Essential Elements Of Communication Research Articles

“The Pop Quiz That Does Everything but Write Itself” Pilot Examination of the Suggestive or Acting Potential of the Word

“Then God said, ‘Let there be light! And there was light.” These words are not only said, but they bring into being what is said. That God created man in his image and likeness is reflected in our speech. By their very nature, our words are creative: when they are uttered, they always create something. In psychological terms, words are the basis of our relationships, successes and failures, and our moods. They define and shape our social environment and govern our thoughts and actions. They influence our self-esteem, well-being, the development of our abilities, and performance and, last but not least, they can affect the functioning of our cells and bodily processes. Suggestion is the term used to describe any message, generally verbal, that has an involuntary effect on the receiver, who can transform words into action as a result. It is an essential element of communication that can occur in many social situations. In our pilot study, we used the tools of suggestive communication in instructions and questions related to a school essay and investigated their impact on performance. Keywords: suggestive communication, altered state of consciousness, performance anxiety, school performance, pop quiz

Psychological Impact of Languages on the Human Mind: Research on the Contribution of Psycholinguistics Approach to Teaching and Learning English.

Language is one of the essential elements of communication. Learning some common language can help people overcome language barriers between people from different countries. English is one of the common languages and it helps individuals adapt to the modern world. Learning the English language is beneficial through teaching methods developed based on Psycholinguistics principles. Four languages are taught by the approach of psycholinguistics that are (to listen, to read, to write and to speak).Psycholinguistics is the integration of psychology (the study of the mind) and linguistics (the study of language). Hence, Psycholinguistics is the study of mind and language. It investigates the procedure taking place in the brain while the perception and creation of language. It studies the psychological impact of languages on the human mind. Recent research focuses on Psycholinguistics theories and talks over the significant impact of psycholinguistics techniques in English Language studying and training. Psycholinguistic studies are based on various ways of responding in a fundamental way and are based on evidence. This study contributes to our understanding of the importance of psychological approaches in teaching and learning English.

Patient handoffs among general surgery residents in Saudi Arabia: a cross-sectional study

BackgroundCommunication failure is a common cause of adverse events. An essential element of communication among health care providers is patient handoff. Patient handoff is defined as a practice whereby a health care provider transfers a patient’s care information to another health care provider to ensure the patient’s safety and continuity of care. To explore this practice, we assessed patient handoffs among general surgery residents in Saudi Arabia.MethodsA cross-sectional survey was conducted with individuals in accredited general surgery residency programs in Saudi Arabia between 2020 and 2021.ResultsParticipants comprised 118 general surgery residents: 66 (57.3%) were female; 67 (72.8%) did not receive any formal training on patient handoff; and 35 (38.8%) reported that they were sometimes interrupted during the patient handoff process. The most common reason for such interruptions was medical personnel paging. Furthermore, 60 (68.1%) general surgery residents stated that these interruptions led to a decreased quality of effective communication, 39 (44.3%) believed it led to decreased quality of patient care, 63 (71.5%) believed it led to the loss of some information related to patient handoff, and 16 (18.1%) believed it led to patient harm. Finally, 31 (34.4%) general surgery residents believed that the existing handoff system at their institutions neither adequately protected the patients’ safety nor allowed for continuity of care, and 51 (68%) reported that their institution did not have a standardized protocol for the verbal patient handoff process. There was a higher proportion of patients with minor harm among residents who did not, rarely or sometimes received verbal or written hand off instructions compare to those who did so always or most of the time (67% vs. 49%, respectively).ConclusionThe patient handoff process among general surgery residents in Saudi Arabia is subjective and is not standardized, and if not addressed, may lead to patient harm. Standardizing this process is paramount to improve patient safety.

POLITENESS STRATEGIES USED BY LECTURERS AND STUDENTS IN THESIS GUIDANCE THROUGH VIRTUAL COMMUNICATIONS

Politeness is an essential element of communication and is used to assure the quality of a relationship through language. Politeness in English classes is paramount to study because the sense of decency is indispensable. In another condition, virtual communication to some extent is challenging since it requires some rules to run proper interactions between lecturers and students. The use of polite expressions is one of the rules to obey, especially in thesis guidance. This study is strived to see the use of politeness strategies in the interaction between lecturers and post-graduates at one state university in Lampung through virtual communication. This study employed qualitative method where the documentation was used to collect the data. The data of this study were conversation between the lecturer and the students through virtual communications: WhatsApp and E-mail. The findings reveal that (1) the positive politeness strategy was strategy mostly used by the students; (2) the lecturer mostly utilized bald-on record strategy, and (3) several factors were believed to influence the use of politeness strategies such as power, institutional position, social distance, age as well as social culture.

