scholarly journals Gender, power, and non-verbal communication

2017 ◽  
Author(s):  
Marianne Schmid Mast ◽  
Valérie Carrard ◽  
Judith A. Hall
Keyword(s):  
Palliative Care ◽  
Power Distribution ◽  
Verbal Communication ◽  
Positive Outcomes ◽  
Medical Encounter ◽  
Verbal Behaviour ◽  
Effective Care ◽  
Gender Power ◽  
Gender And Power

In the study of communication between patients and providers, non-verbal behaviours have often been overlooked. Patients’ non-verbal communication is essential for effective care, and providers’ non-verbal behaviour has been shown to significantly influence medical encounter outcomes. Non-verbal behaviours relative to the power distribution between patients and providers have been shown to greatly impact outcomes with more provider dominance being linked to less positive outcomes. Additionally, gender of both the patients and the providers affect which non-verbal behaviours are shown, and how they are perceived and evaluated. In the present chapter, we discuss the effects of non-verbal communication on how medical encounters unfold in light of the gender and power distribution among provider and patient, the implications of these findings for oncological and palliative care are discussed.

scholarly journals Understanding the Needs of Australian Carers of Adults Receiving Palliative Care in the Home: A Systematic Review of the Literature

2021 ◽  
Vol 7 ◽  
pp. 237796082098568
Author(s):  
Elizabeth M. Miller ◽  
Joanne E. Porter
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Information Needs ◽  
Hospital Admissions ◽  
Positive Outcomes ◽  
Review Of The Literature ◽  
Data Set ◽  
Final Data ◽  
Perceived Impact ◽  
Meta Analyses

Introduction Caring for someone at home requiring palliative care is an ominous task. Unless the current support systems are better utilised and improved to meet the needs of those carers, the demand for acute hospital admissions will increase as the Australian population ages. The aim of this review was to examine the needs of unpaid carers who were caring for adults receiving palliative care in their home in Australia. Methods: A systematic review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines between 2008–2020. Results: Only Australian papers were selected due to the intent to understand carers’ needs in the Australian context and 17 papers made up the final data set. Four themes emerged: 1) Perceived factors influencing caregiving; 2) Perceived impact and responses to caregiving; 3) Communication and information needs; and 4) Perceptions of current palliative support services and barriers to uptake. Conclusion: Carers reported satisfaction and positive outcomes and also expressed feeling unprepared, unrecognised, stressed and exhausted.

scholarly journals Simulated patient and role play methodologies for communication skills and empathy training of undergraduate medical students

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cristina Bagacean ◽  
Ianis Cousin ◽  
Anne-Helene Ubertini ◽  
Mohamed El Yacoubi El Idrissi ◽  
Anne Bordron ◽  
...  
Keyword(s):  
Medical Students ◽  
Communication Skills ◽  
Role Play ◽  
Skills Training ◽  
Verbal Communication ◽  
Simulated Patient ◽  
Background Information ◽  
Undergraduate Medical Students ◽  
Verbal Behaviour ◽  
Verbal Messages

