This dissertation describes a research project about the communication between communication vulnerable people and health care professionals in long-term care settings. Communication vulnerable people experience functional communication difficulties in particular situations, due to medical conditions. They experience difficulties expressing themselves or understanding professionals, and/or professionals experience difficulties understanding these clients. Dialogue conversations between clients and professionals in healthcare, which for example concern health-related goals, activity and participation choices, diagnostics, treatment options, and treatment evaluation, are, however, crucial for successful client-centred care and shared decision making. Dialogue conversations facilitate essential exchanges between clients and healthcare professionals, and both clients and professionals should play a significant role in the conversation. It is unknown how communication vulnerable people and their healthcare professionals experience dialogue conversations and what can be done to support successful communication in these conversations. The aim of this research is to explore how communication vulnerable clients and professionals experience their communication in dialogue conversations in long-term care and how they can best be supported in improving their communication in these conversations.
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Objective: To gain insight into how communication vulnerable people and health-care professionals experience the communication in dialogue conversations, and how they adjust their conversation using augmentative and alternative communication (AAC) or other communication strategies. Methods: Communication vulnerable clients and health-care professionals in a long-term care institution were observed during a dialogue conversation (n = 11) and subsequently interviewed (n = 22) about their experiences with the conversation. The clients had various communication difficulties due to different underlying aetiologies, such as acquired brain injury or learning disorder. Results from the observations and interviews were analysed using conventional content analysis. Results: Seven key themes emerged regarding the experiences of clients and professionals: clients blame themselves for miscommunications; the relevance of both parties preparing the conversation; a quiet and familiar environment benefitting communication; giving clients enough time; the importance and complexity of nonverbal communication; the need to tailor communication to the client; prejudices and inexperience regarding AAC. The observations showed that some professionals had difficulties using appropriate communication strategies and all professionals relied mostly on verbal or nonverbal communication strategies. Conclusion: Professionals were aware of the importance of preparation, sufficient time, a suitable environment and considering nonverbal communication in dialogue conversations. However, they struggled with adequate use of communication strategies, such as verbal communication and AAC. There is a lack of knowledge about AAC, and professionals and clients need to be informed about the potential of AAC and how this can help them achieve equal participation in dialogue conversations in addition to other communication strategies.
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Purpose The purpose of this paper is to clarify which knowledge, skills and behaviors are used to describe excellent performance in professional communication. As the demand for talented communication professionals increases, organizations and educators need an empirically defined set of performance criteria to guide the development of (potentially) excellent communication professionals (ECPs). This research aimed to render a competence profile which could assist in the development of recruitment, training and development to develop relevant programs for high-potential communication practitioners. Design/methodology/approach This mixed-method research was approached in two phases: first, a series of focus groups (n=16) were held to explore work field perspectives resulting in a concept profile, and second, a series of expert panels (n=30) following the Delphi method were conducted to determine the extent of agreement with the findings. Findings Participants clarified that excellent performance is characterized by competences which transcend normative technical skills or practical communication knowledge. The five domains, 16 item ?SEEDS? competence profile describes that ECPs are distinguished by their compounded ability to be strategic, empathic, expressive, and decisive and to see patterns and interrelationships. Research limitations/implications Although a broad range of relevant professionals were involved in both phases, the study could be considered limited in size and scope. Research was conducted in one national setting therefore further research would be necessary to confirm generalizability of the results to other cultural contexts. Originality/value Although many competence frameworks exist which describe normative performance in this profession, specific criteria which illustrate excellent performance have not yet been identified. This competence profile clarifies characteristics which typify excellent performance in professional communication and can be helpful to educators and employers who wish to identify and create suitable training programs for ECPs.
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Background: Research on maternity care often focuses on factors that prevent good communication and collaboration and rarely includes important stakeholders – parents – as co-researchers. To understand how professionals and parents in Dutch maternity care accomplish constructive communication and collaboration, we examined their interactions in the clinic, looking for “good practice”. Methods: We used the video-reflexive ethnographic method in 9 midwifery practices and 2 obstetric units. Findings: We conducted 16 meetings where participants reflected on video recordings of their clinical interactions. We found that informal strategies facilitate communication and collaboration: “talk work” – small talk and humour – and “work beyond words” – familiarity, use of sight, touch, sound, and non-verbal gestures. When using these strategies, participants noted that it is important to be sensitive to context, to the values and feelings of others, and to the timing of care. Our analysis of their ways of being sensitive shows that good communication and collaboration involves “paradoxical care”, e.g., concurrent acts of “regulated spontaneity” and “informal formalities”. Discussion: Acknowledging and reinforcing paradoxical care skills will help caregivers develop the competencies needed to address the changing demands of health care. The video-reflexive ethnographic method offers an innovative approach to studying everyday work, focusing on informal and implicit aspects of practice and providing a bottom up approach, integrating researchers, professionals and parents. Conclusion: Good communication and collaboration in maternity care involves “paradoxical care” requiring social sensitivity and self-reflection, skills that should be included as part of professional training.
