Efficacy of a Standardised Patient Simulation Programme for Chronicity and End-of-Life Care Training in Undergraduate Nursing Students

Background: Standardised patient simulations seem to be useful for improving the communication skills of health sciences students. However, it is important to define the effectiveness of these types of interventions in complex scenarios linked to disease chronicity and end-of-life contexts. Methods: A quasi-experimental study with pre- and post-intervention measures was carried out in a single group. A total of 161 nursing students completed different assessment instruments to measure their attitudes towards communication (Attitude Toward Communication Scale), self-efficacy (Self-Efficacy of Communication Skills, SE-12), and communication skills (Health Professionals Communication Skills Scale, EHC-PS) before and after simulation training with standardised patients. The objective of the program was to train students in non-technical skills for complex situations involving chronicity and end-of-life care. It comprised eight sessions lasting 2.5 h each. Results: The results showed notable baseline gender differences in attitudes towards communication and in the informative communication dimension, with women obtaining higher scores. The participants’ self-efficacy and communication skills significantly improved after completing the intervention, with no significant differences being found for the attitudes towards communication variable. Conclusion: The standardised patient simulation programme for complex scenarios related to chronicity and end-of-life contexts improved communication self-efficacy and communication skills in these nursing students. In future work it will be important to analyse the influence of gender and attitudes towards communication as variables in the learning of communication skills in nursing students.

Pola Komunikasi Organisasi Dalam Pengembangan Program Studi Filsafat Hindu STAH Negeri Mpu Kuturan Singaraja

The STAH Negeri Mpu Kuturan Singaraja Hindu Philosophy Study Program is a new study program with minimal interest in prospective new students. Minimal in quantity, but the organization in the study program is currently complete, both lecturers, employees, and students. The minimum number of lecturers and students requires a form of communication that functions to unite study programs and minimize misunderstandings in interpreting orders or information. This research is a qualitative research with a phenomenological approach. Sources of data in this study were obtained by direct interviews and using several data sources that are helpful in analyzing such as books on communication. Data collection was carried out by observation, interviews with purposive sampling method, literature study, and documentation. The pattern of organizational communication in the Hindu Philosophy Study Program uses more top-down communication patterns, and bottom-up communication. The organizational communication function in the Hindu Philosophy study program STAHN Mpu Kuturan Singaraja is Informative Communication by using WhatsApp group chat Hindu Philosophy Study Programs to help lecturers and employees work on the Tri Dharma of Higher Education to be more focused, Regulatory Communication, namely the delivery of messages related to regulations in carry out the duties of the people who control the message of the organization, Persuasive Communication, namely changing attitudes and behavior as well as beliefs of a person, Integrative Communication functions and is useful for integrating all messages or information and communications that have been given by the leadership of the organization to members of the organization.

Pragmatic Options of the Dialogical Text as a Language Unit

The purpose of the article is to analyse pragmatic variants of a dialogical text as a language unit. It is assumed that the pragmatic context of the dialogical text (dialogue) actualizing is associated with either informative or phatic intentions. Informative and phatic dialogues appear as pragmatic allotext of a dialogical text. The research methodology is based on the synthesis of derivational and anthropocentric language theories. The process of creating a dialogical text is considered, on the one hand, as a derivational process due to the suppositional relationship between the lexeme and the text, and on the other hand, as a process of interpreting the text in the pragmatic context of its actualization. The material for the study was the recording of oral and written speech of regular native speakers in an informal communication situation. The total number of analyzed speech patterns was 140 dialogic texts – 70 texts of each communication type. It is stated that the pragmatic actualization of the dialogical text is associated with the realization of paradigmatic and syntagmatic connections of lexemes. It is revealed that the syntagmatic model of a dialogical text genesis in informative communication is an adjoining model. A paradigmatic model of dialogic text genesis in informative communication is synonymy. In phatic communication, an attachment model was identified as a syntagmatic model of the genesis of a dialogical text. The paradigmatic model for the production of dialogic text in phatic communication is a homonym model.

