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Widyawati IY, Nursalam N, Kusnanto K, Hargono R, Hsieh PL. Grieving as an Internal Factor of Nurse-Patient Interaction in a Dialysis Unit. JURNAL NERS 2018. [DOI: 10.20473/jn.v13i1.8005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: The quality of the nurse-patient interaction is one factor that affects the patient adherence, but a study that provides an overview of factors in the nurse-patient interaction in improving or maintaining dialysis patient adherence has not been found. The aim of this study was to provide an overview of the various factors involved in the interaction process between nurses and patients undergoing dialysis in relation to their adherence to fluid and dietary restrictions.Methods: A qualitative research design with an interpretive phenomenology approach was used in this study. The researcher intends to interpret the findings of the research, in this case the activity of the dialysis patients, in order to get a picture of the various factors involved in the process of interaction between nurse and dialysis patient. The unit of analysis used in this study was the disclosure or exposure of the internal factors of the nurse-patient interaction process, especially in relation to fluid and dietary restrictions. There were 15 participants who were selected based on the inclusion criteria. In-depth interviews, with field notes, were used in this study as the data collection method.Results: The analysis of the theme based on the goal of the research includes grieving, needs and values/morals, but in this article, the researchers only describe one theme - grieving.Conclusion: This result provides an overview of the findings on nurse-patient interaction factors that can serve as baseline data for the development of nursing care, both in nursing assessments and interventions aimed at improving dietary adherence and the fluid restriction of dialysis patients.
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Evans EC. Exploring the Nuances of Nurse-Patient Interaction through Concept Analysis: Impact on Patient Satisfaction. Nurs Sci Q 2017; 29:62-70. [PMID: 26660778 DOI: 10.1177/0894318415614904] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Patient satisfaction is a major priority in healthcare. Nurse-patient interaction has a direct effect on patient satisfaction and is essential to the provision of nursing care. Using the Avant and Walker method of concept analysis, the author explores what shapes nurse-patient interaction; the defining attributes, antecedents, consequences and empirical referents. In addition, cases are provided that illustrate various types of nurse-patient interaction. The author also discusses the concept of nurse-patient interaction in light of current nursing research trends and priorities, adding to the base of nursing knowledge that will facilitate the highest quality nursing care and patient satisfaction.
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Affiliation(s)
- Emily C Evans
- Clinical Assistant Professor, University of Virginia
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Bentley M, Stirling C, Robinson A, Minstrell M. The nurse practitioner-client therapeutic encounter: an integrative review of interaction in aged and primary care settings. J Adv Nurs 2016; 72:1991-2002. [DOI: 10.1111/jan.12929] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Michael Bentley
- School of Health Sciences; University of Tasmania; Hobart Tasmania Australia
| | - Christine Stirling
- School of Health Sciences; University of Tasmania; Hobart Tasmania Australia
| | - Andrew Robinson
- Wicking Dementia Research and Education Centre; University of Tasmania; Hobart Tasmania Australia
| | - Melinda Minstrell
- Wicking Dementia Research and Education Centre; University of Tasmania; Hobart Tasmania Australia
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Giambra BK, Stiffler D, Broome ME. An integrative review of communication between parents and nurses of hospitalized technology-dependent children. Worldviews Evid Based Nurs 2014; 11:369-75. [PMID: 25230724 DOI: 10.1111/wvn.12065] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND With advances in health care, the population of children who are technology-dependent is increasing and, therefore, the need for nurses to understand how best to engage in communication with the parents of these children is critical. Shared communication between the parents of hospitalized technology-dependent children and their nurses is essential to provide optimal care for the child. The components and behaviors of the parent-nurse communication process that improve mutual understanding of optimal care for the child had not previously been examined. RESEARCH QUESTION Among parents of hospitalized technology-dependent children and their nurses, what communication behaviors, components, concepts, or processes improve mutual understanding of optimal care for the child? METHODS An integrative review of both qualitative and quantitative studies was conducted. Key words including communication, hospitalized, nurse, parent, pediatric, and technology-dependent were used to search databases such as Cumulative Index to Nursing and Allied Health and Medline for years 2000-2014. The data regarding the process of parent-nurse communication were extracted as they related to the mutual understanding of optimal care for the child. The data were grouped into themes and compared across studies, designs, populations, and settings. RESULTS Six articles were identified that provided information regarding the processes of shared communication among the parents of hospitalized technology-dependent children and their nurses. Providing clear information, involving parents in care decisions, trust and respect for each other's expertise, caring attitudes, advocacy, and role negotiation were all found to be important factors in shared parent-nurse communication. LINKING EVIDENCE TO ACTION The results of this integrative review inform our understanding of the parent-nurse communication process. The findings provide nurses with an understanding of strategies to better engage in respectful, engaging, and intentional communication with parents of hospitalized technology-dependent children and improve patient outcomes.
