Communication Barriers
Persons With Hearing Impairments
Communication
Blood-Brain Barrier
Cell Communication
Animal Communication
Communication Disorders
Health Communication
Communication Aids for Disabled
Recruiting minority cancer patients into cancer clinical trials: a pilot project involving the Eastern Cooperative Oncology Group and the National Medical Association. (1/572)
PURPOSE: Minority accrual onto clinical trials is of significant interest to cooperative oncology study groups. The Eastern Cooperative Oncology Group (ECOG) conducted a study to identify barriers and solutions to African American accrual onto clinical trials. METHODS: We hypothesize that the National Medical Association (NMA) might provide insight into ways to increase minority participation and that ECOG might facilitate that participation. Four sites were selected in which NMA chapters existed and ECOG main institutions with less than half of the corresponding percentage of minorities in their communities entered trials for 1992. Fifteen workshops were conducted using discussions and open-ended, self-administered questionnaires. RESULTS: Seventy percent of NMA physicians cited mistrust of the research centers, fear of losing patients, and a lack of respect from ECOG institutions as the most important barriers to minority cancer patient referrals, compared with 30% for ECOG physicians. Sixty-nine percent of NMA and 43% of ECOG physicians cited a lack of information about specific trials. Nearly half of NMA physicians (47%) cited a lack of minority investigators as a barrier, compared with 4% of ECOG physicians. Solutions by both groups were improved communication (73%) and culturally relevant educational materials (40%). ECOG physicians cited more minority outreach staff as a potential solution (22% v 6%). NMA physicians cited increased involvement of referring physicians (44% v4%). CONCLUSION: NMA physicians who serve a significant sector of the African American population demonstrated a willingness to participate and work with a cooperative group effort to increase participation of minority patients and investigators. (+info)Lack of knowledge in health professionals: a barrier to providing information to patients? (2/572)
OBJECTIVE: To assess obstetricians' and midwives' knowledge of routine prenatal screening tests for fetal abnormality and factors associated with such knowledge. DESIGN: Questionnaire assessment of antenatal clinic staff. SETTING: Six hospitals within the United Kingdom (four district general hospitals in London, one district general hospital in Wales, and one teaching hospital in Wales), offering routine prenatal screening tests. SUBJECTS: 29 obstetricians and 97 midwives were invited to participate, of whom 21 and 70 respectively responded to the questionnaire. MAIN MEASURES: Knowledge of prenatal tests, according to 19 item multiple choice questionnaire, reluctance to disclose uncertainty, and clinical experience. RESULTS: The overall response rate was 72% (91/126). In all, 43% of midwives and 14% of obstetricians obtained correct responses on fewer than half the items. Reluctance to disclose uncertainty to patients was associated in obstetricians with having less knowledge about prenatal testing (r = -0.50; p < 0.025, Pearson product moment correlation) and in midwives with more clinical experience (r = 0.43; p < 0.001). CONCLUSIONS: Lack of knowledge and greater clinical experience seem to be important barriers to providing patients with information about prenatal screening tests. (+info)Appropriateness of Hispanic print materials: a content analysis. (3/572)
Hispanic women living in the US have a higher rate of later-stage diagnosis of breast cancer, thereby decreasing their chances of surviving the disease. Research shows print materials are more heavily relied on than any other medium to inform this population about early detection and treatment of the disease. Hispanics, moreover, are more likely to read English at below the fourth-grade level than the general US population and have a lower educational attainment than that of non-Hispanic whites. This paper discusses the results of a content analysis of 26 national print breast cancer educational artifacts distributed to Hispanic women. The purpose was to assess the linguistic appropriateness and cultural sensitivity of the materials in efforts to establish preliminary guidelines for the development of future materials. The author concluded that though many of the artifacts displayed elements of cultural competency, all 26 failed to include components essential to reaching and impacting the designated target audience. Even more significant was a survey of health clinics nationwide that determined the 26 print materials as the most heavily relied upon to provide Hispanic women with information on breast cancer. (+info)The use of formal and informal services for antenatal care and malaria treatment in rural Uganda. (4/572)