Abstract Background Verbal and non-verbal communication, as well as empathy are central to patient-doctor interactions and have been associated with patients’ satisfaction. Non-verbal communication tends to override verbal messages. The aim of this study was to analyze how medical students use verbal and non-verbal communication using two different educational approaches, student role play (SRP) and actor simulated patient (ASP), and whether the non-verbal behaviour is different in the two different poses. Methods Three raters evaluated 20 students playing the doctor role, 10 in the SRP group and 10 in the ASP group. The videos were analyzed with the Calgary-Cambridge Referenced Observation Guide (CCG) and, for a more accurate evaluation of non-verbal communication, we also evaluated signs of nervousness, and posture. Empathy was rated with the CARE questionnaire. Independent Mann Whitney U tests and Qhi square tests were performed for statistical analysis. Results From the 6 main tasks of the CCG score, we obtained higher scores in the ASP group for the task ‘Gathering information’ (p = 0.0008). Concerning the 17 descriptors of the CCG, the ASP group obtained significantly better scores for ‘Exploration of the patients’ problems to discover the biomedical perspective’ (p = 0.007), ‘Exploration of the patients’ problems to discover background information and context’ (p = 0.0004) and for ‘Closing the session – Forward planning’ (p = 0.02). With respect to non-verbal behaviour items, nervousness was significantly higher in the ASP group compared to the SRP group (p < 0.0001). Concerning empathy, no differences were found between the SRP and ASP groups. Conclusions Medical students displayed differentiated verbal and non-verbal communication behaviour during the two communication skills training methodologies. These results show that both methodologies have certain advantages and that more explicit non-verbal communication training might be necessary in order to raise students’ awareness for this type of communication and increase doctor-patient interaction effectiveness.

scholarly journals Hope and Persuasion by Physicians During Informed Consent

2014 ◽  
Vol 32 (29) ◽  
pp. 3229-3235 ◽  
Author(s):  
Victoria A. Miller ◽  
Melissa Cousino ◽  
Angela C. Leek ◽  
Eric D. Kodish
Keyword(s):  
Palliative Care ◽  
Informed Consent ◽  
Phase I ◽  
Phase I Trial ◽  
Physician Communication ◽  
Phase I Trials ◽  
Positive Outcomes ◽  
Parent Ratings ◽  
Persuasive Messages ◽  
Perceived Pressure

Purpose To describe hopeful and persuasive messages communicated by physicians during informed consent for phase I trials and examine whether such communication is associated with physician and parent ratings of the likelihood of benefit, physician and parent ratings of the strength of the physician's recommendation to enroll, parent ratings of control, and parent ratings of perceived pressure. Patients and Methods Participants were children with cancer (n = 85) who were offered a phase I trial along with their parents and physicians. Informed consent conferences (ICCs) were audiotaped and coded for physician communication of hope and persuasion. Parents completed an interview (n = 60), and physicians completed a case-specific questionnaire. Results The most frequent hopeful statements related to expectations of positive outcomes and provision of options. Physicians failed to mention no treatment and/or palliative care as options in 68% of ICCs and that the disease was incurable in 85% of ICCs. When physicians mentioned no treatment and/or palliative care as options, both physicians and parents rated the physician's strength of recommendation to enroll in the trial lower. Conclusion Hopes and goals other than cure or longer life were infrequently mentioned, and a minority of physicians communicated that the disease was incurable and that no treatment and/or palliative care were options. These findings are of concern, given the low likelihood of medical benefit from phase I trials. Physicians have an important role to play in helping families develop alternative goals when no curative options remain.

803 Utilizing the Revised Baux Score as a Trigger for Advanced Care Planning with the Palliative Care Team

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S239-S239
Author(s):  
Carrie Littlepage ◽  
Eli Strait ◽  
Jeremy Cabrera ◽  
Jeanne Lee
Keyword(s):  
Palliative Care ◽  
High Risk ◽  
Total Body Surface Area ◽  
Palliative Care Team ◽  
Care Team ◽  
Care Planning ◽  
Advanced Care Planning ◽  
Improvement Project ◽  
Risk Of Mortality ◽  
Effective Care

