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 127 records · Page 7Linked to original sources
PubMed2002

Management of pain in older people within the nursing home: a preliminary study.

The provision of continuing care for older people has largely shifted from the hospital setting to the community, and nursing homes increasingly provide support for older people, many of whom exhibit multiple pathology and complex health and social care needs. However, the quality of pain management within this setting has been identified as an issue of concern. It has been estimated that approximately two-thirds of people aged 65 years and over experience chronic pain, and that the prevalence of chronic pain in nursing home residents is between 45% and 80%. However, there exist a number of barriers to the identification and management of chronic pain among older people resident in nursing homes, including sensory impairments in older people themselves and educational deficits among professionals. Such barriers need to be overcome if pain management is to be improved. The present study involved administering a pre-piloted postal questionnaire to the managers of 121 nursing homes within a geographically defined area. Sixty-eight (56%) were completed and returned. The questionnaire broadly covered the following: prevalence of chronic pain and use of interventions; assessment and management strategies; education and training; and communication barriers. Overall, 37% of nursing home residents were identified as experiencing chronic non-malignant pain (pain lasting longer than 3 months not caused by cancer) and 2% were reported as experiencing chronic malignant pain (pain lasting for more than 3 months caused by cancer). Paracetamol was identified as the most 'often' used analgesia for both pain modalities. Sixty-nine per cent of nursing homes did not have a written policy regarding pain management and 75% did not use a standardised pain assessment tool. Forty-four per cent of nursing homes provided education or training sessions for qualified staff and 34% provided this for care assistants. Forty per cent of qualified staff and 85% of care assistants had no specialist knowledge regarding the management of pain in older people. The present study confirms the need for the development of effective pain management strategies underpinned by appropriate training and education in order to meet the particular needs of older people.

Administrative Personnel↗
PubMed2001

Palliative care: the experience of informal carers within the Bangladeshi community.

Optimal palliative care cannot be realized unless nurses have a full understanding of what the patient's family is experiencing. There is a gap in nursing knowledge related to informal care and ethnic minorities. The aim of this retrospective qualitative exploratory study was to investigate the experiences of Bangladeshi informal carers living in the UK, associated with caring for a dying relative. Semi-structured interviews using an interpreter were carried out and patient notes were examined. Four categories emerged from the data: caring, support, communication, and home and family. In addition to the demands and stresses caused by their relative's symptoms and the knowledge that they were dying, the Bangladeshi carers experienced communication barriers, isolation and anxieties regarding visas and housing--yet all were uncomplaining about their situation. Palliative care nurses working with Bangladeshi families need to be aware of the additional stresses that these families may experience and be able to offer strategies to enable them to cope with them.

Bangladesh↗
PubMed2004

The effect of English language proficiency on length of stay and in-hospital mortality.

BACKGROUND: In ambulatory care settings, patients with limited English proficiency receive lower quality of care. Limited information is available describing outcomes for inpatients. OBJECTIVE: To investigate the effect of English proficiency on length of stay (LOS) and in-hospital mortality. DESIGN: Retrospective analysis of administrative data at 3 tertiary care teaching hospitals (University Health Network) in Toronto, Canada. PARTICIPANTS: Consecutive inpatient admissions from April 1993 to December 1999 were analyzed for LOS differences first by looking at 23 medical and surgical conditions (59,547 records) and then by a meta-analysis of 220 case mix groups (189,119 records). We performed a similar analysis for in-hospital mortality. MEASUREMENTS: LOS and odds of in-hospital death for limited English-proficient (LEP) patients relative to English-proficient (EP) patients. RESULTS: LEP patients stayed in hospital longer for 7 of 23 conditions (unstable coronary syndromes and chest pain, coronary artery bypass grafting, stroke, craniotomy procedures, diabetes mellitus, major intestinal and rectal procedures, and elective hip replacement), with LOS differences ranging from approximately 0.7 to 4.3 days. A meta-analysis using all admission data demonstrated that LEP patients stayed 6% (approximately 0.5 days) longer overall than EP patients (95% confidence interval, 0.04 to 0.07). LEP patients were not at increased risk of in-hospital death (relative odds, 1.0; 95% confidence interval, 0.9 to 1.1). CONCLUSIONS: Patients with limited English proficiency have longer hospital stays for some medical and surgical conditions. Limited English proficiency does not affect in-hospital mortality. The effect of communication barriers on outcomes of care in the inpatient setting requires further exploration, particularly for selected conditions in which length of stay is significantly prolonged.

Aged↗
PubMed2006

Russian-American health care: bridging the communication gap between physicians and patients.

