Integrating psychology with interpersonal communication skills in undergraduate nursing education: Addressing the challenges

The inclusion of the social, behavioural and bio-sciences is acknowledged as essential to the development of the art and science of nursing. Nonetheless, the literature highlights on-going debate about the content and delivery of these subject areas in undergraduate nursing education. The bio-sciences and social sciences in particular have received much attention but more recently the inclusion of psychology in nursing curricula is gaining momentum. Studies conducted on nursing students' views of these supporting sciences have also highlighted problems with their understanding, relevance and application to nursing practice.Although broad guidelines are given as to what should be included, no detail is given as to how much detail or at what level these subjects should be taught. Subsequently, approved institutions are responsible for their own course content. This has resulted in inconsistent and varied approaches to integrating the sciences in undergraduate nursing curricula.Following a recent review of the undergraduate nursing curriculum in one university in the Republic of Ireland a decision was made to combine the teaching, learning and assessment of Applied Psychology with Interpersonal Communication skills. This paper will describe the developmental process and evaluation of the integrated module.     

Auditory-perceptual analysis of voice in abused children and adolescents

IntroductionAbused children and adolescents are exposed to factors that can trigger vocal changes.ObjectiveThis study aimed to analyze the prevalence of vocal changes in abused children and adolescents, through auditory-perceptual analysis of voice and the study of the association between vocal changes, communication disorders, psychiatric disorders, and global functioning.MethodsThis was an observational and transversal study of 136 children and adolescents (mean age 10.2 years, 78 male) who were assessed by a multidisciplinary team specializing in abused populations. Speech evaluation was performed (involving the aspects of oral and written communication, as well as auditory-perceptual analysis of voice, through the GRBASI scale). Psychiatric diagnosis was performed in accordance with the DSM-IV diagnostic criteria and by applying the K-SADS; global functioning was evaluated by means of the C-GAS scale.ResultsThe prevalence of vocal change was 67.6%; of the patients with vocal changes, 92.3% had other communication disorders. Voice changes were associated with a loss of seven points in global functioning, and there was no association between vocal changes and psychiatric diagnosis.ConclusionThe prevalence of vocal change was greater than that observed in the general population, with significant associations with communication disorders and global functioning. The results demonstrate that the situations these children experience can intensify the triggering of abusive vocal behaviors and consequently, of vocal changes.     

Stability of a chronic implanted brain-computer interface in late-stage amyotrophic lateral sclerosis

ObjectiveWe investigated the long-term functional stability and home use of a fully implanted electrocorticography (ECoG)-based brain-computer interface (BCI) for communication by an individual with late-stage Amyotrophic Lateral Sclerosis (ALS).MethodsData recorded from the cortical surface of the motor and prefrontal cortex with an implanted brain-computer interface device was evaluated for 36 months after implantation of the system in an individual with late-stage ALS. In addition, electrode impedance and BCI control accuracy were assessed. Key measures included frequency of use of the system for communication, user and system performance, and electrical signal characteristics.ResultsUser performance was high consistently over the three years. Power in the high frequency band, used for the control signal, declined slowly in the motor cortex, but control over the signal remained unaffected by time. Impedance increased until month 5, and then remained constant. Frequency of home use increased steadily, indicating adoption of the system by the user.ConclusionsThe implanted brain-computer interface proves to be robust in an individual with late-stage ALS, given stable performance and control signal for over 36 months.SignificanceThese findings are relevant for the future of implantable brain-computer interfaces along with other brain-sensing technologies, such as responsive neurostimulation.     

Failure of communication: a patient’s story

The first author, a patient who underwent elective caesarean section and felt pain necessitating conversion to general anaesthesia, describes the experience with particular reference to the perceived poor communication between her and her anaesthetist. This extended from the preoperative visit to the information provided to her general practitioner after discharge. She makes several suggestions which would have made her experience, and those of other patients in similar circumstances, less traumatic. The second author, who had no involvement in events and works in a different Trust, comments upon the events from the perspective of an obstetric anaesthetist.