Abstract Introduction The objectives of this performance improvement project is to facilitate earlier goals of care discussions led by the Palliative Care team for burn patients with a high risk of mortality, and to improve overall communication with families of patients. The Advanced Care Planning Trigger Tool utilizes the Revised Baux Score, a burn mortality scoring system, which is calculated by adding the patient’s age, total body surface area (TBSA) of the patient’s burn as a whole number, and adding an additional 17 points if the patient has an inhalation injury. From January 1st, 2017 to June 1st, 2018 16 patients were admitted to the Burn Center with a Revised Baux Score of over 100. Of those 16 patients, 11 passed away due to their injuries during admission, equaling a 69% mortality. Palliative Care consults were triggered for 4 out of the 16 patients (25%), and all 4 of these patients passed away during their hospital stay. Methods Revised Baux Score is calculated on each new burn admission. A consult to the Palliative Care Team for Advanced Care Planning is triggered within 48 hours of admission, if a patient’s Revised Baux Score is above 110 and they are greater than 60 years old; or any adult patient (over 18 years old) with a score of 130 or greater. Results The project was implemented in June of 2018. This tool led to an increase in Palliative Care team involvement early on for patients with a high risk of mortality from their burn injury, more effective care planning discussions with families and improved collaboration between the Burn team and Palliative Care team. Conclusions All patients with a Revised Baux Score that triggered the Advanced Care Planning Tool for a consult were ordered palliative care consults within 48 hours of admission. Applicability of Research to Practice Advanced Care Planning with the Palliative Care team leads to increased communication and more effective care planning for patients with a high risk of mortality.

scholarly journals A systematic review and critical appraisal of quality indicators to assess optimal palliative care for older people with dementia

2019 ◽  
Vol 33 (4) ◽  
pp. 415-429 ◽  
Author(s):  
Sarah Amador ◽  
Elizabeth L Sampson ◽  
Claire Goodman ◽  
Louise Robinson ◽  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Quality Indicators ◽  
End Of Life Care ◽  
Critical Appraisal ◽  
Complex Interventions ◽  
Service Development ◽  
Life Care ◽  
People With Dementia ◽  
Effective Care

Background: A challenge for commissioners and providers of end-of-life care in dementia is to translate recommendations for good or effective care into quality indicators that inform service development and evaluation. Aim: To identify and critically evaluate quality indicators for end-of-life care in dementia. Results: We found 8657 references, after de-duplication. In all, 19 publications describing 10 new and 3 updated sets of indicators were included in this review. Ultimately, 246 individual indicators were identified as being relevant to dementia end-of-life care and mapped against EAPC guidelines. Conclusions: We systematically derived and assessed a set of quality indicators using a robust framework that provides clear definitions of aspects of palliative care, which are dementia specific, and strengthens the theoretical underpinning of new complex interventions in end-of-life care in dementia.

scholarly journals Multicomponent Palliative Care Interventions in Advanced Chronic Diseases: A Systematic Review

2016 ◽  
Vol 35 (1) ◽  
pp. 173-183 ◽  
Author(s):  
Veerawat Phongtankuel ◽  
Lauren Meador ◽  
Ronald D. Adelman ◽  
Jordan Roberts ◽  
Charles R. Henderson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
English Language ◽  
Chronic Obstructive ◽  
Positive Outcomes ◽  
Spiritual Support ◽  
Obstructive Pulmonary Disease ◽  
Study Selection ◽  
Stage Renal Disease ◽  
End Stage

Background: Many patients live with serious chronic or terminal illnesses. Multicomponent palliative care interventions have been increasingly utilized in patient care; however, it is unclear what is being implemented and who is delivering these interventions. Objectives: To (1) describe the delivery of multicomponent palliative care interventions, (2) characterize the disciplines delivering care, (3) identify the components being implemented, and (4) analyze whether the number of disciplines or components being implemented are associated with positive outcomes. Design: Systematic review. Study Selection: English-language articles analyzing multicomponent palliative care interventions. Outcomes Measured: Delivery of palliative interventions by discipline, components of palliative care implemented, and number of positive outcomes (eg, pain, quality of life). Results: Our search strategy yielded 71 articles, which detailed 64 unique multicomponent palliative care interventions. Nurses (n = 64, 88%) were most often involved in delivering care, followed by physicians (n = 43, 67%), social workers (n = 33, 52%), and chaplains (n = 19, 30%). The most common palliative care components patients received were symptom management (n = 56, 88%), psychological support/counseling (n = 52, 81%), and disease education (n = 48, 75%). Statistical analysis did not uncover an association between number of disciplines or components and positive outcomes. Conclusions: While there has been growth in multicomponent palliative care interventions over the past 3 decades, important aspects require additional study such as better inclusion of key groups (eg, chronic obstructive pulmonary disease, end-stage renal disease, minorities, older adults); incorporating core components of palliative care (eg, interdisciplinary team, integrating caregivers, providing spiritual support); and developing ways to evaluate the effectiveness of interventions that can be readily replicated and disseminated.