OBJECTIVES: The objectives of this article are two-fold: (1) to gather in one place reliable information about Russian-Americans' past medical practices and their current outlook on health care and to provide health care professionals with an overview of the major afflictions suffered by this ethnic group; and (2) to educate Russian-speaking patients about the American heath care system and social services geared towards immigrants by locating and evaluating free, culturally appropriate patient education Web sites available in Russian. METHODS: In order to draw data on specific diseases and conditions affecting the Russian-speaking population, the author searched various scholarly health-related electronic databases. A number of well-established U.S. government consumer-health Web sites were searched to locate patient education resources that can be utilized by recent Russian immigrants. RESULTS: The author provides an overview of the major health problems encountered by the Russian-speaking population before emigration and potential health concerns for Russian immigrant communities. In addition, the author provides a scholarly exploration of patient education materials available in Russian. CONCLUSION: In this increasingly diverse society, physicians are faced with the challenge of providing culturally sensitive health care. Multicultural Web-based health resources can serve as a valuable tool for reducing communication barriers between patients and health care providers, thus improving the delivery of quality health care services. Recommendations for further research are indicated. PRACTICE IMPLICATIONS: The author offers recommendations for practitioners serving Russian-speaking immigrants. Suggestions on utilization of Web resources are also provided.

Acculturation↗
PubMed2005

The experience of dying for Chinese nursing home residents: cultural considerations.

Given the increase of cultural diversity of the elderly population in the United States, there is a need for increased sensitivity of culturally diverse residents. Research on the care of terminally ill Chinese elderly individuals in nursing homes is limited. As part of a larger study on end-of-life care in nursing homes, data were obtained on 34 Chinese residents. Data were obtained through participant observation, event analysis, and in-depth interviews with residents and their families, nursing staff, and physicians. The process of providing care was observed from the time residents were identified as terminally ill until their death. The most significant factors influencing the care Chinese residents received were communication barriers, dislike of Western food, and differing cultural beliefs and customs. These findings offer valuable information in helping to develop and implement interventions to improve the terminal care of Chinese elderly individuals in nursing homes.

Aged↗
PubMed2002

Social context of work injury among undocumented day laborers in San Francisco.

OBJECTIVE: To identify ways in which undocumented day laborers' social context affects their risk for occupational injury, and to characterize the ways in which these workers' social context influences their experience of disability. DESIGN: Qualitative study employing ethnographic techniques of participant-observation, supplemented by semistructured in-depth interviews. SETTINGS: Street corners in San Francisco's Mission District, a homeless shelter, and a nonprofit day labor hiring hall. PARTICIPANTS: Thirty-eight Mexican and Central American male day laborers, 11 of whom had been injured. PRIMARY THEMES: Anxiety over the potential for work injury is omnipresent for day laborers. They work in dangerous settings, and a variety of factors such as lack of training, inadequate safety equipment, and economic pressures further increase their risk for work injury. The day laborers are isolated from family and community support, living in a local context of homelessness, competition, and violence. Injuries tend to have severe emotional, social, and economic ramifications. Day laborers frequently perceive injury as a personal failure that threatens their masculinity and their status as patriarch of the family. Their shame and disappointment at failing to fulfill culturally defined masculine responsibilities leads to intense personal stress and can break family bonds. Despite the high incidence of work injuries and prevalence of work-related health conditions, day laborers are frequently reluctant to use health services due to anxiety regarding immigration status, communication barriers, and economic pressure. IMPLICATIONS: On the basis of these ethnographic data, we recommend strategies to improve ambulatory care services to day laborers in 3 areas: structural changes in ambulatory care delivery, clinical interactions with individual day laborers, and policymaking around immigration and health care issues.

Accidents, Occupational↗
PubMed1992

["Thank you, doctor". Knowledge of intercultural communication is necessary in health care for refugees].

Up to now, the Norwegian population has been homogeneous as regards language and culture, the only exception being the 30,000 indigenous Sami people. With the recent increase of the number of immigrants, particularly refugees and asylum seekers, Norwegian health care workers are faced with a new challenge: communication barriers due to differences in culture. This article lists 12 signal systems and shows how messages can be transmitted, interpreted and misinterpreted, depending on cultural background. Our world view and socio-cultural reference is important for how we interpret messages conveyed in the form of words and nonverbal signals. Ten commandments regarding refugee/intercultural health care are formulated as practical guidelines.

Communication Barriers↗
PubMed2006

Cultural considerations and surgical consent.

