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Shand R, Foster A, Baker C, O'Halloran R. Identifying communication difficulty and context-specific communication supports for patient-provider communication in a sub-acute setting: A prospective mixed methods study. Int J Speech Lang Pathol 2024:1-20. [PMID: 38425157 DOI: 10.1080/17549507.2023.2289350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
PURPOSE To identify the sub-acute rehabilitation inpatients who have communication difficulty and the range of communication supports that can facilitate communicative success. METHOD A prospective cohort mixed methods study was conducted on two inpatient sub-acute rehabilitation wards. Nurses screened all new admissions for communication difficulty using the Inpatient Functional Communication Interview, Screening Questionnaire (IFCI-SQ). Patients identified as having communication difficulty were interviewed by a speech-language pathologist (SLP) using the Inpatient Functional Communication Interview (IFCI). During the interview, the SLP trialled different communication supports. The number of patients who had communication difficulty on the IFCI-SQ was calculated. The number and type of communication supports that improved communication within the patient-SLP interview were calculated. Deductive-dominant qualitative content analysis was conducted on the communication supports used during the IFCI. RESULT Seventy patients were screened. Nurses reported communication difficulty in 45/70 (64%) of patients. A total of 15/45 patients were interviewed by an SLP using the IFCI. The provision of communication supports improved communication for all patients within the context of the patient-SLP interview. CONCLUSION Many sub-acute rehabilitation inpatients have communication difficulty in the hospital setting. A range of communication supports facilitated communication. These insights could inform future communication partner training (CPT) programs.
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Affiliation(s)
- Rosalind Shand
- Monash Health, Melbourne, Australia
- Discipline of Speech Pathology, La Trobe University, Melbourne, Australia
| | - Abby Foster
- Monash Health, Melbourne, Australia
- Discipline of Speech Pathology, La Trobe University, Melbourne, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Caroline Baker
- Monash Health, Melbourne, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
| | - Robyn O'Halloran
- Discipline of Speech Pathology, La Trobe University, Melbourne, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
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Kuo CL, Tsai TH, Tung SM, Lin YE. The usability of an AAC pain description system for patients with acquired expressive communication disorders. Augment Altern Commun 2023; 39:61-72. [PMID: 37171186 DOI: 10.1080/07434618.2023.2206895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023] Open
Abstract
Augmentative and alternative communication (AAC) has been used by patients with acquired expressive communication disorders as an alternative to natural speech. The use of symbols to express pain, which is intangible, is challenging because designing a series of comprehensible symbols to represent personal experiences such as pain is not straightforward. This study describes (a) the development of symbols to express pain that were derived from Chinese pain-related similes and metaphors for an AAC mobile application developed specifically for this study known as PainDiary and (b) an assessment of the appropriateness of the app compared to conventional methods of collecting pain information. The symbols depicted headache pain and discomfort, which is prevalent among neurosurgical patients. The participants were 31 patients diagnosed with acquired expressive communication disorders who were receiving treatment in a neurosurgery general ward of Chang Gung Memorial Hospital in Taiwan and 14 nurses who worked on the ward. Pain information was collected by nurses using conventional methods and the PainDiary app. Assessment data, including the accuracy and efficiency of and user satisfaction with PainDiary, are compared. The results show that use of the app was effective in reporting pain and that patients required less time to report a pain event. The results further indicate that the PainDiary app was better received by younger individuals than by their older counterparts.
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Affiliation(s)
- Chen-Li Kuo
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Information Management, Chang Gung University, Taoyuan, Taiwan
| | - Tsai-Hsuan Tsai
- Department of Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Master of Science Degree Program in Innovation for Smart Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Visual Communication Design, Ming Chi University of Technology, New Taipei City, Taiwan
| | - Shen-Mei Tung
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yueh-E Lin
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Martín-Dorta WJ, García-Hernández AM, Delgado-Hernández J, Sainz-Fregel E, Miranda-Martín RC, Suárez-Pérez A, Jiménez-Álvarez A, Martín-Felipe E, Brito-Brito PR. Psychometric Testing of the CEECCA Questionnaire to Assess Ability to Communicate among Individuals with Aphasia. Int J Environ Res Public Health 2023; 20:3935. [PMID: 36900945 PMCID: PMC10001674 DOI: 10.3390/ijerph20053935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: The CEECCA questionnaire assesses the ability to communicate among individuals with aphasia. It was designed using the NANDA-I and NOC standardised nursing languages (SNLs), reaching high content validity index and representativeness index values. The questionnaire was pilot-tested, demonstrating its feasibility for use by nurses in any healthcare setting. This study aims to identify the psychometric properties of this instrument. (2) Methods: 47 individuals with aphasia were recruited from primary and specialist care facilities. The instrument was tested for construct validity and criterion validity, reliability, internal consistency, and responsiveness. The NANDA-I and NOC SNLs and the Boston test were used for criterion validity testing. (3) Results: five language dimensions explained 78.6% of the total variance. Convergent criterion validity tests showed concordances of up to 94% (Cohen's κ: 0.9; p < 0.001) using the Boston test, concordances of up to 81% using DCs of NANDA-I diagnoses (Cohen's κ: 0.6; p < 0.001), and concordances of up to 96% (Cohen's κ: 0.9; p < 0.001) using NOC indicators. The internal consistency (Cronbach's alpha) was 0.98. Reliability tests revealed test-retest concordances of 76-100% (p < 0.001). (4) Conclusions: the CEECCA is an easy-to-use, valid, and reliable instrument to assess the ability to communicate among individuals with aphasia.
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Affiliation(s)
| | | | | | - Estela Sainz-Fregel
- Primary Care Management of Tenerife, The Canary Islands Health Service, 38400 Puerto de la Cruz, Spain
| | | | - Alejandra Suárez-Pérez
- Rehabilitation Department, University Hospital of the Canary Islands, The Canary Islands Health Service, 38320 San Cristóbal de La Laguna, Spain
| | - Alejandra Jiménez-Álvarez
- Rehabilitation Department, University Hospital of the Canary Islands, The Canary Islands Health Service, 38320 San Cristóbal de La Laguna, Spain
| | - Elena Martín-Felipe
- Neurology Department, Nuestra Señora de la Candelaria University Hospital, The Canary Islands Health Service, 38010 Santa Cruz de Tenerife, Spain
| | - Pedro-Ruymán Brito-Brito
- Training and Research in Care, Primary Care Management Board of Tenerife, The Canary Islands Health Service, Department of Nursing, University of La Laguna, 38200 San Cristóbal de La Laguna, Spain
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4
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Woodring F, Harmon MT. Augmentative and alternative communication (AAC) for nursing students; equipping the next generation of nursing professionals. Nurse Educ Today 2023; 121:105662. [PMID: 36470039 DOI: 10.1016/j.nedt.2022.105662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 11/05/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Augmentative and alternative communication (AAC) is often used for patients who are temporarily non-speaking. However, considering AAC for these patients in intensive care units (ICUs) has only recently started to gain the attention of health care providers in the hospital setting. Currently, few nursing programs include content in their curricula as relates to this population. OBJECTIVES To investigate the feasibility of embedding a brief inservice into an existing undergraduate nursing course, and to determine the feasibility and relevance of AAC use during their clinical ICU rotation. DESIGN A longitudinal survey study using three time points: pre- and post-inservice, and post implementation following a clinical rotation. SETTING University nursing program classroom during an Adult Health and Illness course. PARTICIPANTS Twenty-seven undergraduate nursing students enrolled in the Adult Health and Illness course. METHODS The participants were given a brief inservice educating them on the use of AAC. The students were given AAC boards to use during their ICU clinical rotation. Survey data was collected before and after the inservice and at the end of the clinical rotation. RESULTS Pre-service nursing students responded favorably to a brief inservice embedded into an existing nursing course. Survey data indicated an increase in the students' knowledge of AAC (z = 4.52, p < .05) and awareness that AAC can improve communication between patients and staff (z = 2.24, p < .05). CONCLUSION An interdisciplinary activity between Communication Sciences and Disorders and Nursing departments about AAC could be a new and promising solution to increase communication with non-speaking patients in the ICU.
