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PubMed2004

Using a communication audit to improve communication on clinical placement in pre-registration nursing.

This article describes a novel communication audit conducted with those concerned with the practice placements of pre-registration Nursing students. The study, uniquely, addressed all who were involved in communication concerning placement in what is described as an organisational analysis. The aim of the audit was to identify levels of satisfaction and dissatisfaction with present communication processes and to identify points for improvement. The audit used the Hogard-Barker Communication Audit of Practice a customized version of a well established tool, devised to cover issues relevant to practice placements. A key feature of the tool is the opportunity for participants to identify the amount of communication they are receiving on particular topics and issues against the amount they would like to receive. Participants in the audit included students, assessor mentors, ward managers, clinical facilitators and link tutors. Overall there was considerable dissatisfaction with what was perceived to be the insufficient amount of communication received on a number of topics including allocations, the curriculum, students' learning outcomes and commitments in terms of college work. In addition to identifying points for improvement the audit provides a baseline against which progress can be assessed through a future audit.

Consumer Behavior↗
PubMed1975

The applied communication game: a comment on Muma's "communication game: dump and play".

We now have technology available to teach speech and language skills to children. We cannot always expect children to carry over or generalize this training and spontaneously use this "trained language" in communication situations, so we now must develop technology for teaching interpersonal communication skills. This report commented on a model presented by Muma (1975). Illustrations were presented that should help clinicians train more effective interpersonal communication. The applied communication game provides an objective procedure that utilizes the natural consequences in communication situations to improve communication skill in handicapped children.

Child↗
PubMed1990

Extended communication samples of augmented communicators. II: Analysis of multiword sequences.

The three primary purposes of this project are (a) to identify those word sequences that occur frequently across a group of 10 linguistically intact augmented communicators, (b) to determine the communality with which the various augmented communicators use specific word sequences, and (c) to evaluate the usefulness of word sequences in providing keystroke savings for users of augmentative and alternative communication (AAC) devices as compared to letter-by-letter spelling or single-word retrieval. Communication samples were collected for 14 consecutive days from 10 subjects who used AAC devices. These samples were analyzed with custom software to determine the frequency of occurrence of one-, two-, three-, four-, and five-word sequences. The results revealed that three-, four-, and five-word sequences occurred very infrequently within and across communication samples. Two-word sequences occurred much more frequently than the longer sequences. The authors concluded that clinicians should continue to encourage linguistically intact clients to select long messages (three words or more) for their AAC devices based on message content and the urgency with which messages need to be delivered rather than relying exclusively on statistical analysis. However, statistically based multiword analysis should not be abandoned. Frequently occurring one- and two-word sequences may be an important source of messages that will increase communication efficiency when stored and retrieved in an AAC device.

Adolescent↗
PubMed1998

Maternal responsivity predicts the prelinguistic communication intervention that facilitates generalized intentional communication.

Family systems theory posits that the relative effectiveness of early interventions will vary depending on various aspects of the family. This study tested whether maternal responsivity would predict the extent to which Prelinguistic Milieu Teaching (PMT) facilitated generalized intentional communication better than a contrast treatment that was conducted in a small group by a responsive adult (i.e., Responsive Small Group, RSG). Fifty-eight children with developmental disabilities in the prelinguistic communication period of development were randomly assigned to one of the two staff-implemented treatment groups. Thirty were assigned to RSG; 28 were assigned to PMT. Mothers were kept naive to the intervention methods, hypotheses, and measures. In families with mothers who responded to a high percentage of the children's communication acts at the pre-treatment period, the children in the PMT group used more frequent intentional communication in post-treatment generalization sessions with a trainer and mothers than did children in the RSG group. In the families with mothers who responded to fewer than 39% of their children's communication acts, children in the RSG intervention used more frequent intentional communication in post-treatment generalization sessions with the mothers than did children in the PMT intervention. Other family variables and no child variables that we measured could account for these findings.

Child↗
PubMed2001

Nurses' communication skills: an evaluation of the impact of solution-focused communication training.

