Experiences of Asian American Parents in a Group Intervention for Youth With Schizophrenia

PROBLEM: Schizophrenia, which frequently strikes during adolescence or young adulthood, can have devastating effects on the family. Parents, who are primary caregivers for mentally ill adolescents, often lack the information and skills necessary to cope with the multiple and complex consequences of a major psychiatric disorder. Moreover, parents are ill‐ prepared to help their other children cope with the unpredictable changes that accompany having a mentally ill sibling. Asian American parents face similar issues in dealing with their schizophrenic adolescents. However, there is limited information available about this population. METHODS: The purpose of this qualitative study was to examine the experiences of four Asian American parents who participated in a community‐based, family‐centered, self‐management intervention program for youth with schizophrenia. Participants were interviewed using semistructured interviews and language interpreters. Data were analyzed utilizing content analysis. FINDINGS: Four themes were identified: (a) same, but different; (b) sharing and learning; (c) using skills learned; and (d) working with interpreters. CONCLUSIONS: Results indicate that Asian American parents valued their participation in the group intervention and emphasized their similarities with non‐Asian American families who have a mentally ill youth.     

The better sleep better well‐being programme: Educating and training community healthcare nurses in developing interventions for families of infants with moderate sleep problems: a pilot study

The main aim of this pilot study was to evaluate the benefit of the Better Sleep Better Well‐being (BSBW) educational and training intervention programme regarding infants sleep problems for Community Health Care (CHC) nurses, on their perceptions on their family nursing practice skills and on their job demand, control and support. There were 6 CHC nurses who participated in the BSBW programme, and 26 nurses in the comparison group. The programme consisted of 4 sessions (8 hours per session) of lectures on the aetiology of infants sleep problems as well as on evidence‐based and family relational practices and on 20 sessions of clinical cases, scenarios, discussions and reflections. The main finding indicated that the nurses in the intervention group reported significantly higher family nursing practices skills compared to the nurses in the comparison group. The findings are promising, since they offered additional resources to the CHC nurses, in their clinical practices.     

A support group intervention for at-risk female high school students.

School nurses have an opportunity to engage in early intervention with high-risk adolescents. School-based support groups for depressed adolescents have been effective when aimed at providing skills training as well as emotional support. In this practice improvement project, 14 high-risk female adolescents from two high schools were identified on the basis of signs associated with depression. The students completed a questionnaire about risk and protective factors during the assessment and at the end of the intervention. Twelve students participated in a weekly support group designed to enhance coping skills and to provide emotional support. Assessment revealed that the students were at suicide risk. At the conclusion of the group intervention, there was a 55% decrease in suicidal ideation, a 27% decrease in perceived stress, and a 26% decrease in family distress. In addition, most of the students became engaged in formal treatment for the first time.     

认知学徒模式在临床护生护患沟通技能培训中的应用

目的基于认知学徒模式理论,探索临床护生护患沟通技能培训模式的构建,以提高临床教学效果。方法采用方便抽样法选取上海交通大学护理学院2008级护理学专业于A医院实习的22名护生为研究组,实习期间应用认知学徒模式开展沟通技能培训;同时选取同校于B医院实习的22名护生为对照组,采用传统带教模式。两组护生干预前后同时进行沟通能力测评表及改编版沟通技能自信问卷调查,同时对研究组进行培训满意度的调查。结果干预前,两组护生在沟通能力和沟通自信心方面无差异(P>0.05)。干预后,研究组在沟通自信心方面与对照组比较,差异无统计学意义(P>0.05);但在沟通能力总分及基本语言沟通能力及基本非语言沟通能力方面均高于对照组(P<0.01)。研究组85.7%的护生对培训效果表示满意。结论基于认知学徒模式的沟通技能教学能提高护生护患沟通能力,而对护生沟通自信的影响需进一步研究。该教学模式总体设置合理,结合多种教学形式,形成了良好的整体教学效应,具有可行性。     

Do Thai parents discuss sex and AIDS with young adolescents? A qualitative study

This qualitative study explored parents' and young adolescents' perceptions of communication related to sex and HIV/AIDS. Focus group discussions and group discussion were conducted among 67 adolescents and 30 parents. For the adolescents, group discussion using participatory activities was conducted, followed by five focus group discussions. Group discussions using participatory activities were conducted among parents. Thematic analysis indicated that the adolescents received inadequate information about sex and AIDS from their parents, whom they feared as providing negative judgment, and this represented a key barrier to such discussions. Their parents, on the other hand, reported that they believed their children were still too young to learn about and engage in sexual activities. The parents perceived barriers to communication included a lack of confidence and feelings of embarrassment. Nevertheless, they also recognized their important role in their child's sexual education. Collectively, these results draw attention to the need for a culturally appropriate program to strengthen parent–child communication skills for the topics of sex and HIV/AIDS.     

