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Communication Difficulties (communication + difficulty)
Selected AbstractsChildren's Language and Communication Difficulties: Understanding, Identification and InterventionJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2001Juliet Goldbart [source] Getting IT: Using Information Technology to Empower People with Communication DifficultiesJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 3 2008Linda Selby [source] Does a new undergraduate curriculum based on Tomorrow's Doctors prepare house officers better for their first post?MEDICAL EDUCATION, Issue 12 2003A qualitative study of the views of pre-registration house officers using critical incidents Introduction, In 1994 Manchester University introduced an integrated undergraduate medical course using problem-based learning (PBL) throughout. The study reported here explored whether there were any differences between the new course graduates (NCGs) and the traditional course graduates (TCGs) in the types of scenarios they recalled as ,critical incidents', or challenging cases, while working as pre-registration house officers (PRHOs). The focus is on differences rather than causal links. Method, We used semistructured interviews to generate our data. Twenty-four traditional course graduates and 23 new course graduates were interviewed approximately 3 months after starting their first PRHO placement. Results, We identified 4 types of critical incidents relating to: clinical practice; limitations of competence; emotional involvement; and communication. Traditional course graduates reported difficulties in making patient management decisions, whereas the NCGs were better at dealing with uncertainty, knowing their limits and asserting their rights for support. Communication difficulties and coping with emotional involvement were common across both groups of graduates and hence remain problems in relation to being prepared for the role of a PRHO. Conclusions, Graduates of the new, integrated curriculum seemed to be much better at dealing with uncertainty, knowing their personal limits and asserting their rights for support when they felt these limits had been reached. Communication difficulties and emotional involvement remain major factors in the transition from student to PRHO. [source] The global challenge of type 2 diabetes and the strategies for response in ethnic minority groupsDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 6 2010Flavio Lirussi Abstract Ethnic minorities living in high-income countries usually exhibit a greater risk of developing diabetes along with higher morbidity and mortality rates. We evaluated the effectiveness of interventions to improve glycaemic control in ethnic minority groups. Results of major controlled trials, systematic reviews and meta-analyses were included in the review. Only 1/47 studies addressing diet and exercise interventions reported details on the ethnicity of the studied population. Self-management education was successful if associated with increased self-efficacy; delivered over a longer period; of high intensity; culturally tailored; and when using community educators. Strategies adopted in community-gathering places, family-based, multifaceted, and those tackling the social context were likely to be more effective. A positive relationship was found between social support and self-management behaviour as well as quality of life, but there is little evidence about the impact of organizational changes within health-care services on diabetes control. More research is needed to strengthen the evidence on effective strategies for response to diabetes in ethnic minorities. Also, there is a need to take into account diabetes beliefs and communication difficulties, as well as potential protective factors. Globally, many health-care systems are inadequately equipped to improve diabetes prevention and disease outcomes in these communities. Copyright © 2010 John Wiley & Sons, Ltd. [source] The use of conversational analysis: nurse,patient interaction in communication disability after strokeJOURNAL OF ADVANCED NURSING, Issue 3 2009Clare Gordon Abstract Title., The use of conversational analysis: nurse,patient interaction in communication disability after stroke. Aim., This paper is a report of a study to explore how nursing staff and patients with aphasia or dysarthria communicate with each other in natural interactions on a specialist stroke ward. Background., Nursing staff often talk with patients in a functional manner, using minimal social or affective communication. Little nursing research has been carried out with patients who have communication difficulties. Conversational analysis, used in other healthcare settings, is a way to explore these interactions in depth in order to gain further understanding of the communication process. Method., An observational study was carried out in 2005 and the data were 35·5 hours of videotape recording and field notes with 14 nursing staff and five patients with aphasia or dysarthria. The recordings were analysed using conversation analysis. Findings., Nursing staff controlled the conversations by controlling the topic and flow of conversations, creating asymmetry in all interactions. Patients had very little input because of taking short turns and responding to closed questions. These behaviours are related to the institutional context in which they occur. Conclusion., In rehabilitation, the focus for interaction may be thought to be patient goals, worries or plans for the future, but in this study nursing staff controlled the conversations around nursing tasks. This may be because they do not have the confidence to hold conversations with people with communication