related to cellular communications occurring in the hypothalamus-pituitary-gonadal axis. Indeed, research on adaptive phenomena leads to evolutionary tracks. Thus, going through recent results, we suggest that pheromonal communication precedes local communication which, in turn, precedes communication via the blood stream. Furthermore, the use of different routes of communication by a certain mediator leads to a conceptual change related to what hormones are. Nevertheless, endocrine communication should leave out of consideration the source (glandular or not) of mediator. Finally, we point out that the use of lower vertebrate animal models is fundamental to understanding general physiological mechanisms. In fact, different anatomical organization permits access to tissues not readily approachable in mammals.

Animals↗
PubMed2003

Pragmatic communication skills in patients with Parkinson's disease.

BACKGROUND: Pragmatic communication abilities may depend on intact frontal lobe systems. Independent evidence suggests that some persons with Parkinson's disease (PD) are impaired on measures of frontal lobe function. HYPOTHESIS: We therefore hypothesized in Study 1 that pragmatic communication skills would be impaired in some persons with PD and would be linked to frontal dysfunction in these patients. In Study 2 we hypothesized that PD patients would be unaware of their pragmatic communication deficits. METHODS: In Study 1 we administered tests of pragmatic abilities and frontal lobe functioning to twenty-two persons with Parkinson's disease (PD) and 10 healthy controls. In Study 2 we obtained self-ratings of pragmatic abilities from 11 PD patients and then checked these self-ratings against ratings of these same abilities by the patient's spouses. RESULTS: We found in Study 1 that patients with PD were: (a) significantly impaired on measures of pragmatic communication abilities, especially in the areas of conversational appropriateness, turn-taking, prosodics and proxemics, and that this impairment was significantly related to measures of frontal lobe function. In study 2 we found that PD patients overestimated their own abilities relative to spousal ratings of those abilities and thus were unaware of the extent of their problems with pragmatic social communication skills. CONCLUSION: We conclude that pragmatic social communication skills are impaired in PD and that this impairment may be related to frontal lobe dysfunction.

Aged↗
PubMed2002

Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial.

BACKGROUND: Doctors' communication with patients is commonly hampered by lack of training in this core skill. This study aimed to assess the efficacy of an intensive 3-day training course on communication skills in a randomised controlled trial with a two-by-two factorial design and several outcomes. METHODS: 160 oncologists from 34 UK cancer centres were randomly allocated to four groups: written feedback followed by course; course alone; written feedback alone; and control. At each of two assessment periods, consultations with six to ten consecutive, consenting patients per doctor were videotaped. 2407 patients participated. Outcome measures included objective and subjective ratings made by researchers, doctors, and patients. The primary outcomes were objective improvements after the intervention in key communication skills. Course content included structured feedback, videotape review of consultations, role-play with simulated patients, interactive group demonstrations, and discussion led by a trained facilitator. FINDINGS: In Poisson regression analysis of counts of communication behaviours, course attendance significantly improved key outcomes. The estimated effect sizes corresponded to higher rates of use of focused questions (difference between course attenders [n=80] and non-attenders [n=80] 34%, p=0.003), focused and open questions (27%, p=0.005), expressions of empathy (69%, p=0.003), and appropriate responses to patients' cues (38%, p=0.026), and a 24% lower rate of use of leading questions (p=0.11). There was little evidence for the effectiveness of written feedback. INTERPRETATION: The communication problems of senior doctors working in cancer medicine are not resolved by time and clinical experience. This trial shows that training courses significantly improve key communication skills. More resources should be allocated to address doctors' training needs in this vital area.

Adult↗
PubMed2004

Health-care system frailties and public health control of communicable disease on the European Union's new eastern border.

In May, 2004, the border of the European Union (EU) will shift eastward such that the new frontier will be made up by Ukraine, Belarus, and a considerably longer Russian border. Here, we discuss three issues: first, the factors that have contributed to the growth of communicable disease in Russia, Ukraine, and Belarus; second, how public health systems have responded to these challenges; and third, the implications for the EU as a whole. Since the break-up of the Soviet Union, Russia, Ukraine, and Belarus have witnessed substantial political, social, and economic changes. These events have been reflected in changes in the epidemiology of communicable diseases, including tuberculosis and HIV (ie, HIV-1). Moreover, public health systems, rooted in Soviet traditions, are struggling to respond effectively to the challenges of resurgent infectious diseases, such as tuberculosis, and newly emergent challenges such as HIV. The changing patterns of communicable diseases east of the EU's new border has implications for how the EU aids the strengthening of public health systems east of the new frontier. Transborder spread of communicable diseases also challenges communicable disease control systems within the EU. Concerted action is needed by member states and the EU, building on models of cooperation between institutions that have been successful in areas beyond health, if public health systems are to meet the emerging challenges to communicable disease control.

Communicable Disease Control↗