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PubMed2002

Nurse practitioner and physician communication styles.

No empirical studies of nurse-patient relationships have focused on interpersonal communication and its effects on patient outcomes. In this study, 124 provider-patient interactions of five nurse practitioners (NPs) and four physicians (PHYs) were audiotaped. Communication patterns were examined to determine whether the practitioner's predominant style was informational or controlling and whether style affected patient satisfaction and perceived autonomy support. All providers used predominantly informational styles of communication. Significant differences in communication styles existed between provider groups (F = 5.90, df = 1/8, p =.05) and among individual providers (F = 4.28, df = 8/123, p <.0001). All providers were more controlling in their communication patterns when attempting to make decisions and plan patient care. Examination of communication styles can help NPs develop the skills necessary to provide patient-centered care.

Adult↗
PubMed2005

Social communication intervention for school-age children: rationale and description.

Children of school age with social communication problems form a growing population in need of speech-language intervention. These children have difficulty not just with interpersonal communication, which underpins peer relations, but also with oral and written aspects of the curriculum. The importance of intervention in the school years therefore cannot be underestimated. In this article, a framework and rationale for intervention based on a consideration of social communication as the interdependence of social interaction, social cognition, pragmatics, and language processing are presented. A method of intervention for children with social communication problems is described. The method is illustrated by reference to a study of children with pragmatic language impairments in the United Kingdom. Social communication impairments are not specific to one diagnostic group, and therefore the intervention framework given here is applicable to a range of children with interpersonal communication problems in the school years.

Child↗
PubMedDate not supplied

Knowing what the others know: a study on interprofessional communication between nurses and medical doctors.

Communication and cooperation between experts from different specialties is a necessary element of professional competence. We have set up a research program to investigate cognitive aspects of interprofessional and interdisciplinary communication. We assume that successful communication essentially relies on communicants' ability to take the perspective of the other, i.e., assessing the background knowledge, expertise, plans, and so on, of one's co-communicators. The present paper reports on an interview study with medical doctors and nurses from three paediatric oncology units. The research interview was especially designed to allow for a detailed assessment of the professionals' ability to take their work-partners' perspective. Two areas will be examined: The ability to assess the work demands resulting from parental questions, and the use of differences in professional perspectives for prognosis. With respect to parental questions, doctors' and nurses' assessments of their respective work partner's task demands turned out to be only partly correct. Furthermore, the results suggest that doctors do not effectively benefit from nurses' experiential knowledge about patients when venturing prognoses. Educational measures designed to improve interprofessional communication could help to overcome these deficits.

Child↗
PubMed1995

Augmentative and alternative communication: treatment principles and strategies.

This article has attempted to clarify the principles of AAC evaluation and intervention, in part by dispelling myths that have persisted for too long. To the list of general guidelines for deciding when to consider AAC and how to begin breaking down the barriers to full participation by children with severe impairments, we need to add some warning signs that we have learned to heed in our work with these children. These signs are listed in Table 6 and are indicators that aspects of an approach to AAC must be altered or the child may fail to benefit from an intervention. Each sign conflicts in one way or another with current principles of augmentative and alternative communication. We give you these signs along with some possible ways to eliminate or prevent these errors in the future. Providing the best possible set of strategies for communication for a child with severe communication impairments is an enormously complex task. Whether a child can or cannot be assessed with standard procedures or whether he or she has unitary or multiple disabilities, the barriers to communication are many and intricately constructed. Sorting out strategies and how to apply them ordinarily requires input from the consumers of AAC (i.e., the family, child, and primary communication partners), the core team of professionals, as well as a team of specialists in AAC. Conducting evaluations and intervention is challenging because of institutional, bureaucratic, and professional barriers that each member of the team faces. Few, if any, teams can provide services that meet all of the established principles of best practice for every child that it serves. Yet, attempts to identify weaknesses within AAC programs and work to strengthen them must be given high priority in order to provide the best possible AAC services for such children. Only then will it be possible for children with severe communication impairments to overcome their own barriers and begin to participate in their choice of life's activities. That is, after all, the ultimate goal.

Child↗
PubMed1997

Effective intercellular communication distances are determined by the relative time constants for cyto/chemokine secretion and diffusion.

