GUIDE Communication Framework: Developing Skills to Improve Nurse–Patient Interactions

2021 ◽  
Vol 25 (6) ◽  
pp. 623-627
Author(s):  
Nina Grenon ◽  
Sven Keersmaecker ◽  
Fransen McGinley
Keyword(s):  
Communication Framework ◽  
Patient Interactions

Interactions in psychiatric care consultation in Akan speaking communities

2019 ◽  
Vol 15 (1) ◽  
pp. 40-52
Author(s):  
Nana Aba Appiah Amfo ◽  
Ekua Essumanma Houphouet ◽  
Eugene K. Dordoye ◽  
Rachel Thompson
Keyword(s):  
Diagnostic Tool ◽  
Psychiatric Care ◽  
Code Mixing ◽  
Therapeutic Benefits ◽  
Patient Interactions ◽  
Health Practitioners ◽  
Care Consultation ◽  
Discourse Pragmatics

The present paper examines interactions in psychiatric care consultation in selected hospital settings in three Akan-speaking communities in Ghana, based on 45 audio-recorded doctor/nurse-patient interactions. Using a discourse pragmatics approach, we note how language is used in the management of communication in psychiatric consultations, and how the dominance of healthcare practitioners is enacted. Specifically, we focus on some of the strategies used by the participants to manage the multilingual communicative settings, such as code-mixing. Our findings also suggest that the use of proverbs as a diagnostic tool in psychiatric consultations in Ghana needs to be reviewed. We propose that in order for patients to experience consultation sessions that are more interactive, with possible therapeutic benefits, health practitioners need to make considerable efforts to involve the patients in decisions regarding their health.

Empathy choice in physicians and non-physicians

2019 ◽  
Author(s):  
Daryl Cameron ◽  
Michael Inzlicht
Keyword(s):  
Medical Care ◽  
Potential Risk ◽  
Behavioral Assessment ◽  
Focal Points ◽  
Costs And Benefits ◽  
Patient Interactions ◽  
Trait Empathy ◽  
Physician Empathy ◽  
Physician Patient

Empathy in medical care has been one of the focal points in the debate over the bright and dark sides of empathy. Whereas physician empathy is sometimes considered necessary for better physician-patient interactions, and is often desired by patients, it also has been described as a potential risk for exhaustion among physicians who must cope with their professional demands of confronting acute and chronic suffering. The present study compared physicians against demographically matched non-physicians on a novel behavioral assessment of empathy, in which they choose between empathizing or remaining detached from suffering targets over a series of trials. Results revealed no statistical differences between physicians and non-physicians in their empathy avoidance, though physicians were descriptively more likely to choose empathy. Additionally, both groups were likely to perceive empathy as cognitively challenging, and perceived cognitive costs of empathy associated with empathy avoidance. Across groups, there were also no statistically significant differences in self-reported trait empathy measures and empathy-related motivations and beliefs. Overall, these results suggest that physicians and non-physicians were more similar than different in terms of their empathic choices and in their assessments of the costs and benefits of empathy for others.

scholarly journals Contamination of Healthcare Worker Personal Protective Equipment with MRSA Outside the Intensive Care Unit Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s27-s28
Author(s):  
Gita Nadimpalli ◽  
Lisa Pineles ◽  
Karly Lebherz ◽  
J. Kristie Johnson ◽  
David Calfee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Direct Patient Care ◽  
Care Group ◽  
Surveillance Culture ◽  
Care Hospital ◽  
Contact Precautions ◽  
Patient Interactions ◽  
The Right

