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PubMed2005

[Self-assertion communication in the family].

The present research was aimed at studying the familiar triads (adolescent child-father-mother). The familiar dynamics was approached by empathic skills at intrapersonal level and by communication patterns among the family members at interpersonal level. Empathic skills were evaluated by the Davis Interpersonal Reactivity Index and by the Mehrabian and Epstein Empathy Questionnaire, while communication patterns were evaluated by the Consensus Rorschach test. Modeling a familiar problem-solving situation with the Consensus Rorschach test, we focused on the self-assertion capabilities of the family members in the communication process. This self-assertion was not qualified as positive or negative phenomenon, rather its intrapersonal and interpersonal relationships with empathy and communication styles were evaluated. The present results show a positive correlation of self-assertion with cooperative communication and a negative correlation with blocking communication. It is also shown that at interpersonal level, the self-assertion tendencies of the child are negatively correlated to the emphatic skills of family members.

Adolescent↗
PubMed2006

Modeling interdependencies between information processes and communication paths in hospitals.

OBJECTIVES: For planning hospital information systems it is important to recognize the interrelation between business processes and the communication needs between supporting application systems. We therefore present an approach to model, visualize and analyze those interdependencies. METHODS: The approach is based on the concepts defined in 3LGM2, a meta-model to describe health information systems (HIS). An information process is defined as a sequence of functions using or updating information; a communication path as a sequence of communication links between interfaces belonging to application systems. The search for communication paths belonging to an information process is interpreted as an all-pairs shortest-paths problem. To solve this problem the Floyd-Warshall algorithm is applied. RESULTS: The resulting algorithm has been implemented as function of the 3LGM2 tool, a tool to create 3LGM2 compliant models. With it, it is possible to interactively define information processes at the domain layer and to analyze step by step whether the infrastructure at the logical tool layer is sufficient to communicate necessary data between application systems. CONCLUSIONS: The presented approach enables the representation and analysis of dependencies between information processes and communication paths. With it, the HIS architecture is directly associated with the business needs. This is an important condition for the systematic planning of hospital information systems.

Algorithms↗
PubMed2006

[Skills in management, co-operation and communication in the Pre-Registration House Officership].

INTRODUCTION: In aviation, it has been realised that technical training ensures competence in specific procedures, but does not counter errors due to communication or decision making in a dynamic environment. As a consequence, Crew Resource Management, consisting of training in co-operation, management, and communication skills, was introduced in order to serve as a countermeasure towards human errors. In the same way, medical school ensures academic and technical insight, but rarely offers systematic training in such non-technical skills. The aim of this study is to identify the standard of competence in skills of co-operation, management, and communication at the end of the Pre-Registration House Officership. METHOD: 30 skills of management, co-operation, and communication divided into five main areas were identified. Using the Delphi method through two rounds of questionnaires, an expert panel of 50 doctors evaluated six different standards of competence for each skill. RESULTS: The Panel reached consensus at a 75% level for five skills, all within the main area "Team communication in the acute situation". Consensus was not reached within any of the other four main areas. None of the 30 skills was evaluated as being irrelevant for the Pre-Registration House Officer by more than one panel member. CONCLUSION: There was broad agreement on the need for high standards of competence within the area of team communication. There was considerable disagreement within the panel with regard to the other main areas, but all of the skills listed in this study were found relevant to the Pre-Registration House Officer in the acute situation.

Clinical Competence↗
PubMed1991

Rat ovarian granulosa cell culture: a model system for the study of cell-cell communication during multistep transformation.