The study aimed to analyze reasons for the use or non-use of antenatal care services and malaria treatment among pregnant women living in rural areas in Uganda. Focus group discussions with pregnant women, in-depth interviews with key informants (Traditional Birth Attendants (TBAs) and health workers) and a structured questionnaire administered to pregnant women were used to collect the relevant information. Antenatal care attendance was irregular and few women knew that the purpose of attending antenatal care was to monitor both the growth of the baby and the health status of the woman. Parity significantly influenced antenatal care attendance, but level of education, religion and marital status did not. Fifty-five per cent of the women stated that they had delivered outside the formal health delivery system despite antenatal care attendance. All women in their second pregnancy had delivered their first child in the village, despite TBA training to the contrary. Malaria as perceived by pregnant women is common and multiple health service providers are used for its treatment. About 66% of the mothers reported having suffered from malaria during the current pregnancy; of these more than half had received treatment outside the formal health delivery system. Self-treatment with drugs bought from ordinary shops was commonly reported. Nearly all women (93.3%) knew about the antimalarial drug chloroquine and 83% thought that it was used for the treatment of malaria, not for its prevention. Some women believed that the drug could cause abortion. Health seeking behaviour was influenced by several factors, including the perceived high cost of antenatal care services, of conducting a delivery and treatment, and perceived inadequacy of services provided by the formal health system. Inadequacy of formal health services was perceived by users to be partly due to understaffing and to irregular supply of essential drugs. Intensive health education to pregnant women on the safety of chloroquine use in pregnancy, the importance and the need for regular antenatal care attendance are recommended. In addition, training of more TBAs and continued educational efforts to upgrade their knowledge, regular and adequate supply of essential drugs, and free health services for high-risk groups such as pregnant women are recommended to improve antenatal care services and drug prophylaxis use in pregnancy. (+info)Barriers to meeting the mental health needs of the Chinese community. (5/572)
BACKGROUND: This study aimed to identify the barriers encountered by Chinese people with mental health needs in England which hindered their obtaining appropriate help from the National Health Service (NHS). METHODS: Attenders at Chinese community centres in health authority districts with resident Chinese population in excess of 2000 were invited to fill in a 12-item Chinese Health Questionnaire (12-CHQ). Individuals who scored two or above, indicating a high probability of a mental health problem, were invited to undertake a semi-structured interview. RESULTS: A total of 401 completed the 12-CHQ. Eighty-six (21.4 per cent) screened positive and 71 (82.6 per cent) agreed to be interviewed. Although 70 (98.6 per cent) were registered with a general practitioner (GP), there were long delays before they made contact with health professionals, and the GP was the first port of call for help in only 27 (38.6 per cent) interviewees. Fifty-two (74.3 per cent) had encountered difficulties when they sought professional help. The main barriers were language, interviewees' perceptions of symptoms as somatic rather than psychiatric in origin, lack of knowledge about statutory services, and lack of access to bilingual health professionals. Doctors, particularly GPs, were pivotal in the management of their conditions. The majority were prescribed psychiatric medication with only a small number in contact with community psychiatric services. Unemployment and social exclusion were common. Stigma associated with mental illness and limited knowledge in the community were identified as the causes for the widespread discrimination experienced by the interviewees. CONCLUSION: The mental health needs of these Chinese people were not adequately met by statutory services, nor could they rely on family and friends for care and support. Training for health service staff and access to health advocates are essential to maximize the effectiveness of health professional-patient contacts. The promotion of better understanding of mental illness by the Chinese community is important, and greater flexibility within the NHS is required to ensure those professionals with bilingual skills are used to the best effect. (+info)Do physicians spend more time with non-English-speaking patients? (6/572)
OBJECTIVE: To determine whether physicians at a general internal medicine clinic spend more time with non-English-speaking patients. DESIGN: A time-motion study comparing physician time spent with non-English-speaking patients and time spent with English-speaking patients during 5 months of observation. We also tested physicians' perceptions of their time use with a questionnaire. SETTING: Primary care internal medicine clinic at a county hospital. PATIENTS/PARTICIPANTS: One hundred sixty-six established clinic patients, of whom 57 were non-English speaking and 109 were English speaking, and 15 attending physicians and 8 third-year resident physicians. MEASUREMENTS AND MAIN RESULTS: Outcome measures included total patient time in clinic, wait for first nurse or physician contact, time in contact with the nurse or physician, physician time spent on the visit, and physician perceptions of time use with non-English-speaking patients. After adjustment for demographic and comorbidity variables, non-English-speaking and English-speaking patients did not differ on any time-motion variables, including physician time spent on the visit (26.0 vs 25.8 minutes). A significant number of clinic physicians believed that they spent more time during a visit with non-English-speaking patients (85.7%) and needed more time to address important issues during a visit (90. 4%), (both p <.01). Physicians did not perceive differences in the amount they accomplished during a visit with non-English-speaking patients. CONCLUSIONS: There were no differences in the time these physicians spent providing care to non-English-speaking patients and English-speaking patients. An important limitation of this study is that we were unable to measure quality of care provided or patients' satisfaction with their care. Physicians may believe that they are spending more time with non-English-speaking patients because of the challenges of language and cultural barriers. (+info)How does a change in the administration method affect the reliability of the COOP/WONCA Charts? World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians. (7/572)