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Affiliation(s)
- Faith Woodring
- Speech Language Pathologist, Woodring Services LLC, United States of America.
| | - Mary Towle Harmon
- Communication Sciences and Disorders, Northern Arizona University, Flagstaff, United States of America
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5
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Murray S, Hopf SC. Attitudes toward the use of low-tech AAC in acute settings: a systematized review. Augment Altern Commun 2022; 38:184-195. [PMID: 36128661 DOI: 10.1080/07434618.2022.2122870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The purpose of this systematized review was to investigate how attitudes toward low-tech AAC might be impacting its use in acute care settings. A comprehensive and systematic search of databases identified 23 articles for inclusion. Thematic analysis using the World Health Organization International Classification of Functioning, Disability and Health (ICF) framework facilitated a narrative synthesis of findings. Results suggest that in acute care settings (a) adult patients, families, nursing staff, medical team, and allied health professionals all have opportunities to use but do not regularly engage with AAC; (b) individuals reject low-tech AAC devices for a variety of reasons, including that they are not useful, necessary, suitable, or appropriate in settings such as intensive care units; (c) negative attitudes toward AAC are linked to a lack of initial training and ongoing support, perceived impersonal content, limited functionality, and a lack of consistent availability; and (d) positive attitudes toward low-tech AAC are more prevalent when training and support are offered, low-tech AAC effectiveness is demonstrated, and organizational, financial, and procedural commitments are provided. Limitations of the research are highlighted and future research opportunities are identified.
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Affiliation(s)
- Shaeron Murray
- Independent Rehabilitation Services, Carnegie, Australia.,Charles Sturt University, Albury, Australia
| | - Suzanne C Hopf
- Speech Pathology Department, School of Community Health, Charles Sturt University, Albury, Australia
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6
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Adam D, Kyzas P, Vassiliou L. Text-to-speech apps: empowering communication in head and neck patients. Br J Oral Maxillofac Surg 2021:S0266-4356(21)00354-5. [PMID: 35183370 DOI: 10.1016/j.bjoms.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 11/21/2022]
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7
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Avagyan A, Mkrtchyan H, Shafa FA, Mathew JA, Petrosyan T. Effectiveness and Determinant Variables of Augmentative and Alternative Communication Interventions in Cerebral Palsy Patients with Communication Deficit: a Systematic Review. Codas 2021; 33:e20200244. [PMID: 34378726 DOI: 10.1590/2317-1782/20202020244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/20/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Assess the effectiveness of augmentative and alternative communication (AAC) interventions in patients with CP and to reveal determinant variables of main intervention outcomes: receptive and expressive language. RESEARCH STRATEGIES The search was performed in following databases: MEDLINE (Ovid); PubMed (NLM); Embase (Ovid); Cochrane Database of Systematic Reviews; Cumulative Index to Nursing and Allied Health Literature; Database of Abstracts of Reviews of Effects; Cochrane Central Register of Controlled Trials; Health Technology Assessment database and PEDro. SELECTION CRITERIA Full-text and peer-reviewed studies in English studying the effectiveness of AAC in patients with cerebral palsy were included. Studies with patients (<18 years) diagnosed with CP were included. DATA ANALYSIS A narrative analysis was conducted to evaluate the efficacy of AAC methods. A random-effects model meta-analysis was used to assess determinants of AAC intervention outcomes. RESULTS The online database and manual reference search revealed 445 records. Nine studies investigating a total of 294 subjects with CP met predefined eligibility criteria: 4 studies with single subject, multiple baseline research designs, 3 longitudinal cohort studies, 1 case control study and 1 case series. Results revealed moderate-quality evidence that AAC interventions improve the receptive and expressive communication skills in patients with CP. The random-effects model meta-analysis revealed the power of identified determinant variables affecting the AAC intervention outcomes. CONCLUSION Diversity of CP patients requires proper analysis of determinant variables to ensure the efficacy of AAC assessment and intervention. More studies of high methodological and practical quality assessing the efficacy of AAC interventions are needed to clarify the evidence.
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Affiliation(s)
| | - Hasmik Mkrtchyan
- Department of Speech and Rehabilitation Therapy, Armenian State Pedagogical University after Khachatur Abovyan - ASPU - Yerevan, Armenia
| | - Fatemeh Alsadat Shafa
- Technologies for Management of Health Ltd - Yerevan, Armenia.,School of Medicine, Yerevan Haybusak University - Yerevan, Armenia
| | - Joan Alexandra Mathew
- Technologies for Management of Health Ltd - Yerevan, Armenia.,School of Public Health, American University of Armenia - Yerevan, Armenia
| | - Tigran Petrosyan
- Department of Speech and Rehabilitation Therapy, Armenian State Pedagogical University after Khachatur Abovyan - ASPU - Yerevan, Armenia.,Technologies for Management of Health Ltd - Yerevan, Armenia
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Kuyler A, Johnson E. Patient and nurse content preferences for a communication board to facilitate dialogue in the intensive care unit. Intensive Crit Care Nurs 2020; 63:103005. [PMID: 33358517 DOI: 10.1016/j.iccn.2020.103005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/30/2020] [Accepted: 12/05/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The main aim of this study was to identify patient and nurse content preferences for a communication board to facilitate effective communication (dialogue) in the critical care unit. RESEARCH DESIGN A qualitative research design focusing on explorative and descriptive components was used to address the aim of the research study. The study employed two participant groups. Semi-structured interviews and focus group discussions were conducted with critically ill patients (N = 10) and critical care nurses (N = 30). SETTING The study was conducted in four different private hospitals of the same hospital group in Gauteng, South Africa. FINDINGS Four distinct themes were identified in the research regarding the vocabulary items that participants would like to have included. CONCLUSION The findings suggest that patients perceive a communication board to be valuable in enhancing communication in the critical care unit; that cultural and linguistic diversity should be considered; and that patients and nurses have varying opinions on topics of priority during communication.
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Affiliation(s)
- Ariné Kuyler
- Centre for Augmentative and Alternative Communication, University of Pretoria, Private Bag X20 Hatfield, 0028, South Africa.
| | - Ensa Johnson
- Centre for Augmentative and Alternative Communication, University of Pretoria, Private Bag X20 Hatfield, 0028, South Africa.
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9
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Fager SK, Burnfield JM, Pfeifer CM, Sorenson T. Perceived importance of AAC messages to support communication in rehabilitation settings. Disabil Rehabil Assist Technol 2020; 16:796-801. [PMID: 32141784 DOI: 10.1080/17483107.2020.1736652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE Permanent or temporary speech loss can occur due to a variety of medical conditions and often requires individuals to use augmentative and alternative communication (AAC) strategies and technologies to support communication. The use of AAC in medical and rehabilitation settings is critical to ensure the health, safety and psychological well-being of communicatively vulnerable individuals. METHOD This study surveyed the perceived importance of communication messages within five categories (Basic Needs, Patient-Provider Specific Communication, Social, Feelings, and Messages for Young Children) by individuals with disability who have undergone recent medical care as well as by rehabilitation care providers. RESULTS Results indicated that, with only a few exceptions, participants with disability more frequently selected all of the messages listed under the Patient-Provider Specific, Social, and Feelings categories compared to rehabilitation care providers' responses. Additionally, the individuals with disabilities selected messages that were more personalised to their specific care needs under Basic Needs. Both participant groups were asked to also suggest other messages that they perceived as important under each category. The other suggested messages demonstrated the potential need to provide personalisation to AAC displays to best meet the communication needs of individuals with disability.Implications for RehabilitationThere is a critical need for individuals who find themselves in medical settings (ICU, acute care hospital, rehabilitation hospital, etc.) to be able to communicate. This study provides preliminary information on the breadth of communication content that is perceived as relevant by individuals with disability and rehabilitation care providers. The need to provide personalized as well as a wide range of communication content options was of particular importance to individuals with disability. This information may provide specific guidance on how to best develop augmentative and alternative communication options for individuals in medical settings.
