Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “COMMUNICATION”

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 1,297 records · Page 72Linked to original sources
PubMed2003

Training medical students to communicate with a linguistic minority group.

Effective communication is central to a successful physician-patient relationship. Communication is usually enhanced when the linguistic and cultural attributes of patients are incorporated in health care delivery. With this purpose in mind, the Faculty of Medicine at the University of Ottawa has developed a French-language stream to train future physicians for the francophone minority population of Ontario. As part of this project, a communication skills laboratory was created for francophone students in 1996, since all three tertiary care teaching hospitals operated in English only. The laboratory consists of a controlled environment where francophone students conduct interviews in French while being observed by clinicians trained in observation and feedback techniques. It makes use of simulated patients trained to play specific roles and to give feedback to students. Laboratory sessions take place throughout the first and second years and expose students to 15 scenarios covering different themes in each year. Each scenario includes a communication problem. Facilities are in place for filming the encounters for review by students. The project has had favorable outcomes. Both students and clinician-supervisors find that the laboratory offers an excellent learning environment and describe the cases as realistic and instructive. Clerkship preceptors are pleased with the students' communication skills. Because of the success of the laboratory, faculty authorities plan to translate the scenarios and offer similar sessions to students in the English-language stream. The teaching methods used in the communication skills laboratory may be of interest to other medical schools that serve linguistic minority populations.

Communication↗
PubMed2004

Communication failures: an insidious contributor to medical mishaps.

PURPOSE: To describe how communication failures contribute to many medical mishaps. METHOD: In late 1999, a sample of 26 residents stratified by medical specialty, year of residency, and gender was randomly selected from a population of 85 residents at a 600-bed U.S. teaching hospital. The study design involved semistructured face-to-face interviews with the residents about their routine work environments and activities, the medical mishaps in which they recently had been involved, and a description of both the individual and organizational contributory factors. The themes reported here emerged from inductive analyses of the data. RESULTS: Residents reported a total of 70 mishap incidents. Aspects of "communication" and "patient management" were the two most commonly cited contributing factors. Residents described themselves as embedded in a complex network of relationships, playing a pivotal role in patient management vis-à-vis other medical staff and health care providers from within the hospital and from the community. Recurring patterns of communication difficulties occur within these relationships and appear to be associated with the occurrence of medical mishaps. CONCLUSION: The occurrence of everyday medical mishaps in this study is associated with faulty communication; but, poor communication is not simply the result of poor transmission or exchange of information. Communication failures are far more complex and relate to hierarchical differences, concerns with upward influence, conflicting roles and role ambiguity, and interpersonal power and conflict. A clearer understanding of these dynamics highlights possibilities for appropriate interventions in medical education and in health care organizations aimed at improving patient safety.

Adult↗
PubMedDate not supplied

Effective communication and supervision in the biomedical engineering department.

It is important for biomedical engineering supervisors to master the art of effective communication. Supervisors who have effective communication skills can successfully initiate creative programs and generate a harmonious working atmosphere. Using effective communication, they can promote good working conditions, such as high morale, worker initiative and loyalty to the department, which are almost impossible to measure but imperative for a successful department. However, effective communication tends to be neglected by supervisors who are either functional specialists or managerial generalists. This paper presents several cases of what effective communication truly is and discusses some potential factors that may lead to ineffective communication.

Biomedical Engineering↗
PubMed2004

Enhancing collaborative communication of nurse and physician leadership in two intensive care units.

OBJECTIVE: To test an intervention to enhance collaborative communication among nurse and physician leaders (eg, nurse manager, medical director, clinical nurse specialist) in two diverse intensive care units (ICUs). BACKGROUND: Collaborative communication is associated with positive patient, nurse, and physician outcomes. However, to date, intervention-focused research that seeks to improve collaborative communication is lacking. METHODS: A pretest-posttest repeated measures design incorporated baseline data collection, implementation of the intervention over 8 months, and immediate and 6-months-post data collection. FINDINGS: Communication skills of ICU nurse and physician leaders improved significantly. Leaders also reported increased satisfaction with their own communication and leadership skills. In addition, staff nurse and physician perceptions of nursing leadership and problem solving between groups increased. Staff nurses reported lower personal stress (eg, more respect from co-workers, physicians, and managers), even though they perceived significantly more situational stress (eg, less staffing and time). CONCLUSION: Study findings provide evidence that nurse-physician collaborative communication can be improved.