The Irish healthcare system is failing to meet the needs of minority ethnic groups. This is a factor that has been attributed to communication barriers and lack of cultural awareness between healthcare providers and recipients of care (O'Connor 2005a). Moreover, with increasing diversity in Ireland, encounters between the healthcare professional and patients from ethnic minorities are becoming more common. Patients bring to the medical encounter different languages, explanatory models concerning treatment and illness, religious beliefs, and ways of understanding the experience of suffering. Thus the risk of misunderstanding and inability to complete appropriate assessments surrounding care and in particular the consent process is a growing concern.

Communication Barriers↗
PubMedDate not supplied

Challenging Spanish: ways for nurses to become bilingual.

A desire to provide culturally competent care to an increasing population of non-English-speakers may lead some nurses to consider learning another language as a way to minimize cross-cultural communication barriers. Nurses wishing to learn a second language may be surprised at the variety of ways to acquire bilingual skills, particularly in Spanish, the most common foreign language encountered in the United States. Reasons to learn Spanish are discussed and ways to do so are reviewed. Learning Spanish or another language can enrich the nurse-patient relationship, enhance nurses' self-esteem, and advance nurses' employment opportunities. Bilingual proficiency in English and Spanish (or another language) should be regarded as an authentic clinical skill supporting nurses' cultural and clinical competencies.

Communication Barriers↗
PubMed1992

Managing the difficult physician-patient relationship.

A difficult physician-patient relationship can have significant consequences for both the physician and the patient. Difficult relationships can lead to frustrating, dissatisfying, adversarial and expensive medical care. The difficult relationship is often a consequence of a breakdown in communication between physician and patient. Specific causes include technical communication barriers, difficulty in discussing certain topics, unmet or violated norms and expectations (both the physician's and the patient's) and a mismatch between the physician's and the patient's personality styles. Management goals for the difficult relationship include maintaining professional self-esteem, maintaining physician-patient continuity, minimizing the "medicalization" of the problem by limiting the use of tests and procedures, and minimizing hospitalization and referral. It is also important to remember that although the relationship may continue to be frustrating or conflictual, it can be effectively managed with appropriate strategies.

Adaptation, Psychological↗
PubMed2006

Chest pain: physician perceptions and decision-making in a London emergency department.

STUDY OBJECTIVE: We describe physician perceptions of decision-making for acute coronary syndromes in the emergency department (ED) and the ways in which patient characteristics influence diagnosis. METHODS: This is a qualitative analysis of semistructured interview data from physicians practicing at an ethnically diverse and lower-income London ED. All physicians working more than 3 shifts in the department during a 1-month period were approached for interview. RESULTS: Four themes emerged from the interviews: (1) physicians emphasized the medical history when diagnosing acute coronary syndrome; (2) physicians reported communication barriers as an impediment to diagnosis; (3) physicians cited both epidemiologic data and cultural beliefs when explaining presentation differences between patient groups; (4) physicians interpreted patient complaints by comparing their clinical impressions to a "classic" or "textbook" norm. CONCLUSION: In most cases, physicians relied on the clinical history when making decisions for patients with suspected acute coronary syndromes. In reaching judgments, physicians elicited features of the presentation they thought were salient, interpreted those features in light of epidemiologic knowledge and cultural beliefs, and compared their overall impression of the patient to a "classic" or "textbook" norm. At each step, physicians' perceptions about patients influenced the data gathered and the interpretation of that data. In addition, the expected features of acute coronary syndrome were thought to differ for some patient groups. These results highlight the need for further research into the role of provider beliefs in medical decision-making.

Age Factors↗
PubMed2005

Improving the Deaf community's access to prostate and testicular cancer information: a survey study.

BACKGROUND: Members of the Deaf community face communication barriers to accessing health information. To resolve these inequalities, educational programs must be designed in the appropriate format and language to meet their needs. METHODS: Deaf men (102) were surveyed before, immediately following, and two months after viewing a 52-minute prostate and testicular cancer video in American Sign Language (ASL) with open text captioning and voice overlay. To provide the Deaf community with information equivalent to that available to the hearing community, the video addressed two cancer topics in depth. While the inclusion of two cancer topics lengthened the video, it was anticipated to reduce redundancy and encourage men of diverse ages to learn in a supportive, culturally aligned environment while also covering more topics within the partnership's limited budget. Survey data were analyzed to evaluate the video's impact on viewers' pre- and post-intervention understanding of prostate and testicular cancers, as well as respondents' satisfaction with the video, exposure to and use of early detection services, and sources of cancer information. RESULTS: From baseline to immediately post-intervention, participants' overall knowledge increased significantly, and this gain was maintained at the two-month follow-up. Men of diverse ages were successfully recruited, and this worked effectively as a support group. However, combining two complex cancer topics, in depth, in one video appeared to make it more difficult for participants to retain as many relevant details specific to each cancer. Participants related that there was so much information that they would need to watch the video more than once to understand each topic fully. When surveyed about their best sources of health information, participants ranked doctors first and showed a preference for active rather than passive methods of learning. CONCLUSION: After viewing this ASL video, participants showed significant increases in cancer understanding, and the effects remained significant at the two-month follow-up. However, to achieve maximum learning in a single training session, only one topic should be covered in future educational videos.