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Affiliation(s)
- Susan Koch Fager
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Judith M Burnfield
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Chase M Pfeifer
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Tabatha Sorenson
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
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Tate JA, Newtz C, Ali A, Happ MB. Advancing Patient-Centered Communication Content for Prelicensure Nursing Students Using StudentSPEACS: A Mixed-Methods Study. Nurse Educ 2020; 45:E36-40. [PMID: 31923144 DOI: 10.1097/NNE.0000000000000785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many patients live with communication disorders that present significant challenges during interactions with health care providers across settings. Yet, nurses receive little to no training in how to communicate with communication impaired patients. PURPOSE The purpose of this study was to determine the feasibility and acceptability of delivering the Study of Patient-Nurse Effectiveness With Assistive Communication Strategies (StudentSPEACS) program to prelicensure nursing students and to describe student clinical applications of this content in the year following the communication training. METHODS We used mixed methods to describe student perceptions of StudentSPEACS content and application of content in clinical encounters. RESULTS Junior nursing students (n = 86, 53.75%) responded to the survey. Students rated content as very valuable and rated their overall ability to communicate with patients after the training program as average. Students provided 48 clinical case application exemplars. CONCLUSIONS The StudentSPEACS program can help prelicensure nursing students acquire and practice communication skills with patients who have communication impairments.
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Abstract
Introduction: Patient engagement is engaging patients in their own medical care to heal them faster and take their valuable inputs to improve the health of population. Nurses contribute significantly in treatment, interact and spend most of their time with inpatients. Therefore, exploring the perspectives of nurses on patient engagement-communication is of vital importance. Objective: This article focuses on exploring the communication themes of patient engagement from the perspective of nurses in a multi-speciality hospital in Delhi. Methodology: The exploratory qualitative case study was carried out with semi-structured interviews of 12 nurses, observation at receptions of ICUs and emergency department and analysis of documents from the hospital’s official website. Grounded theory—three-level coding—was performed to identify the themes of patient engagement-communication. Results: A total of nine themes have been identified: ‘attendant’s role’, ‘communicating with patients of different categories’, ‘doctor’s support to nurses’, ‘nurse action’, ‘nurse behaviour’, ‘nurse challenges’, ‘patient actions’, ‘patient emotions’ and ‘wider role of nurses’. Conclusion: Nurses play a critical role in engaging patients through communication. They should change their approach of communication with different types of patients, understand, respect and give due weightage to patient’s emotions and actions and, play a wider role of teacher and guardian than just being the nurse.
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Affiliation(s)
- Harbir Singh
- Birla Institute of Management Technology (BIMTECH), Greater Noida (NCR), Uttar Pradesh, India
| | - Ajoy K. Dey
- Birla Institute of Management Technology (BIMTECH), Greater Noida (NCR), Uttar Pradesh, India
| | - Arunaditya Sahay
- Birla Institute of Management Technology (BIMTECH), Greater Noida (NCR), Uttar Pradesh, India
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12
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Simmons A, McCarthy J, Koszalinski R, Hedrick M, Reilly K, Hamby E. Knowledge and experiences with augmentative and alternative communication by paediatric nurses: a pilot study. Disabil Rehabil Assist Technol 2019; 16:567-579. [PMID: 31691622 DOI: 10.1080/17483107.2019.1685015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE The current mixed methods research study was designed to describe the experience and opinions of paediatric acute care nurses at a single paediatric medical centre regarding augmentative and alternative communication (AAC). This research serves as the beginning of a line of research to determine needs that can be met through later education and training on AAC with paediatric acute care nurses. METHODS Mixed methods were used to gather survey and interview data from nurses at a single paediatric hospital to investigate their knowledge of AAC, perceived relevance of AAC for their patient populations, and preferences for training programmes. RESULTS Quantitative survey and qualitative interview data indicated a need for AAC education for these paediatric nurses. Nurses demonstrated limited knowledge and experience with AAC but communicated both a desire and perceived need to know more to effectively care for their patients. CONCLUSION Nurses reported limited AAC knowledge but expressed a desire for support to use AAC with their patients. AAC education and cross-sector collaboration with healthcare workers such as speech-language pathologists (SLPs) and acute care paediatric nurses are indicated to support effective communication when interacting with patients with complex communication needs (CCN).Implications for rehabilitationImproved background knowledge to develop and implement future nurse education on AAC.Foundation for cross-sector collaboration (e.g., nurses and SLPs) on AAC implementation in paediatric acute care settings.
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Affiliation(s)
- Amanda Simmons
- Audiology and Speech Pathology Department, University of Tennessee Health Science Centre, Knoxville, TN, USA
| | - Jillian McCarthy
- Audiology and Speech Pathology Department, University of Tennessee Health Science Centre, Knoxville, TN, USA
| | | | - Mark Hedrick
- Audiology and Speech Pathology Department, University of Tennessee Health Science Centre, Knoxville, TN, USA
| | - Kevin Reilly
- Audiology and Speech Pathology Department, University of Tennessee Health Science Centre, Knoxville, TN, USA
| | - Ellen Hamby
- Audiology and Speech Pathology Department, University of Tennessee Health Science Centre, Knoxville, TN, USA
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13
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Jansson S, Martin TRS, Johnson E, Nilsson S. Healthcare professionals’ use of augmentative and alternative communication in an intensive care unit: A survey study. Intensive Crit Care Nurs 2019; 54:64-70. [DOI: 10.1016/j.iccn.2019.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 04/02/2019] [Accepted: 04/04/2019] [Indexed: 01/10/2023]
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Gropp M, Johnson E, Bornman J, Koul R. Nurses' perspectives about communication with patients in an intensive care setting using a communication board: A pilot study. Health SA 2019; 24:1162. [PMID: 31934427 PMCID: PMC6917450 DOI: 10.4102/hsag.v24i0.1162] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 02/27/2019] [Indexed: 01/10/2023] Open
Abstract
Background Communication in the intensive care setting (ICS) is critical for both the patient and the medical staff to provide efficient care and thus alleviate possible patient adverse effects. Persons with complex communication needs are particularly vulnerable in ICSs and therefore require additional communication support. Aim This study focused on the perspectives of nurses about communication with patients with communication needs in ICSs using paper-based communication boards, namely the translated Vidatak EZ Board, before and after a training session. Setting A 1650-bed public hospital with a 26-bed ICS in a semi-urban, low socio-economic area in South Africa served as the research setting. Methods A quasi-experimental pre-test post-test group design with withdrawal and a control group was used. Data were gathered using a custom-designed questionnaire completed by ICS nurse participants recruited from a public hospital. Results Responses of some nurses did not change in post-test 1, but their responses did change in post-test 2. Some of the nurses’ perspectives changed, as expected from the pre-test to post-test 1. Nurses recommended specific adaptations to the communication board. Conclusions Most nurses agreed that communication is crucial in ICSs and that a communication board can be implemented; however, limited success was observed implementing the board following a short training. The inter-professional collaboration between nurses and speech-language therapists to provide optimal health care to patients in ICS is emphasised.
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Affiliation(s)
- Martelize Gropp
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Ensa Johnson
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Juan Bornman
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Rajinder Koul
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa.,Department of Communication Sciences and Disorders, Moody College of Communication, The University of Texas at Austin, Austin, United States
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Ferri P, Rovesti S, Padula MS, D'Amico R, Di Lorenzo R. Effect of expert-patient teaching on empathy in nursing students: a randomized controlled trial. Psychol Res Behav Manag 2019; 12:457-467. [PMID: 31417325 PMCID: PMC6602298 DOI: 10.2147/prbm.s208427] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 04/17/2019] [Indexed: 12/30/2022] Open
Abstract
Background: Empathy is a relevant clinical competence for nursing students. Involvement of expert patients in nursing education could help students develop their innate capacity to empathize. Objective: To evaluate the effect of expert-patient teaching on empathy development in nursing students. Methods: This randomized controlled trial was conducted among 144 first-year undergraduate nursing students divided into two equal groups. In the experimental group, the educational intervention consisted of a seminar focused on empathy, followed by a presentation on expert-patient function. Subsequently, each student participated in two interactive meetings with nursing teacher and expert patient. At the end, the nursing teacher encouraged students to reflect on this experience. In the control group, students only attended a similar seminar focused on empathy and afterward participated in two interactive meetings with a nursing teacher to reflect on this topic without expert-patient involvement. Before (T0) and after (T1) the training intervention, the Balanced Emotional Empathy Scale, Jefferson Scale of Empathy — Health Professions Student (JSE-HPS), and a short demographic questionnaire were administered to the two student groups to measure their empathy levels. The study was approved by the Local Ethics Committee of Area Vasta Emilia Nord (protocol 1763, May 11, 2017). Data were statistically analyzed. Results: We found a statistically significant difference between mean scores at T0 and T1 in both scales in the experimental group. Male students, who presented significantly lower levels of empathy at baseline in comparison with females, showed increased in empathy after training on the the Balanced Emotional Empathy Scale in both the experimental and control groups. Conclusion: The present study highlights that involvement of expert patients in teaching is effective in improving empathy levels in both male and female nursing students. Expert-patient teaching can be a promising nursing-education modality for developing empathy.