Parent implemented early intervention for young children with autism spectrum disorder: a systematic review

BACKGROUND: Recent estimates concerning the prevalence of autism spectrum disorder (ASD) suggest that at least one in 200 children is affected. This group of children and families have important service needs. The involvement of parents in implementing intervention strategies designed to help their autistic children has long been accepted as helpful. The potential benefits are increased skills and reduced stress for parents as well as children. METHODS: This research review focused on interventions for children aged 1-6 years, and was carried out using systematic methodology: a comprehensive search of psychological, educational and biomedical databases, as well as bibliographies and reference lists of key articles, contact with experts in the field, and hand search of key journals. Only studies which involved a concurrent element of control were included. RESULTS: The review found very few studies that had adequate research design from which to draw conclusions about the effectiveness of parent-implemented early intervention. Both randomized and controlled studies tended to suggest that parent training leads to improved child communicative behaviour, increased maternal knowledge of autism, enhanced maternal communication style and parent child interaction, and reduced maternal depression. CONCLUSION: It seems that parent training can successfully contribute to intervention for young children with ASD. However, the review highlights the need for improved research in this area.     

Parent-adolescent communication and diabetes: an integrative review

Title. Parent–adolescent communication and diabetes: an integrative review. Aim. This paper presents a synthesis of findings from empirical studies about communication and interaction between parents and their adolescents with diabetes. Background. Communication between parent and adolescent is essential in transitioning the adolescent to increased responsibility for diabetes self‐management. Nurses are in a pivotal position to enhance the type of parent–adolescent communication that facilitates this transition. Data sources. A search of published studies from 1985 to 2006 featuring communication or interaction between parents and adolescents with type 1 diabetes was implemented through a computerized search. Review methods. Papers were organized by type of evidence and were analysed sequentially. Sources were described based on data elements which were extracted. Findings in the areas of productive and problematic parent–adolescent communications were included. Data elements were compared and critiqued, noting consistencies, and findings were summarized and evaluated. Results. Studies across several countries indicate that maternal support, conflict, control, involvement and emotional expression are important communication concepts that are linked to diabetes outcomes in adolescents. The influences of different family structures and cultural and socioeconomic circumstances, as well as developmental status and gender of adolescents on these types of communication, have not been systematically studied. Conclusion. Nurses caring for adolescents with type 1 diabetes need to consider family relationships and communication patterns in achieving health outcomes. Studies of communication, including perspectives of mothers and fathers, and the influence of family structure, economics and culture are needed to build a framework of parent–adolescent interaction and health outcomes for adolescents with type 1 diabetes.     

Training programme in techniques of self-control and communication skills to improve nurses' relationships with relatives of seriously ill patients: a randomized controlled study

The interpersonal relationships with relatives of seriously ill patients may cause anxiety on the part of nurses and the need for adequate communication and self-control skills. To assess the efficacy of training nurses in self-control techniques and communication skills when they interact with relatives of seriously ill patients we planned a randomized, controlled trial in two parallel groups: an experimental group, with immediate training, and a control group, with training delayed for 6 months. We recruited 61 nurses from the nursing staff of a university hospital of 500 beds. The intervention consisted of training in relaxation, cognitive restructuring and some communication skills. The outcome variables were communication skills measured under simulated conditions using an observation instrument of our own, administered by observers masked with respect to the study groups, and the levels of state-anxiety measured with the self-assessment questionnaire the State-Trait Anxiety Inventory, under imaginary conditions. The two groups initially had similar scores in the scales of communication skills, and state and trait-anxiety. After intervention, compared with the control group, the experimental group showed significant improvements in the skills of listening, emphasizing, interrupting and coping with emotions (P < 0.05). State-anxiety levels did not show any changes. In conclusion, the joint training in self-control and communication improves some communication skills in nurses when they interact with relatives of seriously ill patients under simulated conditions.     

