Ethical Practice for Postgraduate Students in Orthopedics: Nurturing Professionalism and Patient Care

Background

In the domain of orthopedics, ethical practice significantly influences professionalism and the quality of patient care delivered by postgraduate students. This narrative review aimed to investigate the implementation and impact of an ethics-centric curriculum tailored for orthopedic postgraduate students.

Methods

The proposed curriculum incorporates methodologies such as case-based learning, interactive discussions, and dedicated mentoring sessions, focusing on the unique ethical challenges encountered in orthopedics.

Results

Introducing the curriculum provided postgraduate students with a robust foundation in ethical principles, enhancing effective communication, and fostering better doctor-patient relationships. Consequently, the students displayed an increased aptitude in navigating intricate ethical dilemmas in their clinical practice.

Conclusion

There is a crucial need for continuous ethics education in orthopedics. Creating a supportive learning environment is essential to cultivate professionalism and promote patient-centered care. This study underscores the transformative potential of ethics training in molding orthopedic professionals who are both competent and deeply committed to maintaining the highest ethical standards.

Effective communication with linguistically diverse patients: A concept analysis

OBJECTIVE

Effective communication is essential to providing high-quality healthcare. For linguistically diverse patients, communication remains a barrier to receiving equitable healthcare throughout the globe. It is necessary to examine the concept of effective communication with linguistically diverse patients.

METHODS

The Walker and Avant method was used to analyze the concept.

RESULTS

We define effective communication with linguistically diverse patients as any verbal or written communication between two or more individuals who do not speak the same language that utilizes accurate translation techniques to reach a shared message or understanding, where all parties involved are listened to and actively engaged. The antecedents, attributes, consequences, and empirical referents are mapped.

CONCLUSION

Effective communication with linguistically diverse patients is limited by a lack of access to professional language assistance, structural racism/discrimination, and policy barriers.

PRACTICE IMPLICATIONS

Healthcare workers hold the power to provide language assistance to patients and should therefore receive training in cultural competency, cultural humility, and how to work with professional medical interpreters and language access programs. Institutions should invest in multimodal approaches to provide equitable healthcare to linguistically diverse patients.

An exploration of communication skills development for student diagnostic radiographers using simulation-based training with a standardised patient: UK-based focus-group study

INTRODUCTION

Communication is an essential skill for all healthcare professionals but is particularly challenging for diagnostic radiographers since their role involves conveying extensive information within a relatively short amount of time. One method to develop communication skills in radiography is through simulation-based training using high fidelity simulation activities. The use of video recording for reflection and debriefing are also important elements that can be utilised to enhance learning. The aim of this project was to explore student radiographers' experiences of a simulation-based activity utilising a standardised patient designed to aid development of communication skills.

METHODS

Fifty-two undergraduate 3rd year diagnostic radiography students at a single Higher Education Institution undertook a simulation roleplay exercise with an expert by experience (EBE) who acted in an anxious manner in order to challenge the student's communication skills following the simulation, students received a debrief session where detailed feedback was provided from the EBE and an academic. Students were also able to watch their video of the simulation and reflect. Students were invited to participate in a focus group to discuss their experience and the learning they had developed and 12 students participated. Transcribed material from the focus groups was thematically analysed to deduce themes of learning developed and ways to improve for future simulations.

FINDINGS

Six main themes were identified from the thematic analysis of the transcripts from 12 diagnostic radiography students. These were patient care, radiographer's role and responsibilities, personal development, feelings, fidelity, and pedagogy. The themes represented the key learning points expressed by students and also aspects of the simulation which could be improved. Overall, the simulation provided a positive learning experience for the students. Having a video recording of the scenario was regarded as beneficial to enable a depth of reflection on non-verbal communication skills, which would be beneficial in future simulation scenarios. Students were aware that even though they used appropriate language their overall manner affected the interaction with the expert by experience more significantly. Students also considered methods to improve their communication if they encountered a similar patient interaction in their future practice.