Adult↗
PubMedDate not supplied

The Parent-Teen Sexual Risk Communication Scale (PTSRC-III): instrument development and psychometrics.

BACKGROUND: Adolescents are a group at high risk for sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV). Several parenting processes, including parental monitoring, support, role modeling, and sexual communication, have been shown to be significant influences of adolescents' sexual attitudes, beliefs, and behaviors. Parent-child sexual risk communication, in particular, has been associated significantly with adolescents' attitudes, beliefs, and behaviors related to risk of and prevention of STIs and HIV. OBJECTIVE: The aim of this study was to report on the development of the Parent-Teen Sexual Risk Communication Scale (PTSRC-III), an eight-item self-report instrument for measuring the amount of communication about sexual risk and sexual risk reduction occurring between parents and their adolescent children, as reported by the adolescent. METHODS: Psychometrics of the PTSRC-III and the stability of the psychometric properties across two samples of late adolescents, college freshmen (N=95) and female licensed drivers aged 19 to 21 years (N=234), are reported. RESULTS: Internal reliability of the scale was excellent (alpha of >.93 and >.88 for sexual risk communication with mothers and fathers, respectively); test-retest reliability was acceptable (r=.88 and .79 over 2 months for PTSRC with mothers and fathers, respectively). Concurrent validity, predictive validity, and stability of psychometrics were also demonstrated. Factor analysis demonstrated a two-factor structure. DISCUSSION: The PTSRC-III provides a valid and reliable measure for assessing female adolescents' perceptions of parent-teen sexual risk communication, particularly with their mothers. Psychometrics were shown to be stable across the two samples. Implications for use and future development are discussed.

Adolescent↗
PubMedDate not supplied

Improving communication skills--a randomized controlled behaviorally oriented intervention study for residents in internal medicine.

OBJECTIVE: We investigated whether patient-centered communication skills can be taught to residents in Internal Medicine by using a time-limited behaviorally oriented intervention. METHOD: Residents working at the Department of Internal Medicine were randomly assigned to an intervention group (IG; N = 19) or a control group (CG; N = 23). In addition to 6 hours of standard medical education per week, the IG received specific communication training of 22.5 hours duration within a 6-month period. Initially and 10 months later, participants performed interviews with simulated patients. Interviews were rated by blinded raters who used the Maastricht History and Advice Checklist-Revised. RESULTS: Compared with the CG, the IG improved substantially in many specific communication skills. Both groups improved in the "amount of medical information identified" and in the ability to "communicate about feasibility of treatment." CONCLUSION: Patient-centered communication skills such as those presented in this intervention study can be taught. The ability to gain medical information and the readiness to communicate about aspects of medical treatment seem to improve with more professional experience; however, they also profit from the intervention.

Adult↗
PubMed2000

Interruption of hepatic gap junctional communication in the rat during inflammation induced by bacterial lipopolysaccharide.