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Affiliation(s)
- Barbara K Giambra
- Evidence-Based Practice Mentor-Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Shafipour V, Mohammad E, Ahmadi F. Barriers to nurse-patient communication in cardiac surgery wards: a qualitative study. Glob J Health Sci 2014; 6:234-44. [PMID: 25363126 PMCID: PMC4825530 DOI: 10.5539/gjhs.v6n6p234] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 06/18/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND An appropriate and effective nurse-patient communication is of the most important aspect of caring. The formation and continuation of such a relationship depends on various factors such as the conditions and context of communication and a mutual understanding between the two. A review of the literature shows that little research is carried out on identification of such barriers in hospital wards between the patients and the healthcare staff. OBJECTIVES The present study was therefore conducted to explore the experiences of nurses and patients on communication barriers in hospital cardiac surgery wards. DESIGN AND METHODS This qualitative research was carried out using a content analysis method (Graneheim & Lundman, 2004). The participants were selected by a purposeful sampling and consist of 10 nurses and 11 patients from the cardiac surgery wards of three teaching hospitals in Tehran, Iran. Data was gathered by unstructured interviews. All interviews were audio-taped and transcribed verbatim. RESULTS Findings were emerged in three main themes including job dissatisfaction (with the sub-themes of workload tension and decreased motivation), routine-centered care (with the sub-themes of habitual interventions, routinized and technical interventions, and objective supervision), and distrust in competency of nurses (with the sub-themes of cultural contrast, less responsible nurses, and their apathy towards the patients). CONCLUSION Compared to other studies, our findings identified different types of communication barriers depending on the nursing settings. These findings can be used by the ward clinical nursing managers at cardiac surgery wards to improve the quality of nursing care.
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Burgoon JK, Proudfoot JG, Schuetzler R, Wilson D. Patterns of Nonverbal Behavior Associated with Truth and Deception: Illustrations from Three Experiments. JOURNAL OF NONVERBAL BEHAVIOR 2014. [DOI: 10.1007/s10919-014-0181-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ross-Davie MC, Cheyne H, Niven C. Measuring the quality and quantity of professional intrapartum support: testing a computerised systematic observation tool in the clinical setting. BMC Pregnancy Childbirth 2013; 13:163. [PMID: 23945049 PMCID: PMC3751507 DOI: 10.1186/1471-2393-13-163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 08/13/2013] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Continuous support in labour has a significant impact on a range of clinical outcomes, though whether the quality and quantity of support behaviours affects the strength of this impact has not yet been established. To identify the quality and quantity of support, a reliable means of measurement is needed. To this end, a new computerised systematic observation tool, the 'SMILI' (Supportive Midwifery in Labour Instrument) was developed.The aim of the study was to test the validity and usability of the 'Supportive Midwifery in Labour Instrument' (SMILI) and to test the feasibility and acceptability of the systematic observation approach in the clinical intrapartum setting. METHODS Systematic observation was combined with a postnatal questionnaire and the collection of data about clinical processes and outcomes for each observed labour.The setting for the study was four National Health Service maternity units in Scotland, UK. Participants in this study were forty five midwives and forty four women.The SMILI was used by trained midwife observers to record labour care provided by midwives. Observations were undertaken for an average of two hours and seventeen minutes during the active first stage of labour and, in 18 cases, the observation included the second stage of labour. Content validity of the instrument was tested by the observers, noting the extent to which the SMILI facilitated the recording of all key aspects of labour care and interactions. Construct validity was tested through exploration of correlations between the data recorded and women's feelings about the support they received. Feasibility and usability data were recorded following each observation by the observer. Internal reliability and construct validity were tested through statistical analysis of the data. RESULTS One hundred and four hours of labour care were observed and recorded using the SMILI during forty nine labour episodes. CONCLUSION The SMILI was found to be a valid and reliable instrument in the intrapartum setting in which it was tested. The study identified that the SMILI could be used to test correlations between the quantity and quality of support and outcomes. The systematic observational approach was found to be an acceptable and feasible method of enquiry.
