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PubMedDate not supplied

Using an outcomes management program in a public health department.

This article and its predecessor offer suggestions to nurses in all service settings by describing how a local public health department planned and implemented its outcomes management program. Included are the steps used to select and analyze reliable and valid quantitative outcomes data, and examples of graphs that depict and interpret those data. The outcomes management program was designed to provide needed information for program planning and evaluation, and for communication with administrators and local government officials.

Data Collection↗
PubMed2004

[Communication skills in the encounter with patients--current examination subject for medical students. Beneficial educational investment].

A continuous and structured training in communication skills for medical students still has a comparatively low priority in the curriculum of Swedish medical schools. A recent American study has demonstrated the value of incorporating such training programs during the early phase of medical studies. The effect of this reported intervention program was evaluated with objective structured clinical examination (OSCE). Significantly higher satisfaction in the medical encounter was documented among patients who met students trained in patient centeredness than among those who met students randomised to a control group. Thus, communication training for medical students improves specific competencies known to affect outcome of care. We report our experience with a similar model of a communication-training program during the first four semesters, with examination at the end of the program, which has been part of the pre-clinical curriculum since 1998 at the Karolinska Institute in Stockholm, Sweden.

Clinical Competence↗
PubMedDate not supplied

Do cigarette warnings warn? Understanding what it will take to develop more effective warnings.

Warnings in cigarette advertisements have been the principal method mandated by the federal government to educate consumers about the risks of smoking. Warnings have been required in all cigarette ads for 30 years and have remained largely unchanged during this time. The current warning program was neither developed nor implemented with specific communication goals in mind. Instead, it was negotiated by the government and tobacco industry representatives. The warning program has served the tobacco industry well by providing it with a key argument in tobacco litigation: "We warned you." It has, however, failed as a public health strategy, since much research has shown that the current warnings are ineffective communication devices. If Congress is to be effective in its efforts to educate consumers about the risks of smoking, it needs to rethink the warning strategy while making use of knowledge regarding how warnings work. The paper draws from current studies in order to develop realistic cigarette warning objectives and points out the considerations necessary to create such warnings. To be effective, warnings must be developed, targeted, tested, and revised over time.

Health Education↗
PubMed2005

[Videophone assistance and home hospitalization: the ViSaDom program].

OBJECTIVE: The purpose of this project was to study the clinical feasibility of videophone-based communication between patients in their homes, and the care teams who work in the Home Hospitalization department (HH). METHODS: This pilot study of videophone users compared them with a group of control patients also in HH. They came from either the adult, maternity or pediatric departments. Patients who met the inclusion criteria and consented to participate in the study were randomly assigned to one of two groups: those who had a videophone installed in their homes (telemedicine group), and those who received the standard HH care (control group). Sixteen patients in the telemedicine group were matched with 16 from the control group, according to age, Karnofsky Index score, and the reason for HH admission. RESULTS: The mean videophone call lasted six minutes, and patients averaged 23 calls each over the study period (0.7 calls per patient per working day). The videophone enabled better follow-up of wounds: for example, the nurse could transmit photos from the patient's home for real-time coordination. It was also useful for following patients suffering from pain, for technical nursing care, and for educating patients and their caregivers. Anxiety (measured with the Hospital Anxiety and Depression Scale) diminished during the study period for the telemedicine patients, compared with the control group (p=0.048). Within the telemedicine group, all patients and their families were very satisfied or satisfied with their care and with the communication (15/15), although the staff's level of satisfaction was slightly lower (14/16); there were no significant differences between groups. CONCLUSION: The ViSaDom program indicates that videophone communication is feasible and acceptable and could be a useful tool for improving the quality, efficiency and effectiveness of care.

Activities of Daily Living↗
PubMed2005

Geriatric interventions: the evidence base for comprehensive health care services for older people.

Specialist geriatric services apply a comprehensive, multidisciplinary evaluation and management approach to the multidimensional and usually interrelated medical, functional and psychosocial problems faced by at-risk frail elderly people. This paper examines currently available data on geriatric interventions and finds ample evidence supporting both the efficacy and the cost-effectiveness of these specialist interventions when utilised in appropriately targeted patients. It is proposed that substantial investment in these programs is required to meet the future demands of Australia's ageing population.

Aged↗
PubMed2006

A randomized controlled trial on the long-term effects of a 1-month behavioral weight control program assisted by computer tailored advice.

