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Communication Problems (communication + problem)
Selected AbstractsLucidity in a woman with severe dementia related to conversation.JOURNAL OF CLINICAL NURSING, Issue 7 2005A case study Aims and objectives., The aim of this study was to explore the presence of lucidity in a woman with severe dementia during conversations and whether it occurred when conversational partners or the woman with severe dementia initiated the conversation topics about the present, past or future time and whether she was presented with support or demands during the conversation. Background., Communication problems as well as episodes of lucidity in people with dementia are reported in the literature. Design., A researcher held 20 hours of conversation with a woman with severe dementia. A daughter participated for about three and a half hours. The conversation was tape-recorded and transcribed verbatim. Methods., The text was divided into units of analysis. Each unit of analysis was then assessed separately and discussed among the authors. Chi-square tests and logistic regression analysis were performed. An ethics committee approved the study. Results., The woman as initiator of the conversation topic and support to the women during conversation from the conversation partner were found to be the most significant factors explaining lucidity, while conversation about the present or past time showed no connection with lucidity. Very few topics (n = 7) concerned future time and they were not used in the statistical analysis. The researcher initiated 41%, the woman 43% and the daughter 16% of the topics. Support was registered in 49%, demands in 15% and both support and demands in 16% of the units of analysis. There were 58% topics about present and 40% about the past time. Conclusions., The presented study is a case study and the results cannot be generalized. For the woman with severe dementia, lucidity was promoted by the conversational parties carefully focusing on conversation topics initiated by the woman while supporting her during conversation. Relevance to clinical practice., To share the same perception of reality, focusing on the topics initiated by the patient with severe dementia and a supporting attitude to what the patient tells, will hopefully give more episodes of lucidity in the patient. This approach in caring for patients with severe dementia might give more meaning and well-being to the conversational partners in daily care. [source] Epidemiology of Adverse Events in Air Medical TransportACADEMIC EMERGENCY MEDICINE, Issue 10 2008Russell D. MacDonald MD Abstract Objectives:, This observational study determined frequency and describes all-cause adverse event epidemiology in a large air medical transport system. Methods:, Records of a mandatory reporting system were reviewed and a data set containing all of the patient care records was searched to identify aviation- and non,aviation-related adverse events. Two reviewers independently identified adverse events and categorized them using an established taxonomy. Descriptive statistics were used to report adverse events, with frequency calculated per 1,000 flights and 1,000 hours flown. Results:, Between January 1, 2002, and June 30, 2005, there were 1,447 reports, of which 598 included an adverse event. Case-finding identified an additional 125. A complete report was available in 680 of 723 (94.1%) events. There were 58,956 flights and 103,632 hours flown during the study period, for a rate of 11.53 adverse events per 1,000 flights (95% CI = 10.7 to 12.4 adverse events) or 6.56 per 1,000 hours flown (95% CI = 6.1 to 7.1 adverse events). The frequencies of events by category were as follows: communication (229; 33.7%), transport vehicle (143; 21.0%), medical equipment (88; 12.9%), patient management (77; 11.4%), clinical performance (68; 10.0%), weather (30; 4.4%), unclassified (24; 3.5%), and patient factors causing death (21; 3.1%). There was possible patient harm in 117 events. Conclusions:, Air medical transport is associated with a low incidence of adverse events and possible patient harm. Communication problems were the most common cause of an event. Determining event epidemiology is necessary to identify modifiable factors, propose solutions to decrease the adverse events, and direct future efforts to improve safety. [source] Participation of children with cerebral palsy is influenced by where they liveDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 5 2004Donna Hammal MSc The study aimed to determine whether degree of participation of children with cerebral palsy (CP) is influenced by where they live, as predicted by the social model of disability. Ninety-two per cent children with CP resident in Northern England and born 1991-1996 were entered into the study. Participation was measured by the Lifestyle Assessment Score and its six component domain scores. Regression analysis was used to investigate variations in participation. There were 443 children (265 male, 178 female; mean age 4 years 8 months [SD1 year 1 month] at time of assessment) in the study. In the regression analysis the following factors remained significant with regard to level