CONCLUSION

There is great potential for simulation-based training in developing communication skills for diagnostic radiography students. EBEs are a vital addition to simulation and educational activities in Higher Education Institutions and should be involved with the design of simulation activities also, as they can bring unique patient insight.

Quality communication can improve patient-centred health outcomes among older patients: a rapid review

BACKGROUND

Effective communication is a cornerstone of quality healthcare. Communication helps providers bond with patients, forming therapeutic relationships that benefit patient-centred outcomes. The information exchanged between the provider and patient can help in medical decision-making, such as better self-management. This rapid review investigated the effects of quality and effective communication on patient-centred outcomes among older patients.

METHODS

Google Scholar, PubMed, Scopus, CINAHL, and PsycINFO were searched using keywords like "effective communication," "elderly," and "well-being." Studies published between 2000 and 2023 describing or investigating communication strategies between older patients (65 years and above) and providers in various healthcare settings were considered for selection. The quality of selected studies was assessed using the GRADE Tool.

RESULTS

The search strategy yielded seven studies. Five studies were qualitative (two phenomenological study, one ethnography, and two grounded theory studies), one was a cross-sectional observational study, and one was an experimental study. The studies investigated the effects of verbal and nonverbal communication strategies between patients and providers on various patient-centred outcomes, such as patient satisfaction, quality of care, quality of life, and physical and mental health. All the studies reported that various verbal and non-verbal communication strategies positively impacted all patient-centred outcomes.

CONCLUSION

Although the selected studies supported the positive impact of effective communication with older adults on patient-centred outcomes, they had various methodological setbacks that need to be bridged in the future. Future studies should utilize experimental approaches, generalizable samples, and specific effect size estimates.

Effective communications on invasive alien species: Identifying communication needs of Swedish domestic garden owners

Invasive alien species threaten biodiversity with domestic gardens acting as a major pathway for the introduction of alien species. Even though the Nordic region is not currently a hotspot for biological invasions, the number of invasions in the Nordic area has been predicted to increase due to climate change. Given a time lag between introduction and invasion, many non-invasive horticultural alien species already introduced into gardens may become invasive in the future. This study aimed to identify the communication needs of Swedish garden owners regarding their management of invasive alien species. A survey among domestic garden owners, informed by topic specialists and local area experts, and interviews with garden owners were conducted in three different bio-climatic areas in a latitudinal gradient across Sweden. The questions targeted invasive alien species and their relations to biodiversity loss and climate change, as well as measures taken to control these species. Analysing the survey data collected in relation to measures taken to control invasive species, Bayesian Additive Regression Tree (BART) modelling was used to identify geographically varying communication needs of the domestic garden owners. In all study areas, the garden owners' measures taken to control invasive alien species were correlated with their strength of beliefs in having experienced local biodiversity loss. A majority of the garden owners were, moreover, uncertain about the impact of climate change on the invasiveness of alien species. In addition, the garden owners' capacity for identifying invasive alien species was often in need of improvement, in particular with respect to the species Impatiens glandulifera, Reynoutria japonica and Rosa rugosa. The results suggest that the evidence-based guidelines for effective communications we developed, have the potential to help communicators meet the local communication needs of garden owners across Sweden, in relation to the management of invasive alien garden species.

Quality of obstetric and newborn care in health centers of Addis Ababa City: using the WHO quality framework

OBJECTIVE

The study aims to assess the quality of obstetric and newborn care using the WHO quality framework.

DESIGN

The study used explanatory sequential mixed methods design.

SETTING

This study was conducted in 50 health centers in Addis Ababa city administration from January 25 to December 31, 2021.

METHODS

A total of 50 health centers were surveyed using a structured questionnaire and 500 women in the postpartum period were interviewed using a structured questionnaire. Delivery records of the 500 women were reviewed using a structured checklist. A total of 338 midwives were interviewed using a structured questionnaire. The quantitative data was analyzed using Statistical Package for Social Sciences (SPSS).