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Affiliation(s)
- Mary C Ross-Davie
- Educational Projects Manager, Midwifery and Reproductive Health, NHS Education for Scotland, Westport 102Westport, Edinburgh EH3 9DN, UK
| | - Helen Cheyne
- Royal College of Midwives Professor of Midwifery & Professor of Maternal and Child Health Research, NMAHP Research Unit, University of Stirling, Stirling FK9 4LA, UK
| | - Catherine Niven
- Emeritus Professor, University of Stirling, Stirling FK9 4LA, UK
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Abstract
The aim of this study was to identify key aspects in the exchange of information and to determine how nurses communicate news to hospitalised children. For this study, we applied the critical incident technique with 30 children aged between 8 and 14 years. Data were collected in paediatric units in a hospital in Alicante (Spain) using participant observation and semi-structured interviews. The analysis yielded three main categories: the children's reaction to the information, nursing staff behaviour as a key aspect in the exchange of information and communication of news as well as children's experience. This article emphasises the need to promote children's consent and participation in nursing interventions. An analysis of these aspects will verify whether children's rights are being respected and taken into account in order to promote children's well-being and adaptation to hospitalisation.
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Paans W, Müller-Staub M, Nieweg R. The Influence of the Use of Diagnostic Resources on Nurses' Communication With Simulated Patients During Admission Interviews. Int J Nurs Knowl 2013; 24:101-107. [DOI: 10.1111/j.2047-3095.2013.01240.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Wolter Paans
- School of Nursing; Research and Innovation Group in Health Care and Nursing; Hanze University of Applied Sciences; Groningen; the Netherlands
- Research and Innovation Group in Health Care and Nursing; Hanze University of Applied Sciences; Groningen; the Netherlands
| | | | - Roos Nieweg
- School of Nursing; Research and Innovation Group in Health Care and Nursing; Hanze University of Applied Sciences; Groningen; the Netherlands
- Research and Innovation Group in Health Care and Nursing; Hanze University of Applied Sciences; Groningen; the Netherlands
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Xu Y, Staples S, Shen JJ. Nonverbal Communication Behaviors of Internationally Educated Nurses and Patient Care. Res Theory Nurs Pract 2012; 26:290-308. [DOI: 10.1891/1541-6577.26.4.290] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Because of language barriers and cultural differences, internationally educated nurses (IENs) face documented communication challenges in health care delivery. Yet, it is unknown how and to what extent nonverbal behaviors affect patient care because of research gap in the existing nursing literature. Methods: This is an exploratory study evaluating nonverbal communication behaviors of IENs interacting with standardized patients (SPs) in a controlled clinical setting through videotape analysis. Participants included 52 IENs from two community hospitals in the same hospital system in a southwestern metropolitan area in the United States. Twelve nonverbal behaviors were rated using a 4-point Likert scale with 4 indicating the best performance by the research team after watching videos of SP–IEN interactions. The global communication performance was also ranked in four areas: genuineness, spontaneity, appropriateness, and effectiveness. The relationships between these four areas and the nonverbal behaviors were explored. Finally, a qualitative analysis of two extreme cases was conducted and supplemented the quantitative findings. Results: The IENs received average scores under 2 in 5 out of the 12 nonverbal behaviors. They were “hugging” (1.06), “lowering body position to patient’s level” (1.07), “leaning forward” (1.26), “shaking hands” (1.64), and “therapeutic touch” (1.66). The top three scores were for “no distractive movement,” “eye contact,” and “smile” (3.80, 3.73, and 3.57, respectively). The average overall global impression score was 2.98. The average score for spontaneity was 2.80, which was significantly lower than the scores for genuineness (3.15), appropriateness (3.11), but comparable to the average score for effectiveness (2.85). Finally, therapeutic touch, interpersonal space, eye contact, smiling, and hugging were all significantly correlated with one or more of the global impression scores, with therapeutic touch showing moderate correlations with all of the scores as well as the overall global impression score. Implications: The IENs’ nonverbal behaviors in areas such as hugging, lowering body position to patient’s level, leaning forward, shaking hands, and therapeutic touch have room for improvement. Targeted interventions focusing on norms and expectations of nonverbal behaviors in the U.S. health care setting are called for to improve quality of care.