Продуктивные способы образования неологизмов концептуализированной группы Brexit в современном англоязычном массмедийном дискурсе

The paper aims to identify the most productive models of neologism formation in the English-language media discourse. The research material includes neologisms of the conceptual-thematic area Brexit. Scientific originality of the study is conditioned by the fact that the English neologisms with the component Brexit are considered as an essential element of communication and an integral part of modern media discourse. The author presents observations and conclusions based on an analysis of factual material. The findings of this study indicate that the most productive ways of the Brexit neologism formation are stem composition, affixation and shortening.

Patient-Provider Communication Training Models for Interactive Speech Devices.

Patient-provider communication plays a major role in healthcare with its main goal being to improve the patient's health and build a trustworthy relationship between the patient and the doctor. Provider's efficiency and effectiveness in communication can be improved through training in order to meet the essential elements of communication that are relevant during medical encounters. We surmised that speech-enabled conversational agents could be used as a training tool. In this study, we propose designing an ontology-based interaction model that can direct software agents to train dental and medical students. We transformed sample scenario scripts into a formalized ontology training model that links utterances of the user and the machine that expresses patient-provider communication. We created two instance-based models from the ontology to test the operational execution of the model using a prototype software engine. The assessment revealed that the dialogue engine was able to handle about 62% of the dialogue links. Future direction of this work will focus on further enhancing and capturing the features of patient-provider communication, and eventual deployment for pilot testing.

Experiential Learning Cycles as an Effective Means for Teaching Psychiatric Clinical Skills via Repeated Simulation in the Psychiatry Clerkship.

ObjectiveThis retrospective study compares differences in clinical performance on the psychiatry clerkship Objective Structured Clinical Examination (OSCE) between students receiving traditional repeated clinical simulation with those receiving repeated clinical simulation using the Kolb Cycle.MethodsPsychiatry clerkship OSCE scores from 321 students who completed their psychiatry clerkship in 2016 and 2017 were compared. Specific performance measures included communication skills as determined by the Essential Elements of Communication, gathering a history, documenting a history and mental status exam, defending a differential diagnosis, and proposing a treatment plan. Results were calculated using repeated two-way analysis of variance between students receiving no simulation and traditional repeated simulation training (TRS) as compared to students receiving no simulation and repeated simulation utilizing the Kolb cycle (KRS).ResultsStudents who received KRS performed significantly better in three of the five components of the clerkship OSCE as compared to students who received TRS. Specifically, students who received KRS performed better on gathering a history (+ 14.1%, p < 0.001), documenting a history (+ 13.4%, p < 0.001), and developing a treatment plan (+ 16.7%, p < 0.001). There were no significant differences in communication skills or in developing and defending a differential diagnosis.ConclusionsPsychiatry clerkship students engaged in repeated simulations explicitly integrated with the Kolb cycle demonstrate improved clinical skills as measured by OSCE performance. Integration of the Kolb cycle in designing simulation experiences should be carefully considered and may serve as a model for individualized coaching in programs of assessment.

Validation of a Modified Jefferson Scale of Empathy for Observers to Assess Trainees.

"Demonstrate insight and understanding into emotion" is a competency amenable to simulation-based assessment. The Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) has validity evidence for patients to assess provider empathy. A version adapted for a third-party observers does not exist. Our aim was to modify the JSPPPE and use recorded standardized encounters to obtain validity evidence. This cross-sectional study used video and data collected from 2 pediatric residencies. In 2018, 4 raters reviewed 24 videos of 12 interns communicating with standardized patients (SP) in 2 encounters and completed a modified JSPPE for observers (JSEO). Reliability between raters was established using Intraclass Correlations (ICC). JSEO mean scores were correlated to Essential Elements of Communication (EEC), JSPPPE, and faculty composite interpersonal communication (IC) scores using Spearman Rank. The mean ICC for all 4 raters was 0.573 (0.376-0.755). When ICC was calculated for pairs of raters, Rater 1 was an outlier. ICCs for mean scores for pairs among the 3 remaining raters was 0.81 to 0.84. Mean JSEO scores from the four raters correlated with the JSPPPE (rho=0.45, P=.03) and IC (rho=0.68, P < .001), but not the EEC (rho=0.345, P=.1). We found validity evidence for the use of a modified JSPPPE for an observer to assess empathy in a recorded encounter with a SP. This may be useful as medical educators shift toward competency-based tracking. The brevity of this tool and potential assessment using video are also appealing.