RESULTS

The study revealed that only a third of the 50 health centers were providing good quality care (a quality score ≥ 75%). All the health centers had the physical resources (100%) to deliver obstetric and newborn care. The majority of the health centers had a system for actionable information (92%), functional referral (80%), and providing dignified care (80%). On the other hand, only a few of the health centers met the quality threshold for effective communication (24%), evidence-based practice of routine obstetric and newborn care (36%), and availability of mechanisms to support and motivate skilled birth attendants (24%). None of the health centers met the quality threshold for emotional support during labour and delivery. Obstetric caregivers' high workload and job dissatisfaction were barriers to quality care.

CONCLUSION

Ensuring quality obstetric and newborn care needs effective quality improvement interventions that aim to ensure women had effective communication, emotional support, and dignity during labour and delivery. Reducing the workload and increasing motivation of birth attendants play a critical role in improving the quality of care.

Accommodating hearing loss in outpatient physician offices in the U.S

BACKGROUND

Approximately 16.2 million Americans ages 18 and older (5.7%) report being deaf or having serious difficulty hearing. Hearing loss impedes effective communication during clinical encounters putting patients' safety at risk. A large fraction of Americans with Disabilities Act lawsuits addresses whether providers offered auxiliary aids and services required to ensure effective communication.

OBJECTIVE

Examine use of different hearing accommodations for deaf or hard of hearing patients by U.S. physicians.

METHODS

We surveyed randomly selected physicians nationwide representing 7 specialties about their reported use of 8 types of accommodations when communicating with adult outpatients who are deaf or have significant difficulty hearing, even with hearing aids (overall weighted response rate = 61.0%). We performed a descriptive analysis of responses, using survey sampling weights.

RESULTS

Among the 526 physicians in this analysis, most were male, white, urban, and practiced in community-based practices. Overall, 81.5% (SE = 1.9) reported that patients with significant hearing limitations get worse quality health care than others. Among participants, 49.8% (2.4) reported never using an in-person sign language interpreter hired by the practice, and 63.2% (2.4) never use video remote interpreting. In contrast, 30.7% (2.1) always and 29.8% (2.2) usually speak louder and slower to patients with significant hearing limitations. None of the 8 accommodations were always or usually used by 8.9% (1.3) of participants.

CONCLUSIONS

More than 32 years after the Americans with Disabilities Act, most physicians do not offer accommodations sufficient to ensure effective communication with adult outpatients with significant hearing limitations.

Respectful maternity care in health centers of Addis Ababa city: a mixed method study

OBJECTIVE

The study aims to assess quality of obstetric and newborn care including respectfulness of the maternity care.

DESIGN

The study used explanatory sequential mixed methods design .

SETTING

This study was conducted in 50 health centres in Addis Ababa city administration January 25 to April 31, 2021.

METHODS

During the quantitative phase 500 women in postpartum period were interviewed using structured questionnaire. In the second phase in-depth interview was conducted with 20 midwives and 13 health centre managers. The quantitative data was analysed using Statistical Package for Social Sciences (SPSS). The qualitative data was analysed using Colaizzi's seven step process.

RESULTS

Only 24.6% of women had respectful maternity care (RMC). Only 46% of women had effective communication during child birth. Only 9.6% of women had emotional support during child birth. Majority of women were encouraged to mobilize, take food and be on labor position of their choice. However, only 22.4 and 18.8% of women respectively had a companion of choice and any pharmacologic pain relief during child birth. One in seven women (15%) had one form of disrespect and abuse during child birth.

CONCLUSION

Ensuring respectful maternity care needs strong policy direction to health facilities, public education on their right to respectful maternity care, training of care givers and monitoring care through engagement of frontline staff and clients.

Training for the future: Introducing foundational skills necessary to promote patient-centered care practice in medical physics graduate programs

Current medical physics graduate training in the United States seldom explicitly includes education on foundational skills necessary to produce Patient-Centered Care (PCC)-focused healthcare providers. Such abilities include effective communication, critical reflection, and ethical decision-making. In this article, we present examples of curricula used to purposefully introduce these skills into graduate training to fill this gap. Presented didactic activities include an introduction to patient communication, ethics in medical physics, and a primer in health disparities for medical physicists. Although development of new curricula is resource-intensive when left to individual programs, we here propose resource-sharing and interprofessional collaboration to overcome these barriers.