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Fakhr-Movahedi A, Salsali M, Negharandeh R, Rahnavard Z. A qualitative content analysis of nurse-patient communication in Iranian nursing. Int Nurs Rev 2011; 58:171-80. [PMID: 21554289 DOI: 10.1111/j.1466-7657.2010.00861.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Communication is the source of patients' health promotion, and nurses cannot do their duties without communicating with patients. Nurses with good communication skills have a great role in alleviating the stressful identity of hospitalization for both patients and their families. AIM To explore cultural and contextual factors influencing nurse-patient communication according to lived experiences of Iranian nurses and patients. METHODS The participants in this qualitative study consisted of eight bachelor's degree nurses and nine patients hospitalized in surgical and medical wards of a referral teaching hospital in Tehran, Iran. Data were gathered through unstructured and semi-structured interviews as well as observations. The data were analysed using a content analysis approach. FINDINGS The data analysis revealed the following theme that encompassed nurse-patient communication in Iranian nursing: 'a patient-centred attitude in the shadow of mechanistic structure'. This theme consisted of three categories: (1) communication as the essence of nursing care, (2) reactive communication and (3) difficulties of nurse-patient communication. CONCLUSION In spite of the nurses' and patients' belief in the importance of communication, in practice each party's role in communication leaves much to be desired. This is because of some structural and socio-cultural factors that hinder effective communication. More attention should be paid by policy makers to remove factors that hinder the nurse-patient communication process.
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Oguchi M, Jansen J, Butow P, Colagiuri B, Divine R, Dhillon H. Measuring the impact of nurse cue-response behaviour on cancer patients' emotional cues. PATIENT EDUCATION AND COUNSELING 2011; 82:163-168. [PMID: 20430567 DOI: 10.1016/j.pec.2010.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 03/03/2010] [Accepted: 04/02/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE This study aimed to explore the impact of nurse responses to patients' and family members' emotional cues and concerns during the chemotherapy education consultation. METHODS 51 cancer patients and 13 nurses participated in this study. Nurse-delivered chemotherapy education sessions were audio-recorded, and patients completed the EORTC QLQ-C30 V3.0 questionnaire before the education. The audio records were transcribed and coded. RESULTS Patients expressed their emotions more than family members, but patients' cues decreased when family were present. Patients with lower emotional wellbeing (greater psychological distress) prior to the consultation did not express more cues/concerns. Nurses responded to patients' and families' cues equally in a cue-facilitative fashion. Facilitative responses were associated with decreased patients' cues. CONCLUSION Family presence appears to hinder patients' cues/concerns. Nurses' PS responses were associated with less cues/concerns by patients. PRACTICE IMPLICATION The current study challenges the common assumption that a higher number of cues is indicative of effective consultation, and indicates the influence of family in patients' cues/concerns.
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Affiliation(s)
- Mayumi Oguchi
- School of Psychology, University of Sydney, NSW, Australia
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Jansen J, van Weert JCM, de Groot J, van Dulmen S, Heeren TJ, Bensing JM. Emotional and informational patient cues: the impact of nurses' responses on recall. PATIENT EDUCATION AND COUNSELING 2010; 79:218-24. [PMID: 20005066 DOI: 10.1016/j.pec.2009.10.010] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Revised: 09/27/2009] [Accepted: 10/03/2009] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To investigate older cancer patients' informational and emotional cues, how nurses respond to these cues and the effect of cues and responses on patients' information recall. METHODS 105 cancer patients (aged >or=65 years) completed a recall questionnaire after an educational session preceding chemotherapy treatment. Recall was checked against the actual communication in videorecordings of the consultations. Patients' emotional and informational cues and subsequent responses by the nurse were rated using an adaptation of the Medical Interview Aural Rating Scale (MIARS). RESULTS Patients gave more informational than emotional cues. The most frequent response to emotional cues was distancing followed by acknowledgement. Nurses gave appropriate information in response to the majority of informational cues. Patients' expression of emotional or informational cues did not influence recall; neither did nurses' responses to informational cues. Responses to emotional cues did affect recall. The more nurses responded by giving 'minimal' encouragements (e.g. 'Hmmm'), the more patients recalled, while distancing responses (e.g. switching focus) were associated with lower recall scores. CONCLUSION Responding to patients' emotions is likely to impact information recall. PRACTICE IMPLICATIONS These results highlight the importance of addressing patients' expressions of emotions in the context of patient education, as it enhances information recall.