Parents with psychosis and their children: experiences of Beardslee’s intervention

To meet children’s needs for information and support when a parent has a mental illness, Beardslee’s family intervention was implemented in Swedish psychosis care. The present study aimed to gain understanding of how parents’ with psychosis and their children experienced having taken part in Beardslee’s family intervention. The study followed COREQ guidelines. Semi‐structured interviews were conducted with 15 participants (8 parents with psychosis and 7 children) who had participated in the family intervention. Data were analysed with content analysis. Results showed that the parents perceived that the intervention had contributed to improved illness knowledge, communication, and understanding in the family. They also appreciated receiving support in finding an age‐adapted way of explaining their illness, but asked for structured follow‐ups in order to maintain communication. However, comparing parents’ and children’s interviews led to discrepancies in perceptions of the overall benefits of the intervention. In conclusion, parents with psychosis need continual support in talking to their children about their illness. Furthermore, discrepancies between parents’ and children’s interviews show the importance of multi‐perspective data collection when studying intervention effects.     

A comparison of the cooperative learning and traditional learning methods in theory classes on nursing students' communication skill with patients at clinical settings

The purpose of this study was to compare the effect of traditional learning and cooperative learning methods on nursing students' communication skill with patients. This was an experimental study in which 34 nursing students in their 2nd semester of program participated. They were divided randomly into two groups, a control group who were taught their medical/surgical nursing course by traditional learning method and an experimental group, who were taught the same material using cooperative learning method. Before and after the teaching intervention, the students' communication skills with patients at clinical settings were examined. The results showed that no significant difference between the two groups in students' communication skills scores before the teaching intervention, but did show a significant difference between the two groups in the interaction skills and problem follow up sub-scales scores after the teaching intervention. This study provides evidence that cooperative learning is an effective method for improving and increasing communication skills of nursing students especially in interactive skills and follow up the problems sub-scale, thereby it is recommended to increase nursing students' participation in arguments by applying active teaching methods which can provide the opportunity for increased communication skills.     

Efficacy of a short-term, intensive social skills training program for burned adolescents

This study examined the efficacy of an intensive, short-term social skills training program in improving the psychosocial adjustment of burned adolescents. Sixty-four adolescents who had suffered a burn injury 2 years previously or longer and who were identified as having psychosocial difficulties (elevated behavioral problems and/or diminished competence) were assigned randomly to receive the treatment intervention or to serve as controls (32 in each group). The intervention was a social skills training curriculum provided in a small group residential format. Didactic and experiential techniques were used in a schedule of activities during a 4-day period. One year after the training program, the group who had received the treatment showed significantly more improvement than did the control group. The program appears to offer advantages to a sizeable group of pediatric burn survivors and indicates the need for further study of interventions to enhance psychosocial competence in the development of pediatric burn survivors.     

Involving patients in decision making and communicating risk: a longitudinal evaluation of doctors' attitudes and confidence during a randomized trial

BACKGROUND: Important barriers to the wider implementation of shared decision making (SDM) and risk communication in practice remain. The attitudes of professionals undergoing training in these approaches may inform how to overcome these barriers, but there are few such data yet available. AIM: To identify the attitudes of professionals during participation in a large practice-based intervention study with substantial individual exposure to SDM and risk communication, and to assess their confidence with these approaches and reported frequency of implementing them. SETTING AND PARTICIPANTS: Twenty general practitioners (GPs) who had been in practice between 1 and 10 years, and participated in an explanatory trial lasting 6 months. The trial interventions comprised training in SDM skills and the use of risk communication materials. The doctors consulted with up to 48 patients each (mean = 40, half of them audio-taped) for the study. METHODS: Questionnaire assessments before and after each training stage. RESULTS: The GPs indicated positive attitudes towards involving patients and towards the training interventions. They indicated that the risk information packs were applicable but had used them only occasionally with patients outside the trial. No statistically significant changes were associated with the specific interventions in terms of doctors' confidence in discussing risk information after the risk communication intervention, or attitudes to patient involvement after the SDM intervention. Most attitudes and confidence ratings showed positive changes during the course of the trial as a cohort effect. Such positive changes were associated with female doctors more than male doctors, but not with MRCGP (postgraduate vocational) qualification. Time constraints remained important throughout the study in not implementing the approach more frequently. CONCLUSIONS: Professionals appear receptive to patient involvement, and willing to acquire the relevant skills. SDM and risk communication training did not appear to contribute differentially to this. Practical barriers such as time constraints should probably be addressed with greater priority than the precise content of training or continuing professional development initiatives if 'involvement' is to become a commoner experience for patients in primary care.     

Rehabilitation-specific communication skills training: improving the physician-patient relationship.