The impact of effective communication-based care on the childbirth experience and satisfaction among primiparous women: an experimental study

Background

There is insufficient scientific evidence on the effect of communication skills of childbirth care providers on maternal childbirth experience and satisfaction. The present study aimed to determine the effect of communication-based care on the childbirth experience and satisfaction among primiparous women.

Methods

A total of 80 primiparous women participated in this experimental study who were randomly assigned into the intervention and control groups. According to the World Health Organization (WHO) care model, the intervention group received effective communication-based care, and the control group received the routine care. Data were collected using demographic and obstetric questionnaires, Labor Agentry Scale (LAS) and Birth Satisfaction Scale-Revised (BSS-R), and Support and Control in Birth (SCIB) scale applied 12 to 24 h after the intervention.

Results

After controlling the effect of confounding variables, the mean scores of childbirth experience (51.23(1.54) and satisfaction (26.03(0.81) in the intervention group were significantly higher than that in the control group (45.33 (1.54) and 22.66 (0.81) respectively; [adjusted mean difference (AMD) = 5.90, CI = 95%: 1.17 to 10.62, P = 0.01] versus AMD =3.37, CI: 95%: 0.87 to 5.87, P = 0.001].

Conclusion

Eeffective communication-based care improved childbirth experience and satisfaction of primiparous women. Therefore, it is recommended that health-care providers should be trained on the communication skills in the delivery room especially during a vital threatened crises such as the Covid pandemic.

Sharing goals by timely communication improves fishermen's satisfaction with marine protected areas: A case study in the Mediterranean

Marine protected areas (MPAs) are considered as a valid tool for mitigating the impact of fishing on marine ecosystems. Their success depends upon their acceptance by implicated stakeholders and on the integration of the stakeholder groups into their management. This integration is especially important with regard to fishermen, whose interests are the most directly affected by MPAs. The relational coordination method posits that effective communication and supportive relationships among stakeholders result in positive stakeholder behaviors and a more effective management of the system. Applying its principles, we designed a survey to evaluate the satisfaction of fishermen associated with five MPAs in the Spanish Mediterranean and determine what mechanisms affect fishermen's acceptance of MPAs. Our results demonstrate that effective communication is particularly important for good supportive relationships and satisfaction among fishermen and other stakeholder groups, as well as satisfaction with the MPA. Sharing objectives with fishermen through timely communication is the primary mechanism to improve fishermen's satisfaction and ameliorate perceptions towards MPA. To address this issue, we recommend more substantial integration of fishermen in the co-management of MPAs.

Patient Satisfaction with a Psychology Consultation-Liaison Service at an Academic Medical Center

One to two-thirds of all medically admitted patients have comorbid psychiatric concerns. To address the cognitive, behavioral, and emotional factors that affect medical hospitalization, psychological or psychiatric consultation-liaison (CL) services are consulted. The current study was designed to understand patient satisfaction with a CL psychology service and how it was associated with satisfaction with overall hospitalization, taking into consideration relevant factors. Adults medically admitted to an academic teaching hospital (N = 220), who were seen at least once by the CL psychology service, completed satisfaction and demographic questionnaires. Most patients reported being satisfied with the CL psychology service, with women reporting higher satisfaction than men. Satisfaction with the CL psychology service was associated with satisfaction with overall hospitalization, but did not differ based on age, race/ethnicity, education, income, length of stay, number of visits, or presence of psychiatric diagnosis. The results suggest that CL psychology services may contribute to improving overall patient experience.