of participation: type of CP (167 with hemiplegia, and of those remaining 240 with bilateral spasticity); intellectual impairment (105 with IQ<50,113 with IQ 50 to 70, and 225 with IQ>70); presence of seizures (115 with active epilepsy); walking disability (114 unable to walk, 81 restricted and needing aids, 186 restricted but unaided, 62 unrestricted); communication problems (61 no formal communication, 51 use alternative formal methods, 126 some delay or difficulty, 205 no communication problems). After adjustment for these factors, there were significant variations with regard to level of participation in the Lifestyle Assessment Score by district of residence. The magnitude of these variations in Lifestyle Assessment Score between districts is similar to that accounted for by severe intellectual impairment. Similar models were obtained for four of the six domain scores. For one of these four, restriction of social interaction, the significant variation between districts was minimally influenced by the underlying type of CP, walking ability, or presence of seizures. Higher levels of participation among children with CP are associated with residence in certain districts. This is not attributable to variations in case-mix or functional capacity of the children. Participation of children with disability is partly a product of their environment. [source] Living with a child with a severe orofacial handicap: experiences from the perspectives of parentsEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2003Ulrika Trulsson Orofacial functions include competences/abilities such as eating, breathing, speech/language, mimicry, as well as oral health, and disturbances are common in children with rare disorders. To describe parental experiences of orofacial function and needs in children with rare disorders, in-depth interviews focusing on orofacial function were carried out with 14 parents. Interviews were transcribed verbatim and analysed in open, axial (theoretical) and selective coding processes according to Grounded Theory. Two core categories emerged from data in the analysis: ,the vulnerable family' and ,support perceived from others'. The data indicated the importance of a balance between these two core categories: the strain caused by living in a family with a child with a severe disability/handicap, and the availability of perceived support from caregivers and significant others. This balance was necessary for the parents in developing self-reliance and in reconciling themselves to their life situations. Parents described orofacial dysfunction in terms of feeding and communication problems, needs for orthodontic treatment to reduce risk of trauma or improve chewing, and drooling. Oral health issues such as dental caries and gingivitis were not mentioned. Five aspects of good professional attitude were recognized: respect, involvement, continuity, knowledge, and availability. [source] Graphical models for coded data transmission over inter-symbol interference channelsEUROPEAN TRANSACTIONS ON TELECOMMUNICATIONS, Issue 4 2004Michael Tüchler We derive graphical models for coded data transmission over channels introducing inter-symbol interference. These models are factor graph descriptions of the transmitter section of the communication system, which serve at the same time as a framework to define the corresponding receiver. The graph structure governs the complexity and nature (e.g. non-iterative, iterative) of the receiver algorithm. A particular graph yields several algorithms optimizing various cost functions depending on the choice of messages communicated along the edges of the graph. We study these different outcomes of message passing and how the corresponding receiver algorithms are related to existing ones. We also devise strategies to find suitable graphs for communication problems of interest. Copyright © 2004 AEI [source] Working on the interface: identifying professional responses to families with mental health and child-care needsHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2003Nicky Stanley BA MA MSc CQSW Abstract The gaps between mental health and child-care services constitute a recognised barrier to providing effective services to families where parents have mental health problems. Recent guidance exhorts professionals to coordinate and collaborate more consistently in this area of work. The present study aimed to identify the barriers to inter-professional collaboration through a survey of 500 health and social care professionals. The views of 11 mothers with severe mental health problems whose children had been subject to a child protection case conference were also interrogated through two sets of interviews. The study found that communication problems were identified more frequently between child care workers and adult psychiatrists than between other groups. Communication between general practitioners and child-care workers was also more likely to be described as problematic. While there was some support amongst practitioners for child-care workers to assume a coordinating or lead role in such cases, this support was not overwhelming, and reflected professional interests and alliances. The mothers themselves