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Affiliation(s)
- Jesse Jansen
- Screening and Test Evaluation Program, Sydney School of Public Health, Centre for Medical Psychology and Evidence-based Decision-Making, University of Sydney, NSW, Australia
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Son HM. [Evaluation of nurses' competency in nurse-patient communication about medications: conversational analysis approach]. J Korean Acad Nurs 2010; 40:1-13. [PMID: 20220276 DOI: 10.4040/jkan.2010.40.1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to develop evaluation criteria for conversations about medication and to demonstrate conversational analysis with actual dialogues on medication as examples. METHODS This study was a secondary analysis of qualitative research using conversational analysis which showed functional phases and patterns of dialogue about medication (greeting, identifying the patient, medicating, finishing). Nurse-patient conversations were videotaped and transcribed and 75 conversations were used for analysis. RESULTS Not all functional phases were showed in the conversations about medication. Therefore, conversations about medication can be considered as incomplete dialogues. The evaluation-criteria were represented in terms of the structure and content of the dialogues. Structural evaluation-criteria were the same as the functional phases, as functional stage is the standard for evaluation. The criteria of evaluation for content suggested 3 domains, content, expression, and interaction with 20 items scored on a Likert-type scale of 5-points. Finally, analysis of actual conversations about medication according to the evaluative criteria were provided. CONCLUSION The results provide the basic data to develop educational programs and strategies to improve nurses' competency in conversation about medication.
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Affiliation(s)
- Haeng Mi Son
- Department of Nursing, University of Ulsan, Nam-gu, Ulsan, Korea.
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Salah AA, Pauwels E, Tavenard R, Gevers T. T-Patterns revisited: mining for temporal patterns in sensor data. SENSORS 2010; 10:7496-513. [PMID: 22163613 PMCID: PMC3231168 DOI: 10.3390/s100807496] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Revised: 02/23/2010] [Accepted: 07/23/2010] [Indexed: 11/17/2022]
Abstract
The trend to use large amounts of simple sensors as opposed to a few complex sensors to monitor places and systems creates a need for temporal pattern mining algorithms to work on such data. The methods that try to discover re-usable and interpretable patterns in temporal event data have several shortcomings. We contrast several recent approaches to the problem, and extend the T-Pattern algorithm, which was previously applied for detection of sequential patterns in behavioural sciences. The temporal complexity of the T-pattern approach is prohibitive in the scenarios we consider. We remedy this with a statistical model to obtain a fast and robust algorithm to find patterns in temporal data. We test our algorithm on a recent database collected with passive infrared sensors with millions of events.
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Affiliation(s)
- Albert Ali Salah
- Informatics Institute, University of Amsterdam, Science Park 107, 1098 XG, Amsterdam, The Netherlands
- Author to whom correspondence should be addressed; E-Mail: ; Tel. +31-20-525-7550
| | - Eric Pauwels
- CWI, Science Park 123, 1098 XG, Amsterdam, The Netherlands; E-Mail:
| | - Romain Tavenard
- University of Rennes 1 - IRISA, 35042 Rennes Cedex, France; E-Mail:
| | - Theo Gevers
- Informatics Institute, University of Amsterdam, Science Park 107, 1098 XG, Amsterdam, The Netherlands
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UITTERHOEVE R, BENSING J, GROL R, DEMULDER P, VAN ACHTERBERG T. The effect of communication skills training on patient outcomes in cancer care: a systematic review of the literature. Eur J Cancer Care (Engl) 2009; 19:442-57. [DOI: 10.1111/j.1365-2354.2009.01082.x] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Turner J, Clavarino A, Butow P, Yates P, Hargraves M, Connors V, Hausmann S. Enhancing the capacity of oncology nurses to provide supportive care for parents with advanced cancer: Evaluation of an educational intervention. Eur J Cancer 2009; 45:1798-806. [DOI: 10.1016/j.ejca.2009.02.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2008] [Revised: 02/24/2009] [Accepted: 02/26/2009] [Indexed: 11/29/2022]
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Lamiani G, Furey A. Teaching nurses how to teach: an evaluation of a workshop on patient education. PATIENT EDUCATION AND COUNSELING 2009; 75:270-273. [PMID: 19027259 DOI: 10.1016/j.pec.2008.09.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Revised: 09/10/2008] [Accepted: 09/17/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To evaluate the effects of a patient education workshop on nurses: (1) communication skills; (2) Knowledge of patient-centered model, patient education process, and sense of preparedness to provide patient education. METHODS Fourteen nurses attended a 2-day workshop on patient education based on a patient-centered model. Data on communication skills were collected by means of pre-/post-written dialogues and analyzed with the Roter Interaction Analysis System (RIAS). Data of nurses' knowledge and sense of preparedness were collected through a post questionnaire comprised of 5-point Likert scale items. RESULTS Post-dialogues showed an increase in patient talking (P<0.001) and in patient-centered communication as indicated by the increase in Psychosocial exchanges (P=0.003) and Process exchanges (P=0.001). Nurses reported that the workshop increased "very much" their knowledge of the patient-centered model (mean=4.19) and patient education process (mean=4.69), and their sense of preparedness to provide patient education (P=0.001). CONCLUSIONS Data suggest the efficacy of the workshop in developing patient-centered communication skills and improving nurses' knowledge and preparedness to deliver patient education. PRACTICE IMPLICATIONS Training based on a patient-centered model and interactive learning methods should be implemented for nurses to improve their ability to deliver effective patient education.