A Strategy for Effective Generational Communication in Veterinary Medicine

In today's veterinary practices, 5 generations (traditionalists, baby boomers, Generation X, millennials, and Generation Z), each with a unique way of looking at the world, are trying to work together effectively. Common strategies for managing this multigenerational workplace include villainizing "other" generations or merely tolerating their presence. Conflict, disagreements, and misunderstanding often get in the way of practicing quality medicine. Thus, veterinary health professionals must develop strategies that allow for effective communication, not only within the practice but also with clients, vendors, and other stakeholders, a strategy that builds bridges among the generations through engagement, regardless of generation.

Communication between mothers and health workers is important for quality of newborn care: a qualitative study in neonatal units in district hospitals in South Africa

Background

There is a high global burden of neonatal mortality, with many newborn babies dying of preventable and treatable conditions, particularly in low and middle-income countries. Improving quality of newborn care could save the lives of many thousands of babies. Quality of care (QoC) is a complex and multifaceted construct that is difficult to measure, but patients’ experiences of care are an important component in any measurement of QoC. We report the findings of a qualitative study exploring observations and experiences of health workers (HWs) and mothers of babies in neonatal units in South Africa.

Methods

A qualitative case study approach was adopted to explore care of newborn babies admitted to neonatal units in district hospitals. Observation data were collected by a registered nurse during working hours over a continuous five-day period. Doctors and nurses working in the neonatal unit and mothers of babies admitted during the observation period were interviewed using a semi-structured interview guide. All interviews were audio recorded. Observation data were transcribed from hand written notes. Audiotapes of interviews were transcribed verbatim and, where necessary, translated into English. A thematic content analysis was used to analyse the data.

Results

Observations and interviews were conducted in seven participating hospitals between November 2015 and May 2016. Our findings highlight the importance of information sharing between HWs and mothers of babies, contrasting the positive communication reported by many mothers which led to them feeling empowered and participating actively in the care of their babies, with incidents of poor communication. Poor communication, rudeness and disrespectful behaviour of HWs was frequently described by mothers, and led to mothers feeling anxious, unwilling to ask questions and excluded from their baby’s care. In some cases poor communication and misunderstandings led to serious mismanagement of babies with HWs delaying or withholding care, or to mothers putting their babies at risk by not following instructions.

Conclusion

Good communication between mothers and HWs is critical for building mothers’ confidence, promoting bonding and participation of mothers in the care of their baby and may have long term benefits for the health and well-being of the mother and her baby.

Reflecting on the communication process in health care. Part 2: the management of complaints

This is Part 2 of a two-part article on the communication process in healthcare practice. Part 1 focused on clinical practice in relation to breaking bad news. In Part 2, the focus is on the management of complaints, including the communication process, and the subsequent emotional impact on the health professional. Efficient management of complaints is vital to ensure positive outcomes for all stakeholders-patients, health professionals and the organisation. Reflection is a highly beneficial tool and this process is used to acknowledge the impact of a complaint on the author, other health professionals and the health organisation, and propose ways in which management of this highly sensitive issue could be improved in the future.

Development of medication-related counselling skills in senior medical students: a checklist-based approach

BACKGROUND

Effective communication between healthcare providers and patients has been established as a vital element in medication compliance and patient safety. Medical curricula worldwide include medication-related counselling skill as a learning outcome for medical graduates. However, this aspect of health-care training is frequently informal and poorly structured in most medical schools. This paper provides an interesting view of students' experiences of using a checklist-based approach to develop and practice patient counselling in relation to prescribed medications.

METHODS

The authors describe introduction of a thirteen item "Patient Education Checklist" (PEC) as part of an optional checklist based exercise (CBE) in year 4 and 5 clinical blocks. Students consulted PEC to discuss relevant practical issues related to medication intake with their patients. Students were expected to submit reflective case summaries regarding their experience of using PEC to counsel patients over a two-week period. The textual data from student submissions was analysed using inductive content analysis.

RESULTS

We received 13 year4 and 17 year5 student submissions. A content analysis of student reflections identified four dominant themes 1.Enhancement in self-confidence in relation to patient education (86.7%), 2. PEC perceived useful for patient counselling (83.3%), 3. Recognising variation in health literacy levels of patients (50%), 4.Fear of overloading the patient with information (23.3%). Students realised the need to present the medication related knowledge in simple language and tailor the amount of information as per patients' understanding. Student reflections included interesting observations about the wide variation in health literacy of patients and insights into patients' concerns and frequent misconceptions about medicines.

