Medicine and Health Sciences Commons^™

Influencing Change In Healthcare Providers: Communication Strategies For A New Era In Healthcare, Ceonne Raasikh

Doctor of Nursing Practice (DNP) Projects

Effective provider communication is the key to patient engagement. However, many providers are not able to effectively communicate with patients, in part due to low health literacy. Evidence in the literature supports the use of specific strategies aimed at improving communication with patients. The purpose of this quality initiative was to influence providers to adopt new communication strategies with their patients. Pharmacists, nurses and physicians were invited to participate in a free, full-day, educational event. During the event providers were alerted to the issue of health literacy and provided communication strategies to improve patient comprehension and engagement. Following the presentation, …

Communication During Palliative Care And End Of Life: Perceptions Of Experienced Pediatric Oncology Nurses, Kathleen Montgomery

Theses and Dissertations

Advances in cancer and supportive therapy have led to improved outcomes for children with cancer. Despite progress, children still die from complications of cancer therapy or their disease. Communication during palliative care and end of life is essential to successful navigation through the end of life continuum. Nurse communication during palliative care and end of life is a phenomenon with limited research, and it is unclear how the level of nursing experience influences the perspectives of nurses communicating during end of life. The purpose of this dissertation study was to describe the commonalities of nurses' experiences of communicating palliative care …

Delivering Patient Decision Aids On The Internet: Definitions, Theories, Current Evidence, And Emerging Research Areas, Aubri S. Hoffman, Robert J. Volk, Anton Saarimaki, Christine Stirling, Linda C. Li, Martin Härter, Geetanjali R. Kamath, Hilary Llewellyn-Thomas

Dartmouth Scholarship

Background: In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension — the delivery of patient decision aids on the Internet — is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods: An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results: The updated definition …

Conversations About The Weight Of America's Children: Barriers Which Prevent Healthcare Providers From Discussing Childhood Obesity, Catherine Blow, Alisa Allicock, Carolynn Desandre, Chandra Cooper-Samuels

Journal of Human Sciences and Extension

A systematic review of the literature was conducted to identify the barriers that prevent practitioners from identifying and counseling parents and caregivers of overweight or obese children. Once identified, barriers were organized into thematic categories (parental, provider, and professional barriers) and recommendations were generated to facilitate discussion about childhood obesity between professionals and parents. Childhood obesity is a significant public health problem. Healthcare providers must be able to effectively communicate with caregivers and put childhood obesity at the front of healthcare discussions. This article provides a synthesis of the relevant literature and makes recommendations for healthcare providers to overcome the …

Variance In Patient Access To Support Persons By Race/Ethnicity And Language Preference: An Analysis Of Patient Survey Data, Andrew J. Jager, Matthew K. Wynia

Journal of Health Disparities Research and Practice

Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had …

The Drug Facts Box: Improving The Communication Of Prescription Drug Information, Lisa M. Schwartz, Steven Woloshin

Dartmouth Scholarship

Communication about prescription drugs ought to be a paragon of public science communication. Unfortunately, it is not. Consumers see $4 billion of direct-to-consumer advertising annually, which typically fails to present data about how well drugs work. The professional label—the Food and Drug Administration's (FDA) mechanism to get physicians information needed for appropriate prescribing—may also fail to present benefit data. FDA labeling guidance, in fact, suggests that industry omit bene

The Effect Of Robot-Child Interactions On Social Attention And Verbalization Patterns Of Typically Developing Children And Children With Autism Between 4 And 8 Years, Sudha Srinivasan, Anjana Bhat

Open Access Author Fund Awardees' Articles

Background: There is anecdotal evidence for the use of robots to facilitate prosocial behaviors such as joint attention and verbalization in children with Autism Spectrum Disorders (ASDs). However, there have been no normative data in typically developing children to evaluate the effects of robot-child interactions on social and communication skills. Objectives: The aim of our study was to evaluate the changes in social attention and verbalization skills of 15 typically developing (TD) children, using a structured 8-session imitation protocol within a robot-adult-child context. We further extended this imitation protocol to two children with ASDs. Methods: Pretest, session1, session 4, session …