Are public health measures and individualised care compatible in the face of a pandemic? A national observational study of bereaved relatives’ experiences during the COVID-19 pandemic

Background: COVID-19 public health restrictions have affected end-of-life care experiences for dying patients and their families. Aim: To explore bereaved relatives’ experiences of quality of care and family support provided during the last days of life; to identify the impact of factors associated with perceived support. Design: A national, observational, open online survey was developed and disseminated via social media, public fora and professional networks (June–September 2020). Validated instruments and purposively designed questions assessed experiences. Analysis used descriptive statistics, logistic regression and thematic analysis of free-text responses. Participants: Individuals (⩾18 years) who had experienced the death of a relative/friend (all care settings) within the United Kingdome during the COVID-19 pandemic. Results: Respondents ( n = 278, mean 53.4 years) tended to be female ( n = 216, 78%); over half were ‘son/daughter’ (174, 62.6%) to the deceased. Deceased individuals (mean 81.6 years) most frequently died in their ‘usual place of care’ ( n = 192, 69.3%). Analysis established five conceptual themes affecting individualised care: (1) public health restrictions compounding the distress of ‘not knowing’; (2) disparate views about support from doctors and nurses; (3) challenges in communication and level of preparedness for the death; (4) delivery of compassionate care; (5) emotional needs and potential impact on grief. Male respondents (OR 2.9, p = 0.03) and those able to visit (OR 2.2, p = 0.04) were independently associated with good perceptions of family support. Conclusion: Despite public health restrictions, individualised care can be enabled by proactive, informative communication; recognising dying in a timely manner and facilitating the ability to be present before death.

Development of a Patient-Oriented Intervention to Support Patient-Provider Conversations about Unnecessary Lower Back Pain Imaging

Background: despite the efforts of multiple stakeholders to promote appropriate care throughout the healthcare system, studies show that two out of three lower back pain (LBP) patients expect to receive imaging. We used the Choosing Wisely Canada patient-oriented framework, prioritizing patient engagement, to develop an intervention that addresses lower back pain imaging overuse. Methods: to develop this intervention, we collaborated with a multidisciplinary advisory team, including two patient partners with lower back pain, researchers, clinicians, healthcare administrators, and the Choosing Wisely Canada lead for Saskatchewan. For this qualitative study, data were collected through two advisory team meetings, two individual interviews with lower back pain patient partners, and three focus groups with lower back pain patient participants. A lower back pain prescription pad was developed as an outcome of these consultations. Results: participants reported a lack of interactive and informative communication was a significant barrier to receiving appropriate care. The most cited content information for inclusion in this intervention was treatments known to work, including physical activity, useful equipment, and reliable sources of educational material. Participants also suggested it was important that benefits and risks of imaging were explained on the pad. Three key themes derived from the data were also used to guide development of the intervention: (a) the role of imaging in LBP diagnosis; (b) the impact of the patient-physician relationship on LBP diagnosis and treatment; and (c) the lack of patient awareness of Choosing Wisely Canada and their recommendations. Conclusions: the lower back pain patient-developed prescription pad may help patients and clinicians engage in informed conversations and shared decision making that could support reduce unnecessary lower back pain imaging.

STRATEGI KOMUNIKASI DAKWAH PENYULUH AGAMA NON PNS DALAM MEMBINA MASYARAKAT DESA BATU NYADI KECAMATAN KETUNGAU HILIR KABUPATEN SINTANG