CONCLUSION

Students perceived PEC as a useful tool in adding focus and structure to student patient interactions. They report that it substantially improved their confidence and added quality to patient encounters. Future research is required to assess the effect of CBE on medication compliance and therapeutic outcome. PEC might serve as a useful resource for pharmacy and nursing students.

Impact of disease screening on awareness and management of hypertension and diabetes between 2011 and 2015: results from the China health and retirement longitudinal study

BACKGROUND

There has been a limited recognition of hypertension and diabetes in China which has compromised optimal treatment. It is not clear if a screening program implemented by a national health survey has improved awareness and management of these conditions.

METHODS

The China Health and Retirement Longitudinal Study (CHARLS) is an ongoing longitudinal health survey conducted since 2011 among Chinese people aged 45 years and older. Participants have been assessed every two years by interviews, physical examinations, and fasting glucose samples were taken in 2011. In 2013 and 2015, participants were asked about awareness and management of selected chronic diseases, and they first became aware of these conditions.

RESULTS

Of the 11,000+ participants screened in 2011, 4594 were identified with hypertension and 1703 with diabetes by medical examinations. Over 80% of the middle-aged and elderly Chinese diagnosed with hypertension and/or diabetes in 2011 reported in 2015 that they were unaware of the disease(s). Although some improvement was observed between 2011 and 2015, the main reason for the increase in awareness was a medical examination initiated by the study participant (over 75%), by their work unit or community (12-15%), and rarely (less than 3%) by the CHARLS examination. Participants with a rural household registration status and lower BMI were the most likely to be unaware and to remain unaware of their condition(s).

CONCLUSIONS

Disease screening in CHARLS did not lead to significant improvements in awareness of hypertension and diabetes. Improvements should be made by the systematic feedback of screening results to survey participants and the monitoring of disease awareness over time. This will be essential to improve disease recognition and facilitate optimal management.

Doctor-patient communication tricks. Oncological study at Campus Bio-Medico University of Rome

OBJECTIVE

Doctor-patient relationship is a very important variable in the oncological clinical consultation.

METHODS

We have analyzed 100 outpatients oncological visits (first visits and follow up visits). We conducted an observational study of the extra verbal communication (non-verbal and para-verbal) with a structured observation grid. We have analyzed the three stages of the visit: 1. Patient's admission, 2. Communication flows and 3. Information exchange between doctor and patient.

RESULT

In the first visit doctor introduce himself (85%). In the follow-up visit the doctor has received the patient with a handshake (86%) while in the first examination in 100%. In the follow-up visit the short phase of pleasantries was present in 61% of cases, while in the first examination in 45% of cases. Doctor drawn an outline, a design or wrote a note in 45% of first examination and 25% of the follow up.

CONCLUSION

Extra verbal communication is more important than the verbal. We suggest useful tips on what "do not" and what "do better" during clinical consultations.

CONCLUSION

Against what it is often believed eye contact is not always necessary or useful in establishing a good doctor-patient relationship it depends on the patient's preferred representational system.

Effectiveness of brief psychological interventions for suicidal presentations: a systematic review

BACKGROUND

Every year, more than 800,000 people worldwide die by suicide. The aim of this study was to conduct a systematic review of the effectiveness of brief psychological interventions in addressing suicidal thoughts and behaviour in healthcare settings.

METHODS

Following PRISMA guidelines, systematic searches were conducted in MEDLINE, CINAHL, EMBASE, the Cochrane Central Register of Controlled Trials and PsycINFO databases. A predefined search strategy was used. Two independent reviewers screened titles and abstracts followed by full texts against predefined inclusion criteria. Backward and forward citation tracking of included papers was conducted. Quality appraisal was conducted using the Cochrane Risk of Bias Tool for Randomized Controlled Trials and the CASP tool for randomised controlled trials. The small number and heterogeneity of studies did not allow for meta-analysis to be conducted. A narrative synthesis was conducted.