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Haalbaarheidsonderzoek Communication & Multimedia Design in het kader van het strategisch project Verbreding aanbod informaticaopleidingen.
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Purpose: Aphasia after stroke has been shown to lead to communication difficulties between healthcare professionals (HCP) and people with aphasia. Clinical guidelines emphasize the importance of teaching HCP to use supportive conversative techniques through communication partner training (CPT). The aim of this study is to explore and describe the experiences of HCP in communicating with people with aphasia and their needs and wishes for the content in CPT. Materials and methods: The data were collected through qualitative semi-structured interviews with 17 HCP. HCP were recruited from two geriatric rehabilitation centres in the Netherlands and one academic hospital in Belgium. The interviews drew upon the qualitative research methodologies ethnography and phenomenology and were thematically analysed using the six steps of Braun & Clarke. Results: Three themes were derived from the interviews. HCP experienced that communication difficulties impede healthcare activities (theme 1) and reported the need to improve communication through organizational changes (theme 2), changing the roles of SLTs (theme 3) and increasing knowledge and skills of HCP (theme 4). Conclusions: According to HCP, communication difficulties challenge the provision of healthcare activities and lead to negative feelings in HCP. HCP suggest that communication can be improved by providing more time in the healthcare pathway of people with aphasia, adapting healthcare information to the needs of people with aphasia, commitment of physicians and managers, changing the roles of SLTs and improving knowledge and skills of HCP. Implications for rehabilitation Communication between healthcare professionals (HCP) and people with aphasia can be improved by training HCP to use supportive conversation techniques and tools. An important condition for successful implementation of communication partner trainings in healthcare centres is to identify the experiences of HCP with communication with people with aphasia and their needs and wishes for training content. This study shows that communication problems between HCP and people with aphasia impede diagnosis and therapy with considerable implications for healthcare quality. The suggestions that HCP have concerning the content of communication partner trainings can be placed under "education" and "implementation and post-training support." HCP describe specific roles for speech-and language therapists to fulfil after the training and suggest two main changes that should be made at an organizational level.
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Many healthcare professionals experience difficulties in discussing sexual health with their patients. The aim of this review was to synthesize results of studies on communication practices in interactions about sexual health in medical settings, to offer healthcare professionals suggestions on how to communicate about this topic. Veel zorgprofessionals ervaren problemen bij het bespreken van seksuele gezondheid met hun patiënten. Het doel van deze review was een synthese te presenteren van studies naar communicatiepraktijken in interactie over seksuele gezondheid in medische settings, om zorgprofessionals handreikingen te bieden voor communicatie over dit thema.
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Interprofessional communication and collaboration during hospitalisation is critically important to provide safe and effective care. Clinical rounds are an essential interprofessional process in which the clinical problems of patients are discussed on a daily basis. The objective of this exploratory study was to identify healthcare professionals’ perspectives on the “ideal” interprofessional round for patients in a university teaching hospital. Three focus groups with medical residents, registered nurses, medical specialists, and quality improvement officers were held. We used a descriptive method of content analysis. The findings indicate that it is important for professionals to consider how team members and patients are involved in the decision-making process during the clinical round and how current social and spatial structures can affect communication and collaboration between the healthcare team and the patient. Specific aspects of communication and collaboration are identified for improving effective interprofessional communication and collaboration during rounds.
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Purpose: Artificial intelligence (AI) and automation are currently changing human life with a great implication in the communication field. This research focusses on understanding the current and growing impact of AI and automation in the role of communication professionals to identify what skills and training are needed to face its impacts leading to a recommendation. Design/methodology/approach: The research involves methodological triangulation, analysing and comparing data gathered from consulting with experts using the Delphi method, focus group with communication students, and literature review. Findings: Findings show that the likely impacts are on the one hand the enhancing of efficiency and productivity, as well as freeing communication professionals to focus on the creative side, strategy and analytical thinking, on the other hand, repetitive and low-level jobs could be lost, being higher position jobs or those involving creativity and decision making harder to automate. Two types of training are needed: to gather experience with the current AI and automated tools, and to focus on developing human qualities that AI cannot replicate. Originality/value: The outcomes of this research are valuable to help current and future communication practitioners, as well as organisations, to be one step ahead and survive the age AI and automation, being aware of its current and near-future impacts. The paper offers a list of recommended soft and technical skills, as well as training needed, categorizing them in low, medium and high priority.
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Empathy is an important competence for communication professionals. This article investigates two aspects of empathy in an educational setting: the validity of self versus other assessments and the manifestation of empathy in communicative behaviors. Communication students were given a mediating role in discussions with two clients and their empathy was measured using self-ratings and client assessments. Videos of highest- and lowest-rated students were analyzed to identify empathy-related behaviors. No correlation was found between self-rated empathy and clients’ assessments. Several verbal and nonverbal behaviors corresponded to empathy: body language, an other-orientation in asking questions, paraphrasing, and a solution orientation.
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