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Affiliation(s)
- Paola Ferri
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy
| | - Sergio Rovesti
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy
| | - Maria Stella Padula
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy
| | - Roberto D'Amico
- Research and Innovation Area, Department of Maternal-Infant and Adult Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy
| | - Rosaria Di Lorenzo
- Psychiatric Intensive Treatment Facility, Department of Mental Health and Drug Abuse, AUSL Modena, Modena 41122, Italy
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Appelgren M, Bahtsevani C, Persson K, Borglin G. Nurses' experiences of caring for patients with intellectual developmental disorders: a systematic review using a meta-ethnographic approach. BMC Nurs 2018; 17:51. [PMID: 30524202 PMCID: PMC6276187 DOI: 10.1186/s12912-018-0316-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 11/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research suggests that registered nurses (RNs) do not feel adequately prepared to support patients with intellectual disability disorder (IDD). This is unsurprising, as few European health sciences curricula include undergraduate and graduate training courses in IDD. As RNs are often in the front line of care, eliciting in-depth knowledge about how they experience nursing this group of patients is vital. Our aim in this study was to develop a conceptual understanding about RNs' experiences of nursing patients with IDD. METHOD We undertook a systematic review and meta-ethnography to synthesise qualitative research studies found in PubMed, CINAHL, PsycINFO, ERIC databases and by manual searching to identify additional studies. We condensed translatable second-order constructs, and developed an idiomatic translation. Finally, we formulated line of argument (LOA) syntheses to capture the core of the idiomatic translations. RESULTS We included eighteen published studies from eight countries involving 190 RNs. The RNs' experience of nursing patients with IDD were reflected in 14 LOAs. Six of these reflected a tentatively more distinctive and at times unique conceptualisation of RNs' experience of nursing this group of patients. The remaining eight LOAs represented a conceptualisation of nursing per se, a conceptualisation of nursing that was interpreted as a universal experience regardless of context and patient group. CONCLUSION Lack of awareness and knowledge are likely breeding grounds for the 'otherness' that still surrounds this group of patients. In encounters between patients and RNs, focusing on the person behind the disability label could be one way to secure relevant nursing care for patients with IDD. Undertaking appropriate under- and postgraduate education alongside the implementation of nursing models focusing on patient-centred care would help RNs in reducing the health and care inequalities this group of patients still face. TRIAL REGISTRATION PROSPERO 2017: CRD42017077703.
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Affiliation(s)
- Marie Appelgren
- 1Department of Care Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden
- City of Malmö, Borough Administration Operation Support Management, SE-205 80 Malmö, Sweden
| | - Christel Bahtsevani
- 1Department of Care Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden
| | - Karin Persson
- 1Department of Care Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden
| | - Gunilla Borglin
- 1Department of Care Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden
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Giménez‐Espert MDC, Prado‐Gascó VJ. The role of empathy and emotional intelligence in nurses’ communication attitudes using regression models and fuzzy‐set qualitative comparative analysis models. J Clin Nurs 2018; 27:2661-2672. [DOI: 10.1111/jocn.14325] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2018] [Indexed: 01/17/2023]
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Hidecker MJC, Slaughter J, Abeysekara P, Ho NT, Dodge N, Hurvitz EA, Workinger MS, Kent RD, Rosenbaum P, Lenski M, Vanderbeek SB, DeRoos S, Paneth N. Early Predictors and Correlates of Communication Function in Children With Cerebral Palsy. J Child Neurol 2018; 33:275-285. [PMID: 29366365 PMCID: PMC8583866 DOI: 10.1177/0883073817754006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Birth characteristics and developmental milestones were evaluated as early predictors/correlates of communication in children with cerebral palsy. The hypothesis was that maternal report of child's age for vocal play and first words would predict current functional communication. A case series of 215 children, 2 to 17 years (mean age = 8.2 years, SD = 3.9) with cerebral palsy was recruited from medical practices in 3 Michigan cities. Early developmental data were collected by maternal interview. The child's Communication Function Classification System (CFCS) level was obtained from parent. Predictors of less functional communication included gestational age >32 weeks, number of comorbidities, age of first words after age 24 months, and use of communication methods other than speech. Several birth characteristics and developmental language milestones were predictive of later communication performance for children with cerebral palsy. These characteristics and milestones should trigger referrals for communication evaluations, including speech, language, hearing, and/or augmentative and alternative communication.
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Affiliation(s)
- Mary Jo Cooley Hidecker
- Division of Communication Disorders, University of Wyoming, Laramie, WY, USA.,Department of Epidemiology& Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Jaime Slaughter
- Department of Health Systems & Sciences Research and Department of Epidemiology & Biostatistics, Drexel University, PA, USA
| | - Purni Abeysekara
- Department of Community Health & Prevention, Drexel University, PA, USA
| | - Nhan T Ho
- Sergievesky Center, Columbia University Medical Center, New York, NY, USA
| | - Nancy Dodge
- Department of Pediatrics, Helen DeVos Children’s Hospital, Grand Rapids, MI, USA
| | - Edward A Hurvitz
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | | | - Ray D Kent
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Madeleine Lenski
- Department of Epidemiology& Biostatistics, Michigan State University, East Lansing, MI, USA
| | | | - Steven DeRoos
- Division of Pediatric Neurology, Helen DeVos Children’s Hospital, Grand Rapids, MI, USA
| | - Nigel Paneth
- Departments of Epidemiology& Biostatistics and Pediatrics & Human Development, Michigan State University, East Lansing, MI, USA
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O'Halloran R, Coyle J, Lamont S. Screening patients for communication difficulty: The diagnostic accuracy of the IFCI staff questionnaire. Int J Speech Lang Pathol 2017; 19:430-440. [PMID: 27686874 DOI: 10.1080/17549507.2016.1209560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 03/17/2016] [Accepted: 05/22/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Many patients have difficulty communicating about their healthcare. At present there is no tool to identify these patients. This research investigated whether the Inpatient Functional Communication Interview Staff Questionnaire (IFCI SQ) could detect patients who have difficulty communicating their healthcare needs by investigating the sensitivity, specificity and internal consistency of the IFCI SQ. METHOD Fifty patients and their nurses participated in this research. Every second consecutive admission on the general medical ward of a hospital was assessed for communication difficulty by a speech-language pathologist on the IFCI and screened for communication difficulty by a nurse using the IFCI SQ. RESULT At a cut off score of <2, the IFCI SQ had a sensitivity of 95% and a specificity of 77% compared with the IFCI. The IFCI SQ is a useful test in identifying patients who have communication difficulty and is an extremely good test at ruling out patients who do not have communication difficulty. The internal consistency of the IFCI SQ was also high at 0.954. CONCLUSION The IFCI SQ is a promising tool to detect patients in hospital with communication difficulty. Further research is required to explore the psychometric properties of the IFCI SQ in more detail.