scholarly journals Enhancing legacy in palliative care: study protocol for a randomized controlled trial of Dignity Therapy focused on positive outcomes

2015 ◽  
Vol 14 (1) ◽  
Author(s):  
Lori P. Montross-Thomas ◽  
Scott A. Irwin ◽  
Emily A. Meier ◽  
Jarred V. Gallegos ◽  
Shahrokh Golshan ◽  
...  
Keyword(s):  
Palliative Care ◽  
Randomized Controlled Trial ◽  
Study Protocol ◽  
Controlled Trial ◽  
Positive Outcomes ◽  
Randomized Controlled ◽  
Dignity Therapy ◽  
Care Study

The Power of Non-Verbal Communication: Predicting Job Performance by Means of Thin Slices of Non-Verbal Behaviour

2005 ◽  
Vol 35 (2) ◽  
pp. 362-383 ◽  
Author(s):  
Deléne Visser ◽  
John D. L. Matthews
Keyword(s):  
Job Performance ◽  
Selection Method ◽  
Verbal Communication ◽  
Effect Sizes ◽  
Call Centre ◽  
Thin Slice ◽  
Video Recordings ◽  
Verbal Behaviour ◽  
Audio Channel ◽  
Thin Slices

The purpose of the study was to investigate whether ratings of brief exposures to ‘non-verbal’ and ‘non-verbal plus verbal’ behaviour could successfully predict on-the-job performance in a call centre. A panel often judges who were exposed to 30-second silent video recordings of 29 call centre operators carrying out their jobs were asked to rate the non-verbal behaviour of the operators on several dimensions. Two weeks later they were asked to repeat their judgments with the audio channel included. The judgments were correlated with management ratings and customer ratings of the operators' performance. The correlations varied between 0.31 and 0.46, representing medium to large effect sizes. The inclusion of the verbal channel did not significantly improve the accuracy of the thin-slice judgments of non-verbal behaviour. The implications of using ratings of non-verbal behaviour as a selection method were discussed.

scholarly journals Lessons Learned from a Small Pediatric Continuous Renal Replacement Therapy Program

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Tanya Holt ◽  
Olivia Griffin ◽  
Amelie Cyr ◽  
Rebecca Brockman ◽  
Laura Wihak ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Small Volume ◽  
Pediatric Intensive Care ◽  
Lessons Learned ◽  
Positive Outcomes ◽  
The Past ◽  
Therapy Program ◽  
Effective Care

Continuous renal replacement therapy (CRRT) has become a pillar of care in pediatric intensive care units (PICUs) over the past few decades. Quality indicators (QIs) have been evaluated that reflect safe and accountable CRRT. However, there is a paucity of data on outcomes and QIs in smaller-volume CRRT programming. The purpose of this retrospective study was to evaluate the efficiencies, effectiveness, and outcomes of a small-volume CRRT program. Eighty-two patients received CRRT over a 13-year period, and 79% survived to discharge. Sepsis or nonseptic shock (n = 11 (22%) versus n = 6 (50%); p value = 0.004) and time to CRRT initiation after PICU admission (1.1 versus 5.0 days; p value = 0.005) were independent predictors for mortality. The program also had positive outcomes for QIs related to CRRT efficiency and time of initiation, dosing delivery, and rate of adverse events. This study is important as it illustrates the opportunity that smaller centers have to initiate CRRT programming and provide safe and effective care.

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