A cell's ability to effectively communicate with a neighboring cell is essential for tissue function and ultimately for the organism to which it belongs. One important mode of intercellular communication is the release of soluble cyto- and chemokines. Once secreted, these signaling molecules diffuse through the surrounding medium and eventually bind to neighboring cell's receptors whereby the signal is received. This mode of communication is governed both by physicochemical transport processes and cellular secretion rates, which in turn are determined by genetic and biochemical processes. The characteristics of transport processes have been known for some time, and information on the genetic and biochemical determinants of cellular function is rapidly growing. Simultaneous quantitative analysis of the two is required to systematically evaluate the nature and limitations of intercellular signaling. The present study uses a solitary cell model to estimate effective communication distances over which a single cell can meaningfully propagate a soluble signal. The analysis reveals that: (i) this process is governed by a single, key, dimensionless group that is a ratio of biological parameters and physicochemical determinants; (ii) this ratio has a maximal value; (iii) for realistic values of the parameters contained in this dimensionless group, it is estimated that the domain that a single cell can effectively communicate in is approximately 250 micron in size; and (iv) the communication within this domain takes place in 10-30 minutes. These results have fundamental implications for interpretation of organ physiology and for engineering tissue function ex vivo.

Animals↗
PubMed2000

Rethinking communication apprehension: a Myers-Briggs perspective.

This study is an examination of relationships between Myers-Briggs personality type preferences, based on Jungian theory, and communication apprehension. Results showed that participants who preferred introversion or sensing reported significantly higher levels of communication apprehension in general and across the group, dyadic, meeting, and public contexts than did participants who preferred extraversion or intuition. In addition, participants who preferred feeling reported higher levels of communication anxiety in the public context than those who preferred thinking. Findings support the assumption that communication apprehension is biologically based, suggest that the Myers-Briggs type preference framework offers an alternative way of understanding communication apprehension, and point out the need for new approaches to understanding the phenomenon of communication apprehension.

Adult↗
PubMedDate not supplied

Exploring relationships among communication, sexual satisfaction, and marital satisfaction.

This study examined relationships among couple communication, sexual satisfaction, and marital satisfaction in 387 married couples. Regression analyses demonstrated that communication and sexual satisfaction independently predict marital satisfaction. However, there is a significant interaction between communication and sexual satisfaction; if couples are successful at communicating constructively, sexual satisfaction fails to contribute to marital satisfaction. Alternatively, if couples have difficulty communicating but are sexually satisfied, they will experience greater marital satisfaction than if they have a less satisfying sexual relationship. Thus, sexual satisfaction may partially compensate for the negative effects of poor communication on marital satisfaction.

Adult↗
PubMed2004

An evaluation of the cost of designing, delivering and assessing an undergraduate communication skills module.

Communication skills courses are considered expensive to run in terms of time, human resource and finance. This paper reports on the financial cost of designing, delivering and assessing a communication skills module delivered to fifth-year medical students. Costs are classified into three categories: personnel, standardized patients and administrative. The total cost attributable to the design and delivery of the Communication Skills Module was 8987 Euros, comprising 7900 Euros personnel costs, 960 Euros standardized patient costs and 127 Euros administrative costs. The total cost for assessing communication skills by an OSCE was 7223 Euros. This comprised 5309 Euros personnel costs, 1600 Euros standardized patient costs and 314 Euros administrative costs. As communication skills are often taught by smaller faculty departments, such as that of general practice, justification of financial outlay is crucial. As doctor-patient communication is a generic skill, consideration needs to be given to reducing the burden of cost borne by the individual department providing the teaching.

Communication↗
PubMed2004

Stakeholder opinion of functional communication activities following traumatic brain injury.

PRIMARY OBJECTIVE: To establish a process whereby assessment of functional communication reflects the authentic communication of the target population. The major functional communication assessments available from the USA may not be as relevant to those who reside elsewhere, nor assessments developed primarily for persons who have had a stroke as relevant for traumatic brain injury rehabilitation. RESEARCH DESIGN: The investigation used the Nominal Group Technique to elicit free opinion and support individuals who have compromised communication ability. A survey mailed out sampled a larger number of stakeholders to test out differences among groups. METHODS AND PROCEDURES: Five stakeholder groups generated items and the survey determined relative 'importance'. The stakeholder groups in both studies comprised individuals with traumatic brain injury and their families, health professionals, third-party payers, employers, and Maori, the indigenous population of New Zealand. MAIN OUTCOMES AND RESULTS: There was no statistically significant difference found between groups for 19 of the 31 items. Only half of the items explicitly appear on a well-known USA functional communication assessment. CONCLUSIONS: The present study has implications for whether functional communication assessments are valid across cultures and the type of impairment.

Attitude to Health↗
PubMed1995

Factors associated with Hispanic women's HIV-related communication and condom use with male partners.