Adult↗
PubMed2000

Recruitment of American Indians and Alaska Natives into clinical trials.

Challenges in recruiting American Indians and Alaska Natives into cancer clinical trials are addressed in this article. Researchers, health care providers, and American Indian and Alaska Native patients face significant communication barriers when prevention or treatment trials are designed or implemented. For researchers, the challenges lie in understanding the cultural distinctiveness of individual tribes, coping with the family orientation of Indian subjects, dealing with the lack of standardized research measures, and defining the subject's pathway in seeking and obtaining healing and health care services. For providers, the challenges center on patient-provider communication, illness beliefs, transportation, and sociocultural barriers. This article explores these complex issues and offers recommendations for researchers and health care providers on conducting research in American Indian and Alaska Native populations.

Alaska↗
PubMed1994

Telephone communication when the patient is deaf or hard-of-hearing.

Newly developed technology and specially trained operators offer physicians and deaf or hard-of-hearing patients several options for communicating by telephone. This article discusses communication equipment, implications and benefits of direct physician/patient communication, removal of communication barriers, and confidentiality.

Communication Devices for People with Disabilities↗
PubMed1998

Referrals for depression by primary care physicians. A pilot study.

BACKGROUND: Communication between primary care physicians (PCPs) and mental health providers (MHPs) is integral to the management of depressive disorders. Our study investigated referrals from PCPs to MHPs in a rural research network. METHODS: From April 1997 to September 1997, 5 family physicians tracked 6 weeks of referrals for depression and non-mental health problems and assessed the outcomes of these referrals after 3 months. The referrals were characterized by the nature and extent of communication between the PCP and the MHP and by the effectiveness of the consultation. RESULTS: Sixty-seven patients (44 with non-mental health disorders and 23 with depressive disorders) were identified and followed. Analysis of the initial referral process showed that the referring physicians felt a greater sense of urgency for the referrals for depression. Written evidence of the referral in the patient's chart at the 3-month survey was more common for non-mental health disorders. CONCLUSIONS: This pilot study demonstrates that there are communication barriers between PCPs and their mental health colleagues. Enhanced communication might improve satisfaction with the referral process. The details of the referral process need further study.

Communication↗
PubMed1999

Cultural barriers to successful communication during orthodontic care.

OBJECTIVE: To determine to what extent barriers related to culture and language, and how inappropriate expectations might impede orthodontic care, among Pakistani Muslims when compared to white Caucasians from similar socio-economic backgrounds in Bradford, UK. DESIGN: Semi-structured interviews. SETTING: Dentists were interviewed in the clinic. Parents and children were interviewed separately in the waiting room or in adjacent rooms depending on availability. PARTICIPANTS: Four dentists working in the Community and Hospital Dental Services, 30 children and 10 parents of white and Pakistani origin. RESULTS: Among the white Caucasian groups, three-way communication involving parents, children and dentist enhanced understanding, supported orthodontic treatment and reinforced the need for good home care. Among Pakistani families communication was primarily two-way, involving the dentist and the child. Parents and families had limited understanding of the process and were unable to offer a comparable level of support that would benefit their children most. This can place additional burdens on the Pakistani child patient and requires a very positive approach from the dental team. CONCLUSIONS: There is a clear need for chairside support, through patient advocates or interpreters, as well as the provision of appropriate educational material to match parents' educational needs on behalf of their children.

Adolescent↗
PubMed2005

[To integrate patient's preferences in intensive care treatment plans].

An increasing number of terminally ill patients are admitted into the intensive care unit, and decisions of limitation, or of palliative care are made to avoid medical futility. The principle of autonomy states that the patient (or in case of necessity his relatives) should make end of life decision after detailed information. The exercise of autonomy is difficult due to the disease of the patient and the nature of invasive treatments, but also due to organisational and communication barriers. The latter can be surmounted by a proactive approach. Early communication with the patient and relatives about the sometimes-limited expectations of an invasive treatment plan, and the possibility of palliative care allow to integer patient's preferences in the formulation of a therapeutical plan.

Critical Care↗