Gap junctional cellular communication is important in the propagation of signals that coordinate hepatic metabolism. Hepatocytes express two different connexin (Cx) genes, Cx32 and Cx26, which encode for the subunit component of gap junction channels. Previous studies have shown that the expression of hepatic Cx32 is reduced during inflammatory conditions. The objective of this study was to evaluate whether this decrease in Cx32 expression results in a decrease in hepatic gap junctional communication. Transfer of the dye Lucifer Yellow between hepatocytes was measured after microinjection of single cells in an isolated perfused liver. Livers were harvested from rats subjected to an inflammatory condition induced by administration of bacterial lipopolysaccharide (LPS). A decrease in gap junctional cellular communication was observed within 6 h of the LPS treatment. This decrease in dye coupling was reversible, because gap junctional communication returned to control levels within 48 h of the LPS injection. The inhibition of hepatic gap junctional communication was associated with the disappearance of Cx32 and Cx26 from the hepatocyte plasma membrane as detected by indirect immunostaining. Cx32 mRNA levels were also reduced during inflammation as previously reported. However, Cx26 mRNA levels were unaffected or even transiently increased after the injection of LPS without significant increase in the polypeptide level. Thus, the down-regulation of Cx32 and Cx26 from the hepatocyte surface is apparently due to a rapid degradation of the polypeptide from the cell surface. We hypothesize that this loss of gap junctional cellular communication within the liver may contribute to the disordered hepatic metabolic that occurs during inflammatory states.

Animals↗
PubMed2003

Intensive communication: four-year follow-up from a clinical practice study.

PURPOSE: To determine the durability of the effects of a change in practice designed to promote the use of advanced supportive technology when it is of benefit but to limit its burdens when it is ineffective. We have reported that institution of a process of intensive communication reduced length of intensive care unit stay for dying patients and reduced mortality in a before-and-after study in a cohort of patients admitted to an adult intensive care unit. We now report the results of a 4-yr extension of this intervention. MATERIALS AND METHODS: The number of counseling sessions, intensive care unit length of stay, and mortality were measured for 2,361 adult medical patients consecutively admitted to a university tertiary care hospital. To determine the durability of the effects of our intervention, we compared our experience during the subsequent 4 yrs with that of the 134 consecutive patients before and 396 patients after our intensive communication intervention. RESULTS: We conducted an equivalent number of intensive communication sessions in our subsequent practice as during the intervention (1.5 vs. 1.6 sessions per patient admitted to the intensive care unit). However, sessions tended to be of shorter duration, and direct participation by social workers, chaplains, and care coordinators was less frequent in our subsequent experience. Intensive communication produced a significant and durable reduction in length of stay (median length of stay, 4 days [2-11 days, interquartile range] before; 3 days [2-6 days, interquartile range] during the study; 3 days [2-6 days, interquartile range] subsequently). Our intervention was associated with a significant and durable reduction in intensive care unit mortality (31.3% before, 22.7% during the intervention, 18% subsequently; p <.001). CONCLUSIONS: Intensive communication is associated with durable reductions in intensive care unit length of stay and reduced mortality in critically ill adult medical patients. Intensive communication was applied more efficiently subsequent to the intervention, and its effectiveness does not seem to be dependent on nondirect caregivers' participation in the sessions. This process encourages the continuation of advanced supportive technology to patients with the potential to survive and allows the earlier withdrawal of advanced supportive technology when it is ineffective.

Aged↗
PubMed2005

Doctor-patient communication and satisfaction with care in oncology.

PURPOSE OF REVIEW: This review summarises current knowledge on the impact on patient satisfaction of initiatives undertaken to enhance the communication between doctors and their patients in oncology. RECENT FINDINGS: Recent studies have assessed the effectiveness of different approaches aimed at improving doctor-patient communication in oncology. These have been assessed on outcomes related to the patient (e.g., anxiety, quality of life, medical knowledge, satisfaction) or to the doctor (e.g., communication behaviour, attitudes). Patient satisfaction has been recognised as a particularly relevant outcome, and a positive effect of recent initiatives to improve the interaction between cancer patients and their doctors on patient satisfaction has been suggested. SUMMARY: To better respond to cancer patients' health care needs, various strategies focusing on doctor-patient communication have been developed. Addressing patients' overall needs and sharing complex information in an emotionally charged context and under time constraints is a daily challenge for the oncology clinician, resulting often in cancer patients' dissatisfaction. Recent interventions elaborated to facilitate doctor-patient communication in oncology focus on patients, such as handing out of videos or written preparatory information; on doctors, such as patients' self-rating feedback to doctors or communication skills trainings; or on both, such as the audiotaping of the consultation or the provision of decision aids. Although these strategies offer promising results, further research should be implemented to assess their appropriateness across sociocultural contexts and their long-term effectiveness in clinical practice.