To determine factors influencing Hispanic women's HIV-related communication and condom use with their primary male partner, 189 Dominican, Puerto Rican, and Mexican women were interviewed regarding sexual behaviour and condom use, relationship characteristics, perceived risk for HIV, and HIV-related communication with the primary male partner. Level of HIV-related communication with the primary male partner was associated with the woman's perceived risk for HIV and her rating of the openness with which she could communicate with her primary partner. Mexican women were less likely than Puerto Rican or Dominican women and women with multiple partners were less likely than those with one partner to communicate about HIV-related issues with their primary partner. Women reporting more condom use with their primary partner were younger, had discussed HIV-related issues more with the primary partner, and were less likely to expect negative reactions to requests for condom use than those reporting less condom use. These results suggest that prevention programmes that increase both general and HIV-specific communication between members of a couple may facilitate safer sex practices by the couple. Prevention programmes that encourage women to insist on condom use should consider the woman's expectations about her partner's reaction as a potential barrier to the initiation of safer sex practices.

Acculturation↗
PubMedDate not supplied

Storybook-based communication intervention for girls with Rett syndrome and their mothers.

PURPOSE: Storybook reading provides a natural language learning context in which to support early symbolic communication. In this study, we explored the impact of (1) resting hand splints, (2) light tech augmentative communication systems such as voice-output devices and symbols, and (3) very basic parent training on the symbolic communication and labelling behaviours of six girls with Rett syndrome. METHOD: Mothers and daughters were videotaped as they read familiar and unfamiliar storybooks in their homes. RESULTS: Group and individual data collected from the six girls indicated that they became more active and successful participants in the interactions during storybook reading. The girls employed a wider range of communication modes and increased the frequency of their labelling. Familiar storybook reading encouraged greater symbolic communication than unfamiliar storybooks in half the girls. CONCLUSION: This study suggests that motivated parents may not require expensive technologies or lengthy training in order to enhance their children's early communication and participation in storybook reading.

Adult↗
PubMedDate not supplied

Evaluating parent use of functional communication training to replace and enhance prelinguistic behaviours in six children with developmental and physical disabilities.

PURPOSE: To evaluate parent use of functional communication training (FCT) to replace and enhance prelinguistic behaviours in six young children with developmental and physical disabilities. METHOD: Initially, the communicative functions of the children's prelinguistic behaviours were assessed by parent interviews. Three communication functions were identified for each child and intervention goals to replace or enhance the child's existing prelinguistic behaviours were developed in consultation with parents. After a baseline phase, parents received training on implementation of FCT. Intervention was staggered across the three communicative functions in a multiple-probe design. RESULTS: Intervention was associated with increases in the replacement communication behaviour. Treatment gains were generally maintained at the monthly follow-ups. CONCLUSION: The results suggest that parents can use FCT to enhance communication skills in children with developmental and physical disabilities.

Abnormalities, Multiple↗
PubMedDate not supplied

Weaving meanings together in an AIDS residence: communicative practices, perceived health outcomes, and the symbolic construction of community.

This study examines the role of communicative practices in the symbolic construction of health and community among residents living in a residential facility for people with AIDS. Questionnaire results show that two types of communicative practices--governance/support and everyday/special--are significantly related to residents' perceived physical and emotional health outcomes, their perceptions of the residence as a community (as opposed to a facility or institution), and their satisfaction with living there. Everyday/special practices reveal the communicative means by which perceived health is socially constructed, while governance/support practices reveal the importance of meta-communication for massaging the issues and tensions that pervade community life, and both sets of communicative practices help explain members' perceptions of the residence as a community and their satisfaction with living there. The study provides additional evidence regarding the constitutive nature of communication as a connecting thread that weaves together individual and collective meanings to help create and sustain such concepts as health and community.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Crisis and emergency risk communication as an integrative model.

This article describes a model of communication known as crisis and emergency risk communication (CERC). The model is outlined as a merger of many traditional notions of health and risk communication with work in crisis and disaster communication. The specific kinds of communication activities that should be called for at various stages of disaster or crisis development are outlined. Although crises are by definition uncertain, equivocal, and often chaotic situations, the CERC model is presented as a tool health communicators can use to help manage these complex events.

Communication↗
PubMedDate not supplied

Health communication: making the most of new media technologies--an international overview.

Not since the hundred years following Gutenberg's invention of the printing press in c. 1450 has there been such a tidal wave of change in the way humans communicate. We are moving from the Age of Mass Communication into the Age of Interactive Communication, in which many of the old communication models will be insufficient or redundant. The rate of diffusion of these new media technologies almost defies comprehension. The convergence of computer, telecommunication, and televisual technologies is presenting the consumer with a myriad of choices. The challenge for the communicator is to find a way through this maze and to ensure that the message is received. For the health communication professional, the urgency of the message often adds further difficulty to the task. Differing rates of diffusion internationally and a confusion of technologies do not make the problem any easier.

Communication↗
PubMedDate not supplied

Semantic and inferencing abilities in children with communication disorders.