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Affiliation(s)
- Giulia Lamiani
- Center for Nursing Excellence, Brigham and Women's Hospital, Boston, MA 02120, USA
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Connor M, Fletcher I, Salmon P. The analysis of verbal interaction sequences in dyadic clinical communication: a review of methods. PATIENT EDUCATION AND COUNSELING 2009; 75:169-177. [PMID: 19097842 DOI: 10.1016/j.pec.2008.10.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Revised: 09/30/2008] [Accepted: 10/07/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To identify methods available for sequential analysis of dyadic verbal clinical communication and to review their methodological and conceptual differences. METHODS Critical review, based on literature describing sequential analyses of clinical and other relevant social interaction. RESULTS Dominant approaches are based on analysis of communication according to its precise position in the series of utterances that constitute event-coded dialogue. For practical reasons, methods focus on very short-term processes, typically the influence of one party's speech on what the other says next. Studies of longer-term influences are rare. Some analyses have statistical limitations, particularly in disregarding heterogeneity between consultations, patients or practitioners. Additional techniques, including ones that can use information about timing and duration of speech from interval-coding are becoming available. CONCLUSION There is a danger that constraints of commonly used methods shape research questions and divert researchers from potentially important communication processes including ones that operate over a longer-term than one or two speech turns. Given that no one method can model the complexity of clinical communication, multiple methods, both quantitative and qualitative, are necessary. PRACTICE IMPLICATIONS Broadening the range of methods will allow the current emphasis on exploratory studies to be balanced by tests of hypotheses about clinically important communication processes.
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Affiliation(s)
- Martin Connor
- Division of Clinical Psychology, University of Liverpool, Liverpool L69 3GB, United Kingdom
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Leydon GM. ‘Yours is potentially serious but most of these are cured’: optimistic communication in UK outpatient oncology consultations. Psychooncology 2008; 17:1081-8. [DOI: 10.1002/pon.1392] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Brunero S, Lamont S, Myrtle L, Fairbrother G. The Blue Card: a hand-held health record card for mental health consumers with comorbid physical health risk. Australas Psychiatry 2008; 16:238-43. [PMID: 18608170 DOI: 10.1080/10398560801979222] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We aimed to determine the effectiveness of a hand-held record (the 'Blue Card') for seriously mentally ill consumers by investigating effects on consumer knowledge of physical health risk factors, consumer involvement in care and communication with healthcare professionals. METHOD Consumers were given and educated in the use of the Blue Card, which contained information regarding their physical health. Consumers completed a pre- and post-knowledge questionnaire and commented on the effectiveness of the Blue Card with respect to their knowledge of physical health risks. RESULTS Statistically significant improvements in consumer knowledge were shown at the 3-month follow-up, with high retention of the Blue Card being demonstrated. Consumers that used the card described their use of the card positively. CONCLUSIONS The results are very encouraging. Further studies of this low-cost intervention are warranted to establish its effectiveness and utility.
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Affiliation(s)
- Scott Brunero
- Department of Liaison Mental Health Nursing, Prince of Wales Hospital, Randwick, NSW, Australia.