BACKGROUND: An interviewer is often needed to administer the COOP/WONCA Charts to Chinese patients, and this may affect the reliability of results. OBJECTIVES: We aimed to find out the reliability of the COOP/WONCA Charts administered by an interviewer, and whether a change in the interviewer or administration method would affect the results. METHODS: We carried out a cross-sectional test-retest study on 487 Chinese adult patients attending a family medicine clinic in Hong Kong. The COOP/WONCA Charts were administered by the same interviewer, two different interviewers or self-completion and interviewer administration, on test and retest. The random, inter-observer and inter-method variances were compared with the inter-subject variance. The reliability coefficient of each COOP/WONCA Chart was calculated for each method of administration. RESULTS: Random errors could change the scores by 0.57-1.04, inter-observer variations could change the scores of four charts by 0.72-0.80, and a change in the method could change the physical fitness score by 1.79 and the daily activities score by 1.31, on a five-point scale. The reliability coefficients of the six COOP/WONCA Charts were 0.68-0.92 for one interviewer, 0.59-0.82 for two interviewers and 0.46-0.81 for two methods. CONCLUSION: The Chinese COOP/WONCA Charts were reliable in detecting real differences when administered by an interviewer. A change in the method of administration significantly decreased the reliability of the results. The use of more than one method of data collection in the same survey should be discouraged. (+info)"First aid for scalds" campaign: reaching Sydney's Chinese, Vietnamese, and Arabic speaking communities. (8/572)
OBJECTIVES: As a serious yet preventable problem, scald injuries in children have been a priority for prevention in Australia and other developed countries. Not only can the occurrence of scalds be prevented, but immediate first aid treatment offers an effective method for secondary prevention, reducing the severity of scalds. Despite the success of scald prevention initiatives, local evidence suggested that first aid knowledge was lacking in some minority ethnic groups. To redress this gap, the "First Aid for Scalds" campaign for those from a non-English speaking background was specifically targeted to three ethnic groups (Vietnamese, Chinese, and Arabic), with the aim of increasing the proportions of parents and caregivers who had correct knowledge of first aid treatment for scalds. The primary strategy was a media campaign, including advertisements on ethnic radio and in ethnic newspapers. METHODS: The evaluation design included formative research and impact evaluation. The impact evaluation study involved random population based telephone surveys with each of the three language groups, before and after the campaign, to assess the reach and effectiveness of the campaign. RESULTS: After the campaign, there were significant increases in the proportion of people who knew the correct first aid treatment for scalds. There were substantial variations in campaign recall and knowledge between each of the three language groups. The largest improvement was found in the Vietnamese group. CONCLUSION: The association between campaign recall and increase in correct knowledge, and the absence of any similar interventions during the campaign period, give credence to the conclusion that the changes observed were a result of the campaign. The results demonstrate the value of community based injury prevention campaigns specifically targeting linguistically diverse communities. (+info)Communication barriers in a medical context refer to any factors that prevent or hinder the effective exchange of information between healthcare providers and patients, or among healthcare professionals themselves. These barriers can lead to misunderstandings, errors, and poor patient outcomes. Common communication barriers include:
1. Language differences: When patients and healthcare providers do not speak the same language, it can lead to miscommunication and errors in diagnosis and treatment.
2. Cultural differences: Cultural beliefs and values can affect how patients perceive and communicate their symptoms and concerns, as well as how healthcare providers deliver care.
3. Literacy levels: Low health literacy can make it difficult for patients to understand medical information, follow treatment plans, and make informed decisions about their care.
4. Disability: Patients with hearing or vision impairments, speech disorders, or cognitive impairments may face unique communication challenges that require accommodations and specialized communication strategies.
5. Emotional factors: Patients who are anxious, stressed, or in pain may have difficulty communicating effectively, and healthcare providers may be less likely to listen actively or ask open-ended questions.
6. Power dynamics: Hierarchical relationships between healthcare providers and patients can create power imbalances that discourage patients from speaking up or asking questions.
