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PubMedDate not supplied

Physician executives' persuasive styles of communication in upward influence situations.

This article examines the communicator style choices of physician executives when attempting to persuade a superior whose own style of communication is attractive and unattractive. In the November-December 1990 issue of Physician Executive, the author reported on persuasive strategies physician executives use to influence such targets of influence. Whereas the earlier study focused on what physician executives communicate to be persuasive, the present investigation treated the way physician executives communicate to persuade attractive and unattractive superiors. The results suggest that the way physician executives communicate in upward influence situations is affected by the way their superiors communicate with them.

Adult↗
PubMed1999

Patient-centered communication.

The term patient-centered communication (PCC) has been used to describe a group of communication strategies and behaviors that promote mutuality, shared understandings, and shared decision making in health care encounters. There is evidence to suggest that advanced practice nurse and patients use these strategies to co-produce highly individualized clinical discourse. Although the communication behaviors associated with PCC have been studied separately, their impact as an integrated communications strategy has not been studied. Suggestions for developing PCC as a mid-range theory of health care communication encompassing other more specific communication concepts are offered.

Communication↗
PubMed1998

Early communication intervention with young children with Pierre Robin sequence.

Young children with Pierre Robin sequence are at considerable risk to develop delayed or disordered communication development. This study investigated the effectiveness of early communication intervention with four young children with Pierre Robin sequence, aged 5 to 28 months. The Proportional Change Index (Wolery, 1983) was used to determine the amount of child progress that took place during the intervention period. The results indicated that regular early communication intervention sessions over an extended period of time produced positive results, especially for expressive language abilities. The presence of a slight hearing loss due to otitis media, seemed to have influenced the effectiveness of early communication intervention. One subject displayed an associated disorder and evidenced the slowest rate of development for receptive and expressive language abilities as well as a limited phonetic repertoire for consonants. All but one subject had limited phonetic repertoires possibly due to velopharyngeal incompetence. Early communication intervention services should be delivered regularly over an extended period of time and the hearing abilities and speech production skills of young children with Pierre Robin sequence should be followed closely during early communication intervention.

Child, Preschool↗
PubMed2000

[Analysis of pragmatic aspects of communication behavior of verbal and nonverbal autistic children].

The analysis and intervention of communication is an important focus of autism research. The present study is a microanalysis of the communicative behaviour of 10 autistic children with their parents and a therapist. Protests, appropriate initiation and responses of the children were analysed in relation to demands and the specific feedback of the adults. After 20 months of structured therapy changes in the communicative behaviour of the participants were demonstrated. Autistic children showed different communicative pattern with their parents compared to a therapist. The non-verbal group exhibited significantly more protests and decreased responsivity with their parents compared to the therapist. The verbal group interacted with their parents predominantly by echolalia. After 20 months a significant reduction in protests, increased compliance and responsivity were obvious in the non-verbal group. The verbal group showed a reduction in echolalia as well as increased responsive and spontaneous communication. The results demonstrate that even non-verbal autistic children are sensitive towards different interaction partners. Over the observation period participants showed a reduction in behaviour problems and positive developments of communicative behaviour.

Adult↗
PubMedDate not supplied

Aided augmentative communication in managing children with cerebral palsy.

The use of an aided augmentative communication system to achieve effective communication between the pediatric dentist and the child with cerebral palsy is described. This type of communication involves symbols placed on a communication board and may be used together with conventional behavior management techniques for successful delivery of dental treatment. A multidisciplinary team caring for the child is necessary to achieve successful outcomes. Aided augmentative communication is a promising adjunct for the care of the child with communication impairment, and may be of particular value in pediatric dental practices where the staff are able to practice and master its use for selected child patients.

Adolescent↗
PubMed2001

Culture and diversity in the nursing classroom: an impact on communication and learning.

This article discusses culture and diversity in the nursing classroom and its impact on communication and learning. Today's nursing classrooms are heavily populated with students from many ethnic, psychological and sociocultural backgrounds. It is necessary that nurse educators recognize that many communication patterns value diversity, and is a major support in many learning styles of their students. Without a thorough understanding of diversity and communication among cultures, major challenges exist for both professors and students. The nursing curriculum and classroom materials should portray diversity so that all subject matter reflects a range of cultural perspectives. Higher education curricula are probably the most diverse in the world, and with a global perspective, and the United States being a "melting pot," these curricula will become even more diverse in the future. Nursing education has the responsibility to teach students how to communicate on a global scale. These global models of communication will assist students to successfully enter professional nursing practice with strong communication skills and a level of cultural competence that professional nurses need to know.