Clinical Competence↗
PubMed2026

Sex pheromone communication and its regulation by the sex determination pathway in cockroaches.

Sexual communication in animals orchestrates a series of interactive behaviors from locating and recognizing potential partners to courtship and final mating decisions and is thus critical for sexual reproduction and population fitness. Highly efficient communication between the sexes requires not only the production and emission of species-specific signals but also their precise detection and interpretation by the receiving individuals. Cockroaches, as one of the most evolutionarily ancient and successful group of insects, are quintessential chemical communicators that rely heavily on sex pheromones for sexual communication. They have long served as excellent model organisms in studies of chemical ecology. Although the biochemical characterization of sex pheromones in several species was largely accomplished during the last century, the past two decades have witnessed remarkable progress in understanding the molecular genetics of sex pheromone communication and its regulation, particularly driven by functional genomics. This review first provides an updated comparative survey of the pheromone components identified across distinct taxa. We then synthesize, but not limited to, recent advances in identification of key molecules controlling sex pheromone production, characterization of candidate chemosensory receptors and their neural processing pathways, and the regulatory roles of the sex determination cascade in shaping sexually dimorphic traits in both pheromone production and perception. Finally, we highlight key scientific questions that remain unsolved and propose future directions aimed at extending our mechanistic understanding of cockroach pheromone communication, as well as at developing behavior-based pest management strategies.

biosynthetic pathway↗
PubMed2005

A quantitative analysis of anaesthetist-patient communication during the pre-operative visit.

Previous communication research in general medical practice has shown that effective communication enhances patient compliance, satisfaction and medical outcome. It is expected that communication is equally important in anaesthesia, since patients often suffer from anxiety and lack of knowledge about anaesthetic procedures. However, little is known about the nature of communication during routine anaesthetic visits. The present study of 57 authentic anaesthetic visits provides the first results on the structure and content of communication in the pre-operative setting using the Roter Interaction Analysis System (RIAS). Patient-centred communication behaviours of anaesthetists and the extent of patient involvement were particularly investigated. From the 57 pre-operative visits, 18 267 utterances were coded. The mean (SD) [range] duration of the visit was 16.1 (7.8) [3.7-42.7] min. Anaesthetists provided 169 (68) and patients 153 (82) utterances per visit (53.5% vs. 46.5%). Physician and patient gender had no impact on the distribution of utterances and the duration of the visit. Conversation mainly focussed on biomedical issues with little psychosocial discussion (< 0.1% of all anaesthetist utterances). However, anaesthetists quite frequently used emotional comments toward patients (7%) and involved them in the conversation. The use of facilitators, open questions and emotional statements by the anaesthetist correlated with high patient involvement. The amount of patient participation in anaesthetic decisions was assessed with the Observing Patient Involvement Scale (OPTION). Compared with general practitioners, anaesthetists offered more opportunities to discuss treatment options (mean (SD) OPTION score 26.8 (16.8) vs. 16.8 (7.7)).

Adult↗
PubMed2007

Communication skills in blind children: a preliminary investigation.

BACKGROUND: There are anecdotal reports that blind children sometimes use language inappropriately, but there has been no recent systematic investigation of the communication skills of children with congenital blindness. The aim of the present study was to conduct a preliminary investigation of the communication skills of a group of children with congenital blindness. METHODS: The parents of eight congenitally blind children completed the Children's Communication Checklist-2. RESULTS: The checklist ratings showed that the communication profiles of a large proportion of the group warranted clinical investigation or were indicative of a communication disorder. CONCLUSIONS: The results from this preliminary investigation support the need for a larger study on the communication skills of children with congenital blindness.

Adolescent↗
PubMed2006

Communication in heart failure: perspectives from older people and primary care professionals.