The Collaboration Particle; Applying The Formalism Of Quantum Theory To Cognition., Kelsey E. Landis, Hontas F. Farmer

Hontas F Farmer

We propose that collaboration between two people can be thought of as a quantum cognitive process wherein the relevant reality to be comprehended is an idea being communicated from one person to the other. Through a combination of writing center pedagogy and quantum theory, supported by mathematical evidence, we assert that collaboration can be effectively and equally established in both face-to-face and online writing tutoring sessions through conscious, active meditation to harness what can be thought of as a particle. Included is an analysis of writing center scholarship to show how collaboration is traditionally considered in a writing center context, …

Narrative Medicine As A Means Of Training Medical Students Toward Residency Competencies, Shannon L. Arntfield, Kristen Slesar, Jennifer Dickson, Rita Charon

Paediatrics Publications

Objective: This study sought to explore the perceived influence of narrative medicine training on clinical skill development of fourth-year medical students, focusing on competencies mandated by ACGME and the RCPSC in areas of communication, collaboration, and professionalism. Methods: Using grounded-theory, three methods of data collection were used to query twelve medical students participating in a one-month narrative medicine elective regarding the process of training and the influence on clinical skills. Iterative thematic analysis and data triangulation occurred. Results: Response rate was 91% (survey), 50% (focus group) and 25% (follow-up). Five major findings emerged. Students perceive that they: develop and improve …

Physician Satisfaction: The Role Of E-Mail Communication In The Practice Of Medicine, Joaquin Alvarado

Honors Theses

Communication between a physician and a patient is an integral part to the healthcare delivery system. E-mail has the power to fully utilize a physician’s medical expertise for the good of the patient. However, many physicians do not offer this service to their patients in the United States. This study analyzes factors that impact e‐mail utilization among physicians and whether e-mail use contributes to career satisfaction of physicians using the 2008 Health Tracking and Physician Survey. Controlling for the effect of physician and practice characteristics, such as financial incentive for providing services, gender, specialty, practice type, and reliance on Medicaid …

A Librarian By Any Other Name: The Role Of The Informationist On A Clinical Research Team, Sally A. Gore

Sally A. Gore

In 2012, the Lamar Soutter Library (LSL), University of Massachusetts Medical School, successfully collaborated with two principal investigators at UMMS, as well as their research team, to receive a supplemental grant from the National Library of Medicine. The award, an “NLM Administrative Supplements for Informationist Services in NIH-funded Research Projects”, was one of eight awarded nationally. It provides funding to support an informationist, or in-context information specialist, who serves the research team by offering expertise in the areas of data and information management. For 18 months, the informationist is serving as a member of the research team on the grant, …

Ultrasonic Vocalizations In Eph/Ephrin Mutant Mice, Bryna Rickenbach-Cline

Dissertations, 2014-2019

Purpose: Murine mammals, more commonly known as mice, emit ultrasonic vocalizations or “yelps” to communicate. It has been found that adult mice use these vocalizations to communicate with each other, and infant mice utilize ultrasonic vocalizations to communicate with their mother. It is known that a relationship exists between hearing ability and vocalization (Bass-Ringdahl, 2010). This study aims to record yelps/ vocalizations of four strains of mouse pups to determine how the development of hearing relates to the vocalizations that are emitted. It is thought that mice with compromised genes that encode for signaling proteins that are essential to the …

Language In Genetics Research Informed Consent: The Language Gap And Unrecognized Miscommunication, Justin Morgenstern

Electronic Thesis and Dissertation Repository

Informed choice is fundamentally a process of communication, reliant entirely on the tools of language. However, the meanings and understandings of words change with time, setting, and context, threatening the basis of consent. We conducted a qualitative content analysis of Canadian genetics research documents, exploring the impacts of language on informed consent. Numerous language usages were noted as potential barriers to informed consent, including language that was vague, variable, and unusually defined. Unique combinations of words were observed to generate novel concepts without clear meanings and definitions were absent or unclear. However, the ambiguity of the language was concealed by …

A Review Of “Music And Movement” Therapies For Children With Autism: Embodied Interventions For Multisystem Development, Sudha M. Srinivasan, Anjana N. Bhat