7. Noise and distractions: Environmental factors such as noise, interruptions, and distractions can make it difficult for patients and healthcare providers to hear, focus, and communicate effectively.
Effective communication is critical in healthcare settings, and addressing communication barriers requires a multifaceted approach that includes training for healthcare providers, language services for limited English proficient patients, and accommodations for patients with disabilities.
According to the World Health Organization (WHO), "hearing impairment" is defined as "hearing loss greater than 40 decibels (dB) in the better ear in adults or greater than 30 dB in children." Therefore, "Persons with hearing impairments" refers to individuals who have a significant degree of hearing loss that affects their ability to communicate and perform daily activities.
Hearing impairment can range from mild to profound and can be categorized as sensorineural (inner ear or nerve damage), conductive (middle ear problems), or mixed (a combination of both). The severity and type of hearing impairment can impact the communication methods, assistive devices, or accommodations that a person may need.
It is important to note that "hearing impairment" and "deafness" are not interchangeable terms. While deafness typically refers to a profound degree of hearing loss that significantly impacts a person's ability to communicate using sound, hearing impairment can refer to any degree of hearing loss that affects a person's ability to hear and understand speech or other sounds.
In the medical context, communication refers to the process of exchanging information, ideas, or feelings between two or more individuals in order to facilitate understanding, cooperation, and decision-making. Effective communication is critical in healthcare settings to ensure that patients receive accurate diagnoses, treatment plans, and follow-up care. It involves not only verbal and written communication but also nonverbal cues such as body language and facial expressions.
Healthcare providers must communicate clearly and empathetically with their patients to build trust, address concerns, and ensure that they understand their medical condition and treatment options. Similarly, healthcare teams must communicate effectively with each other to coordinate care, avoid errors, and provide the best possible outcomes for their patients. Communication skills are essential for all healthcare professionals, including physicians, nurses, therapists, and social workers.
Physician-patient relations, also known as doctor-patient relationships, refer to the interaction and communication between healthcare professionals and their patients. This relationship is founded on trust, respect, and understanding, with the physician providing medical care and treatment based on the patient's needs and best interests. Effective physician-patient relations involve clear communication, informed consent, shared decision-making, and confidentiality. A positive and collaborative relationship can lead to better health outcomes, improved patient satisfaction, and increased adherence to treatment plans.
In the context of medicine, particularly in neurolinguistics and speech-language pathology, language is defined as a complex system of communication that involves the use of symbols (such as words, signs, or gestures) to express and exchange information. It includes various components such as phonology (sound systems), morphology (word structures), syntax (sentence structure), semantics (meaning), and pragmatics (social rules of use). Language allows individuals to convey their thoughts, feelings, and intentions, and to understand the communication of others. Disorders of language can result from damage to specific areas of the brain, leading to impairments in comprehension, production, or both.
The Blood-Brain Barrier (BBB) is a highly specialized, selective interface between the central nervous system (CNS) and the circulating blood. It is formed by unique endothelial cells that line the brain's capillaries, along with tight junctions, astrocytic foot processes, and pericytes, which together restrict the passage of substances from the bloodstream into the CNS. This barrier serves to protect the brain from harmful agents and maintain a stable environment for proper neural function. However, it also poses a challenge in delivering therapeutics to the CNS, as most large and hydrophilic molecules cannot cross the BBB.
Cell communication, also known as cell signaling, is the process by which cells exchange and transmit signals between each other and their environment. This complex system allows cells to coordinate their functions and maintain tissue homeostasis. Cell communication can occur through various mechanisms including:
1. Autocrine signaling: When a cell releases a signal that binds to receptors on the same cell, leading to changes in its behavior or function.
2. Paracrine signaling: When a cell releases a signal that binds to receptors on nearby cells, influencing their behavior or function.
3. Endocrine signaling: When a cell releases a hormone into the bloodstream, which then travels to distant target cells and binds to specific receptors, triggering a response.
4. Synaptic signaling: In neurons, communication occurs through the release of neurotransmitters that cross the synapse and bind to receptors on the postsynaptic cell, transmitting electrical or chemical signals.
5. Contact-dependent signaling: When cells physically interact with each other, allowing for the direct exchange of signals and information.
Cell communication is essential for various physiological processes such as growth, development, differentiation, metabolism, immune response, and tissue repair. Dysregulation in cell communication can contribute to diseases, including cancer, diabetes, and neurological disorders.