A spontaneously immortalized clonal granulosa cell line (SIGC) derived from primary rat ovarian granulosa cell cultures was developed as a model system to explore the process of transformation using an epithelial cell type. SIGC has an epithelial morphology and grows in culture without undergoing luteinization. The cell line is thought to represent an intermediate step in carcinogenesis because it seems to grow indefinitely in culture but does not form clones in soft agar or tumors in nude mice. Indirect immunofluorescence and Western blot analysis verified the constitutive expression of the recessive oncogene product p53 in the cell line, thereby suggesting a possible mechanism of immortalization. Ultrastructural studies indicated that SIGC cells are characterized by an undifferentiated phenotype with prominent intermediate filaments, desmosomes, and gap junctions. The identification of cytokeratin by indirect immunofluorescence and Western blot analysis suggests that SIGC functions as an epithelial cell type. Functional studies of cell-cell communication by a dye transfer technique (fluorescence recovery after photobleaching) showed reduced communication compared to normal primary granulosa cells in culture. SIGC cells were transfected with early region genes of SV40 virus in an attempt to generate fully transformed cell lines. The resulting cell line SV-SIGC expressed T-antigen, was anchorage independent, formed tumors in nude mice, and had reduced intercellular communication as compared to SIGC cells. Explants from the tumors in nude mice were used to generate another cell line (T-SV-SIGC), which exhibited further reduction in both the incidence and the rate of communication. These results clearly demonstrated a progressive loss of functional communication during multistep transformation of an ovarian cell type. These data demonstrate that this assay system based on an epithelioid cell type can be used to study the relationship between intercellular communication and the multistep process of carcinogenesis.

Animals↗
PubMed1991

Caring for the terminally ill: communicating with patients and family.

Caring for terminally ill patients requires effective communication skills. It is important that medical personnel understand appropriate ways to communicate with the patient in order to inform him about his illness, throughout its duration. Physicians must develop an understanding of how patients communicate and ways to respond to that communication. Furthermore, the physician needs to communicate with the family of the terminally ill patient. Effective communication must become a regular part of the treatment.

Communication↗
PubMed1989

Communicative competence in a group of visually impaired children.

Aspects of verbal and non-verbal communicative competence of five visually-impaired six and seven year old children were investigated. The Profile of Communicative Appropriateness (Penn, 1983) was used to assess communicative competence in one discourse interaction with a known interlocutor (mother). The results indicated that the subjects were predominantly appropriate in terms of verbal communication, and predominantly inappropriate in terms of non-verbal communication. Severity of visual impairment influenced performance in terms of non-verbal communication. Research and therapeutic implications are discussed.

Blindness↗
PubMed1987

Selective lack of intercellular communication between transformed and nontransformed cells as a common property of chemical and oncogene transformation of BALB/c 3T3 cells.

BALB/c 3T3 cells can be transformed by transfection of an activated cellular oncogene as well as by chemicals. When the cells were transformed by pEJ-ras transfection, a marked increase in Mr 21,000 protein expression was found by Western blotting and immunohistochemical staining, whereas no such increase was detected in cells transformed by methylcholanthrene, suggesting two different molecular mechanisms. By directly microinjecting a fluorescent dye (Lucifer Yellow CH) into individual cells, we measured junctional intercellular communication among and between transformed and surrounding nontransformed cells. In both chemical and oncogene transformation studies, transformed cells and surrounding normal cells have similar capacities for gap-junctional communication, but there was complete lack of communication between transformed and nontransformed cells. When BALB/c 3T3 cells were transformed by methylcholanthrene initiation followed by phorbol ester promotion, again we saw no intercellular communication between transformed and nontransformed cells, suggesting that the observed selective communication block between transformed and nontransformed cells may be a general phenomenon in BALB/c 3T3 cells. These results indicate that selective lack of intercellular communication between transformed and surrounding normal cells may be an important phenomenon that separates transformed cells and nontransformed cells, permitting transformed cells to maintain autonomous growth.

Cell Communication↗
PubMed1986

Communication: key contributor to effectiveness--the research.

This field study of 327 professional nurses at an east coast teaching hospital investigated the effects of nurses' satisfaction with different facets of organizational communication on their job satisfaction and job performance. The author found that certain aspects of communication (e.g., communication with supervisor, communication climate, personal feedback, and communication with top-level executives) are influential contributors to nurses' job satisfaction and, to a lesser extent, to nurses' job performance. The author suggests a number of ways nurse executives can increase the communication effectiveness of their nursing staffs.