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Uitterhoeve R, De Leeuw J, Bensing J, Heaven C, Borm G, DeMulder P, Van Achterberg T. Cue‐responding behaviours of oncology nurses in video‐simulated interviews. J Adv Nurs 2007; 61:71-80. [DOI: 10.1111/j.1365-2648.2007.04467.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ruud Uitterhoeve
- Ruud Uitterhoeve MScN RN Researcher Centre for Quality of Care Research, Nursing Science, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Jacqueline De Leeuw
- Jacqueline de Leeuw MScN RN Researcher Neurosensoric Cluster, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Jozien Bensing
- Jozien Bensing PhD Professor of Clinical and Health Psychology Department of Health Psychology, Utrecht University and Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Cathy Heaven
- Cathy Heaven PhD RN Researcher and Communication Skills Tutor Maguire Communication Skills Training Unit, Christie Hospital, Manchester, UK
| | - George Borm
- George Borm PhD Associate Professor in Statistics Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Pieter DeMulder
- Pieter deMulder (deceased) MD PhD Professor Medical Oncology Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Theo Van Achterberg
- Theo van Achterberg PhD RN Professor Nursing Science Centre for Quality of Care Research, Nursing Science, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Kaner E, Heaven B, Rapley T, Murtagh M, Graham R, Thomson R, May C. Medical communication and technology: a video-based process study of the use of decision aids in primary care consultations. BMC Med Inform Decis Mak 2007; 7:2. [PMID: 17214891 PMCID: PMC1781432 DOI: 10.1186/1472-6947-7-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2006] [Accepted: 01/10/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Much of the research on decision-making in health care has focused on consultation outcomes. Less is known about the process by which clinicians and patients come to a treatment decision. This study aimed to quantitatively describe the behaviour shown by doctors and patients during primary care consultations when three types of decision aids were used to promote treatment decision-making in a randomised controlled trial. METHODS A video-based study set in an efficacy trial which compared the use of paper-based guidelines (control) with two forms of computer-based decision aids (implicit and explicit versions of DARTS II). Treatment decision concerned warfarin anti-coagulation to reduce the risk of stroke in older patients with atrial fibrillation. Twenty nine consultations were video-recorded. A ten-minute 'slice' of the consultation was sampled for detailed content analysis using existing interaction analysis protocols for verbal behaviour and ethological techniques for non-verbal behaviour. RESULTS Median consultation times (quartiles) differed significantly depending on the technology used. Paper-based guidelines took 21 (19-26) minutes to work through compared to 31 (16-41) minutes for the implicit tool; and 44 (39-55) minutes for the explicit tool. In the ten minutes immediately preceding the decision point, GPs dominated the conversation, accounting for 64% (58-66%) of all utterances and this trend was similar across all three arms of the trial. Information-giving was the most frequent activity for both GPs and patients, although GPs did this at twice the rate compared to patients and at higher rates in consultations involving computerised decision aids. GPs' language was highly technically focused and just 7% of their conversation was socio-emotional in content; this was half the socio-emotional content shown by patients (15%). However, frequent head nodding and a close mirroring in the direction of eye-gaze suggested that both parties were active participants in the conversation CONCLUSION Irrespective of the arm of the trial, both patients' and GPs' behaviour showed that they were reciprocally engaged in these consultations. However, even in consultations aimed at promoting shared decision-making, GPs' were verbally dominant, and they worked primarily as information providers for patients. In addition, computer-based decision aids significantly prolonged the consultations, particularly the later phases. These data suggest that decision aids may not lead to more 'sharing' in treatment decision-making and that, in their current form, they may take too long to negotiate for use in routine primary care.