OBJECTIVES: To examine the long-term effects of a new behavioral weight control program (Kenkou-tatsujin, KT program). The program consisted of twice-interactive letter communications including computer-tailored personal advice on treatment needs and behavioral modification. DESIGN: A randomized controlled trial comparing Group KM: KT program with 6-month weight and targeted behavior's self-monitoring, Group K: KT program only, Group BM: an untailored self-help booklet with 7-month self-monitoring of weight and walking, and Group B: the self-help booklet only. PARTICIPANTS: Two hundreds and five overweight Japanese females were recruited via a local newspaper. MEASUREMENTS: Weight loss (body weight, BMI, reduction quotient, etc.) and behavioral changes (daily eating, exercise and sleeping habits). FINDINGS: A significant weight loss was observed in all groups. At 1 month, Groups KM and K were superior, but at 7 months, the mean weight loss was significantly more in Group KM than the other 3 groups. At 7 months, 8 dietary habits and 4 physical activities were improved in all subjects. Habitual improvement was related to the weight loss in Groups KM and K at 1 month.

Adult↗
PubMedDate not supplied

[Home care of children with chronic diseases: cooperation between hospital and home care workers].

Newborns with chronic problems needing continuous and special care even after discharge are not very frequent but represent a challenge for the caring team. The discharge program of the Neonatal Care ward of Trento hospital includes several steps: discharge meetings of teh neonatologist and the nurse responsible for the child, the head nurse, the psychologist and, when possible, the social worker; a training program for the parents; the coordination of communications and interventions of the home-care nurses and a detailed post-discharge planning. From 1995 a home-hospital program, as an alternative to the hospital admission was started. To describe how the team functions and stress the need of a close integration among the team members, the case of Ahmed is presented. This case faced the team with several challenges, because of the lack of parent's knowledge of the italian language and of the severity of the child's problems. Every care plan is developed building on newborn's needs and patients' resources. Data on the patients-problems dealt with from 1991 to 1995 and the interventions and resources needed are presented.

Chronic Disease↗
PubMed2000

The turmoil of aboriginal enumeration: mobility and service population analysis in a central Australian community.

This paper documents Aboriginal population change and mobility over time in a remote community in central Australia. The movement of population has implications for service delivery and resource allocation. Aboriginal population in the region is characterised by high mobility. We conducted four population surveys in a selected remote community over a 12 month period and categorised individuals into four mutually exclusive groups: residents, dual residents, visitors and absent residents. Based on these categories we developed two population classifications: actual and potential service populations. The potential service population was consistently higher than the Australian Bureau of Statistics (ABS) census figure. We question the use of ABS census estimates as appropriate population figures for determining resource allocation to remote communities. We quantify inter- and intra-community mobility. When the potential population is used as denominator, 35% of the population of this community was classified as inter-community mobile. Given this level of mobility we argue that: (1) Resources should be allocated to compensate health services for the additional time and resource requirements to deal with the high level of population mobility. (2) Health programs such as STD control, trachoma, scabies and other communicable diseases common in Central Australia should be coordinated and delivered as regional programs often crossing State/Territory borders.

Australia↗
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↗
PubMed1989

A four-year program to train residents in emergency medical services.

There is general agreement that residents in the field of emergency medicine require extensive training in emergency medical services (EMS). This paper outlines a comprehensive four-year training program in EMS that has been integrated into the emergency medicine residency curriculum of the University of Cincinnati since 1985. The EMS program is comprehensive and makes it possible for the level and type of EMS activities that are provided to match the evolving expertise of the resident. The program provides a significant amount of practical training in ground and aeromedical transport, in disaster work, in telemetry communications, and in other areas. Evaluation of the program is at an early stage but informal reports are strongly positive.

Curriculum↗
PubMed2003

A radiation protection program prospectus based on the collection of 10 years of key performance indicator data.

In 1992, the University of Texas Health Science Center at Houston Radiation Safety Program began assembling data on a monthly basis that described various program activities. At the end of calendar year 2002, a decade of data had been collected, so the information was summarized into a novel program prospectus, displaying various indicator parameters in a format similar to that used in a commercial enterprise prospectus provided to potential investors. The consistent formatting of the data afforded a succinct and easily digestible snapshot of program activities and trends. Feedback from various program stakeholders, even those unschooled in radiation safety matters, was overwhelmingly positive. The prospectus aided in communicating the scope of work undertaken by the program, and has helped maintain program support, even in challenging economic times. The data summary is also proving to be useful in making future projections regarding program needs.

Academic Medical Centers↗
PubMed1998

In search of cultural sensitivity and inclusiveness: communication strategies used in rural HIV prevention campaigns designed for African Americans.

Recently, rates of HIV and AIDS are rapidly and disproportionately increasing among minority communities in the rural South. Culturally specific health communication about HIV and inclusion of minority voices in the administration and implementation of HIV programs have been found to be the most effective methods for prevention. The purpose of this discussion is to examine these health communication strategies in HIV prevention programs designed for African American communities in rural Alabama. Effective, culturally sensitive, and inclusive prevention efforts documented in health communication literature are identified, and the use of these efforts through a case study of rural Alabama's minority-focused HIV prevention programs is examined The research reveals that, although the state is making use of culturally tailored communication strategies, educators continue to encounter problems connecting with and involving target populations. Reasons for these problems and recommendations for changes are discussed.

Journal Article↗