Background: Estimates of contamination of healthcare personnel (HCP) gloves and gowns with methicillin-resistant Staphylococcus aureus (MRSA) following interactions with colonized or infected patients range from 17% to 20%. Most studies were conducted in the intensive care unit (ICU) setting where patients had a recent positive clinical culture. The aim of this study was to determine the rate of MRSA transmission to HCP gloves and gown in non-ICU acute-care hospital units and to identify associated risk factors. Methods: Patients on contact precautions with history of MRSA colonization or infection admitted to non-ICU settings were randomly selected from electronic health records. We observed patient care activities and cultured the gloves and gowns of 10 HCP interactions per patient prior to doffing. Cultures from patients’ anterior nares, chest, antecubital fossa and perianal area were collected to quantify bacterial bioburden. Bacterial counts were log transformed. Results: We observed 55 patients (Fig. 1), and 517 HCP–patient interactions. Of the HCP–patient interactions, 16 (3.1%) led to MRSA contamination of HCP gloves, 18 (3.5%) led to contamination of HCP gown, and 28 (5.4%) led to contamination of either gloves or gown. In addition, 5 (12.8%) patients had a positive clinical or surveillance culture for MRSA in the prior 7 days. Nurses, physicians and technicians were grouped in “direct patient care”, and rest of the HCPs were included in “no direct care group.” Of 404 interactions, 26 (6.4%) of providers in the “direct patient care” group showed transmission of MRSA to gloves or gown in comparison to 2 of 113 (1.8%) interactions involving providers in the “no direct patient care” group (P = .05) (Fig. 2). The median MRSA bioburden was 0 log 10CFU/mL in the nares (range, 0–3.6), perianal region (range, 0–3.5), the arm skin (range, 0-0.3), and the chest skin (range, 0–6.2). Detectable bioburden on patients was negatively correlated with the time since placed on contact precautions (rs= −0.06; P < .001). Of 97 observations with detectable bacterial bioburden at any site, 9 (9.3%) resulted in transmission of MRSA to HCP in comparison to 11 (3.6%) of 310 observations with no detectable bioburden at all sites (P = .03). Conclusions: Transmission of MRSA to gloves or gowns of HCP caring for patients on contact precautions for MRSA in non-ICU settings was lower than in the ICU setting. More evidence is needed to help guide the optimal use of contact precautions for the right patient, in the right setting, for the right type of encounter.Funding: NoneDisclosures: None

scholarly journals 431 - DEMENTIA IN PRIMARY CARE AND DOCTOR-PATIENT-CARER INTERACTIONS: PRELIMINARY FINDINGS

2020 ◽  
Vol 32 (S1) ◽  
pp. 147-147
Author(s):  
Conceição Balsinha ◽  
Steve Iliffe ◽  
Sónia Dias ◽  
Manuel Gonçalves-Pereira
Keyword(s):  
Primary Care ◽  
Family Carer ◽  
Family Carers ◽  
Medical Encounter ◽  
Triadic Interactions ◽  
Patient Interactions ◽  
The Family ◽  
Different Types ◽  
Third Person ◽  
Ongoing Project

INTRODUCTION: Primary care visits of persons with dementia involve different types of communication, bringing together the patient, the family carer and the general practitioner (GP). A particular challenge is the necessary involvement of a third person (the carer) in patient-doctor encounters (or the patient in carer-doctor encounters, as dementia advances). These triad dynamics should be better understood, as health outcomes are expected to result from or be mediated by them.OBJECTIVE: Our aim is to explore triadic dynamics in Portuguese primary care consultations with persons with dementia, their family carers and GPs.METHODS: This is the first part of an ongoing project (Dementia in Primary Care: the Patient, the Carer and the Doctor in the Medical Encounter - Bayer Investigation Grant | NOVAsaúde Ageing 2018). Consultations with persons with dementia, their carers and GPs (purposive sampling) are audio-recorded, transcribed verbatim and thematically analysed. We report the analysis of interactions of the first six consultations, using NVIVO® software.RESULTS: The most frequent type of interaction was between GPs and carers, followed by interactions involving the whole triad. The patients who had more recent relationships with their GPs tended to participate less, irrespective of the stage of dementia. Carers were the ones most often initiating triadic interactions, and GPs the ones most often terminating them by directly addressing the patients. Doctor-carers interactions were very sparse in some consultations.DISCUSSION AND CONCLUSION: These preliminary findings suggest that doctor-patient interactions may be limited in a number of GPs’ consultations, seemingly compromising patient-centred approaches. Nevertheless, even when GPs were involved in triadic interactions they often tried to address the patient directly. We are looking forward to complete this part of the project: to our knowledge, there is practically no evidence from live-recorded primary care consultations about these triadic dynamics.

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