追加反馈对护生沟通能力的影响

目的:探讨临床教学中追加反馈对护生沟通技能效果的影响。方法:随机抽取某院实习的护理专业2007级本科生56名,分为实验1组(28人)和实验2组(28人)。实验1组采用结果反馈(KR),反馈内容为沟通错误的信息;实验2组采用表现反馈,反馈内容为沟通错误及正确沟通的信息。结果:两组在沟通技能整个阶段成绩有显著性差别(P0.01)。结论:学习和实践过程中追加反馈的类型和内容对护生沟通技能的把握和运用有影响,表现反馈较结果反馈能够明显提高护生沟通技能。     

Improving therapeutic outcomes in autism spectrum disorders: Enhancing social communication and sensory processing through the use of interactive robots

For children with autism spectrum disorders (ASDs), social robots are increasingly utilized as therapeutic tools in order to enhance social skills and communication. Robots have been shown to generate a number of social and behavioral benefits in children with ASD including heightened engagement, increased attention, and decreased social anxiety. Although social robots appear to be effective social reinforcement tools in assistive therapies, the perceptual mechanism underlying these benefits remains unknown. To date, social robot studies have primarily relied on expertise in fields such as engineering and clinical psychology, with measures of social robot efficacy principally limited to qualitative observational assessments of children's interactions with robots. In this review, we examine a range of socially interactive robots that currently have the most widespread use as well as the utility of these robots and their therapeutic effects. In addition, given that social interactions rely on audiovisual communication, we discuss how enhanced sensory processing and integration of robotic social cues may underlie the perceptual and behavioral benefits that social robots confer. Although overall multisensory processing (including audiovisual integration) is impaired in individuals with ASD, social robot interactions may provide therapeutic benefits by allowing audiovisual social cues to be experienced through a simplified version of a human interaction. By applying systems neuroscience tools to identify, analyze, and extend the multisensory perceptual substrates that may underlie the therapeutic benefits of social robots, future studies have the potential to strengthen the clinical utility of social robots for individuals with ASD.     

Efficacy of a dyadic intervention to improve communication between patients with cancer and their caregivers: A randomized pilot trial

ObjectiveCancer-related communication is critical for patients’ and caregivers’ adaptation to illness. This randomized pilot study was conducted to test the feasibility, acceptability, and efficacy of a specific dyadic intervention to improve communication.MethodsA four weekly-session intervention was developed to reinforce cancer-related patient-caregiver communication. Patients receiving treatment for any diagnosed cancer, and their caregivers, were recruited from two oncology clinics in Belgium. Sixty-four patient-caregiver dyads were assigned randomly to intervention and waitlist groups. Cancer-related dyadic communication, dyadic coping and emotional distress were assessed at baseline and post-intervention.ResultsThe intervention attrition rate was 6 %. Linear mixed models were performed on 60 dyads. Significant two-way group × time interaction indicated improvement in participants’ cancer-related dyadic communication frequency (β = ?1.30; SE = 0.31; p = .004), self-efficacy (β = ?10.03; SE = 3.90; p = .011) and dyadic coping (β = ?5.93; SE = 2.73; p = .046) after the intervention.ConclusionThese results indicate that the brief dyadic communication intervention is feasible and acceptable, and show preliminary evidence of efficacy.Practice implicationsEncouraging patients and caregivers to discuss personal cancer-related concerns may improve their ability to cope with the illness together.     

The women’s health objective structured clinical exam: a multidisciplinary collaboration

Abstract

Purpose: To determine the preliminary benefits of a Women’s Health Objective Structured Clinical Exam (OSCE) which integrates psychiatry and obstetrics and gynecology principles into communication-focused doctor-patient paradigms.

Method: The authors extracted medical student survey data from pre- and post-OSCE program evaluations (n?=?193). Using McNemar’s tests, the authors compared pre- and post-OSCE proportions of students reporting comfort levels with interactions involving terminally diagnosed patients, domestic violence, breast feeding, and other areas relevant to women’s health.

