Effective communication to improve udder health: can social science help?

Improved udder health requires consistent application of appropriate management practices by those involved in managing dairy herds and the milking process. Designing effective communication requires that we understand why dairy herd managers behave in the way they do and also how the means of communication can be used both to inform and to influence. Social sciences- ranging from economics to anthropology - have been used to shed light on the behaviour of those who manage farm animals. Communication science tells us that influencing behaviour is not simply a question of „getting the message across‟ but of addressing the complex of factors that influence an individual‟s behavioural decisions. A review of recent studies in the animal health literature shows that different social science frameworks and methodologies offer complementary insights into livestock managers‟ behaviour but that the diversity of conceptual and methodological frameworks presents a challenge for animal health practitioners and policy makers who seek to make sense of the findings – and for researchers looking for helpful starting points. Data from a recent study in England illustrate the potential of „home-made‟ conceptual frameworks to help unravel the complexity of farmer behaviour. At the same time, though, the data indicate the difficulties facing those designing communication strategies in a context where farmers believe strongly that they are already doing all they can reasonably be expected to do to minimise animal health risks.

Comparison of low-power wireless communication technologies for wearable health-monitoring applications

Health monitoring technologies such as Body Area Network (BAN) systems has gathered a lot of attention during the past few years. Largely encouraged by the rapid increase in the cost of healthcare services and driven by the latest technological advances in Micro-Electro-Mechanical Systems (MEMS) and wireless communications. BAN technology comprises of a network of body worn or implanted sensors that continuously capture and measure the vital parameters such as heart rate, blood pressure, glucose levels and movement. The collected data must be transferred to a local base station in order to be further processed. Thus, wireless connectivity plays a vital role in such systems. However, wireless connectivity comes at a cost of increased power usage, mainly due to the high energy consumption during data transmission. Unfortunately, battery-operated devices are unable to operate for ultra-long duration of time and are expected to be recharged or replaced once they run out of energy. This is not a simple task especially in the case of implanted devices such as pacemakers. Therefore, prolonging the network lifetime in BAN systems is one of the greatest challenges. In order to achieve this goal, BAN systems take advantage of low-power in-body and on-body/off-body wireless communication technologies. This paper compares some of the existing and emerging low-power communication protocols that can potentially be employed to support the rapid development and deployment of BAN systems.

COMMUNICATION AND INFORMATION BARRIERS TO HEALTH ASSISTANCE FOR DEAF PATIENTS

IN BRAZIL, recent regulations require changes in private and public health systems to make special services available to deaf patients. in the present article, the researchers analyze the perceptions of 25 sign language using patients regarding this assistance. The researchers found communication difficulties between these patients and health services staff, as well as a culture clash and a harmful inability among the service providers to distinguish among the roles of companions, caretakers, and professional translator/interpreters. Thus, it became common for the patients to experience prejudice in the course of treatment and information exchange, damage to their autonomy, limits on their access to services, and reduced efficacy of therapy. The researchers conclude that many issues must be dealt with if such barriers to health access are to be overcome, in particular the worrying degree of exclusion of deaf patients from health care systems.

Communication in Smoking Cessation and Self-management : a study at Nurse-led COPD-clinics in Primary Health Care