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Affiliation(s)
- Robyn O'Halloran
- a Discipline of Human Communication Sciences , La Trobe University , Bundoora , Victoria , Australia and
| | - Julieanne Coyle
- b Department of Speech Pathology & Music Therapy, Monash Health , Melbourne , Australia
| | - Sue Lamont
- b Department of Speech Pathology & Music Therapy, Monash Health , Melbourne , Australia
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Ferri P, Rovesti S, Panzera N, Marcheselli L, Bari A, Di Lorenzo R. Empathic attitudes among nursing students: a preliminary study. Acta Biomed 2017; 88:22-30. [PMID: 28752829 DOI: 10.23750/abm.v88i3 -s.6610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIM An empathic approach is fundamental for therapeutic relationship between nurse and patient. According to some researchers, female nursing students show higher empathic attitude in comparison with males, but both show a decline in empathy level as their studies progress. This preliminary study evaluated the self-reported emotional empathy level among undergraduate students at first and second year of nursing 3-year course. METHOD To assess empathy level, the Balanced Emotional Empathy Scale (BEES) was administered to all students enrolled in the 2015/16 academic year (N=142), at the beginning of first year (T0) and at mid-point of second year (T1) of nursing course. Data were statistically analyzed. RESULTS 118 nursing students participated in the first and 99 in the second survey. The BEES global mean score for the longitudinal group (n=99) slightly decreased from T0 (mean=37.1±19.5 SD) to T1 (mean=33.5±22.6 SD) (t=1.20, p=0.23; t-test for paired data). Female students reported a statistically significant higher mean BEES score compared to male students in both surveys. CONCLUSIONS Our preliminary data suggest a slight decline in empathy level among nursing students with the progress of study course, in accordance with previous studies. In particular, our study shows higher levels of empathy in female students and lower levels in male students, compared to other studies. Further surveys aimed at investigating the empathy attitude at the end of nursing course could confirm the decline tendency reported by this preliminary study. Other research focusing on the causes of empathy decline are necessary to explain this phenomenon.
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Affiliation(s)
- Paola Ferri
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia.
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Choi J, Campbell ML, Gélinas C, Happ MB, Tate J, Chlan L. Symptom assessment in non-vocal or cognitively impaired ICU patients: Implications for practice and future research. Heart Lung 2017; 46:239-245. [PMID: 28487184 DOI: 10.1016/j.hrtlng.2017.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 04/01/2017] [Accepted: 04/07/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Symptom assessment in critically ill patients is challenging because many cannot provide a self-report. OBJECTIVES To describe the state of the science on symptom communication and the assessment of selected physical symptoms in non-vocal ICU patients. METHODS This paper summarizes a 2014 American Thoracic Society Annual International Conference symposium presenting current evidence on symptom communication, delirium, and the assessment of common physical symptoms (i.e., dyspnea, pain, weakness, and fatigue) experienced by non-vocal ICU patients. RESULTS Symptom assessment begins with accurate assessment, which includes an evaluation of delirium, and assistance in symptom communication. Simple self-report measures (e.g., 0-10 numeric rating scale), observational measures (e.g., Respiratory Distress Observation Scale and Critical-Care Pain Observation Tool), or objective measures (e.g., manual muscle testing and hand dynamometry) have demonstrated utility among this population. CONCLUSION Optimizing symptom assessment with valid and reliable instruments with minimum patient burden is necessary to advance clinical practice and research in this field.
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Affiliation(s)
- JiYeon Choi
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
| | | | - Céline Gélinas
- McGill University Ingram School of Nursing, Montreal, Quebec, Canada
| | - Mary Beth Happ
- The Ohio State University College of Nursing, Columbus, OH, USA
| | - Judith Tate
- The Ohio State University College of Nursing, Columbus, OH, USA
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Abstract
This metasynthesis presents an enlarged interpretation and understanding of nonvocal mechanically ventilated patients’experiences with communication. Peplau’s interpersonal relations theory provided the theoretical framework for the metasynthesis. The final sample included 12 qualitative studies, for a total of 111 participants. The data, methods, and theoretical frameworks were critically interpreted. Commonthreads detected across study participants’individual experiences were synthesized to form a greater understanding of nonvocal ventilated patients’ perceptions of being understood. Five overarching themes were divided into two groups. The first group of themes was categorized as the characteristics of nonvocal ventilated patients’communication experiences. Nonvocal individuals were often not understood, which resulted in loss of control and negative emotional responses. The second group of themes was categorized as the kind of nursing care desired by nonvocal patients in order to be understood. Nonvocal patients wanted nursing care that was delivered in an individualized, caring manner. This facilitated positive interpersonal relations between the patient and the nurse. Findings are discussed in relation to the current state of knowledge on this topic.
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Kahriman I, Nural N, Arslan U, Topbas M, Can G, Kasim S. The Effect of Empathy Training on the Empathic Skills of Nurses. Iran Red Crescent Med J 2016; 18:e24847. [PMID: 27621922 PMCID: PMC5002343 DOI: 10.5812/ircmj.24847] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 12/17/2014] [Accepted: 01/02/2015] [Indexed: 12/30/2022]
Abstract
Background The profound impact of empathy training on quality nursing care has been recognized. Studies have shown that there has been little improvement in nurses’ communication skills, and that they should work to enhance this area. Relevant training will lead to an improvement in nurses’ empathic skills, which in turn, will enable them to understand their patients better, establish positive interpersonal relationships with them, and boost their professional satisfaction. Objectives To reveal the effect of empathy training on the empathic skills of nurses. Patients and Methods This study was conducted as an experimental design. The research sample consisted of 48 nurses working at the pediatric clinics of Farabi hospital of Karadeniz Technical University in Turkey (N = 83). Two groups, an experimental group (group 1) and a control group (group 2) were determined after questionnaires were supplied to all nurses in the study sample. At first, it was intended to select these groups using a random method. However, since this may have meant that the experimental and control groups were formed from nurses working in the same service, the two groups were selected from different services to avoid possible interaction between them. The nurses in the Group 1 were provided with empathy training through group and creative drama techniques. Pre-tests and post-tests were conducted on both groups. Data was collected via a questionnaire designed around the topic “empathic skill scale-ESS”, developed by Dokmen. The Kolmogorov Smirnov test was employed to assess whether the measurable data was suitable for normal distribution. Data was presented as numbers and percentage distributions, as mean ± standard deviation and Chi-square, and as student t tests and paired t tests. The level of significance was accepted as P < 0.05. Results The nurses in the experimental group had a mean score of 146.7 ± 38.8 and 169.5 ± 22.1 in the ESS pre-test and post-test, respectively. Although the nurses in the control group had a pre-test mean score of 133.7 ± 37.1, which increased to 135.1 ± 51.7 after the training, no statistically significant difference was found (P = 0.886). A comparison of the groups indicated that they scored similarly in the pre-test. However, the experimental group scored significantly higher than the control group in the post-test (P = 0.270 and P = 0.015, respectively). Conclusions In the light of these findings, it is recommended that communication skills should be widely included in in-service training programs; similar studies should be conducted on broader control groups formed through randomization; and a comparison should be made between the findings.
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Affiliation(s)
- Ilknur Kahriman
- Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
- Corresponding Author: Ilknur Kahriman, Faculty of Health Sciences, Karadeniz Technical University, Eczacilik Fakulte Binasi, Universite Binasi, Farabi Cad 61080 Trabzon, Turkey. Tel: +90-4622300476, Fax: +90-4622300475, E-mail:
| | - Nesrin Nural
- Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
| | - Umit Arslan
- Pre-School Education Division, Department of Primary Education, Faculty of Education, Karadeniz Technical University, Trabzon, Turkey
| | - Murat Topbas
- Department of Public Health, Farabi Hospital, Medicine Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Gamze Can
- Department of Public Health, Farabi Hospital, Medicine Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Suheyla Kasim
- The Top Management of Nursing, Farabi Hospital, Karadeniz Technical University, Trabzon, Turkey
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Blackstone SW, Pressman H. Patient Communication in Health Care Settings: new Opportunities for Augmentative and Alternative Communication. Augment Altern Commun 2015; 32:69-79. [PMID: 26694249 DOI: 10.3109/07434618.2015.1125947] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Delivering quality health care requires effective communication between health care providers and their patients. In this article, we call on augmentative and alternative communication (AAC) practitioners to offer their knowledge and skills in support of a broader range of patients who confront communication challenges in health care settings. We also provide ideas and examples about ways to prepare people with complex communication needs for the inevitable medical encounters that they will face. We argue that AAC practitioners, educators, and researchers have a unique role to play, important expertise to share, and an extraordinary opportunity to advance the profession, while positively affecting patient outcomes across the health care continuum for a large number of people.