Communication↗
PubMed1998

[From inquiry to interactive communication].

Three functions of communication are distinguishable in the practice of dentists: the function directly related to the treatment, the function related to 'informed consent' and the preventive function. For these three functions different communication-models are applicable: communication as transfer-of-information, communication as persuasion and communication as interaction. It is argued that the interaction model of communication is the most promising model nowadays.

Communication↗
PubMedDate not supplied

Rx for caries prevention: time line for home care. A software aid for communication of patient instructions for management of dental caries.

Treatment of a caries active patient requires the clinician to be knowledgeable in the restorative and risk management issues with which these patients often present. Modifications of risk factors that promote dental caries play an important part in the long-term restorative success in these patients. Patient compliance to recommendations addressing modifiable caries risk factors for maintenance of oral health is important to long-term caries risk management. Effective dentist-patient or hygienist-patient communication is a first step to encouraging a proactive role by the patient. Others have reported verbal communication accompanied by written communication to result in better compliance compared to verbal communication, alone (Tagliacozzo & Ima, 1970; MacDonald, MacDonald & Phoenix, 1977; Baker & others, 1991; Harvey & Plumridge, 1991; Vukmir & others, 1993; Makoul, Arntson & Schofield, 1995). Further evidence shows that medical patients who misunderstand their treatment plans and associated instructions usually exhibit poor compliance to following directions (Cargil, 1992; Counsell, Geddis & Smith, 1993; Vukmir & others, 1993; Makoul & others, 1995; Mayeaux & others, 1996). Computer-generated (printed) instructions were shown to significantly increase compliance to emergency room instructions when compared to verbal or verbal + hand-written instructions (Vukmir & others, 1993). Written instructions for use in management of dental caries have not been widely addressed in the literature (Fuller & Harding, 1991; Benn & others, 1997). This report presents a novel computer-generated, graphic approach to written communication that recognizes the patient's need to be reminded that home care consists of daily cyclic events. The objective of this approach is to promote communication with and comprehension by a wider population range than what might be affected by text-only instructions. The software for this method is pre-loaded with recommendations that can be modified by the dentist or hygienist and can be easily adapted as part of a comprehensive disease management program used in the office.

Communication↗
PubMed2002

Teaching medical communication skills: a call for greater uniformity.

BACKGROUND AND OBJECTIVES: Evidence suggests that strategies used in teaching communication skills vary widely among, and within, medical education programs. Such variance also exists in the amount of emphasis placed on specific communication skills. This study examines the degree of variability among medical faculty in identifying opportunities for teaching communication skills. METHODS: Sixty-seven medical faculty (physicians and behavioral scientists) reviewed a videotaped interview of a clinician with a standardized patient. Using a transcript of the interview, participants identified moments in the tape they believed warranted an instructional intervention to reinforce or modify the clinician's communication skills. Items identified by the participants were compared to items identified by a panel of experts. Frequencies and ANOVAs were used to report on consistency and on consistency as a function of faculty experience and educational background. RESULTS: Faculty demonstrated marked differences in identifying teachable moments across all six communication categories: (1) rapport building, (2) agenda setting, (3) information management, (4) active listening for the patient's perspective, (5) responding to emotion, and(6) skills in reaching common ground. Of 67 respondents, 29.6% identified none of the opportunities to teach rapport building, while only 31% identified all opportunities; 32.8% identified none of the information management opportunities, 26.9% identified all; 77.6% failed to identify the agenda-setting opportunity, 22% did identify the opportunity; 25.4% identified none of the active listening opportunities, 9% identified all; 57.6% identified none of the responding to emotion opportunities, 18% identified all; 35.8% did not identify the opportunity for reaching common ground, 64% did identify the opportunity. CONCLUSIONS: Our findings demonstrate that faculty who teach communications vary widely in the issues that they identify and about which they chose to teach. Recommendations are made for further research in this area.

Communication↗
PubMed2002

[Communication center in public health].