BACKGROUND: Semantic and inferencing abilities have not been fully examined in children with communication difficulties. AIMS: To investigate the inferential and semantic abilities of children with communication difficulties using newly designed tasks. METHODS & PROCEDURES: Children with different types of communication disorder were compared with each other and with three groups of typically developing children: those of the same chronological age and two groups of younger children. In total, 25 children aged 11 years with specific language impairment and 22 children, also 11 years of age, with primary pragmatic difficulties were recruited. Typically developing groups aged 11 (n=35; age-match), and those aged 9 (n=40) and 7 (n=37; language similar) also participated as comparisons. OUTCOMES & RESULTS: For Semantic Choices, children with specific language impairment performed significantly more poorly than 9- and 11-year-olds, whilst the pragmatic difficulties group scored significantly lower than all the typically developing groups. Borderline differences between specific language impairment and pragmatic difficulties groups were found. For inferencing, children with communication impairments performed significantly below the 11-year-old peers, but not poorer than 9- and 7-year-olds, suggesting that this skill is in line with language ability. Six children in the pragmatic difficulties group who met diagnosis for autism performed more poorly than the other two clinical groups on both tasks, but not statistically significantly so. CONCLUSIONS: Both tasks were more difficult for those with communication impairments compared with peers. Semantic but not inferencing abilities showed a non-significant trend for differences between the two clinical groups and children with pragmatic difficulties performed more poorly than all typically developing groups. The tasks may relate to each other in varying ways according to type of communication difficulty.

Aging↗
PubMedDate not supplied

Predicting communicative competence at 2 and 3 years from pragmatic skills at 10 months.

It is proposed that children play an important part in determining the kinds of linguistic experience they receive, influencing their language environment by means of early pragmatic communication. These early behaviours may also be predictive of later communicative competence. As a preliminary investigation into the wider implications of children's potential influence over their linguistic environment, a study was undertaken which looked at infant pragmatic signalling systems and joint engagement skills, to establish whether these early interactive behaviours might be related to children's subsequent communicative development. During the course of the study, the frequency and distribution of early pragmatic behaviours in a random sample of 145 10-month-old infants were investigated, and their subsequent language development followed up at ages 24 and 36 months. The study examined (a) the predictive validity of specific pragmatic behaviours at age 10 months for language development at age 24 months and (b) the specificity and stability of profiles of communicative disability at 2 and 3 years. A subset of behaviours was identified which would have correctly predicted 82.4% of children found to have communicative difficulties at 24 months and 85.4% of those who did not. Predictive language profiles drawn up at age 24 months were substantially confirmed when the children were reassessed at age 36 months. It is proposed that specific early communicative behaviours may be predictive of a child's subsequent linguistic development. Additionally, 2-year-old children will be exhibiting certain patterns of language acquisition which may be significant for subsequent linguistic development. Implications for intervention are discussed.

Child Behavior↗
PubMed2002

Comparative effects of phthalate monoesters on gap junctional intercellular communication and peroxisome proliferation in rodent and primate hepatocytes.

Several phthalate esters, compounds used as plasticizers in a variety of commercial products, have been shown to induce hepatic tumors in rodents. In this study, the comparative effects of phthalate monoesters on inhibition of gap junctional intercellular communication and induction of peroxisomal beta-oxidation were assessed in primary cultured hepatocytes from rats, mice, hamsters, cynomolgus monkeys, and humans. A human liver cell line was also utilized. Eight monoesters examined included mono-2-ethylhexyl phthalate (MEHP), mono-n-octyl phthalate (MNOP), mono-isononyl phthalate (MINP, 3 types, -1, -2, and -3), mono-isoheptyl phthalate (MIHP), mono-isodecyl phthalate (MIDP), and mono-(heptyl, nonyl, undecyl) phthalate (M711P). Gap junctional intercellular communication was measured 4 and 24 h after treatment by lucifer yellow dye coupling. Gap junctional intercellular communication was inhibited in rat and mouse hepatocytes by all eight monoesters in a concentration-dependent manner. In most cases, gap junctional intercellular communication was significantly reduced at the lowest concentrations tested (50 pM). Inhibition of gap junctional intercellular communication in rodent cells was substantially reversed within 24 h of monoester removal. In contrast, cell-to-cell communication was not inhibited in hamster, cynomolgus, or human hepatocytes or in a human liver cell line at any concentration examined. In rat hepatocytes, peroxisomal beta-oxidation was elevated after treatment with MEHP, MINP, MIHP, and MIDP but not MNOP or M711P, and with all but MIHP in mouse hepatocytes. The eight phthalates produced no marked change on peroxisomal beta-oxidation in hepatocytes from other species. These data provide additional evidence that the toxicological effects of phthalate esters are species specific.

Adult↗