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Abstract
AIMS AND OBJECTIVES This study aimed to identify the approaches used by nurses to address the sensory requirements of patients to respond to the concerns and needs in this area. BACKGROUND Preventing sensory problems is very important for intensive care nurses as these problems may cause various additional health problems in intensive care patients; however, no study has evaluated the approaches used by nurses in this respect. DESIGN The study was conducted as a descriptive study in all internal medicine intensive care units at hospitals located within the borders of the metropolitan municipality in the capital city of Turkey. METHOD Data were collected using case forms that were developed through expert opinions to identify the approaches of nurses for the sensory requirements of patients. The study was conducted with 95 nurses who agreed to be involved in the study of the 107 internal medicine intensive care nurses in the research population. RESULTS Most of the nurses (86.3%) who took part in this study indicated that intensive care patients had sensory requirements, but 80% clarified that their priority was to maintain life support and to meet their physiological needs. Almost all of the nurses were able to accurately identify the specific sensory problems of the six different ones in cases that were assigned to them. However, this ratio decreased when identifying the proper approach for the given sensory requirement. CONCLUSIONS Nurses were able to identify sensory requirements of patients, but they do need support in deciding the appropriate management approach. This study may fill the gap in the literature regarding the approaches of nurses towards sensory requirements and to provide contribution for future research. RELEVANCE TO CLINICAL PRACTICE To help intensive care patients with sensory problems, nurses should routinely assess patients' psychology and should do appropriate interventions.
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Affiliation(s)
| | - Duygu Hiçdurmaz
- Psychiatric Nursing Department, Hacettepe University Faculty of Nursing, Ankara, Turkey
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Lowe DB, Taylor MJ, Hill SJ. Communication Vulnerabilities in Working-age Australians with Musculoskeletal Conditions: A Cross-sectional Analysis. J Rheumatol 2015; 42:1484-93. [DOI: 10.3899/jrheum.140989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2015] [Indexed: 12/21/2022]
Abstract
Objective.To estimate the prevalence of communication vulnerability (CV) and its association with various health measures among working-age Australians with musculoskeletal conditions (MSK). The various vulnerability characteristics may lead to inadequate communication between consumers and healthcare professionals.Methods.Prevalence of CV among 18–64 year olds, with or without MSK, was analyzed using the Australian Bureau of Statistics’ National Health Survey 2007–08 data. Associations between CV and measures of health complexity (accumulating multimorbidity and risk factors) and health burden (poorer self-rated health, psychological distress, and pain restricting work) in the MSK population were estimated using logistic regression. Further analyses were conducted for each vulnerability characteristic to determine the degree of association (crude and adjusted) with measures of interest.Results.CV were more prevalent in working-age Australians with MSK (65%) than those without (51%). Adjusted for age and sex among working-age Australians with at least 1 MSK, those with 1 or more CV were more likely to have multimorbidity [adjusted OR (aOR) = 1.8, 95% CI 1.5–2.2], lifestyle risk factors (aOR = 2.1, 95% CI 1.5–2.8), poorer self-rated health (aOR = 3.4, 95% CI 2.7–4.2), greater psychological distress (aOR = 2.9, 95% CI 2.3–3.7), and pain restricting employment (aOR = 1.7, 95% CI 1.4–2.1) compared with those without CV.Conclusion.For working-age people, there is an association between MSK and CV. For those with MSK, CV were associated with increased likelihood of health complexity and burden. These findings have policy and clinical relevance. Research is needed to determine whether interventions that address these specific CV characteristics reduce the burden of disease within these populations.
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Abstract
We used a qualitative focus group design to explore the experiences and challenges of nurses who work with hospitalized patients experiencing the sudden inability to verbalize their needs, also known as sudden speechlessness. In response to open-ended questions in facilitated focus groups, 18 nurses discussed issues around the care and communication needs of suddenly speechless (SS) patients. Nurses identified multiple, commonly occurring communication challenges when caring for SS patients. They believed these challenges led to poorer recognition of patient needs, with the potential for compromised patient care. Nurses described how the lack of reliable strategies to facilitate communication sometimes resulted in negative patient outcomes, including unmet psychosocial needs and the potential that informed consent and educational issues were being inadequately addressed for the SS patients. Even experienced nurses indicated ongoing problems in communicating with SS patients, despite using a multitude of strategies, leaving many to deal with issues of frustration and role conflict.
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El-Soussi AH, Elshafey MM, Othman SY, Abd-Elkader FA. Augmented alternative communication methods in intubated COPD patients: Does it make difference. Egyptian Journal of Chest Diseases and Tuberculosis 2015. [DOI: 10.1016/j.ejcdt.2014.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Hemsley B, Balandin S. A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: informing new translational research. Augment Altern Commun 2014; 30:329-43. [PMID: 25229213 PMCID: PMC4266100 DOI: 10.3109/07434618.2014.955614] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 06/06/2014] [Indexed: 11/13/2022] Open
Abstract
Poor patient-provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication.
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Affiliation(s)
- Bronwyn Hemsley
- School of Humanities and Social Science, Faculty of Education and Arts, The University of Newcastle, New South Wales, Australia
| | - Susan Balandin
- School of Health and Social Development, Faculty of Health, Deakin University, Victoria, Australia
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Adib-Hajbaghery M, Rezaei-Shahsavarloo Z. Nursing students' knowledge of and performance in communicating with patients with hearing impairment. Jpn J Nurs Sci 2014; 12:135-44. [PMID: 25243617 DOI: 10.1111/jjns.12057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 06/14/2014] [Indexed: 12/01/2022]
Abstract
AIM The present study aimed to investigate nursing students' knowledge of and performance in communicating with patients with hearing impairment. METHODS A cross-sectional study was conducted on all senior nursing students (n = 71) in a nursing school in Iran in 2013. Data collection was performed with a demographics questionnaire, knowledge questionnaire, and performance assessment checklist. Two stages were designed to evaluate the students. In the first stage, students conducted an interview with a simulated patient with hearing impairment who experienced chest pain. In the second stage, students answered the knowledge questionnaire. Descriptive statistics, independent sample Student's t-test, and Pearson correlation coefficient were used to analyze the data. RESULTS In total, 11.3% of participants had a history of caring for a patient with hearing impairment. The majority of students evaluated their performance in communicating with such patients at a moderate level. A significant difference was observed between the mean score of knowledge in men and women (P = 0.05), and male students gained higher scores. In total, 61.5% of the students had low to very low levels of knowledge and 87.3% of them had weak to very weak performance in communicating with patients with hearing impairment. CONCLUSION Nursing students are lacking in knowledge and skills required for effective communication with patients with hearing impairment. Nurse educators should pay more attention to this issue as it is their responsibility to prepare nurses who are competent to deal with common issues they will face in practice.
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Affiliation(s)
- Mohsen Adib-Hajbaghery
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
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Capri C, Buckle C. ‘We have to be Satisfied with the Scraps’: South African Nurses' Experiences of Care on Adult Psychiatric Intellectual Disability Inpatient Wards. J Appl Res Intellect Disabil 2014; 28:167-81. [DOI: 10.1111/jar.12118] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Charlotte Capri
- Psychology; University of Stellenbosch; Stellenbosch South Africa
| | - Chanellé Buckle
- Psychology; University of Stellenbosch; Stellenbosch South Africa
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Adib Hajbaghery M, Rezaei Shahsavarloo Z. Assessing the Nursing and Midwifery Students Competencies in Communication With Patients With Severe Communication Problems. Nurs Midwifery Stud 2014; 3. [DOI: 10.5812/nms.18143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Adib Hajbaghery M, Rezaei Shahsavarloo Z. Assessing the Nursing and Midwifery Students Competencies in Communication With Patients With Severe Communication Problems. Nurs Midwifery Stud 2014. [DOI: 10.17795/nmsjournal18143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hwang CS, Weng HH, Wang LF, Tsai CH, Chang HT. An Eye-Tracking Assistive Device Improves the Quality of Life for ALS Patients and Reduces the Caregivers’ Burden. J Mot Behav 2014; 46:233-8. [DOI: 10.1080/00222895.2014.891970] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Happ MB, Garrett KL, Tate JA, DiVirgilio D, Houze MP, Demirci JR, George E, Sereika SM. Effect of a multi-level intervention on nurse-patient communication in the intensive care unit: results of the SPEACS trial. Heart Lung 2014; 43:89-98. [PMID: 24495519 DOI: 10.1016/j.hrtlng.2013.11.010] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 11/22/2013] [Accepted: 11/23/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To test the impact of two levels of intervention on communication frequency, quality, success, and ease between nurses and intubated intensive care unit (ICU) patients. DESIGN Quasi-experimental, 3-phase sequential cohort study: (1) usual care, (2) basic communication skills training (BCST) for nurses, (3) additional training in augmentative and alternative communication devices and speech language pathologist consultation (AAC + SLP). Trained observers rated four 3-min video-recordings for each nurse-patient dyad for communication frequency, quality and success. Patients self-rated communication ease. SETTING Two ICUs in a university-affiliated medical center. PARTICIPANTS 89 intubated patients awake, responsive and unable to speak and 30 ICU nurses. MAIN RESULTS Communication frequency (mean number of communication acts within a communication exchange) and positive nurse communication behaviors increased significantly in one ICU only. Percentage of successful communication exchanges about pain were greater for the two intervention groups than the usual care/control group across both ICUs (p = .03) with more successful sessions about pain and other symptoms in the AAC + SLP group (p = .07). Patients in the AAC + SLP intervention group used significantly more AAC methods (p = .002) and rated communication at high difficulty less often (p < .01). CONCLUSIONS This study provides support for the feasibility, utility and efficacy of a multi-level communication skills training, materials and SLP consultation intervention in the ICU.