RESULTS

Four controlled studies of brief psychological interventions were included, conducted in Switzerland, the U.S. and across low and middle-income countries. Three studies were conducted with adults and one with adolescents. All studies were judged to be at low risk of bias. All of the interventions were implemented with patients after attending emergency departments and involved 3412 participants. The main outcomes were suicide, suicide attempts, suicidal ideation, depression and hospitalization. The components of the interventions were early therapeutic engagement, information provision, safety planning and follow-up contact for at least 12 months. The interventions drew to, different degrees, on psychological theory and techniques. Two trials that measured suicidal ideation found no impact. Two studies showed fewer suicide attempts, one showed fewer suicides and one found an effect on depression.

CONCLUSIONS

Although the evidence base is small, brief psychological interventions appear to be effective in reducing suicide and suicide attempts. All studies to date have been conducted with people who had attended the ED but the interventions could potentially be adopted for inpatient and other outpatient settings. Early engagement and therapeutic intervention based on psychological theories of suicidal behaviour, sustained in follow-up contacts, may be particularly beneficial.

TRIAL REGISTRATION

Systematic review registration: PROSPERO CRD42015025867.

The influence of effective communication, perceived respect and willingness to collaborate on nurses' perceptions of nurse-physician collaboration in China

BACKGROUND

Nurse-physician collaboration is a critical prerequisite for high-quality care. Previous researchers have addressed multiple factors that influence collaboration. However, little of this research has explored the influence of interactional factors on nurses' perception of nurse-physician collaboration in China.

AIMS

To examine the influence of interactional factors (effective communication, perceived respect and willingness to collaborate) on nurses' perception of nurse-physician collaboration.

METHODS

A cross-sectional survey of 971 registered nurses in nine hospitals was conducted. An author-designed interactional factor questionnaire and the Nurse-Physician Collaboration Scale were used to collect data. Multiple regression analysis was used.

RESULTS

Nurse-physician collaboration was identified as at a moderate level (mean = 3.93 ± 0.68). Interactional factors (effective communication, perceived respect and willingness to collaborate) were identified as relatively moderate to high (mean = 4.03 ± 0.68, mean = 3.87 ± 0.75, mean = 4.50 ± 0.59, respectively). The results showed that effective communication, perceived respect and willingness to collaborate explained 57.3% of the variance in nurses' perception of nurse-physician collaboration (Adjusted R² = 0.573, F = 435.563, P < 0.001). Perceived respect (β = 0.378) was the strongest factor relevant to nurses' perception of nurse-physician collaboration, second was effective communication (β = 0.315), and the weakest factor among these three factors was willingness to collaborate (β = 0.160).

CONCLUSION

Nurses' perceptions of collaboration were relatively positive, mainly in Sharing of patient information; however, improvements need to be made regarding Joint participation in the cure/care decision-making process. Effective communication, perceived respect and willingness to collaborate significantly affect nurses' perception of nurse-physician collaboration, with perceived respect having greater explanatory power among the three interactional factors. It is necessary for hospital managers to develop strategies to build professional respect for nurses, facilitate effective nurse-physician communication and improve nurses' willingness to collaborate.

Experiences of nursing undergraduates on a redesigned blended communication module: A descriptive qualitative study

BACKGROUND

Education is going through accelerated changes to accommodate the needs of contemporary students. However, there are ongoing concerns regarding the quality of education in communication skills for nurses and other healthcare professionals. Many studies have been conducted to evaluate the effectiveness of a blended learning pedagogical tool in enhancing the learning of nursing undergraduates. However, little is known about students' experiences of a blended learning model for teaching communication skills.

OBJECTIVE

To explore first year nursing students' experiences of the blended learning design adopted in a communication module.

DESIGN

A descriptive qualitative design was adopted.

SETTINGS AND PARTICIPANTS

Data were collected in the form of written reflections from 74 first year nursing undergraduates who were enrolled in a university-affiliated nursing school.