This study aims to find out the communication strategy of non-civil servant Religious Extension Workers in fostering rural communities which are formulated into three questions as follows: the role of Non-Civil Servant Religious Extension Workers in realizing rural communities. Diffusion of communication da'wah Non-civil servant Religious Extension in fostering rural communities and innovation of communication da'wah Non-civil servant Religious Extension in fostering rural communities in the district Ketungau Hilir Sintang district. The research method uses descriptive methods by making Non-Civil Servant Religious Extension of Sintang district that fosters rural communities as the main source in this research. This type of research is qualitative. The results showed that non-civil servant religious extension workers acted as agents of change by conducting persuasive-informative communication in resuscitating and fostering rural communities in ketungau hilir subdistrict of Sintang district. Diffusion of da'wah communication carried out by non-civil servant Religious Extension in fostering rural communities in the district ketungau Hilir Sintang district through activities in the form of ta'lim assembly and coaching da'wah cadres carried out at several points in the village of Beloh Mulyo, Indung Sepring, Mengaret and Batu Nyadi Village. Da'wah communication innovation carried out by non-civil servant religious extension workers in the form of implementation of da'wah cadreization program in the village through training activities and ta’lim assembly.

Using critical information to strengthen pandemic preparedness: the role of national public health agencies

COVID-19 has demonstrated that most countries’ public health systems and capacities are insufficiently prepared to prevent a localised infectious disease outbreak from spreading. Strengthening national preparedness requires National Public Health Institutes (NPHIs), or their equivalent, to overcome practical challenges affecting timely access to, and use of, data that is critical to preparedness. Our situational analysis in collaboration with NPHIs in three countries—Ethiopia, Nigeria and Pakistan—characterises these challenges. Our findings indicate that NPHIs’ role necessitates collection and analysis of data from multiple sources that do not routinely share data with public health authorities. Since initiating requests for access to new data sources can be a lengthy process, it is essential that NPHIs are routinely monitoring a broad set of priority indicators that are selected to reflect the country-specific context. NPHIs must also have the authority to be able to request rapid sharing of data from public and private sector organisations during health emergencies and to access additional human and financial resources during disease outbreaks. Finally, timely, transparent and informative communication of synthesised data from NPHIs will facilitate sustained data sharing with NPHIs from external organisations. These actions identified by our analysis will support the availability of robust information systems that allow relevant data to be collected, shared and analysed by NPHIs sufficiently rapidly to inform a timely local response to infectious disease outbreaks in the future.

What factors influence symptom reporting during an emerging infectious disease outbreak? A rapid review of the evidence

Introduction During any emerging infectious disease outbreak, people with symptoms of the illness are often asked to report their symptoms to the health service in a timely manner, to facilitate contract tracing. Numerous factors may influence an individuals willingness to report these symptoms. Understanding these factors has become urgent during the COVID-19 pandemic Objective To determine which factors influence symptom reporting during an emerging infectious disease outbreak Methods We conducted a rapid review of the evidence. We included papers based on primary research, published in peer-reviewed journals, written in English, included factors associated with symptom reporting or accessing healthcare, and related to a major public health incident involving an infectious disease outbreak Results Five themes were identified as facilitators of symptom reporting or accessing healthcare (accurate and informative communication, symptom severity, concern about exposure, ease of access, and relationship with the healthcare provider). Seven themes were identified as barriers of symptom reporting or accessing healthcare (lack of knowledge, fear, stigmatization, invasion of privacy, low concerns about symptoms, economics, and practicalities of attending a healthcare facility) Discussion If contract tracing services are to be effective, members of the public need to have the capability, opportunity and motivation to use them. The themes identified should be used to evaluate the information provided to the public about such a service, the routes of access, and the underlying polices relating to the service, in order to ensure that as many people as possible with relevant symptoms will make contact

The internet and social media as a theme and channel of humor

This paper deploys the tools of relevance theory to establish a common pragmatic mechanism operating in humorous texts (stand-up comedy, jokes, sketches) themed on the omnipresence of the Internet and social media in human life. It is postulated that this mechanism resides in incongruity between shared cultural assumptions expressing high esteem for rational actions and informative communication, and private assumptions endorsed by internet application users, who find phatic communication pleasurable. It is claimed that incongruity so understood is not a central but additional pragmatic mechanism in various humorous genres, and it tends not to be resolved, as tension between these two sets of assumptions lingers on.