OBJECTIVE: Evaluate the effectiveness of a rehabilitation-specific communication skills training program for physicians. DESIGN: Three groups of rehabilitation patients were interviewed 3 mo after discharge, one group before and two groups after implementation of a communication skills training program. The setting was a free-standing rehabilitation hospital with a residency training program. A total of 245 patients who had been discharged from the rehabilitation hospital participated in the study. A communication skills training program that was designed specifically for physicians and patients in the rehabilitation setting was used as an intervention. Patients' perceptions of the extent to which physicians accomplished 18 communication tasks highlighted by the training program were gauged in a structured telephone interview. RESULTS: Participants interviewed after the training program was implemented more strongly agreed that their physicians accomplished the communication tasks assessed than did patients interviewed before the training program began. On 14 of 18 items, the differences were statistically significant (P < 0.05). CONCLUSION: Specialty-specific communication training can improve physician communication skills.     

丈夫沟通技能培训对同步放化疗宫颈癌患者婚姻质量、希望水平及社会功能的影响高杰 齐晓晓 李娟 李傲梅

目的 研究丈夫沟通技能培训对同步放化疗宫颈患者婚姻质量、希望水平及社会功能的影响。方法 选择2017年12月~2018年12月之间在我院接受放化疗治疗的120例宫颈癌手术患者为研究对象,将这些患者随机分为观察组和对照组,每组均为60例。两组患者均进行常规护理,同时观察组患者的丈夫进行沟通技能培训。干预三个月后,利用婚姻质量调查问卷评价两组患者婚姻质量。通过Herth希望量表(HHI)评价两组患者希望水平。利用PSP-CAN评价两组患者社会功能。结果 干预后,观察组患者的婚姻质量调查问卷、希望量表及社会功能量表分数均显著优于干预前,差异显著,P＜0.05；且,干预后,观察组患者婚姻质量调查问卷、希望量表及社会功能量表分数均显著优于对照组,差异显著,P＜0.05。结论 对同步放化疗宫颈患者在常规护理的基础上进行丈夫沟通技能培训,能够明显提高患者婚姻质量、提升患者希望水平,增强患者社会功能,提高患者生活质量,值得进一步深入研究并推广。     

支架式教学对专科实习护生临床沟通能力影响的研究

目的 探讨神经内科运用支架式教学在实习护生临床沟通能力中的应用效果。 方法采用方便抽样法选取淄博市某医学院校在A医院神经内科实习的20名护生为干预组,实习期间在传统带教基础上采用支架式教学开展沟通技能培训,同时选取同校在B医院神经内科实习的20名护生为对照组,采用传统带教模式,实习时间为2个月。在干预前后同时进行沟通能力测评和沟通技能自信问卷调查。 结果 实习2个月后,干预组临床沟通能力明显好于对照组(t=4.763,P<0.01)。干预组沟通自信得分高于对照组(t=2.184,P<0.05)。 结论 支架式教学模式能有效提高实习护生的临床沟通能力和沟通自信心。     

Online learning versus blended learning of clinical supervisee skills with pre-registration nursing students: A randomised controlled trial

BackgroundThe World Health Organisation amongst others recognises the need for the introduction of clinical supervision education in health professional education as a central strategy for improving patient safety and patient care. Online and blended learning methods are growing exponentially in use in higher education and the systematic evaluation of these methods will aid understanding of how best to teach clinical supervision.ObjectiveThe purpose of this study was to test whether undergraduate nursing students who received clinical supervisee skills training via a blended learning approach would score higher in terms of motivation and attitudes towards clinical supervision, knowledge of clinical supervision and satisfaction of learning method, when compared to those students who received an online only teaching approach.DesignA post-test-only randomised controlled trial.MethodsParticipants were a total of 122 pre-registration nurses enrolled at one United Kingdom university, randomly assigned to the online learning control group (n = 60) or the blended learning intervention group (n = 62). The blended learning intervention group participated in a face-to-face tutorial and the online clinical supervisee skills training app. The online learning control group participated in an online discussion forum and the same online clinical supervisee skills training app. The outcome measures were motivation and attitudes using the modified Manchester Clinical Supervision Scale, knowledge using a 10 point Multiple Choice Questionnaire and satisfaction using a university training evaluation tool. Statistical analysis was performed using independent t-tests to compare the differences between the means of the control group and the intervention group. Thematic analysis was used to analyse responses to open-ended questions.ResultsAll three of our study hypotheses were confirmed. Participants who received clinical supervisee skills training via a blended learning approach scored higher in terms of motivation and attitudes – mean (m) = 85.5, standard deviation (sd) = 9.78, number of participants (n) = 62 – compared to the online group (m = 79.5, sd = 9.69, n = 60) (p = .001). The blended learning group also scored higher in terms of knowledge (m = 4.2, sd = 1.43, n = 56) compared to the online group (m = 3.51, sd = 1.51, n = 57) (p = .015); and in terms of satisfaction (m = 30.89, sd = 6.54, n = 57) compared to the online group (m = 26.49, sd = 6.93, n = 55) (p = .001). Qualitative data supported results.ConclusionBlended learning provides added pedagogical value when compared to online learning in terms of teaching undergraduate nurses clinical supervision skills. The evidence is timely given worldwide calls for expanding clinical skills supervision in undergraduate health professional education to improve quality of care and patient safety.     