problems. Nursing staff need to receive training to reinforce communication rehabilitation programmes and to engage more fully with patients in their care, but also that a wider institutional culture of partnership is developed on stroke wards. [source] Support needs of children's nurses involved in child protection casesJOURNAL OF NURSING MANAGEMENT, Issue 6 2009VICKI ROWSE MA Aim, This qualitative study explored the experiences of nurses working in a hospital paediatric department, who had direct involvement in child protection cases, to discover their support needs and suggest developments in training and support. Background, The study was inspired by an awareness of increasing anxiety amongst nurses involved in child protection cases. Method, A phenomenological approach was used with fifteen nurses during semi-structured interviews, which were taped, transcribed and analysed thematically. Results, Involvement in child protection has a lasting impact; nurses need procedural information from a knowledgeable supporter during a case; and, they need individualized support. The personal qualities of the Named Nurse for Safeguarding Children were crucial. Conclusions, Involvement in child protection cases has lasting effects for individuals. The emotions generated can lead to interagency and inter-professional communication difficulties and affect the future management of child protection by individuals. Seeking support can be hampered by individuals' fear of ridicule or of making a mistake. Implications for nursing management, This study has implications for the training of children's nurses in child protection procedures, and the provision of appropriate effective support for individuals. The long-term effects of involvement are previously unreported by nurses. [source] Evolution of the caregiving experience in the initial 2 years following strokeRESEARCH IN NURSING & HEALTH, Issue 3 2003Carole L. White Abstract Relationships between stroke survivor and family caregiver factors and the caregiver's health-related quality of life (HRQL) and overall quality of life (QoL) were examined in 97 dyads during the first and second years after stroke. Compared to age- and sex-matched population norms, caregivers scored significantly lower on the mental subscales of HRQL, and differences were greater for women than for men. Caregiver characteristics (older age, less burden, and fewer physical symptoms) were associated with better HRQL (mental summary scale) in the first year, with similar findings in the second year. Moderate stroke survivor physical impairment and caregiver characteristics (younger age and better HRQL) were associated with better QoL in the first year. During the second year poorer caregiver physical and mental health and caring for a stroke survivor with communication difficulties were associated with diminished QoL. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26: 177,189, 2003 [source] Challenges and Strategies Related to Hearing Loss Among Dairy FarmersTHE JOURNAL OF RURAL HEALTH, Issue 4 2005Louise Hass-Slavin MSc ABSTRACT: Context: Farming is often imagined to be a serene and idyllic business based on historical images of a man, a horse, and a plow. However, machinery and equipment on farms, such as older tractors, grain dryers, and vacuum pumps, can have noise levels, which may be dangerous to hearing with prolonged, unprotected exposure. Purpose: This qualitative study in Ontario, Canada, explored the challenges and coping strategies experienced by dairy farmers with self-reported hearing loss and communication difficulties. Through in-depth interviews, 13 farmers who experience significant hearing loss were questioned about the challenges they face as a result of hearing loss and the strategies they use to overcome or compensate for problems. Findings: The 2 major challenges encountered by dairy farmers with a hearing loss were: (1) obtaining information from individuals, within groups, and through electronic media; and (2) working with animals, machinery, and noise. To cope with these challenges, participants used strategies identified as problem and emotion focused. Conclusions: Four themes arose from analysis of the challenges encountered and strategies used: 1Hearing loss is experienced as a "familiar," but "private," problem for dairy farmers. 2Communication difficulties can negatively affect the quality of relationships on the farm. 3Safety and risk management are issues when farming with a hearing loss. 4The management or control of excessive noise is a complex problem, because there are no completely reliable yet practical solutions. [source] Inclusion or control? commissioning and contracting services for people with learning disabilitiesBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 4 2006Liam Concannon Accessible summary ,,The rise of new public management has seen the role of the social worker becoming increasingly administrative and less about face to face contact with service users. ,,When commissioning managers seek to help people with learning disabilities plan their services, who actually makes the decisions? ,,Direct payments are proposed as the answer for people with learning disabilities to take the lead, but is this a real shift in power from managers to service users? This paper examines what commissioning and contracting means for people with learning disabilities. It asks if the voices of service users are heard when it comes to planning their services and, more significantly, are their choices respected and acted upon by commissioners? The government believes the introduction of direct payments will change the way social care is administered, by placing both the decision-making and funding, firmly in the hands of people