Results: The proportion of students reporting comfort with each communication domain increased between pre- and post-OSCE assessments. The greatest improvements were observed for discussions related to domestic violence (41% gain), terminal illness (37% gain) and postpartum depression/psychosis (23% gain). Ninety-four percent felt that this Women’s Health OSCE was a valuable learning experience.

Conclusion: The authors conclude that this Women’s Health OSCE was a successful addition to the medical student clinical curriculum as measured by student satisfaction and self-reported improved comfort levels with challenging communication paradigms. Future studies will investigate the effect that this learning activity has on competency.     

Risk perception and choice of place of birth in women with high risk pregnancies: A qualitative study

Objective To examine the perception of risk among a group of women with high risk pregnancies who were either planning to give birth in hospital, or at home despite medical advice to the contrary. The intention was to consider differences and similarities between the groups to examine how perception of risk relates to choice of place of birth.Design Qualitative study using semi-structured interviews. Setting Maternity department in a hospital in South East England.Participants Twenty-six women with high risk pregnancies, at least 32 weeks pregnant. Half were planning hospital births and half homebirths.Measurements and findings Semi-structured interviews to investigate women's understanding and assessment of risk. Results were analysed using thematic analysis. Five themes emerged: understanding of situation; judgement of risk; reassuring factors; impact of risk; and coping with risk. Women from both groups had some understanding of the implications of their medical/obstetric conditions. They displayed concerns about their babies' wellbeing. Women planning homebirths assessed their risks as lower and expressed less concerns than women planning hospital births. Women planning hospital births more frequently described following professional advice.Key conclusions Risk perception is individual and subjective. Women with high risk pregnancies who plan to give birth at home perceive risk differently to women who plan hospital births.Implications for practice Healthcare professionals working with women with high risk pregnancies should be aware of the potential for differences in definitions and perceptions of risk within this group.     

Too far away to work with each other: Does location impact on pharmacists’ perceptions of interprofessional interactions?

In recent years, the delivery of health services has seen a shift towards interprofessional teamwork in order to effectively utilise the skills of each member of the healthcare team to deliver optimal patient care. Nevertheless, a variety of barriers, including lack of communication between healthcare professionals (HCPs), have been identified. The expanding clinical services provided by community pharmacies have increased the potential for pharmacist-HCP interaction; however, primary care pharmacy environments vary from individual distinct premises to part of interprofessional ‘health centres’. As such, one potential factor affecting interprofessional communication could be the geographical location (‘space’) of HCPs. This study sought to determine whether these different primary healthcare ‘spaces’ impact on the frequency of interprofessional interactions. An anonymous, self-complete questionnaire was sent to all community pharmacies in Wales (n = 716) to quantify the frequency of interprofessional interactions between community pharmacists and other HCPs. A response rate of 62% was achieved. Results showed that pharmacists working in pharmacies physically linked to general practitioner (GP) surgeries had significantly more frequent interaction with HCPs based within the surgeries. This suggests that housing HCPs in the same physical space will enable more interprofessional interaction, supporting the drive to improve the quality of patient care.     

Development of socio-communicative skills in 9- to 12-month-old individuals with fragile X syndrome

We investigated the early socio-communicative development of individuals with fragile X syndrome (FXS) by undertaking a retrospective analysis of family videos. Videos were analyzed to identify existing communicative forms and functions. Analyses were undertaken on seven children who were later diagnosed with FXS. The children were filmed when they were 9–12 months old and before being diagnosed. Fourteen different communicative forms and six different communicative functions were observed. All participants were observed to express the functions of ‘Attention to self’ and ‘Answering’, but none indicated ‘Requesting action’, ‘Requesting information’, ‘Choice making’, or ‘Imitating’. Results suggest that children with FXS may have a limited range of communicative forms and functions when they are from 9 to 12 months of age. However, further research is necessary to gain a specific developmental profile of socio-communicative forms and functions in FXS.