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PubMedDate not supplied

Communication of a cancer diagnosis: patients' perceptions of when they were first told they had cancer.

Fifty consecutive cancer patients cared for by a palliative medicine program were interviewed concerning the initial communication of their diagnosis. The majority of patients were satisfied with the manner and the circumstances in which the information was imparted. A minority of women were significantly more unhappy than men about the manner in which they were told. Sophisticated techniques are available to help physicians impart bad news effectively and humanely.

Adult↗
PubMed1999

The role of medical organizations in supporting doctor-patient communication.

The clinical competence of physicians depends largely on the education, accreditation, certification and licensing programs offered by the various Canadian medical organizations. In virtually all of these, doctor-patient communication is a required element. Educational programs at all levels are subject to accreditation by a number of different organizations including undergraduate medical programs (Committee on Accreditation of Canadian Medical Schools), residency training (College of Family Physicians of Canada and Royal College of Physicians and Surgeons of Canada) and continuing medical education (CFPC and RCPSC). Doctor-patient communication is a key element in teaching at all levels. The two colleges also emphasize communications in the certification process. The provincial licensing authorities are aware of the importance of effective communication between physicians and patients. Several of the them have physician assessment programs, and recently they have started to assess a model of mandatory performance review. Both of these approaches assess physician-patient communication. There is increasing pressure, with strong support from consumers, that some level of communication skills competency should be imposed by the licensing authorities. Most approaches to exposing physicians to communications focus on rewards rather than coercion but a number of possible schemes could be considered to promote communication skills.

Accreditation↗
PubMed1992

PC-based application programs in large health care systems.

Public health care agencies lack the infrastructure to meet the increasing operational demands on them, but there is little comparative data on alternative operational structures and systems from which to formulate remedies. Improved information management systems could help address both the workload and the gathering of critically needed data. PC-based database and application programs (PC-APs) that communicate with the mainframe are proposed as a methodology for filling the information-processing gap between mainframe computing and manual information systems. We also propose a model for systematic study of information management systems in clinical settings which can be used to evaluate other aspects of clinical program operations as well. A pilot study demonstrating these methodologies suggests that this is a fruitful approach to assessing ambulatory care operations and that PC-APs can improve administrative and clinical functions and enhance FTE productivity at lower overall cost.

Ambulatory Care Information Systems↗
PubMed2003

Differences in altruistic roles and HIV risk perception among staff, peer educators, and students in an adolescent peer education program.

This qualitative study examines how adolescent peer educators understand and communicate HIV prevention messages. Semistructured ethnographic interviews were conducted with 21 program participants, including staff, peer educators, and students. Interviews were transcribed and analyzed using concept analysis, a method for identifying shared concepts among interview subjects. We found (a) similar beliefs about HIV transmission and risk reduction across groups; (b) different, but strong, altruistic roles among staff and peer educators; and (c) differences in HIV risk perception across the three groups. Altruistic roles took two forms. Staff acted as life skills mentors, whereas peer educators acted as HIV educators. Students were more passive, receiving counseling but not passing it on to others. Staff contextualized HIV risk, whereas peer educators and students emphasized risk. Although similar HIV knowledge across groups suggests program efficacy, stronger altruistic roles or contextualization of HIV risk may affect how prevention messages are delivered.

Adolescent↗
PubMedDate not supplied

"Adding pizzazz". A presentation skills workshop for healthcare practitioners.

Healthcare practitioners are often called upon to share their expertise with colleagues. Frequently, expert practitioners are asked to make presentations at patient support groups, professional rounds, workshops, meetings, and conferences. Often these expert practitioners have not had the opportunity to develop strong presentation skills. Consequently, many are reluctant to give presentations. When they do present, they often have difficulty communicating their ideas effectively. This article describes the creation of a presentation skills program for healthcare practitioners. Essential program content is identified as well as measures taken to make this an effective, economical, and popular training program.

Audiovisual Aids↗
PubMedDate not supplied

Competence of nursing graduates in technical, communicative, and administrative skills.

This survey examined baccalaureate, diploma, and associate degree nursing program graduates regarding their perception of their competency in technical, communicative, and administrative skills and their supervisors' perceptions of their competency. Differences were found among graduates' perceptions of their competency as well as in supervisors' perceptions of graduates' competency in these skills.

Clinical Competence↗
PubMed1988

A peer review process to assess the quality of graduate medical education.

Accreditation standards for graduate medical education require the internal evaluation of programs. In this paper, the authors describe a system of peer review instituted to meet these requirements and report on the supporting administrative structure and outcome of the peer review process. Although time-consuming and in some cases causing apprehension among staff members and residents, the experience of a peer review process was useful for staff members, residents, and administrators. Peer review was found to be effective in identifying program strengths and weaknesses and in increasing communication among staff members and between administrators and staff members about the teaching programs.

Internship and Residency↗
PubMed2003

Care not cure: dialogues at the transition.

Physicians and patients find it hard to communicate when treatment fails to cure or control cancer. Communication barriers include fear of "giving up," losing the medical team, and discussing death. The quality of physician-patient communication affects important outcomes including patient distress, coping, and quality of life, and physician burnout. Communication skills that can be taught, learned, and maintained for physicians at all levels of training, and effective educational programs have been described. Research on communication skills training should focus on the best method of delivery, the "dose-response" effect, and how to measure success of training in complex health care environments.

Adaptation, Psychological↗
PubMed1992

High-performance computing, high-speed networks, and configurable computing environments: progress toward fully distributed computing.