Open Access Author Fund Awardees' Articles

The rising incidence of Autism Spectrum Disorders (ASDs) has led to a surge in the number of children needing autism interventions. This paper is a call to clinicians to diversify autism interventions and to promote the use of embodied music-based approaches to facilitate multisystem development. Approximately 12% of all autism interventions and 45% of all alternative treatment strategies in schools involve music-based activities. Musical training impacts various forms of development including communication, social-emotional, and motor development in children with ASDs and other developmental disorders as well as typically developing children. In this review, we will highlight the multisystem impairments of …

Adolescent Sexual And Reproductive Health: Interviewing Skills, Clara Keegan Md, Nellie Wirsing Md

Family Medicine Scholarly Works

Objectives

Increase comfort with discussion of sexual health topics relevant to adolescents: sexual history, contraception, sexually transmitted infections, options counseling, coming out.

Begin to apply motivational interviewing techniques to the adolescent population.

Commentary: Changing The Channel: Public Health Communication In The 21st Century, Anna Goodman Hoover

Frontiers in Public Health Services and Systems Research

This commentary asserts the need for research examining the use and efficacy of social media as a tool for meeting public health stakeholders’ information needs. The author points to several potential research questions for the field, situates studies addressing these questions within the PHSSR Research Agenda, and introduces the work of Harris et al. that is included in this issue of Frontiers. The commentary closes with a call for horizontal stakeholder communication that supports evidence-based decision-making.

The Nature And Perceived Influence Of Lifestyle Discussions With Older Adults In Primary Care, Shoshana H. Bardach

Theses and Dissertations--Gerontology

The Nature and Perceived Influence of Lifestyle Discussions with Older Adults in Primary Care Rationale: A healthy diet and physical activity help with disease prevention and disease management and can promote quality of life regardless of the age at which an individual begins engaging in these behaviors. Despite the value of these health behaviors, many older adults do not follow lifestyle recommendations. Given that older adults frequently interact with the healthcare system, primary care providers are well situated to counsel older adults to improve their health behaviors. Unfortunately, we do not know how to most effectively engage in this counseling. …

Hardwiring Excellence: Applying Healthy Work Environment Principles To The Pediatric/Nicu Department, Diane Pelant

Nursing Posters

The goals of HWE is to improve trust, communication, employee engagement, patient satisfaction, patient safety, and patient clinical outcomes through skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership.

Rehabilitation Fall Prevention Strategies, May Schomer, Kathy Toulouse

Nursing Posters

To improve communication and education among health care workers on fall prevention measures in order to decrease fall rates and increase patient satisfaction.

Northern Stars Of Education: Enhancing Nursing Practice Through Collaboration, Jenelle Brekken, Kristin Brandt, Tammy Filippi, Mary Leyk

Nursing Posters

To utilize collaboration to increase communication, innovation, and support.

“It Is Not A Disease We Treat, But A Person”: Medical Students’ Reflections On Their First Rotations To An Oncology And Palliative Care Unit, John Kearsley, Elizabeth Lobb

Health Sciences Papers and Journal Articles

The vast array of technologic advances in medicine has transformed traditional medical practice and education. However, these advances are not without their critics (1-7). Some medical educators and students suggest that the “final product” of medical education has many of the characteristics of the applied scientist (2) rather than those of the humane physician-healer (8). Many medical students bring to their studies an idealism and an empathy that, for many, is quickly eroded over time. According to Bellini and Shea (4), they may never fully recover their empathy. Several studies have concluded that a significant decline in empathy occurs during …

Lessons Learned From Aac Camp, Janet L. Dodd

Communication Sciences and Disorders Faculty Articles and Research

Children who benefit from augmentative and alternative communication (AAC) need not only the support of individuals knowledgeable in the technologies themselves, but ones who understand the translation of language intervention principles to AAC.