Adult↗
PubMed1984

[An electronic communication aid with a large keyboard for artificial respiration patients in the intensive care unit].

An increasing number of patients under mechanical ventilation in ICUs suffers from being cut off from normal communication. The existing communication facilities, such as letter-boards, magnetic letters, pictograms, Yes-no-signals and attempts at written communication are very often insufficient or not to be mastered by the weakened ICU respirator patient. We, therefore, present an electronic communicator consisting of a keyboard with big push-buttons and an illuminated running-letter display. Up to one page of text can be stored in memory and recalled later as running or printed text. Initial experiences with the electronic communicator show that even weakened respirator patients with diminished sensomotoric abilities successfully manage to communicate with the staff.

Communication Devices for People with Disabilities↗
PubMed1984

Lack of intercellular communication between chemically transformed and surrounding nontransformed BALB/c 3T3 cells.

In order to study the possible role of intercellular communication in the process of in vitro cell transformation, the communicating capacity of BALB/c 3T3 cells transformed by 20-methylcholanthrene was investigated using a dye transfer method. Morphologically transformed foci, detectable 4 to 5 weeks after treatment with 20-methylcholanthrene (1.0 microgram/ml), are clearly distinguishable under the phase-contrast microscope from surrounding nontransformed monolayer cells; therefore, a tracer dye can be injected into individual cells, and gap-junctional communication between and among transformed and nontransformed can be studied directly. When fluorescent Lucifer Yellow CH was microinjected into a cell within the transformed focus, the dye was transferred to other transformed cells but not to cells in the adjacent nontransformed area, although they were in physical contact. Similarly, dye injected into a nontransformed cell was transferred to neighboring nontransformed cells but not to cells in an adjacent transformed focus. These results indicate that when BALB/c 3T3 cells are transformed by 20-methylcholanthrene they can no longer communicate with surrounding normal cells, although they maintain the ability to communicate with other transformed cells in the focus. These results suggest that loss of the ability to communicate with surrounding nontransformed cells may be one of the important determinants of induction and expression of the final malignant transformation.

Animals↗
PubMed1984

Development of the ability to distinguish communicative intention and literal message meaning.

Children's ability to distinguish the literal meaning of a message and the speaker's communicative intent was investigated in 2 experiments. First- and second-grade children evaluated brief referential communication messages for ambiguity under 2 conditions. In an informed condition, the children knew which referent the speaker had intended. In an uninformed condition, they did not know the intended referent. 2 communication systems were used. In Experiment 1, the messages were written on cards and read to the child; in Experiment 2, a novel communication system was used. The developmental pattern of results was similar for both studies. The results showed that the first graders in the informed condition often claimed that an ambiguous message could not refer to a referent the speaker had not meant, whereas children in the uninformed condition were able to detect the referential ambiguity of the message. There were no condition differences for the second graders. The results suggest that young children's ability to analyze the literal meaning of a message is affected by the accessibility of the speaker's communicative intent and that children may develop a general ability to analyze representations of communicative intention.

Child↗
PubMed1980

Referential communication skill levels of moderately mentally retarded adolescents.

Referential communication skills of moderately mentally retarded adolescents (20 speaker-listener dyads) were investigated. In Study 1, subject performance on referential communication activities divided into three skill levels requiring sampling, comparison, and critical-features analysis was examined. Degree of idiosyncratic messages communicated by retarded speakers was investigated in Study 2. Listening competence of retarded and adult listeners was compared in Study 3. Retarded subjects did consistently better on referential communication tasks requiring only sampling than on tasks requiring comparison or critical analysis. Referential communication messages provided by retarded speakers did not have greater meaning to themselves than to others. Finally, retarded listeners and adult listeners did not differ significantly in their ability to utilize the information given by retarded speakers. Implications of the findings for the study of the social communications of retarded children were discussed.

Adolescent↗
PubMed1995

Physicians and the communication of "bad news": parent experiences of being informed of their child's cleft lip and/or palate.