The next several years will see the maturing of a collection of technologies that will enable fully and transparently distributed computing environments. Networks will be used to configure independent computing, storage, and I/O elements into "virtual systems" that are optimal for solving a particular problem. This environment will make the most powerful computing systems those that are logically assembled from network-based components and will also make those systems available to a widespread audience. Anticipating that the necessary technology and communications infrastructure will be available in the next 3 to 5 years, we are developing and demonstrating prototype applications that test and exercise the currently available elements of this configurable environment. The Lawrence Berkeley Laboratory (LBL) Information and Computing Sciences and Research Medicine Divisions have collaborated with the Pittsburgh Supercomputer Center to demonstrate one distributed application that illuminates the issues and potential of using networks to configure virtual systems. This application allows the interactive visualization of large three-dimensional (3D) scalar fields (voxel data sets) by using a network-based configuration of heterogeneous supercomputers and workstations. The specific test case is visualization of 3D magnetic resonance imaging (MRI) data. The virtual system architecture consists of a Connection Machine-2 (CM-2) that performs surface reconstruction from the voxel data, a Cray Y-MP that renders the resulting geometric data into an image, and a workstation that provides the display of the image and the user interface for specifying the parameters for the geometry generation and 3D viewing. These three elements are configured into a virtual system by using several different network technologies. This paper reviews the current status of the software, hardware, and communications technologies that are needed to enable this configurable environment. These interdependent technologies include: (1) user interface and application program construction methodologies, (2) the interprocess communication (IPC) mechanisms used to connect the software modules of the application, (3) the network protocols and interface hardware used by the IPC for communicating between modules running on separate and independent computing system elements, (4) the telecommunications infrastructure that provides the low-level data transfer functions for the networks that connect the geographically distributed elements used by the application, and (5) the nature of the functional elements that will be connected to form virtual systems.

Computer Communication Networks↗
PubMedDate not supplied

A program design to promote clinical judgment.

This article describes a unique continuing education program designed to enhance critical thinking, clinical judgment, and communication skills of practicing nurses in an acute care setting. The program design and implementation strategies are described in detail. The authors include specific examples for those who want to develop a similar program to improve the practice of registered nurses in the acute care setting.

Acute Disease↗
PubMedDate not supplied

Making cancer prevention effective for African-Americans.

In order to reduce the racial disparities in cancer death rates, prevention programs designed for minorities must concentrate on the cancer sites and intervention methods which offer the greatest promise for closing the mortality gap. Generally accepted methods to achieve these results were recently published by the U.S. Preventive Services Task Force. Effective intervention recommendations will be increased when researchers understand the cultural differences of minorities, communicate clearly, collaborate with other programs, and treat the program participants with respect.

Adult↗
PubMed1984

The influence of communicator characteristics on the nutrition attitudes and behavior of high school students.

The development of school health programs requires that careful attention be paid to the communication of health information. One factor important to the communication process is the characteristics of the health communicator. Both the expertise of communicators and the similarity of communicators to their audiences have been found to influence acceptance of health messages. The purpose of this study was to determine the impact of both similarity and expertise on the nutrition behavior and attitudes of high school students. Results of the study indicate that the greater the perceived similarity of the communicator, the greater the influence of the communicator. The communicator perceived to be both low in similarity and high in expertise was the least influential communicator. School health educators need to consider their students perceptions in developing health programs. Health educators can enhance their influence by forming linkages with their students, ie, emphasizing common interests and experiences. By emphasizing their similarities with their students rather than expertise, school health educators are likely to increase their effectiveness.

Adolescent↗
PubMed2005

The National Cancer Institute's cancer information service: a new generation of service and research to the nation.

The National Cancer Institute (NCI), the nation's leading agency for cancer information and research, mandated by the U.S. Congress to provide accurate, up-to-date information about cancer to all segments of the U.S. population, established the Cancer Information Service (CIS) on July 1, 1975. Using a two-pronged approach, the telephone information service and education programs for the public and health professionals, the CIS was designed to maximize its reach. In 1982, the CIS implemented three tools: the Call Record Form to record data about each call to the service, a national user survey, and a system of national test calls. These resulted in a rich data source and an infrastructure that allowed collaborative health communications research with the CIS to emerge later in the decade. As the CIS embarks on a new generation of service to the nation, it is now characterized by three vital components that advance the NCI's overall mission of cancer prevention and control: a Partnership Program, Multichannel Contact Centers, and a Health Communications Research Program.

Communication↗
PubMed2001

Vaccine safety: risk communication--a global perspective.

The complexity of risks connected with both vaccine-preventable diseases as well as with immunization will be discussed and used as the basis for conclusions: -what should be done to avoid damage to current and future immunization programs and -how to improve risk communication. The need for more complete data on true, perceived and unknown immunization risks necessitates strengthening our research capabilities as well as surveillance and vaccine safety programs, and to critically examine the factors influencing public sentiments, taking into account that public perceptions of risk vary depending on the characteristics of risk. A concerted effort is needed to improve benefit and risk communication at all levels. The medical community should play a key role for improved communication.

Communication↗
PubMed1990

Prosocial effects of entertainment television in India.

The study examines the prosocial effects of Hum Log (We People), India's 1st long running television soap opera. Hum Log was a prosocial TV program that was designed to promote women's status in Indian society. Regression analysis was used to measure the degree to which exposure to Hum Log affected viewers' (1) awareness of certain prosocial beliefs promoted by the series, (2) level of TV dependency, (3) involvement with the characters of Hum Log, and (4) adherence to 3 prosocial beliefs promoted by Hum Log. Exposure to Hum Log was positively associated with viewer's awareness of the program's prosocial messages, TV dependency, and involvement with TV characters in the series. Viewers who were more exposed to Hum Log were also more likely to believe in women's equality and women's freedom of choice, but not in family planning. The implications of these findings are discussed in terms of present and future research on the use of prosocial TV programs for development in Asia.

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