Barriers to effective cancer pain management: A survey of hospitalized cancer patients in Australia

The purpose of this study was to examine attitudinal barriers to effective pain management in a consecutively recruited cohort of 114 cancer patients from four Australian hospitals. When surveyed, 48% of this sample reported experiencing pain within the previous 24 hours. Of these, 56% reported this pain to be distressing, horrible or excruciating, with large proportions indicating that this pain had affected their movement, sleep and emotional well-being. Three factors were identified as potentially impacting on patients responses to pain-poor levels of patient knowledge about pain, low perceived control over pain, and a deficit in communication about pain. A trend for older patients to experience more severe pain was also identified. These older patients reported being more willing to tolerate pain and perceive less control over their pain. Suggestions are made for developing patient education programs and farther research using concepts drawn from broader social and behavioral models. J Pain Symptom Manage 2002:23:393-405. (C) U.S. Cancer Pain Relief Committee, 2002.

Impact of social group processes and functional diversity on communication in networked organizations

This study examines the role of social group processes in perceptions of effective communication in Australian Cooperative Research Centres (CRCs). Communication professionals in 25 CRCs discussed the barriers and opportunities for communication in their diverse networked organizations. Thematic analysis of the transcripts highlighted the contribution of social group processes to both barriers and opportunities. Communication challenges implicated the social identity of organizational members, many of which were associated with distinct structural aspects of these organizations. Opportunities for communication frequently involved features that implicated social identity, including taking advantage of existing organizational or industry identities, preventing conflicting identities from becoming salient, and promoting a collective CRC identity.

Work issues for young people with psychosis: Barriers to employment

Young people who have had a mental illness face significant barriers to both gaining and maintaining employment. A study using a qualitative design and consisting of two focus groups, was conducted to focus on the issues experiencedby young people diagnosed with psychosis wanting to gain employment. The participants were 10 registered clients of an Australian mental health service that had a specialised early psychosis programme. The themes identified in this study concerned loss, low self-confidence and self-esteem, stigma, treatment issues, the need for support, and difficulties in identifying and achieving goals. Further research is warranted to gain a greater understanding of the type of programme that would best assist young people to gain and maintain employment.

Perceptions of mental health service delivery among staff and Indigenous consumers: it's still about communication

Objective: A needs analysis was undertaken to determine the quality and effectiveness of mental health services to Indigenous consumers within a health district of Southern Queensland. The study focussed on identifying gaps in the service provision for Indigenous consumers. Tools and methodologies were developed to achieve this. Method: Data were collected through the distribution of questionnaires to the target populations: district health service staff and Indigenous consumers. Questionnaires were developed through consultation with the community and the Steering Committee in order to achieve culturally appropriate wording. Of prime importance was the adaptation of questionnaire language so it would be fully understood by Indigenous consumers. Both questionnaires were designed to provide a balanced perspective of current mental health service needs for Indigenous people within the mental health service. Results: Results suggest that existing mental health services do not adequately meet the needs of Indigenous people. Conclusions: Recommendations arising from this study indicate a need for better communication and genuine partnerships between the mental health service and Indigenous people that reflect respect of cultural heritage and recognises the importance of including Indigenous people in the design and management of mental health services. Attention to the recommendations from this study will help ensure a culturally appropriate and effective mental health service for Indigenous consumers.

An evaluation of the Keep on Talking program for maintaining communication skills into old

Communication skills change with age as a result of sensory deficits, memory loss, and increasing word finding difficulties The Keep on Talking program (L. Hickson, H. Barnett, L. Worrall, & E. Yiu, 1994) was developed to assist older people to develop their own strategies for maintaining communication skills into old age. Two hundred and fifty-two healthy older people were recruited from the community and were assessed on a battery of communication assessments on entry to the study and at 1 year after entry. The experimental group (n = 120) participated in the 5-week group Keep on Talking program run by volunteers A further 130 control subjects were assessed only. The short-term effectiveness of the program was evaluated using a short knowledge based and attitudinal questionnaire and qualitative written feedback. At the I-year follow up, subjects were also asked whether they had taken any action as a result of the project. Results concluded that there was a significant difference between the number of correct questionnaire responses on the knowledge based items and the ratings on the attitudinal items pre- and postprogram questionnaire for the experimental subjects. Qualitative written feedback was positive with many participants remarking on the amount of information that they had acquired. Forty-eight experimental and 69 control subjects (n = 117) were assessed I year later, and there was a significant difference between the groups in terms of the number of subjects who reported having taken action as a result of the program. The Keep on Talking program increased knowledge about communication, produced a positive change in attitude toward the importance of communication, and encouraged participants to take action to maintain their communication skills. Maintaining communication skills may prevent social isolation. This simple 5-hour group program has been effective in empowering participants to maintain. their communication skills as they age.

The impact of interpersonal and intergroup communication accommodation on perceptions of Chinese students in Australia

Using the framework of communication accommodation theory the authors examined convergence and maintenance on evaluations of Chinese and Australian students. In Study 1, Australian students judged interactions between an Anglo-Australian. and another interactant who either maintained his or converged in speech style. Results indicated that participants were aware of convergence but that speaker ethnicity (Anglo-Australian, Chinese Australian or Chinese national) was a stronger influence on evaluations and future intentions to interact with the speaker In Study 2, Australian students judged Chinese speakers who maintained communication style or converged on interpersonal speech markers, intergroup markers, or both types of markers. Results indicated that the more participants defined themselves in intergroup terms, the more positively they judged intergroup convergence relative to interpersonal convergence and maintenance. This points to the importance of distinguishing between, convergence on interpersonal and intergroup speech markers, and underlines the role of individual differences in the evaluation of convergence.

Nurturing communication by health professionals toward patients: A communication accommodation theory approach

This study explores the role of nurturing communication in distinguishing interpersonal and intergroup interactions between health professionals and patients, from the perspective of communication accommodation theory (CAT). Participants (47 men and 87 women) rated videotapes of actual hospital consultations on 12 goal and 16 strategy items derived from CAT. Health professionals in interpersonal interactions were perceived to pay more attention to relationship and emotional needs and to use more nurturant discourse management and emotional expression. These results point the way toward elucidating the perceived optimal balance in accommodative behavior, both group based and interpersonal, in these contexts, and they highlight the importance of nurturant communication to this process.