AIMS: This paper describes the evaluation of a short training course in solution-focused brief therapy (SFBT) skills. This evaluation examined the relevance of SFBT skills to nursing and the extent to which a short training course affected nurses' communication skills. BACKGROUND: Nurses' communication skills have been criticized for many years, as has the training in communication skills that nurses receive. The absence of a coherent theoretical or practical framework for communication skills training led us to consider the utility of SFBT as a framework for a short training course for qualified nurses, the majority of them are registered nurses working with adults. DESIGN AND METHODS: Quantitative and qualitative data were collected: the former using pre- and post-training scales, the latter using a focus group conducted 6 months after the training. Data were analysed using the Wilcoxon signed-rank test and content analysis. RESULTS AND FINDINGS: Quantitative data indicated positive changes in nurses' practice following the training on four dimensions, and changes in nurses' willingness to communicate with people who are troubled reached levels of significance. Qualitative data uncovered changes to practice, centred on the rejection of problem-orientated discourses and reduced feelings of inadequacy and emotional stress in the nurses. CONCLUSIONS: There are indications that SFBT techniques may be relevant to nursing and a useful, cost-effective approach to the training of communication skills. Solution focused brief therapy provides a framework and easily understood tool-kit that are harmonious with nursing values.

Attitude of Health Personnel↗
PubMed2003

Evaluating first-year medical students' attitudes to learning communication skills before and after a communication skills course.

This longitudinal study explores 216 medical students' attitudes towards communication skills learning before (TI) and at the end (72) of their first-year communication skills course. They completed the Communication Skills Attitude Scale and a personal details questionnaire satisfactorily at Ti and T2. Univariate statistics established whether attitudes differed between TI and T2 for the whole sample and for the sample split by demographic and education-related characteristics. Students rated their communication skills slightly but significantly lower at the end of their communication skills course than before the start of the course. Positive attitudes towards communication skills learning became significantly lower by the end of the course compared with the start. Repeated measures ANOVAs indicated that significant two-way interactions existed between attitudes at TI and T2 and the demographic characteristics: gender, language and ethnicity. These findings are discussed in the paper, along with their implications for educational practice and further research.

Adolescent↗
PubMed1999

Is there a use for tailored print communications in cancer risk communication?

The manner of presentation of cancer risk information is critical to its understanding and acceptance by the individual recipient. Optimal communication of cancer risk information must effectively translate the technical meaning and subtleties of risk and its associated factors to a conceptual level understandable by the recipient. Tailored print communications (TPCs) may be an appropriate medium for cancer risk communication (CRC). TPCs are more refined than targeted communication materials. They are print materials created especially for an individual on the basis of knowledge about that person. The goal is to provide individually relevant and appropriate information. This review examines the nature of TPCs, assesses the use and potential of TPCs for the purpose of CRC, and highlights new directions in CRC. Articles dealing with TPCs were located by searching the MEDLINE(R) and PsychInfo(R) databases and seeking in-press articles. TPCs were identified for several areas of CRC, including dietary change, smoking cessation, mammography use, hormone replacement therapy, health risk appraisal, and genetic susceptibility to cancer. Although TPCs have been used in a number of different behavioral areas, they have not yet achieved their potential for CRC. The use of TPCs in the communication of cancer risk shows great promise, however, particularly as knowledge evolves regarding both the nature of risk and the most effective tailoring of health communication messages.

Communication↗
PubMedDate not supplied

The impact of adults' communication clarity versus communication deviance on adolescents with learning disabilities.

Research has demonstrated that confusing styles of parental communication--"communication deviances" (CD)--are associated with cognitive disorder in offspring. The present study examined the immediate effects of adult communication clarity versus deviance on sixty-one 11- to 15-year-old male and female adolescents with learning disabilities (LD). Subjects were randomly assigned to complete the Rorschach Arrangement Task (RorAT) under conditions of either clear (n = 30) or unclear (n = 31) instructions from an adult. Immediately thereafter, the adolescents were administered a test of abstract thinking--The Twenty Questions Task (TQT). Strategies used to solve the task were assessed. As hypothesized, adolescents in the clear communication condition performed significantly better on the RorAT and used more efficient cognitive strategies on the TQT than did adolescents in the unclear communication condition. A new theory with implications for teaching and parenting is proposed for understanding the influence of adult communication on students with LD.

Adolescent↗
PubMed1998

Nurse-patient communication in palliative care: an evaluation of a communication skills programme.