Animal communication is the transmission of information from one animal to another. This can occur through a variety of means, including visual, auditory, tactile, and chemical signals. For example, animals may use body postures, facial expressions, vocalizations, touch, or the release of chemicals (such as pheromones) to convey messages to conspecifics.
Animal communication can serve a variety of functions, including coordinating group activities, warning others of danger, signaling reproductive status, and establishing social hierarchies. In some cases, animal communication may also involve the use of sophisticated cognitive abilities, such as the ability to understand and interpret complex signals or to learn and remember the meanings of different signals.
It is important to note that while animals are capable of communicating with one another, this does not necessarily mean that they have language in the same sense that humans do. Language typically involves a system of arbitrary symbols that are used to convey meaning, and it is not clear to what extent animals are able to use such symbolic systems. However, many animals are certainly able to communicate effectively using their own species-specific signals and behaviors.
Communication disorders refer to a group of disorders that affect a person's ability to receive, send, process, and understand concepts or verbal, nonverbal, and written communication. These disorders can be language-based, speech-based, or hearing-based.
Language-based communication disorders include:
1. Aphasia - a disorder that affects a person's ability to understand or produce spoken or written language due to damage to the brain's language centers.
2. Language development disorder - a condition where a child has difficulty developing age-appropriate language skills.
3. Dysarthria - a motor speech disorder that makes it difficult for a person to control the muscles used for speaking, resulting in slurred or slow speech.
4. Stuttering - a speech disorder characterized by repetition of sounds, syllables, or words, prolongation of sounds, and interruptions in speech known as blocks.
5. Voice disorders - problems with the pitch, volume, or quality of the voice that make it difficult to communicate effectively.
Hearing-based communication disorders include:
1. Hearing loss - a partial or complete inability to hear sound in one or both ears.
2. Auditory processing disorder - a hearing problem where the brain has difficulty interpreting the sounds heard, even though the person's hearing is normal.
Communication disorders can significantly impact a person's ability to interact with others and perform daily activities. Early identification and intervention are crucial for improving communication skills and overall quality of life.
Health communication is the scientific field that uses communication strategies and methods to inform and influence individual health behaviors and organizational, community, and public policies. It combines disciplines such as psychology, sociology, anthropology, and public health to develop and disseminate messages that will improve health literacy, engage individuals in self-care, and promote positive changes in healthcare systems and policy. Health communication can be used to increase awareness of health issues, prevent the spread of diseases, reduce risky behaviors, and promote healthy lifestyles. It encompasses a wide range of activities including interpersonal communication between patients and healthcare providers, mass media campaigns, social marketing, patient education materials, and community-based participatory research.
Communication aids for disabled are devices or tools that help individuals with disabilities to communicate effectively. These aids can be low-tech, such as communication boards with pictures and words, or high-tech, such as computer-based systems with synthesized speech output. The goal of these aids is to enhance the individual's ability to express their needs, wants, thoughts, and feelings, thereby improving their quality of life and promoting greater independence.
Some examples of communication aids for disabled include:
1. Augmentative and Alternative Communication (AAC) devices - These are electronic devices that produce speech or text output based on user selection. They can be operated through touch screens, eye-tracking technology, or switches.
2. Speech-generating devices - Similar to AAC devices, these tools generate spoken language for individuals who have difficulty speaking.
3. Adaptive keyboards and mice - These are specialized input devices that allow users with motor impairments to type and navigate computer interfaces more easily.
4. Communication software - Computer programs designed to facilitate communication for individuals with disabilities, such as text-to-speech software or visual scene displays.
5. Picture communication symbols - Graphic representations of objects, actions, or concepts that can be used to create communication boards or books.
6. Eye-tracking technology - Devices that track eye movements to enable users to control a computer or communicate through selection of on-screen options.
These aids are often customized to meet the unique needs and abilities of each individual, allowing them to participate more fully in social interactions, education, and employment opportunities.
Nonverbal communication in a medical context refers to the transmission of information or messages through visual, auditory, tactile, olfactory, and kinesthetic channels, excluding spoken or written language. It includes facial expressions, body posture, gestures, eye contact, touch, physical appearance, use of space, and paralanguages such as tone of voice, volume, and pitch. In healthcare settings, nonverbal communication plays a crucial role in building rapport, expressing empathy, conveying emotions, and understanding patients' needs and concerns. Healthcare providers should be aware of their own nonverbal cues and interpret those of their patients to enhance clinical encounters and improve patient-centered care.