ABSTRACTThe general aim of this thesis was to investigate behavioral change communication at nurse-led chronic obstructive pulmonary disease (COPD) clinics in primary health care, focusing on communication in self-management and smoking cessation for patients with COPD.Designs: Observational, prospective observational and experimental designs were used.Methods: To explore and describe the structure and content of self-management education and smoking cessation communication, consultations between patients (n=30) and nurses (n=7) were videotaped and analyzed with three instruments: Consulting Map (CM), the Motivational Interviewing Treatment Integrity (MITI) scale and the Client Language Assessment in Motivational Interviewing (CLAMI). To examine the effects of structured self-management education, patients with COPD (n=52) were randomized in an intervention and a control group. Patients’ quality of life (QoL), knowledge about COPD and smoking cessation were examined with a questionnaire on knowledge about COPD and smoking habits and with St. George’s Respiratory Questionnaire, addressing QoL. Results: The findings from the videotaped consultations showed that communication about the reasons for consultation mainly concerned medical and physical problems and (to a certain extent) patients´ perceptions. Two consultations ended with shared understanding, but none of the patients received an individual treatment-plan. In the smoking cessation communication the nurses did only to a small extent evoke patients’ reasons for change, fostered collaboration and supported patients’ autonomy. The nurses provided a lot of information (42%), asked closed (21%) rather than open questions (3%), made simpler (14%) rather than complex (2%) reflections and used MI non-adherent (16%) rather than MI-adherent (5%) behavior. Most of the patients’ utterances in the communication were neutral either toward or away from smoking cessation (59%), utterances about reason (desire, ability and need) were 40%, taking steps 1% and commitment to stop smoking 0%. The number of patients who stopped smoking, and patients’ knowledge about the disease and their QoL, was increased by structured self-management education and smoking cessation in collaboration between the patient, nurse and physician and, when necessary, a physiotherapist, a dietician, an occupational therapist and/or a medical social worker.Conclusion The communication at nurse-led COPD clinics rarely involved the patients in shared understanding and responsibility and concerned patients’ fears, worries and problems only to a limited extent. The results also showed that nurses had difficulties in attaining proficiency in behavioral change communication. Structured self-management education showed positive effects on patients’ perceived QoL, on the number of patients who quit smoking and on patients’ knowledge about COPD.

Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics in primary health care

Background: Smokers with chronic obstructive pulmonary disease (COPD) have high nicotine dependence making it difficult to quit smoking. Motivational interviewing (MI) is a method that is used in stimulating motivation and behavioral changes. Objective: To describe smoking cessation communication between patients and registered nurses trained in MI in COPD nurse-led clinics in Swedish primary health care. Methods: A prospective observational study with structured quantitative content analyses of the communication between six nurses with basic education in MI and 13 patients in non-smoking consultations. Results: Only to a small extent did nurses’ evoke patients’ reasons for change, stimulate collaboration, and support patients’ autonomy. Nurses provided information, asked closed questions, and made simple reflections. Patients’ communicationwasmainly neutral and focusing on reasons for and against smoking. It was uncommon for patients to be committed and take steps toward smoking cessation. Conclusion: The nurses did not adhere to the principles of MI in smoking cessation, and the patients focused to a limited extent on how to quit smoking. Practice implications: To make patients more active, the nurses need more education and continuous training in motivational communication.

Graduate nurses communication with health professionals when managing patients medications

Aim and objectives. The aim was to examine how graduate nurses communicated with other health professionals about their medication management activities in the acute care context. The objectives were to determine the types of information communicated about patients' medications and the communication processes used during interactions with other nurses, doctors and pharmacists.

Background. Graduate nurses are challenged with enormous responsibilities and their competence is constantly tested in an ever-changing arena. One of their responsibilities involves communicating with other health professionals about patients' medications.

Design. A qualitative exploratory research design was used for this study.

Methods. Participant observation and semi-structured interviews were conducted to elicit information from 12 graduate nurses with university degrees employed in a metropolitan public hospital, in Melbourne, Australia. Graduate nurses were observed once for two hours and interviewed on the same day of the observation at a mutually convenient time. The purpose of these interviews was to clarify activities observed and to obtain further information.

Results. The results highlighted how work dynamics of the clinical setting had an impact on the ability of graduate nurses to communicate effectively with other nurses, doctors and pharmacists. These work dynamics included the availability of doctors and the structure of ward rounds. The results also demonstrated the value graduate nurses placed on communicating particular information such as evaluating the effect of medication changes and organizing discharge medication.

Conclusions. Graduate nurses were effective in communicating about medication management activities when they initiated or were prepared for such interactions. When graduate nurses were not prepared, such as during impromptu ward rounds, they did not participate effectively and important information was not communicated.

Relevance to clinical practice. It is important to understand how collegial communication facilitates accurate exchange of information and effective decision-making to achieve optimal health care outcomes for patients.