Good communication between nurses and patients is a central aspect of palliative care. However, evaluation of courses designed to improve nurses' communication skills has been inconclusive. Most courses have concentrated on skills training, although communication training programmes which have been integrated into clinical practice over time and have also focused on attitudes and used a range of teaching methods, have been shown to be effective. A study was set up to evaluate whether a communication skills course which would focus on knowledge, attitudes and skills would improve nurses' communication skills. One-hundred-and-ten nurses completed a 26 h training programme over six months and completed precourse and postcourse audiotape recordings of a patient assessment. An overall statistically significant improvement in assessment skills between pretest and post-test mean total scores (P < 0.001) was found, with statistically significant improvements in six of the nine key areas assessed. The nurses reported that although some elements of the programme, such as role play, had been stressful they felt more confident in handling difficult situations. The longer integrated communication skills programme which allows nurses to explore attitudes, raise self-awareness and develop knowledge and skills appears to be effective.

Adult↗
PubMed2005

Cancer patients' perception of the quality of communication before and after the implementation of a communication strategy in a regional cancer center in India.

PURPOSE: Physician communication is one of the areas that cancer patients have expressed their lowest level of satisfaction. Very few studies have used patient-based outcomes in the Developing world. METHODS: We conducted a survey of 400 consecutive patients attending our outpatient clinic (Step I). Survey results were used to make changes in the physical layout of the setting to increase privacy and to educate staff regarding practical techniques on communication (Step II). A second group of 400 patients were interviewed immediately after the implementation of the new communication strategy (Step III). RESULTS: Comparing Step I (n = 400) and Step III (n = 400) we observed a favorable response ("yes" v "no") with regard to overall satisfaction with communication in 52 patients (13%) versus 132 patients (33%; P = .0001), privacy in 21 patients (5%) versus 279 patients (70%; P = < .001), no interruptions in 170 patients (42%) versus 330 patients (82%; P = < .001), clear language in 57 patients (14%) versus 227 patients (57%; P = < .001), sufficient time in 88 patients (22%) versus 168 patients (42%; P = < .001), doubts cleared by the doctor in 105 patients (26%) versus 225 patients (56%; P = < .001). Patients older than 65 years and manual laborers were significantly more satisfied compared with younger patients and those patients with nonmanual occupations, during both Steps I and III. CONCLUSION: We conclude that cancer patients in Developing countries have many unmet needs regarding communication and that simple changes in the organization of clinics and oncologist education can result in major improvements in satisfaction with the quality of communication.

Adult↗
PubMed2004

Enacting "health communication": the field of health communication as constructed through publication in scholarly journals.

Based on an analysis of articles in health communication journals and in regional, national, and international communication journals, this study identifies publication trends and research priorities for health communication articles in the 1990s and the year 2000. Based on a content analysis of article abstracts, researchers determined the extent to which health communication articles appeared in various journals as well as the emphasis on specific topics in health communication research, methodological approaches, and theoretical frameworks. The article concludes with reflections on the implications of this study for future work in the area of health communication.

Communication↗
PubMed1997

The Erlangen Hospital Communication Hub: migration from proprietary to standardised communication.

The Erlangen communication hub allows medical subsystems to exchange data by two completely different methods. Since 1995 a communication data base, which is implemented using the relational data base system ADABAS D, contains data from the most important hospital systems. This data can be accessed by other medical systems. Thus, the communication data base allows subsystems which do not have a standardised interface to implement proprietary system interconnections via access based on SQL. The capabilities of this interconnection are dependent on both the implementation and the data which is made available by the communication data base. This contains mainly basic patient data and the results of tests performed by various laboratory systems. In addition to this proprietary communication system we have since the end of 1996 a communication server which can also handle standardised message formats such as HL7, EDIFACT, DICOM3. Future subsystems which possess standard interfaces will be connected via this server. The connection of the patient management system IS-H and the central laboratory system to the database has been proceeding since the beginning of 1997.

Computer Communication Networks↗
PubMed1998

The Erlangen university hospital communication hub--proprietary and standardised communication.

The University of Erlangen-Nuremberg contains 22 hospitals and 11 autonomous medical departments which are spread out over a large area in the city of Erlangen. The necessary connections of these units and their computer based subsystems to each other and to the medical computer centre via fibre optics cables is complete. The internal cabling of the individual units is largely completed. Based on this network the Erlangen communication hub allows medical subsystems of the Erlangen university hospitals to exchange data by two completely different methods. Since 1995 a communication data base, which is implemented using the relational data base system ADABAS D, contains data from the most important hospital systems. This data can be accessed by other medical systems. Thus the communication data base allows subsystems which do not have a standardised interface to implement proprietary system interconnections via access based on SQL. The capabilities of this interconnection are dependent on both the implementation and the data which is made available by the communication data base. This contains mainly basic patient data and the results of tests performed by various laboratory systems. In addition to this proprietary communication system we have since the end of 1996 a communication server which can also handle standardised message formats such as HL7, EDIFACT, DICOM3. Future subsystems which possess standard interfaces will be connected via this server. The connection of the patient management system IS-H and the central laboratory system to the database has been proceeding since the beginning of 1997.