Acute Lung Injury And Acute Respiratory Distress Syndrome Requiring Tracheal Intubation And Mechanical Ventilation In The Intensive Care Unit: Impact On Managing Uncertainty For Patient-Centered Communication, Robert F. Johnson Jr., Jillian Gustin

Peer Reviewed Articles

A 56 year-old male presented with symptoms of pneumonia and findings consistent with acute lung injury (ALI). Deterioration of respiratory function occurred over the first 24 hours of hospitalization leading to placement in an intensive care unit (ICU) followed by tracheal intubation and mechanical ventilation (ETMV). At that time criteria defining acute respiratory distress syndrome (ARDS) were present. The palliative medicine service was asked to address concerns expressed by the patient’s spouse reflecting uncertainty regarding outcome expectations.

When interacting with families of incapacitated critically ill patients, clinicians are advised to employ a patient-centered communication process to alleviate family distress and …

Comparing Spoken Language Treatments For Minimally Verbal Preschoolers With Autism Spectrum Disorders, Rhea Paul, Daniel Campbell, Kimberly Gilbert, Ioanna Tsiouri

Communication Disorders Faculty Publications

Preschoolers with severe autism and minimal speech were assigned either a discrete trial or a naturalistic language treatment, and parents of all participants also received parent responsiveness training. After 12 weeks, both groups showed comparable improvement in number of spoken words produced, on average. Approximately half the children in each group achieved benchmarks for the first stage of functional spoken language development, as defined by Tager-Flusberg et al. (J Speech Lang Hear Res, 52: 643–652, 2009). Analyses of moderators of treatment suggest that joint attention moderates response to both treatments, and children with better receptive language pre-treatment do better with …

Defining The Importance Of Mental Preparedness For Risk Communication And Residents Well-Prepared For Wildfire, Christine Eriksen, Timothy Prior

Faculty of Science, Medicine and Health - Papers: part A

Building on a recognised information-to-action gap in wildfire risk communication, this paper examines what being physically and mentally 'well prepared' actually means to wildfire agency staff and volunteers in charge of disseminating risk information. Using the results of an open-ended survey conducted in southeast Australia, we examine how a set of preparedness messages is interpreted. The paper demonstrates that the concept of wildfire preparedness is ambiguous, and that being 'well prepared' is a complex mix of practical and mental preparedness measures. Many of the individual interpretations of preparedness messages are found to not align with the official outlined intent. In …

Is There Any Effect Of Demographic Features On Development Of Hyperemesis Gravidarum In The Turkish Population?, Zeynep Kamalak, Nermi̇n Köşüş, Aydin Köşüş, Deni̇z Hizli, Ayli̇n Ayrim, Gonca Kurt

Turkish Journal of Medical Sciences

To assess the effect of maternal demographic variables on development of hyperemesis gravidarum (HG) in pregnant Turkish women. Materials and methods: Two hundred consecutive women with HG were defined as the study group, and 200 consecutive pregnant women without any signs or symptoms of HG matched for age, parity, and gestational age were defined as the control group. Personal information, including lifestyle, educational level, occupation, and economic status were obtained via questionnaire. Results: The number of abortions was higher but parity was lower in the HG group. The time interval between 2 pregnancies was significantly shorter in the HG group …

Women Who Stutter : Experiences Of Developing Self-Management And Quality Of Life, Katherine Milton

Theses : Honours

Background and Purpose: Research suggests that stuttering can impact an individual’s quality of life and how they perceive themselves in interactions with others. As a larger proportion of adults who stutter are men, limited research is available regarding the specific experiences of women who stutter (WWS). Existent literature regarding WWS was mainly published in the 1970s -1980s and may no longer represent current issues. This study aimed to explore the current influences on quality of life, perception of stuttering, self-management strategies, and gender issues experienced by WWS.

Methods and Procedures: This grounded theory study used a convenience sample of eight …

Communication Metaphor Of Patient Prognosis In The Spirit Of Hope, Dory Hanks

Theses and Graduate Projects

Prognosis for terminally ill patients is intended to serve the purpose of educating patients on the expected clinical outcome of their illness. This information is generally communicated to a patient by their primary physician when options for fufiher treattnent or "cure" are limited. Learning a prognosis may be helpful to some patients, while burdensome to others. A review of the literature reveals many barriers to effective communication of prognosis. The purpose of this project is to develop a metaphor for enhanced communication of prognosis to be used by hospice nurses that incorporates a caring perspective on living with hope during …