Nurses’ perceptions of barriers to collaborative care of communication difficulties and dysphagia in persons with stroke

Introduction: Colonoscopy screening is an effective method of detecting and preventing colorectal cancer. Standard procedure for most colonoscopies (98%) is to use conscious sedation, which can cause short-term cognitive impairment postprocedure, including communication difficulties. In this study, we explored providers’ (gastroenterology doctors and nurses) perceptions of the barriers to optimal communication with patients immediately following colonoscopy. Methods: We conducted interviews with 61 providers across 5 clinical configurations. Interviews were transcribed and coded with NVivo version 11 software. Results: Themes emerged regarding barriers to optimal provider–patient communication postcolonoscopy: patient barriers (sedation and patient characteristics), caregiver barriers, and system characteristics. Conclusions: Providers’ perceived barriers to communication are an important topic to study. They endorsed, in particular, interventions that target the postcolonoscopy time frame when patients may still be sedated, but providers must convey important discharge and follow-up instructions.

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Home-care nurses’ perceptions of unmet information needs and communication difficulties of older patients in the immediate post-hospital discharge period

BMJ Quality & Safety ◽

10.1136/bmjqs-2012-001207 ◽

2013 ◽

Vol 22 (4) ◽

pp. 324-332 ◽

Cited By ~ 25

Author(s):

Katrina M Romagnoli ◽

Steven M Handler ◽

Frank M Ligons ◽

Harry Hochheiser

Keyword(s):

Home Care ◽

Hospital Discharge ◽

Older Patients ◽

Information Needs ◽

Communication Difficulties ◽

Nurses Perceptions ◽

Home Care Nurses

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Improving Patient Safety and Patient–Provider Communication

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig12-2019-0021 ◽

2019 ◽

Vol 4 (5) ◽

pp. 1017-1027 ◽

Cited By ~ 1

Author(s):

Richard R. Hurtig ◽

Rebecca M. Alper ◽

Karen N. T. Bryant ◽

Krista R. Davidson ◽

Chelsea Bilskemper

Keyword(s):

Acute Care ◽

Augmentative And Alternative Communication ◽

Health Care Team ◽

Provider Communication ◽

Alternative Communication ◽

Patient Provider Communication ◽

Acute Care Settings ◽

Nurses Perceptions ◽

Communication Needs ◽

The Impact

Purpose Many hospitalized patients experience barriers to effective patient–provider communication that can negatively impact their care. These barriers include difficulty physically accessing the nurse call system, communicating about pain and other needs, or both. For many patients, these barriers are a result of their admitting condition and not of an underlying chronic disability. Speech-language pathologists have begun to address patients' short-term communication needs with an array of augmentative and alternative communication (AAC) strategies. Method This study used a between-groups experimental design to evaluate the impact of providing patients with AAC systems so that they could summon help and communicate with their nurses. The study examined patients' and nurses' perceptions of the patients' ability to summon help and effectively communicate with caregivers. Results Patients who could summon their nurses and effectively communicate—with or without AAC—had significantly more favorable perceptions than those who could not. Conclusions This study suggests that AAC can be successfully used in acute care settings to help patients overcome access and communication barriers. Working with other members of the health care team is essential to building a “culture of communication” in acute care settings. Supplemental Material https://doi.org/10.23641/asha.9990962

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The Labeling Problem in Aphasia

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.5102.176 ◽

1986 ◽

Vol 51 (2) ◽

pp. 176-180 ◽

Cited By ~ 10

Author(s):

Audrey L. Holland ◽

Davida Fromm ◽

Carol S. Swindell

Keyword(s):

Speech Disorders ◽

Case Description ◽

Test Results ◽

Apraxia Of Speech ◽

Poor Agreement ◽

Motor Speech ◽

Motor Speech Disorders ◽

Communication Difficulties ◽

Token Test ◽

Primary Problem

Twenty-five "experts" on neurogenic motor speech disorders participated in a tutorial exercise. Each was given information on M, a patient who had communication difficulties as the result of stroke, and asked to complete a questionnaire about his problem. The information included a detailed case description, an audiotape of M's speech obtained at 4, 9, 13, and 17 days post-stroke, and test results from the Western Aphasia Battery, the Token Test, and a battery for apraxia of speech. The experts were in excellent agreement on M's primary problem, although it was called by seven different names. The experts were in poor agreement on his secondary problem(s), e.g., the presence and type of aphasia and dysarthria. The results suggest that labeling is difficult, even for "experts." Furthermore, the practicing clinician needs to be sensitive to the likelihood of more than one coexisting problem.

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