The Communications Center's portfolio covers areas such as marketing, contacts, distribution of information, sales activities and collection of bills by telephone (encashment). A special emphasis is Customer Care Management (Customer Relationship Management) to the patient and his caregivers (relatives), the customers, especially the physicians who send their patients to the hospital and the hospital doctor. By providing communication centers, the hospital would be able to improve the communication with the G.P.s, and identify the wishes and requirements more accurately and easily from the beginning. Dealing effectively with information and communication is already also of special importance for hospital doctors today. One can assume that the demands on doctors in this respect will become even more complex in the future. Doctors who are involved in scientific research are of course fully aware of the growing importance of the Internet with its new information and communication channels. Therefore analysing the current situation, the demands on a future information management system can be formulated: A system that will help doctors to avoid dealing with little goal-oriented information and thus setting up effective communication channels; an information system which is multi-media oriented towards the interests and needs of the patients and patient's relatives and which is further developed continually and directly by those involved.

Communication↗
PubMedDate not supplied

[Communication interventions: windows of opportunity].

OBJECTIVE: An understanding of how verbal and non verbal language develops and how it is related to social behavior is essential in order to devise effective interventions for children with disorders of communication. We review the literature on interventions for children with communication disorders from the perspective of the clinical neurologist emphasizing both therapeutic and pharmacological interventions. FINDINGS: Our knowledge on effective interventions in children with disorders of communications is limited due to the heterogeneity of the population and the lack of well controlled studies. There is some limited data suggesting that therapeutic interventions for children with language impairments are most effective if all forms of communication are emphasized. Interventions should be adapted to the age of presentation and associated clinical findings of the child. CONCLUSIONS: A multimodal intervention approach is essential to maximize the potential of children with communication disorders. The role of medication in interventions for children with disorders of communication is limited to the treatment of associated symptoms that may interfere with the ability of a child to receive non pharmacological therapeutic interventions.

Brain↗
PubMed2002

Leader as communicator.

This article examines common communication factors that have an impact on leader effectiveness (language, listening, mode of delivery, and feedback) and the role of the organization, organizational culture, and group dynamics in the development of the leader as a communicator. Communication, like any skill, is a learned behavior that is honed over time. Communication is a two-way process with stimulus-response shaping future behavior. But, it is even more complex when used in an organizational setting because there are multilevel communications, multiple message, senders and receivers, and competing agendas. Leaders in today's complex health care organizations must be skilled communicators to earn trust and respect. Once trust and respect have been earned, others are willing to listen to the leader's vision and to help make it a reality because, done well, it demonstrates expertise, critical thinking, achievement, and mentoring abilities.

Communication↗
PubMed1992

Communication with patients as a problem in undergraduate medical education.

The work is based on the following concepts: communication with patients ceases being a matter of experience learning only (the trial and error method) and should become a part of systematic training; it should not be included only into continuous education of graduated physicians but must be gradually introduced into undergraduate education as well; it is not an optional activity which may but may not be performed by physicians, but it is a specific component of their clinical competence. Today attempts to instruct medical students in communication with patients and their relatives are being made at many medical schools all over the world. Reports on such instruction are, however, scattered in various journals or in internal publications published by universities, faculties and clinics. Thus they are not available very easily. If there exist some survey works, they are mostly conceived on the national level. The objective of the study presented here is to show a comparatively comprehensive survey dealing with the medical student instruction on the international level, analyze trends in development and identify problems that have not been solved so far. The work consists of five chapters. The first one gives a short survey of current concepts in communication with patients reaching beyond the traditional training in taking medical history. Among others, the following factors are included here: explanation of both diagnostical and therapeutical methods to the patient, informing the patient about results obtained from the examination, telling him or her general conclusions and recommendations, informing patients of social associations of the disease, developing in the patients those attitudes which support their cooperation with physicians and the patient's will to live, ability to treat serious and terminal patients properly, ability to treat patients' relatives and communicate with other members of a medical team. The second chapter shows current attempts to train the medical student-patient communication in Czechoslovakia, especially at Charles University. Third chapter describes how medical students in the former USSR were instructed, especially at medical schools in Moscow. This kind of information is still difficult to be had for people from abroad. The fourth chapter is the most important. Current attempts to train medical students in communication with patients in Europe, North and South America, Asia, Africa and Australia are described there. Reference frames in which the instruction takes place (medical, educational, psychological frames) are studied.(ABSTRACT TRUNCATED AT 400 WORDS)

Communication↗
PubMed1992

Profile of the prelinguistic intentional communicative behaviors of children with profound mental retardation.