valued support from professionals whom they felt were ,there for them' and whom they could trust. There was evidence from the responses of child-care social workers that they lacked the capacity to fill this role in relation to parents and their statutory child-care responsibilities may make it particularly difficult for them to do so. The authors recommend that a dyad of workers from the child-care and community mental health services should share the coordinating key worker role in such cases. [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] HYPERTENSION MANAGEMENT: LIFESTYLE INTERVENTIONS IN A TRANSCULTURAL CONTEXTJOURNAL OF RENAL CARE, Issue 4 2009Tai Mooi Ho SUMMARY Hypertension is a risk factor for cardiovascular and kidney diseases. According to estimation, the prevalence of hypertension will increase unless extensive and effective preventive measures are implemented. The diversity of languages and cultures of the hypertensive patients requiring adequate blood pressure control make communications difficult in many instances. Nursing intervention for patients to adopt a healthy lifestyle requires effective communication. But the communication problems encountered in a culturally diverse context can result in undesirable outcomes for the patients and the health-care team. This paper describes the production of a document to assist staff address the difficulty in intercultural communication, which could be used anywhere in the world. This document can facilitate nursing intervention to achieve optimal hypertension management in a transcultural context, responding to the challenge regarding preventive measures to halt increase in hypertension prevalence. [source] Old English Literature and Feminist Theory: A State of the FieldLITERATURE COMPASS (ELECTRONIC), Issue 6 2008Mary Dockray-Miller Feminist and gender scholars working in Anglo-Saxon studies in the past ten years have been asking new and important questions of a variety of Old English and Anglo-Latin texts. Most crucially, this interdisciplinary new work redefines the historiographical paradigms of Anglo-Saxon cultural production and reception so that women must now be regularly included in discussions of Anglo-Saxon cultural agency. This paradigm shift can and should inform broader cultural understandings of the history of gender relations, despite current communication problems among the varied subfields of medieval studies and gender studies. Furthermore, the pedagogy of both medievalists and faculty specializing in later periods must be informed by this shift as well. [source] Routine and adaptive expert strategies for resolving ICT mediated communication problems in the team settingMEDICAL EDUCATION, Issue 7 2009Lara Varpio Context, The use of information and communication technologies (ICTs) for supporting interprofessional communication is becoming increasingly common in health care. However, little research has explored how ICTs affect interprofessional communication, or how novices are trained to be effective interprofessional ICT users. This study explores the interprofessional communication strategies of nurses and doctors (trainees and experts) when their communications were mediated by a specific ICT: an electronic patient record (EPR). Methods, A total of 72 doctors and nurses participated in this 8-month study on a paediatric in-patient ward. Eighty hours of non-participant observations and 20 semi-structured interviews were conducted. All data were rendered anonymous prior to analysis. Using a constructivist grounded theory approach, one researcher read and analysed all data recursively. As emergent themes were identified, exemplary portions of the data were discussed with three additional researchers to resolve discrepancies and confirm the coding structure. Expertise literatures informed the final analyses. Results, Three interprofessional communication strategies were identified: (i) all participants routinely formulated ,workarounds' to circumvent problematic EPR-mediated communications; (ii) workarounds were classifiable as instances of Abandoning, Forcing or Submitting to the EPR, and (iii) novices learned workaround strategies through an informal curriculum, but they did not learn to manage the interprofessional effects of these workarounds. Conclusions, Trainees relied on workarounds as simplified routines, demonstrating routine expertise. Staff members, demonstrating adaptive expertise, used workarounds as part of a broader network of people and communication tools. Explicit training regarding this network and the ways in which workarounds conceal this network may help trainees develop adaptive expertise. [source] On-again/off-again dating relationships: How are they different from other dating relationships?PERSONAL RELATIONSHIPS, Issue 1 2009RENÉ M DAILEY This article explores the understudied yet prevalent phenomenon of on-again/off-again (on-off) dating relationships. Study 1 (N= 445 U.S. college students) showed that almost two thirds of participants had experienced an on-off relationship. Analyses of open-ended responses about relationship experiences showed on-off partners were less likely to report positives (e.g., love and understanding from