The objective of this study was to explore the attitudes of older people and primary care professionals towards communication of diagnosis, prognosis and symptoms in heart failure. Forty-four interviews were conducted with people aged>60 years with heart failure (New York Heart Association III-IV) recruited from general practices in the UK. Ten focus groups were held with primary care professionals involved in heart failure management. Data were analysed thematically with the aid of the NUD*IST computer program. Participants reported problems with communication, including not being given enough information about their condition, or being given complex information that they did not understand. Many understood little about heart failure and the causes of, and ways to manage, their symptoms. Few participants had had discussions about the prognosis with any health professional, and this was confirmed in professional accounts. Difficulties with terminology were frequently reported: a diagnosis of 'heart failure' was rarely communicated to patients to avoid causing anxiety. Educational needs were identified by most primary care professionals in relation to heart failure management and specifically in relation to communication. In conclusion, communication was identified as being inadequate within primary care from both the patient and professional perspectives. These findings point to a need for an educational intervention tailored specifically to the need to improve the communication skills of primary care professionals in chronic heart failure.

Aged↗
PubMed1984

Staff-patient communication in coronary care units.

It is now over 20 years since coronary care units (CCUs) began to be opened. The purpose of providing constant observation for patients with myocardial infarction, and immediate specialized treatment when necessary has been fulfilled. But there is increasing evidence that psychosocial aspects of care may be just as important to the patients' total well-being as physical care. Communication is a key factor, and since nurses are the staff members most constantly present in CCUs they can exert considerable influence on communication between patients and their visitors, nurses and perhaps other staff. But patients are all individuals who each have their own ways of reacting to illness. If their particular communication needs are to be met then this aspect of nursing care must be planned, based on careful preliminary assessment. There is some evidence that nurses' communication skills are not always well-developed. This is not surprising since there has been little structured and knowledge-based teaching of interpersonal skills in basic nurse education in the United Kingdom in the past, or in many other countries. Communication is a major component of care which merits more consideration, including the needs of patients, visitors and nurses; the aims of nurse-patient-visitor communication; and approaches to improving it.

Anxiety↗
PubMed2005

Communication with critically ill patients.

AIM: This paper reports a study that investigated the experiences of a group of critical care Jordanian nurses concerning verbal communication with critically ill patients. BACKGROUND: There is evidence that communication in critical care settings is not sufficiently implemented in practice. Inadequate nurse-patient communication results in increased levels of stress and anxiety. Verbal communication can help patients preserve their self-identity and self-esteem, which in turn will enhance their well-being and optimism. METHOD: The study was guided by the phenomenological hermeneutics of Heidegger. Data were generated in 2002 from in-depth interviews and overt participant observation, and analysed qualitatively. FINDINGS: Unconscious patients received less verbal communication and interaction than verbally responsive patients. CONCLUSION: Communication with sedated or unconscious patients in intensive care units should not be viewed as only an interactive process. Rather, it should be perceived as the means to give the information and support that such patients need.

Attitude of Health Personnel↗
PubMed2006

Communication skills and cultural awareness courses for healthcare professionals who care for patients with sickle cell disease.