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Grilo AM, Santos MC, Rita JS, Gomes AI. Assessment of nursing students and nurses' orientation towards patient-centeredness. Nurse Educ Today 2014; 34:35-39. [PMID: 23582876 DOI: 10.1016/j.nedt.2013.02.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 02/12/2013] [Accepted: 02/28/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Being patient centered is a core value for nursing. Patient centered-care has been related to patient and health provider satisfaction, better health outcomes, higher quality of care and more efficient health care delivery. OBJECTIVES The purpose was to assess the orientation adopted by nurses and students in patient care, using The Patient-Practitioner Orientation Scale, as well as to compare the results between resident nurses and students from different academic years. SETTINGS Public School of Nursing and a Central Hospital, in Lisbon (Portugal). PARTICIPANTS Students in the first, second and fourth year of nursing school and nurses participated in the study. METHODS For data collection, we used The Patient-Practitioner Orientation Scale (European Portuguese version), an instrument designed to measure individual preferences toward the dimension of caring a sharing in health professional-patient relationship. Students and nurses also filled out two additional questions about their perception of competence in technical and communication skills. Additional demographic information was also collected, including gender, age, academic year and length of professional experience. RESULTS A total of 525 students (84.7% female) and 108 nurses (77.8% female) participated in this study. In general, caring sub-scores, measuring the preference of about attending to patient emotional aspects, were higher than sharing sub-scores, measuring beliefs about giving information and perceiving patient as a member of the health team. Students were significantly more patient-centered throughout their nursing education (p<0.001). Comparing to students in the second and fourth academic years (p<0.001) nurses' scores were significantly lower both in total PPOS and in caring and sharing subscales. CONCLUSIONS These results reinforce the idea that patient centeredness may be developed in academic context. The scores obtained highlight the importance of studies that aim to identify factors that may explain the decrease of patient centeredness in professional practice.
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Affiliation(s)
- Ana M Grilo
- Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096 Lisboa, Portugal.
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Lancioni GE, Singh NN, O’reilly MF, Sigafoos J, Oliva D. Assistive Technology for People with Severe/Profound Intellectual and Multiple Disabilities. Autism and Child Psychopathology Series 2014. [DOI: 10.1007/978-1-4899-8029-8_10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Stans SEA, Dalemans R, de Witte L, Beurskens A. Challenges in the communication between 'communication vulnerable' people and their social environment: an exploratory qualitative study. Patient Educ Couns 2013; 92:302-312. [PMID: 23809168 DOI: 10.1016/j.pec.2013.05.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 05/28/2013] [Accepted: 05/30/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Communication vulnerable people are often unable to communicate effectively within their social environment, hindering client-centered care and participation in daily life. This study aims to explore the experiences of communication and the factors that influence this in long term care settings. METHODS A qualitative study using the critical incident method. Communication vulnerable clients and people within their immediate environment were interviewed about their communication experiences. RESULTS Thirty-nine individuals in three settings participated in the interviews, of which 14 were clients. Specific challenges in communication were presented in different relationships. The main influencing factors in the communication between clients and professionals were: effort put into improving the communication, knowledge of the professional, augmentative and alternative communication, time for communication and the influence and power of the client. CONCLUSION Communication vulnerable people and people within their immediate environment face daily challenges in communicating with each other. In particular, communication among clients, can be very difficult. Augmentative and alternative communication tools are only rarely used. PRACTICE IMPLICATIONS Professionals need to develop adequate knowledge and skills to improve their communication. Also, more attention should be focussed on use of AAC, communication between professionals and family members, and support in the communication among clients.
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Affiliation(s)
- Steffy E A Stans
- Zuyd University of Applied Sciences, Faculty of Health, Heerlen, The Netherlands.
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Blakeman JR, Samuelson SJ, McEvoy KN. Analysis of a Silent Voice: A Qualitative Inquiry of Embroidery Created by a Patient with Schizophrenia. J Psychosoc Nurs Ment Health Serv 2013; 51:38-45. [DOI: 10.3928/02793695-20130402-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 03/12/2013] [Indexed: 11/20/2022]
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Downey D, Happ MB. The Need for Nurse Training to Promote Improved Patient-Provider Communication for Patients With Complex Communication Needs. ACTA ACUST UNITED AC 2013. [DOI: 10.1044/aac22.2.112] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Hospitalized patients across the age continuum often present with complex communication needs (CCN) due to motor, sensory, cognitive, and linguistic barriers they may experience during their admission. Although hospitals recognize the need to enhance communication to improve quality and safety for all patients, the emphasis has been primarily on improving ”care coordination” amongst the health care providers the patient encounters across all points of admission. Most hospitals have yet to focus on improving the patient-provider communication experience, especially for patients with CCN. However, this population no longer can be ignored, as new standards mandate efforts to improve communication for patients with CCN. Nurses, as the team members responsible for continuous care during hospital stays, and speech-language pathologists, as communication disorders specialists, are positioned distinctively to facilitate patient communication and prevent miscommunications between patients and care providers. This article highlights the need to enhance the patient-provider communication experience for patients with CCN. We review the state of nurse training for patients with CCN, discuss the role speech-language pathologists can play in developing and implementing nurse training protocols, and outline basic elements nurse training modules should include.
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Affiliation(s)
- Debora Downey
- Center of Excellence in Critical and Complex Care, The Ohio State University College of Nursing Columbus, OH
| | - Mary Beth Happ
- Center of Excellence in Critical and Complex Care, The Ohio State University College of Nursing Columbus, OH
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Thompson J, Mckeever M. The impact of stroke aphasia on health and well-being and appropriate nursing interventions: an exploration using the Theory of Human Scale Development. J Clin Nurs 2012; 23:410-20. [DOI: 10.1111/j.1365-2702.2012.04237.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Many children are surviving prematurity and serious childhood illnesses due to advances in technology and medical care. As a result, more children are entering public school systems with complex health care needs and intellectual and developmental disabilities. School nurses are responsible for caring for these children; however, many nurses feel unprepared due to a lack education on disability studies in nursing school, difficulty with effective communication, and a lack of experience. A qualitative study was conducted to explore the perceptions and challenges of school nurses who worked with students with intellectual and developmental disabilities. Participants included eight nurses who worked in a public school setting, and data were collected through personal interviews, observations, and field notes. Results were analyzed categorically, and data showed that school nurses identified that they lacked education in disability studies and encountered challenges with communication, conducting health assessments, and screenings in students with intellectual and developmental disabilities.
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Balandin S, Hemsley B, Sigafoos J, Green V, Forbes R, Taylor C, Parmenter T. Communicating with Nurses: The Experiences of 10 Individuals with an Acquired Severe Communication Impairment. BRAIN IMPAIR 2012. [DOI: 10.1375/brim.2.2.109] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractSuccessful communication is integral to quality health care and successful nursing practice. Ten people who had been in hospital in the 12 months prior to the study and who had no functional speech at that time were interviewed about their communication experiences with nurses. Overall, these individuals experienced difficulties, some of which appeared to be related to a lack of augmentative and alternative communication (AAC) resources and a lack of knowledge of AAC among nurses. In addition, the participants noted that nurses did not always have the time or the skills to communicate effectively with them. The participants suggested strategies to improve communication interactions between patients with no or limited functional speech and nurses. These strategies include pre-admission briefing and training nurses about effective strategies for communicating with patients who are unable to speak, including the use of augmentative and alternative communication systems.