with learning disabilities. However, the question remains as to how far this can be successful, considering the complicated administration and financial processes involved. The paper explores new ground in terms of research by investigates the effects that new public management, in the form of commissioning and contracting, has on the lives of people with learning disabilities. It looks at the relationship between the service user, care manager and commissioner, and asks whether management structures help individuals or actually create further barriers to participation and inclusion. Summary This paper seeks to critically assess the impact made by the introduction of commissioning and contracting as a new culture of social care in learning disability services. It offers an evaluation of the growth in importance of the user as consumer. Does the commissioning and the contract process give users with learning disabilities a greater influence over their services and ultimately their lives? It is suggested that far from empowering people with learning disabilities to have a say in the services they want, the emerging culture of business contracts and new public management transfers power firmly back into the hands of professionals making the decisions. Social work practice is changing in response to major shifts in social trends and at the behest of market values. Traditional models are being rejected and the challenge for social work is to adapt itself to operate within a competency based paradigm. The paper argues that at the centre of this new culture is a government use of a system of performance management that successfully drives down cost. Thus there remain contradictions between the adoption of a mixed economy of care; services planning; consumerism; resource constraints; and the communication difficulties experienced by many people with learning disabilities. [source] The personal experience of juvenile Huntington's disease: an interpretative phenomenological analysis of parents' accounts of the primary features of a rare genetic conditionCLINICAL GENETICS, Issue 6 2006Section Editor: Barbara Bowles Biesecker, email: barbarab@mail.nih.gov There has been a paucity of research into the psychosocial impact of juvenile Huntington's disease (JHD) on the child and the family. The study reported here is part of larger project that aimed to address this and investigate the social and health care needs of those affected by JHD. Ten semistructured interviews with the main caregiver(s) were carried out and were analyzed using the qualitative methodology interpretative phenomenological analysis. The main themes arising from the analysis are reported here: first becoming aware something is wrong; physical symptoms; speech and communication difficulties; behavioral problems; a slow but relentless process. These are discussed in relation to extant literature. We hope the article will be helpful to clinicians working with families where a child is affected by JHD and also contribute to the general literature on understanding symptoms in childhood illness. [source] Situated Knowledge and Learning in Dispersed TeamsBRITISH JOURNAL OF MANAGEMENT, Issue S2 2002Deborah Sole This qualitative field study explores how geographically dispersed teams learn and accomplish challenging work by drawing on knowledge situated in the multiple physical locales they span. We propose the construct of situated knowledge as important for understanding the learning process in dispersed teams. Data collected on seven development projects, each spanning multiple sites, reveal that situated knowledge is at the same time a valuable resource and a source of communication difficulty for dispersed teams. We find that, because their members understand and participate in locale,specific practices, dispersed teams can easily access and use unique locale,specific knowledge resources to resolve problems that arise in those same locales. However, when dispersed teams need knowledge situated at a site other than where the problem occurred, they must first recognize and adjust for locale,specific practices within which that knowledge is embedded before they can use it. The paper reports on analyses of 44 learning episodes that involved identifying and engaging situated knowledge, and draws from these data to identify implications for research and practice. [source] Latino worker perceptions of construction risks,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2010Nancy Nivison Menzel PhD Abstract Background Construction is a hazardous occupation, with Latino (Hispanic) workers at a greater risk for death than other ethnicities/races. Latinos accounted for over half of construction injuries involving days away from work in Nevada in 2006. Methods This study recruited 30 Latino construction workers from three Southern Nevada trade unions to participate in four focus groups conducted in Spanish to determine their perceived risks for injury. Audiotapes were transcribed into English transcripts, which were analyzed for themes. Results Themes included language/communication difficulties, traditional Latino values, construction trade skill level differences, and health literacy. Participants were unfamiliar with the workers' compensation system. Conclusions Small contractors in particular should provide more effective safety training in Spanish and appropriate safety equipment. Unions should offer English language training using simulation and more information about workers' compensation rights. Occupational health providers should consider Latino beliefs and communication needs when assessing health status or providing care. Am. J. Ind. Med. 53:179,187 2010. © 2009 Wiley-Liss, Inc. [source] | |||||||||||||||||||