partners) and more likely to report negatives (e.g., communication problems, uncertainty) than partners who had not broken up and renewed. Study 2 (N= 236), employing quantitative measures, substantiated these findings and further showed a greater number of renewals was associated with greater negatives and fewer positives. Results highlight the need for further investigation regarding on-off relationships, and theories potentially useful in explaining these relationships are discussed. [source] Original Article: Audit of severe acute maternal morbidity describing reasons for transfer and potential preventability of admissions to ICUAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2010Beverley A. LAWTON Background:, Maternal mortality is a rare event in the developed world. Assessment of severe acute maternal morbidity (SAMM) is therefore an appropriate measure of the quality of maternity care. Aims:, The aim of the study was to conduct a retrospective audit of SAMM cases (pregnant women admitted to a New Zealand Intensive Care Unit) to describe clinical, socio-demographic characteristics, pregnancy outcomes and preventability. Methods:, Severe acute maternal morbidity cases were reviewed by a multidisciplinary panel to determine reasons for admission to ICU, to classify organ-system dysfunction and to determine whether the SAMM case was preventable or not. Inclusion criteria were: admission to ICU between 2005 and 2007 during pregnancy or within 42 days of delivery. Results:, Twenty-nine SAMM cases were reviewed, of which 10 (35%) were deemed preventable. The most common reasons for transfer to ICU were: the need for invasive vascular monitoring, hypotension and disseminated intravascular coagulation. The most frequent types of preventable events were: inadequate diagnosis/recognition of high-risk status, inappropriate treatment, communication problems and inadequate documentation. All five SAMM cases of septicaemia were deemed preventable. Of the ten preventable cases, three were Maori (50% of the Maori in total audit), four were Pacific (67% of the Pacific in total audit) and three were women of ,other' ethnicities (17.6%, 3 of 17 in the audit). Conclusions:, An audit of SAMM cases describing reasons for transfer to ICU and preventability is feasible. We recommend that a prospective national SAMM audit process be introduced in New Zealand as a quality of care measure. [source] Mobbing against nurses in the workplace in TurkeyINTERNATIONAL NURSING REVIEW, Issue 3 2010S.Y. Efe msn EFE S.Y. & AYAZ S. (2010) Mobbing against nurses in the workplace in Turkey. International Nursing Review57, 328,334 Aim:, The aim of the study was to determine whether the nurses have been exposed to mobbing or not, and to reveal the causes of the mobbing between 3 November 2008 and 31 December 2008. Methods:, This research was a mixed method study involving survey and focus group interviews. The sample was calculated using sample calculation formula, and 206 nurses were included in the survey study. Four focus group interviews were later carried out with 16 nurses. The survey method and semi-structured question form were used to collect data. The percentage and chi-square were used to evaluate the quantitative data, and for the analysis of the qualitative data, descriptive analyses were made through direct quotations from the nurses' statements. Findings:, According to the mobbing scale, 9.7% of the nurses had been exposed to mobbing, but according to their own declarations, 33% had been exposed. Some of the nurses (25.2%) who expressed that they had been exposed to mobbing reported that the executor of mobbing was the head nurse and 9.2% said that the reason for mobbing was ,communication problems'. Nurses under 25 years of age and those who work in intensive care units are apparently exposed to mobbing more frequently than others (P < 0.05). Conclusions:, It is suggested that head nurses' mobbing behaviours should be determined and they should be educated about leadership. Nurses should be educated about assertiveness to prevent mobbing. The necessary measures should be adopted to solve the ,communication problems', which are shown as a major reason for mobbing. [source] Improper coloring of unit disk graphsNETWORKS: AN INTERNATIONAL JOURNAL, Issue 3 2009Frédéric Havet Abstract Motivated by a satellite communications problem, we consider a generalized coloring problem on unit disk graphs. A coloring is k -improper if no more than k neighbors of every vertex have the same colour as that assigned to the vertex. The k -improper chromatic number ,k(G) is the least number of colors needed in a k -improper coloring of a graph G. The main subject of this work is analyzing the complexity of computing ,k for the class of unit disk graphs and some related classes, e.g., hexagonal graphs and interval graphs. We show NP-completeness in many restricted cases and also provide both positive and negative approximability results. Because of the challenging nature of this topic, many seemingly simple questions remain: for example, it remains open to determine the complexity of computing ,k for unit interval graphs. © 2009 Wiley Periodicals, Inc. NETWORKS, 2009 [source] | ||||||||||