Computer Communication Networks↗
PubMed2002

Communication across the divide. A trial of structured communication between general practice and emergency departments.

AIM: To evaluate the impact of structured form letters for general practitioner to emergency department (ED) communication. METHOD STUDY POPULATION: one hundred and fifty-five GPs with practices in the Liverpool local government area in metropolitan Sydney and patients referred by them to ED at Liverpool over five months from June to October 1998. DESIGN: randomised control trial of GPs as unit of randomisation; intervention GPs were encouraged to follow a structured proforma for their written communication with the ED. Control GPs were left to usual referral procedures. The ED was encouraged to fax a brief report back to GPs using the form. Impact measures: the quality of the referral letters was evaluated using a checklist that included: reason for referral; examination finding; medical history; investigations; psychosocial history; allergies; drugs given in the surgery and present medication. Surveys were sent every month to GPs to assess communication from the ED and adverse events observed by GPs. RESULTS: Most letters from GPs to the ED contained information on reasons for referral, medical history and examination findings. Reasons for referral were present in 95% of the intervention group GPs' letters compared with 99% of those of the control group. Investigations were included with 27% and present medications in 37%. Letters from GPs in the intervention group were more likely to contain a psychosocial history than those in the control group (13% compared with 1%). Most GPs reported receiving a letter from the ED although this was rarely by fax; most were brought to them by the patient. Phone calls were received by about one in five GPs each month. Most GPs found both of these to be useful. There were no differences between communication received by GPs in the intervention and control groups. CONCLUSION: This study demonstrates that improvements to communication between GPs and EDs are difficult and may require a systemic change within general practice and the hospital. Electronic systems may allow the sort of reciprocal communication required to establish and sustain improvement.

Communication↗
PubMed1992

Guidelines for meeting the communication needs of persons with severe disabilities. National Joint Committee for the Communicative Needs of Persons with Severe Disabilities.

In summary, the current best practices in the facilitation and enhancement of communication among persons with severe disabilities reflect six major tenets: (a) communication is social behavior; (b) effective communicative acts can be produced in a variety of modes; (c) appropriate communicative functions are those that are useful in enabling individuals with disabilities to participate productively in interactions with other people; (d) effective intervention must also include efforts to modify the physical and social elements of environments in ways that ensure that these environments will invite, accept, and respond to the communicative acts of persons with severe disabilities; (e) effective intervention must fully utilize the naturally occurring interactive contexts (e.g., educational, living, leisure, and work) that are experienced by persons with severe disabilities; and (f) service delivery must involve family members or guardians and professional and paraprofessional personnel. These six tenets have resulted in assessment, intervention, and service delivery models that offer maximum responsiveness to the need to establish communicative repertoires that will allow persons with severe disabilities to function effectively in least restrictive environments--in productive interactions with others.

American Speech-Language-Hearing Association↗
PubMed1996

The effect of Danquah Communication System (DanCS) boards on maladaptive behaviours among individuals with severe intellectual impairment and non-verbal communication skills.

There is evidence that some individuals with severe intellectual impairment who are non-verbal may, out of frustration, display such inappropriate behaviour as aggression and self-injury as a means of communicating their needs to caregivers. The purpose of this study was to develop an inexpensive augmented communication device and to teach individuals with multiple impairment to use this method to communicate their needs in order to reduce their aggressive behaviours. The Dan Communication System (DanCS) symbol boards were therefore designed with computerized voice interface to help the individuals communicate to caregivers by means of audio and visual signs. A working DanCS board has been successfully developed and can now be mass produced by a manufacturer. The DanCS board is illustrated and described. A measurement device called the Goal Attainment Scale (GAS) that focused on three target behaviours; pressing of symbols, control of aggression, and social interaction with caregivers, was used to evaluate progress in the participating subjects (N = 30). Results showed that the multiply impaired individuals in the study significantly improved in all the targeted behaviours through the use of the DanCS. Details of the study are reported.

Adult↗