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Radtke JV, Tate JA, Happ MB. Nurses' perceptions of communication training in the ICU. Intensive Crit Care Nurs 2012; 28:16-25. [PMID: 22172745 DOI: 10.1016/j.iccn.2011.11.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Revised: 11/14/2011] [Accepted: 11/15/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To describe the experience and perceptions of nurse study participants regarding a communication intervention (training and communication tools) for use with nonspeaking, critically ill patients. RESEARCH METHODOLOGY/DESIGN Small focus groups and an individual interview were conducted with six critical care nurses. Transcripts were analysed using qualitative content analysis and constant comparison. SETTING Two ICUs within a large, metropolitan medical centre in western Pennsylvania, United States of America. MAIN OUTCOME MEASURES Critical care nurses' evaluations of (1) a basic communication skills training programme (BCST) and (2) augmentative and alternative communication strategies (AAC) introduced during their study participation. RESULTS Six main categories were identified in the data: (1) communication value/perceived competence; (2) communication intention; (3) benefits of training; (4) barriers to implementation; (5) preferences/utilisation of strategies; and 6) leading-following. Perceived value of and individual competence in communication with nonspeaking patients varied. Nurses prioritised communication about physical needs, but recognised complexity of other intended patient messages. Nurses evaluated the BCST as helpful in reinforcing basic communication strategies and found several new strategies effective. Advanced strategies received mixed reviews. Primary barriers to practise integration included patients' mental status, time constraints, and the small proportion of nurses trained or knowledgeable about best patient communication practices in the ICU. CONCLUSIONS The results suggest that the communication skills training programme could be valuable in reinforcing basic/intuitive communication strategies, assisting in the acquisition of new skills and ensuring communication supply availability. Practice integration will most likely require unit-wide interdisciplinary dissemination, expert modelling and reinforcement.
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Mesko PJ, Eliades AB, Christ-Libertin C, Shelestak D. Use of Picture Communication Aids to Assess Pain Location in Pediatric Postoperative Patients. J Perianesth Nurs 2011; 26:395-404. [DOI: 10.1016/j.jopan.2011.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 06/16/2011] [Accepted: 09/08/2011] [Indexed: 11/24/2022]
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Bandeira FM, Faria FPD, Araujo EBD. Quality assessment of inhospital patients unable to speak who use alternative and extended communication. Einstein (São Paulo) 2011; 9:477-82. [DOI: 10.1590/s1679-45082011ao2083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 10/25/2011] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To implement the use of alternative communication boards in patients hospitalized and unable to communicate by speech. Methods: A descriptive study with a sample of 30 patients hospitalized and unable to communicate by speech. Boards were made with Boardmaker® Software that consists of a graphical database containing Pictorial Communication Symbols. To assess the quality of life of these patients, the Portuguese SF-36, a translated version of the Medical Outcomes Study, was applied before and after the study. Results: We found that all domains of the SF-36 showed changes after the application of communication boards. We observed that the minimum score was assigned to the mental health domain, whereas the most affected and with greatest involvement and least compromise was the overall health status. Conclusion: The quality of life assessment of patients showed improvement with the use of communication boards, demonstrating the importance and necessity of communication between the patient and staff and the patient and family members.
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Hemsley B, Balandin S, Worrall L. Nursing the patient with complex communication needs: time as a barrier and a facilitator to successful communication in hospital. J Adv Nurs 2011; 68:116-26. [PMID: 21831131 DOI: 10.1111/j.1365-2648.2011.05722.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Effective nurse-patient communication is an essential aspect of health care. Time to communicate, however, is limited and subject to workload demands. Little is known about how nurses manage this 'lack of time' when caring for patients with developmental disability and complex communication needs, who typically communicate at a slow rate. AIM The aim of this study was to investigate nurses' expressed concepts of 'time' in stories about communicating with patients with developmental disability and complex communication needs in hospital. METHOD In 2009, 15 hospital nurses from a range of wards in two metropolitan hospitals participated in interviews about barriers to and strategies for successful communication with patients with developmental disability and complex communication needs in hospital. The data were analysed using narrative inquiry methodology and the stories verified with the participants. RESULTS Nurses identified 'time' as a barrier and a facilitator to successful communication. Time as a barrier was related thematically to avoiding direct communication and preferring that family or paid carers communicated on behalf of the patient. Time as a facilitator was related to valuing communication, investing extra time, and to applying a range of adaptive communication strategies to establish successful communication. CONCLUSIONS Time is perceived by nurses as both an enemy and friend for improving communication. Nurses who perceive that communication takes too long may avoid communication and miss opportunities to improve communication through increased familiarity with the person's communication methods. Those who take time to communicate narrate applying a range of strategies to achieve success in basic needs communication.
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Affiliation(s)
- Bronwyn Hemsley
- Communication Disability Centre, University of Queensland, Brisbane, Australia.
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Radtke JV, Baumann BM, Garrett KL, Happ MB. Listening to the voiceless patient: case reports in assisted communication in the intensive care unit. J Palliat Med 2011; 14:791-5. [PMID: 21291327 DOI: 10.1089/jpm.2010.0313] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Communication problems experienced by nonspeaking, critically ill patients in the Intensive Care Unit (ICU) have serious implications for the physical and psychological well-being of patients and the quality of their care. These problems are most profound for those with prolonged critical illnesses who are at the highest risk of dying. Recently, speech language pathologist (SLP) services have been used to provide augmentative and alternative communication (AAC) assistance to this vulnerable group of patients, their caregivers, and medical staff. Here we present three clinical cases that illustrate the application of AAC strategies across different levels of illness severity and communication impairment for nonspeaking patients in the ICU. Both high-tech communication devices with voice output and low-tech options were used for each patient according to their motor and cognitive abilities. To accommodate fluctuations in patient status and communication needs, multiple AAC strategies were integrated into the communication repertoire and tailored for each case. Medical personnel involved in these cases attributed enhanced communication efficiency, improved ventilator weaning trials, and increased patient engagement to the AAC techniques. This approach has the potential to improve symptom communication and to ease suffering for seriously ill ICU patients with speech limitations.
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Affiliation(s)
- Jill V Radtke
- Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania 15261, USA
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Adams D, Oliver C. The expression and assessment of emotions and internal states in individuals with severe or profound intellectual disabilities. Clin Psychol Rev 2011; 31:293-306. [PMID: 21382536 DOI: 10.1016/j.cpr.2011.01.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 01/05/2011] [Accepted: 01/06/2011] [Indexed: 11/20/2022]
Abstract
The expression of emotions and internal states by individuals with severe or profound intellectual disabilities is a comparatively under-researched area. Comprehensive or standardized methods of assessing or understanding the emotions and internal states within this population, whose ability to communicate is significantly compromised, do not exist. The literature base will be discussed and compared to that applicable to the general population. Methods of assessing broader internal states, notably depression, anxiety, and pain within severe or profound intellectual disabilities are also addressed. Finally, this review will examine methods of assessing internal states within genetic syndromes, including hunger, social anxiety, and happiness within Prader-Willi, Fragile-X and Angelman syndrome. This will allow for identification of robust methodologies used in assessing the expression of these internal states, some of which may be useful when considering how to assess emotions within individuals with intellectual disabilities.
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Abstract
Ascertaining the symptom experience of chronically critically ill (CCI) patients is difficult because of communication impairment and fluctuations in patient cognition and physiologic conditions. The use of checklist self-report ratings is hampered by the inability of most CCI patients to respond verbally to symptom queries. In addition to the communication problems caused by mechanical ventilation, the apparently diverse idioms of symptom expression add to the potential for miscommunication regarding symptom experience. Although patient communication impairment is a major barrier to symptom identification, symptom assessment and treatment are fundamental components of nursing care for CCI. This article reviews and describes the unique constellation of symptoms experienced by many critically ill patients. We report our observations of symptom communication among CCI patients and nurses and discuss inconsistency in the language of symptom expression among nurses and patients. Clinically applicable strategies to improve nurse-patient symptom communication and suggestions for refinement of symptom assessment in chronic critical illness are provided.
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