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Affiliation(s)
- Eileen Kaner
- Institute of Health and Society, The Medical School, Newcastle University, NE2 4HH, UK
| | - Ben Heaven
- Institute of Health and Society, The Medical School, Newcastle University, NE2 4HH, UK
| | - Tim Rapley
- Institute of Health and Society, The Medical School, Newcastle University, NE2 4HH, UK
| | - Madeleine Murtagh
- Institute of Health and Society, The Medical School, Newcastle University, NE2 4HH, UK
| | - Ruth Graham
- Institute of Health and Society, The Medical School, Newcastle University, NE2 4HH, UK
| | - Richard Thomson
- Institute of Health and Society, The Medical School, Newcastle University, NE2 4HH, UK
| | - Carl May
- Institute of Health and Society, The Medical School, Newcastle University, NE2 4HH, UK
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Edwards N, Peterson WE, Davies BL. Evaluation of a multiple component intervention to support the implementation of a 'Therapeutic Relationships' best practice guideline on nurses' communication skills. PATIENT EDUCATION AND COUNSELING 2006; 63:3-11. [PMID: 16935459 DOI: 10.1016/j.pec.2006.07.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2006] [Revised: 07/26/2006] [Accepted: 07/31/2006] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To determine if there was an improvement in nurses' communication skills 5 months after a multiple component intervention to implement the Registered Nurses' Association of Ontario best practice guideline 'Establishing Therapeutic Relationships'. METHODS A matched pair, before and after design was used. Eight client scenarios with corresponding client comments were read aloud to nurses who were asked to respond verbally, as though they were interacting with the client. Responses were audio-taped and transcribed. The frequency and quality of nurses' active listening, initiating and assertiveness skills were measured pre- and post-implementation of the guideline. RESULTS Twenty-two nurses responded at both time points. Active listening skills were most frequently used. There was a statistically significant decrease in the number of active listening skills used, but a statistically significant improvement in the quality of active listening and initiating statements and frequency of initiating skills. CONCLUSION Nurses demonstrated improvements in selected communication skills following the implementation of a multiple component intervention that included a best practice guideline. PRACTICE IMPLICATIONS A combination of strategies that support the implementation of a best practice guideline is described. Results indicate some improvement in communication skills that are essential to the establishment of therapeutic nurse-client relationships.
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Affiliation(s)
- Nancy Edwards
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Canada
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van Dulmen S, Finset A, Langewitz W, Zimmermann C, Peltenburg M, Visser A, Bensing J. Five years of EACH (European Association for Communication in Healthcare). PATIENT EDUCATION AND COUNSELING 2006; 62:379-84. [PMID: 16859868 DOI: 10.1016/j.pec.2006.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2006] [Accepted: 06/01/2006] [Indexed: 05/11/2023]
Abstract
Five years after launching EACH (European Association for Communication in Healthcare) we look back at what EACH achieved so far and announce new ideas and activities EACH plans to carry out in the near future. During the past five years several scientific, educational as well as societal changes have taken place in the area of communication in healthcare that all underline the need for continued international collaboration in line with the activities employed by EACH so far. Within communication research the focus has shifted from counting communication utterances to unraveling sequences of patient cues and provider responses. In the field of teaching it is becoming more and more common to attend to the training of trainers as well. Within these developments, new areas of interest arise and need attention. To comply with these increasing demands, EACH invites new persons to become a member of one of the recently launched committees in the area of research, teaching and publishing.
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Affiliation(s)
- Sandra van Dulmen
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands.
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Tulsky JA. Interventions to Enhance Communication among Patients, Providers, and Families. J Palliat Med 2005; 8 Suppl 1:S95-102. [PMID: 16499474 DOI: 10.1089/jpm.2005.8.s-95] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Whether patient suffering is caused by physical symptoms, unwanted medical intervention, or spiritual crisis, the common pathway to relief is through a provider who is able to elicit these concerns and is equipped to help the patient and family address them. This paper reviews the current state of knowledge in communication at the end of life, organized according to a framework of information gathering, information giving, and relationship building; and then focuses on interventions to enhance communication among patients, providers, and families. Several observations emerge from the existing literature. Patients have highly individualized desires for information and we cannot predict patient preferences. Communication coding methodology has advanced significantly yet the current systems remain poorly understood and largely inaccessible. Physicians and other health care providers do not discuss sufficiently treatment options, quality of life or respond to emotional cues from patients, and there is plenty of room for improvement. On the positive side, we have also learned that physicians and other health care providers can be taught to communicate better through intensive communication courses, and that communication interventions can improve some patient outcomes. Finally, huge gaps remain in our current knowledge, particularly with regard to understanding the relationship between communication style and outcomes. These findings suggest several recommendations. We should create larger and more diverse datasets; improve upon the analysis of recorded communication data; increase our knowledge about patient preferences for information; establish a stronger link between specific communication behaviors and outcomes; and identify more efficient ways to teach providers communication skills.
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Affiliation(s)
- James A Tulsky
- Center for Palliative Care and the Department of Medicine, Duke University, and the Veterans Affairs Medical Center, Durham, North Carolina 27705, USA.
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