METHODS

Students were asked to complete an online reflective exercise regarding an undergraduate communication module on their last day of class, and the submitted reflections were analyzed. A thematic analysis was conducted and ethics approval was obtained for this study.

RESULTS

Six overarching themes and fifteen subthemes were generated. The six overarching themes were: 1) Helpful and engaging classroom experience, 2) valuable online activities, 3) meaningful assessment, 4) appreciation for interprofessional education, 5) personal enrichment, and 6) overall feedback and recommendations.

CONCLUSIONS

The students in this study felt that the blended pedagogy communication module enhanced their learning and boosted their confidence in facing similar situations. Interprofessional education was well-accepted among students as they attained a deeper understanding on the importance of interprofessional learning and an appreciation towards other professionals. Blended pedagogy can be used in teaching communication skills to nursing students to provide a holistic and up-to-date learning experience. Future studies should consider engaging students in face-to-face interviews to obtain a deeper understanding on their experiences of a blended pedagogy incorporated communication module.

The communication and emotional support needs to improve women's experience of childbirth care in health facilities in Southwest Nigeria: A qualitative study

OBJECTIVE

To improve women's childbirth experiences in health facilities, their psychosocial and communication needs have to be met. However, what constitutes these specific needs is poorly understood, particularly in Sub-Saharan Africa. This paper explores women's needs for communication and emotional support during facility-based childbirth.

METHODS

Qualitative research was conducted in a large referral maternity hospital and its catchment communities in Akure, Nigeria. In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted among women of reproductive age, midwives, doctors, and facility administrators. Thematic analysis was used to synthesize findings, and then interpreted within the context of this study and existing quality of care framework.

RESULTS

Forty-two IDIs and 10 FGDs are included in this analysis. Participants reported such needs as communication in simple words in local language by healthcare staff, having their husbands as birth companions, spiritual support, and prayers from family members and healthcare providers.

CONCLUSION

To increase, improve, and sustain facility-based childbirth in Nigeria, health systems should appreciate the uniqueness and importance of each woman's needs during childbirth. Practical and sustainable actions should be taken to meet these needs, within the confines of the acceptable sociocultural norms.

Aspirational characteristics for effective leadership of improvement teams

Working on quality improvement has become an innate part of managing a pediatric radiology service. To help radiologists effectively lead improvement teams, eight aspirational characteristics are discussed. These are: 1) Be a good listener, 2) Effectively communicate around an accountability cycle, 3) Stress simplicity: Prioritization and pace, 4) Expend energy to optimize people development, 5) Lead with optimism, 6) Create a culture of wellness and sustainability, 7) Have a progressive attitude toward failure and 8) Project humility over arrogance.

The effect of person-centred communication on parental stress in a NICU: a randomized clinical trial

AIM

To investigate the effect of the Guided Family-Centred Care intervention, developed by the lead author, on parental stress in a neonatal intensive care unit (NICU).

METHODS

Parents (n = 134) of infants born ≤34 weeks gestational age were randomly assigned to a standard care group (n = 60) or intervention group (n = 74) between April 2011 and August 2012. Guided Family-Centred Care components used were as follows: scheduled nurse-parent dialogues, semi-structured reflection sheets and person-centred communication. Parental stress was assessed at discharge using parent-reported outcomes on the Nurse Parent Support Tool and the Parental Stressor Scale: Neonatal Intensive Care Unit.

RESULTS

The total stress scores reported by parents did not vary significantly between the intervention and standard groups, with a mean (SD) of 2.70 (0.67) versus 2.84 (0.71), respectively. However, the confidence interval included the prespecified clinical significance level. Subscale and Nurse Parent Support Tool scores did not differ between the groups. Overall, mothers reported more stress than fathers (p < 0.001).

CONCLUSION

Our study was unable to demonstrate the effect of person-centred communication using the Guided Family-Centred Care intervention. It may be necessary to replicate the design to address the risk of contamination and add instruments sensitive to human interaction.