OBJECTIVE: Physicians often are called on to deliver "bad news" in the form of a diagnosis with unhappy implications. Few guidelines exist for practitioners who wish to meet patient and family expectations for clear and caring communication. To develop recommendations for physicians, this study was undertaken to document how biologic parents of children born with a specific, non-life-threatening birth defect perceive the encounter with a physician during which they were informed of their children's diagnosis. The study also examines parental preferences for how this communication might best be managed and compares those with parent reports of their actual experiences. METHODOLOGY: Biologic parents of children born with cleft lip and/or palate (n = 100) were studied with a self-administered questionnaire about the diagnostic encounter in which they rated theoretically derived dimensions of physician communication. Their experiences, as well as their preferences for communication in a hypothetical case, were compared through the use of ratings and open-ended qualitative narratives. RESULTS: Parents learned the diagnosis at birth (90%) from a physician (96%). Many report positive experiences, but there are significant differences between what parents experienced and what they desire in the informative interview. Parents wanted more opportunity to talk and to show their feelings and wanted the physician to try harder to make them feel better. As compared with their experiences, parents indicated a desire to have more information and more of a discussion about the possibility of mental retardation. They wanted the physician to show more caring and confidence, and wanted more referral to other parents, than they had experienced. Dimensions of physician behavior were more positively perceived by parents who were informed by a physician whom they felt they knew well. CONCLUSIONS: It is possible for physicians to effectively deliver bad news, such as the diagnosis of a birth defect, to parents. This study suggests specific communicative and educational approaches that are likely to improve parental satisfaction with such physician communications.

Cleft Lip↗
PubMed1993

Managing the language and learning needs of the communication-impaired preschool child. A proactive approach.

If a proactive approach to assessment and intervention had been used in the case study presented at the beginning of this article, the following might have occurred: The SLP would have asked the parents and brother of the 3 1/2-year-old child referred for a communication evaluation to participate in the assessment activities. The parents would have been asked to prioritize their expectations for their daughter's communication, behavior, and school success. They would have been told the SLP would do the same based on her knowledge of performance expectations in these areas for a 3 1/2-year old. Both the parents and the SLP would have agreed to consider describing the child's communication, behavior, and potential for school success in more than a single setting or context. The child would have been seen in her home as well as in a preschool setting. The clinician would have observed the child's play with both familiar and unfamiliar children and adults. The parents would have kept a log of their child's communication successes and failures for one week. The clinician would have used those situations the parents identified as successful and unsuccessful to specify the child's strengths and weaknesses. The parents would have been asked to write down ideas they had on the type of intervention, if any, they felt their daughter needed to meet the expectations they set. The clinician would do the same and would have consulted with an educational specialist and a psychologist to obtain their perspective on the educational and cognitive needs of a preschooler. The speech-language pathologist would have asked other professionals to assist in assessment of this child. The psychologist would have completed some testing in the home with the SLP providing help in interpreting the child's responses. The educational specialist would have invited the SLP to observe the child in a diagnostic preschool setting to assess the child's ability to understand and communicate in an unfamiliar environment with peers. The team, including the parents, the SLP, psychologist, and educational specialist would have met to share the information they had gathered about the child's communication, behavior, and potential for success in school. The SLP would have acted as a case manager and listed the strengths and weaknesses each participant identified for the child. When the list was complete, the SLP would have presented consistent areas of strength and weakness reported across contexts. The team members would have developed statements of their performance expectations for the child.(ABSTRACT TRUNCATED AT 400 WORDS)

Child Language↗
PubMed1995

Teaching communication skills: part of medical education?