AIMS: This paper reports a project evaluating the efficacy and impact of a pilot communication skills and cultural awareness course for healthcare professionals who care for patients with sickle cell disease. BACKGROUND: Poor communication between patients with sickle cell disease and healthcare professionals causes suspicion and mistrust. Many patients feel that they are negatively labelled by the healthcare system and are sceptical of opening themselves to an unsympathetic system. They may therefore appear hostile and aggressive when interacting with healthcare professionals, which in turn leads to distortions and misunderstandings between both groups. The use of good communication skills by healthcare professionals is therefore vital for good healthcare practice. METHODS: Forty-seven healthcare professionals took part in a series of three pilot courses each lasting 3 days. Healthcare professionals were taught a repertoire of communication skills and cultural awareness strategies to use in challenging situations that arise in their care of sickle cell patients. Expert facilitators used a variety of teaching techniques, such as professionally-made videos, role-play, and group exercises. Participants' confidence in dealing with challenging situations was assessed at baseline, immediately after the intervention, and at 3- and 6-month postintervention. FINDINGS: A repeated measures anova revealed a statistically significant increase in confidence from pre- to postcourse scores. Confidence scores further increased from immediately postcourse and 3 months postcourse follow-up. These were then maintained at 6 months postcourse. CONCLUSION: The overall findings of this local study demonstrated that this type of communication skills and cultural awareness training had a positive and enduring impact on professionals' perceived ability and confidence in communicating with patients with sickle cell disease. Participants attributed this to the learner-centred approach of the course that provided them with the opportunity to transfer and apply the taught skills in their daily practice. This type of training might be helpful in reducing mistrust and increasing empathetic responses in healthcare professional.

Adult↗
PubMed1997

Doctor-patient communication: a study of junior house officers.

This study evaluates junior house officers' perceptions of their communication skills with cancer patients; the usefulness of their undergraduate communication skills training; and their sources of emotional support. All 42 junior house officers employed at Guy's and Lewisham Hospitals in August 1994 were interviewed using a study-specific, semi-structured interview. Sixty-seven per cent of junior house officers felt they had adequate communication skills in relation to medical issues, but only 36% felt they had adequate skills in relation to psychological issues. Thirty-one per cent of doctors reported that they never, or nearly never, enquired about the emotional adjustment of dying patients. Lack of time was the most commonly reported reason for avoiding asking about psychological problems (62% of junior house officers), followed by wishing to avoid awkward questions (51%) and inadequacy of skills to deal with such issues (44%). Ninety-eight per cent of junior house officers had attended the 1-week undergraduate communication skills course at Guy's and St Thomas's Hospital Medical School (UMDS). Sixty-seven per cent of those who had attended found the course helpful and 62% felt they would benefit from further training as junior house officers. Seventy-four per cent felt they could discuss their work-related concerns with colleagues and 95% felt they could talk to friends. In contrast only about 9% felt they could, if needed, talk to a counsellor. Although the majority of the junior house officers reported benefit from their communication skills training, the course does not appear to be meeting all their communication training needs. Junior house officers require further training opportunities at the undergraduate and postgraduate levels. Traditional counselling services for junior house officers may not be meeting their support needs.

Adaptation, Psychological↗
PubMed2004

Assessment of medical communication skills by computer: assessment method and student experiences.

BACKGROUND: A computer-assisted assessment (CAA) program for communication skills designated ACT was developed using the objective structured video examination (OSVE) format. This method features assessment of cognitive scripts underlying communication behaviour, a broad range of communication problems covered in 1 assessment, highly standardised assessment and rating procedures, and large group assessments without complex organisation. SETTING: The Academic Medical Centre (AMC) at the University of Amsterdam, the Netherlands. Aims To describe the development of the AMC Communication Test (ACT); to describe our experiences with the examination and rating procedures; to present test score descriptives, and to present the students' opinions of ACT. DESIGN: The ACT presents films on history taking, breaking bad news and shared decision making. Each film is accompanied by 3 types of short essay questions derived from our assessment model: "knows", "knows why/when" and "knows how". Evaluation questions about ACT were integrated into the assessment. Participants A total of 210 third year medical undergraduates were assessed. This study reports on the 110 (53%) students who completed all evaluation questions. RESULTS: Marking 210 examinations took about 17 days. The test score matched a normal distribution and showed a good level of discrimination of the students. About 75% passed the examination. Some support for the validity of our assessment model was found in the students' differential performance on the 3 types of questions. The ACT was well received. Student evaluations confirmed our efforts to develop realistic films that related well to the communication training programme. CONCLUSIONS: The ACT is a useful assessment method which complements interpersonal assessment methods for the evaluation of the medical communication skills of undergraduates.

Attitude of Health Personnel↗