Improving medical student intensive care unit communication skills: a novel educational initiative using standardized family members

OBJECTIVE: To determine whether intensive care unit (ICU) communication skills of fourth-year medical students could be improved by an educational intervention using a standardized family member. DESIGN: Prospective study conducted from August 2003 to May 2004. SETTING: Tertiary care university teaching hospital. PARTICIPANTS: All fourth-year students were eligible to participate during their mandatory four-week critical care medicine clerkship. INTERVENTIONS: The educational intervention focused on the initial meeting with the family member of an ICU patient and included formal teaching of a communication framework followed by a practice session with an actor playing the role of a standardized family member of a fictional patient. At the beginning of the critical care medicine rotation, the intervention group received the educational session, whereas students in the control group did not. MEASUREMENTS AND MAIN RESULTS: At the end of each critical care medicine rotation, all students interacted with a different standardized family member portraying a different fictional scenario. Sessions were videotaped and were scored by an investigator blinded to treatment assignment using a standardized grading tool across four domains: a) introduction; b) gathering information; c) imparting information; and d) setting goals and expectations. A total of 106 (97% of eligible) medical students agreed to participate in the study. The total mean score as well as the scores for the gathering information, imparting information, setting goals, and expectations domains for the intervention group were significantly higher than for the control group (p < .01). CONCLUSIONS: The communication skills of fourth-year medical students can be improved by teaching and then practicing a framework for an initial ICU communication episode with a standardized family member.     

Effects of a communication course for clinicians on parents' perception of care – a randomized controlled trial

Introduction:  In paediatric care, it is a great challenge to make sure that all parties feel involved and heard, they all have had the opportunity to take part in the decisions and all the participants experienced that their expectations to the consultation are fulfilled. Previous research in communication skills training has primarily focused on the behavioural changes of clinicians, and only few studies have investigated the effect from the perspective of the user.
Method:  A randomized controlled trial including medical doctors and nurses from paediatric outpatients' clinics was carried out. The intervention group completed a 5-day communication course, whereas the control group had no intervention. The intervention was evaluated using questionnaires measuring parents' perception of the communication and their satisfaction. The questionnaires were filled out by parents to children consulting a clinician in the outpatient's clinic.
Results:  Before the intervention, 75% (314/419) answered the questionnaire and 65% (271/419) were included in the precourse analysis. After the intervention, 68% (946/1395) answered the questionnaire and 55% (764/1395) were included in the postcourse analysis. There were no significant differences between the satisfaction of parents visiting clinicians from the intervention group and those visiting clinicians from the control group; however, the proportion of parents who had a positive perception of the communication was up to 9.8% higher in the intervention group compared with the control group. For example: 'the clinician told my child what he/she could do in order to feel better'.
Discussion:  Although no statistically significant differences were found, the study indicates that parents who had visited a clinician from the intervention group have experienced the communication as more positive.     

A Pilot Study Examining the Effectiveness of the PEERS Program on Social Skills and Anxiety in Adolescents with Autism Spectrum Disorder

The Program for the Evaluation of the Enrichment of Relational Skills (PEERS), a social skills intervention for high functioning adolescents with autism spectrum disorder (ASD), has been proven efficacious in randomized control trials. However, the effectiveness of the PEERS program in community settings has not been studied. The present small-scale pilot study examined the effectiveness of the PEERS program in a community setting. Five adolescents and their caregivers participated in the PEERS intervention. Results indicated that the adolescents showed significant improvement in their social engagement, social cognition, social communication, social motivation, and knowledge of PEERS skills and concepts from pre- to post-intervention. Furthermore, adolescents showed significant reductions in their internalizing and autistic symptoms from pre- to post-intervention. The findings from this small-scale pilot study support the effectiveness of the PEERS program in community-based settings.