The prelinguistic intentional communicative behaviors of 10 noninstitutionalized children with profound mental retardation were analyzed according to five profile parameters: communicative rate, communicative function, discourse structure, communicative means, and syllable shape. Subjects used a predominance of regulatory communicative functions, initiated discourse structure, gestural communicative means, and nontranscribable vocalizations/vocalizations without consonants. Findings were compared to previously reported data from children without mental retardation and institutionalized children with severe and profound mental retardation.

Child↗
PubMed2003

[Evaluation of mental and communication functions in mapuche and non mapuche elderly subjects in rural communities in Southern Chile].

BACKGROUND: The main predictors of functional impairment in the elderly are alterations in mental or communication functions. AIM: To study mental and communication functions in rural elderly subjects of Mapuche and non Mapuche origin. PATIENTS AND METHODS: Elderly subjects coming from a rural Mapuche community and a non Mapuche community were studied. Subjects were interviewed at their homes. The communication and mental function assessments of the Functional Autonomy Measurement System were applied. RESULTS: Fifty one Mapuche and 49 non Mapuche subjects with a mean age of 71 +/- 7 and 74 +/- 8 years respectively, were studied. Fifty four percent were female and 31% were illiterate. Twenty six percent had impairment in mental functions. The item with the highest difficulty was memory. The visual function was the most severely impaired among communication items. Mapuche elderly subjects had significantly higher degrees of impairment in mental and communication functions. CONCLUSIONS: There is a higher degree of mental and communication impairment among rural Mapuche elderly subjects than in their non Mapuche counterparts.

Aged↗
PubMed2004

Communication assessment using the common ground instrument: psychometric properties.

BACKGROUND AND OBJECTIVES: Recent guidelines from the Association of American Medical Colleges and from the Accreditation Council for Graduate Medical Education strongly suggest that communications teaching and assessment be part of medical education at all levels. This study's objective was to validate an instrument to assess communications skills. This instrument, Common Ground, is linked to the core, generic communication skills emphasized by the consensus statements of Toronto and Kalamazoo. METHODS: A total of 100 medical students were recruited from two medical schools and tested with four-station, communications-focused objective structured clinical examinations. Using Common Ground, trained raters performed checklist and global rating assessments. Experts globally assessed 20 representative interviews. RESULTS: Inter-rater reliability for Common Ground was 0.85 for the overall global ratings and 0.92 for the overall checklist assessment. Generalizability coefficient was 0.80 for 50 minutes of testing. The correlation between the ratings of trained raters and a panel of communication experts was 0.84. CONCLUSIONS: The Common Ground assessment instrument assesses core communication skills with sufficient reliability, validity, and generalizablity to make decisions on medical students' performance.

Communication↗
PubMed2004

Adolescents' self-efficacy to communicate about sex: its role in condom attitudes, commitment, and use.

This study examined whether and how self-efficacy to communicate with parents and peers about sex relate to sexually experienced adolescent males' and females' (N= 144, 112) condom attitudes, intentions, and use. Results showed that males who reported greater self-efficacy to communicate with parents used condoms more frequently; and both males and females who can communicate with peers used condoms more frequently. Self-efficacy to communicate with peers was related to more positive condom attitudes, which in turn were associated with greater condom commitment and use. Greater ability to communicate with parents was also related to greater condom commitment and use among males. These results suggest the importance of designing interventions that give adolescents the skills they need to feel efficacious in their ability to communicate about sex and contraception.

Adolescent↗
PubMed2005

A correlates of peer, supervisor, and patient communication effectiveness satisfaction.

Using a sample of 200 medical technologists over a 4-year period, this study investigated whether peer, supervisor, and patient communication satisfaction facets were related but distinct referents. Confirmatory factor analyses on the medical technologist sample and a second independent sample of 85 medical/health professionals supported the distinctiveness of these three referents. Correlational differences between communication satisfaction referents were found. Specifically, professional withdrawal intent, gathered twice before communication satisfaction, had stronger negative relationships to patient versus peer communication satisfaction. Job satisfaction and organizational withdrawal intent also exhibited correlational differences to communication satisfaction referents. One unexpected finding across both samples was that there was higher communication satisfaction with patients of the opposite versus same sex.

Administrative Personnel↗