Hypertension is generally a symptomless disease, but it needs lifelong treatment in most cases. This places enormous demands on individual doctors treating individual patients. Communication under these circumstances should be a skillful blend of patient education (for example about lifestyle, other risk factors, reasons for treatment) coupled with the development of a strong personal interest in, and relationship with, the patient in order to motivate that patient to follow advice and therapy. Communication skills in medicine are learnt slowly and often only by experience. Medical school deans are under enormous pressure to add extra items into an already crowded curriculum, and so education in communication tends to have a low priority. Before a school can take such interest in educating students in communication it first has to take an interest in the education of its teachers. Rather belatedly, medical schools are now taking such an interest. Previously academic promotion depended mainly on research publications and public profile and little on an assessment of an ability to teach. Increasingly both undergraduate and postgraduate teaching is now subject to assessment from those taught, and universities are now making formal assessments of their teachers' ability in communication. In Oxford all newly appointed teachers are asked to appear before a panel, give a short 10-15 min communication and to listen to criticism of their technique. Video filming of their performance is a valuable feedback in getting lecturers to see their own faults and to help improve their techniques. It is very important to begin such training not only at lecturer level but also at student level.(ABSTRACT TRUNCATED AT 250 WORDS)

Communication↗
PubMedDate not supplied

[Communication disorders in schizophrenic patients. Cognitive explanation and clinical reconsideration].

The definition of schizophrenic patients communication disorders sets many problems (partly linked to the descriptive vagueness of the Bleuler mental dissociation syndrome) and leads today to give up those signals, considered as of little specification, for symptoms of easier definition. Nevertheless, french clinicians go on using the dissociation concept to make the diagnostic of schizophrenia, faithful to Bleuler teaching according to which the communication of these patients would be very specific. The object of this article is to take up with the Bleuler logic and to propose hypothesis of cognitive abnormalities that underlie the symptomatic expression of the communication troubles of these patients and point out, from these hypothesis, how a more specific rereading of the language, thought and communication disorders is possible. Two cognitive abnormalities are suggested by the literature data to explain some schizophrenic communication disorders, abnormalities which seem at least partly independent. The first one can be described in the terms of a model of action and brings down communication to its dimension of discursive action. The authors define it as a trouble of a mechanism of action supervision, of the action monitoring, or of the planning of discourse. The symptomatic expressions of this trouble may be described when the subject is under interview conditions soliciting it Examples of such clinical situations are given. The second abnormality may be described in the terms of the "Theory of Mind" and concern the difficulties of some schizophrenic patients to attribute mental states to their interlocuters. Here again, examples of clinical conditions are given, allowing us to investigate this abnormality.

Attention↗
PubMed1994

Communication patterns in patients with erectile dysfunction and their partners.

Patients with erectile dysfunction (ED) and their partners (n = 18) were compared on perceived distress caused by the ED, attribution of responsibility for the ED and marital communication. Comparisons were also made between couples in whom the ED was organically based versus those in whom it was psychogenically based. No differences were found between organic versus psychogenic ED couples on perceived distress, attributions, or marital communication skills. Patients and partners differed on communication (P < 0.001), attributions (P < 0.001) and perceptions of distress experienced by their spouse (P < 0.001). However, both members of the couple found the ED equally distressing. Partners tended to attribute more responsibility for the ED to themselves when they believed it was psychogenic (P < 0.001), while patients claimed sole responsibility regardless of their perceptions of its etiology. Patients had clinically problematic communication scores (P < 0.001), while partners did not. Contrary to initial hypotheses, communication scores did not predict agreement/disagreement between patients and partners on perceived etiology, attributions or distress. Discussion is focused on the need for therapy to address couples' communication specific to sexual activity and the effects of the ED.

Communication↗
PubMed1994

Communication strategies of adult cochlear implant candidates.

Adult cochlear implant candidates' abilities to cope with communication breakdown were assessed using the Communication Strategies Task (CST). Forty adult cochlear implant candidates with acquired hearing losses and 10 adults with normal hearing served as subjects. Appropriateness of responses to the CST were rated by 10 certified speech-language pathologists and audiologists. Seventy-six percent of the subjects demonstrated difficulty identifying onset or resolution of communication breakdown, communicators' feelings, factors contributing to communication breakdown, and appropriate repair strategies. The responses of individuals with sudden hearing losses did not differ significantly from the responses of individuals with progressive hearing losses. Response patterns did not correlate with the age of onset of the hearing loss, duration of deafness, age at the time of evaluation, or educational background. The results of this study suggest that ability to cope with communication breakdown must be evaluated on an individual basis.

Adaptation, Psychological↗