Gender Differences in Students' Interpersonal Communication

Objective: Interpersonal communication is an essential element of communication that creates meaningful social relationships in the academic environment. Students who have good interpersonal communication skills will be capable of interacting with others. However, it was reported that some students still have a low capacity for interpersonal communication caused by various factors, and one of them is gender. This research attempts to investigate the students’ interpersonal communication concerning gender and to find out whether there is a difference between male and female students in terms of interpersonal communication.&#x0D; Methodology: This study was conducted through a descriptive method. The subject of this study includes 88 students consisting of 66 male and 22 female students at one state polytechnic in Bandung, Indonesia. The data were collected in terms of interpersonal communication and gender.&#x0D; Results: The results show that male students had a slightly higher score of interpersonal communication than females. Regarding the significant elements of effective interpersonal communication, it was found that there are differences in the dominant component of interpersonal communication between male and female students. Female students dominated the area of equality, indicating that they have a more dominant ability to position themselves as equivalent to their communication partners to create comfortable communication. Male students dominated the area of openness, empathy, supportiveness, and a positive attitude showing that they have a more dominant ability to show a willingness to communicate honestly and full of understanding, so they were able to give support and positive thought.&#x0D; Implication: The study recommends the use of appropriate communication activities that can encourage the students to be open, to be supportive, and to be positive. This condition will enable teachers to choose and apply the appropriate methods in the teaching and learning process to support the development of students’ interpersonal communication.

Still Coming Out of the Dark: Enduring Effects of Simulation-Based Communication Skills Training for Radiology Residents—Four-Year Follow-Up

PurposeTo evaluate the long-term efficacy of simulation-based communication skills training for radiology residents. Method and MaterialsThe simulation-based communication skills training curriculum was developed in 2014. The curriculum included a teaching module based on the essential elements of communication. Two sets of 6 communication scenarios encountered by radiologist were created. First and fourth year radiology residents reviewed the teaching module and completed the 6 simulated scenarios. They then underwent debriefing sessions, received faculty and staff evaluations. Four years later, the former first year residents (now fourth years) reviewed the teaching module again and repeated the simulation. They again underwent debriefing sessions after the simulation. This time the residents’ communication skills were evaluated by faculty and staff. ResultsA total of 5 residents participated in this simulation-based skills training. The resident performance 4 years after initial training show not only that residents maintained their improved scores, but also that their scores improved further as compared to after the initial training. The average overall score for all but 1 resident increased at the 4 year follow-up simulation. From 2014 to 2018, the average score of all the residents increased from 72.4% to 81.4%. Comparison of the average scores of each student across 6 stations from 2014 to 2018 showed a statistically significant difference between the scores after 4 years (P = 0.014). ConclusionsSimulation-based communication skills training is effective and long lasting.

The importance of language in maternity services

An essential element of communication in maternity services is the use of language. This article will examine three key themes in the use of language: medical jargon, emotive language and those for whom English is not a first language. Medical jargon detracts from patient autonomy, and emotive language can influence women's mindset and experience both positively and negatively. When English is not an individual's first language, women feel defenceless and lack understanding. This can be mitigated by the use of an interpreter; however, their misuse, or a health professional's inexperience in using them, can limit their effectiveness.

Interprofessional Healthcare Student Training in the Care of Sexual Assault Patients Utilizing Standardized Patient Methodology.

The medical assessment of sexual assault (SA) is challenging because SA patients are often hesitant to disclose their medical needs, which puts them at further physical and psychological risk, and because of provider unease in conducting SA examinations. This challenge is compounded by a lack of provider training. The study goals were to develop an interprofessional simulation event that would foster SA interview skills, foster effective communication with SA patients, and increase learner confidence in assessing SA patients. Participants were senior-year school of medicine (n = 165) and advanced practice registered nursing (n = 30) students (N = 195) who were enrolled in a mandatory Military Sexual Assault Assessment and Treatment course, along with data provided by trained standardized patients (SPs, n = 16) who participated in the simulation event and in assessments of learners. Measures included the Sexual Assault Interview Skills Checklist, the Essential Elements of Communication, and the Confidence in SA Assessment scale. Data were analyzed using analysis of variance and t tests at the P < 0.05 threshold. Postsimulation Sexual Assault Interview Skills Checklist and Essential Elements of Communication scores demonstrated an acceptable level of competence according to both students and SPs. Confidence in SA assessment rose significantly from presimulation to postsimulation. Before simulation, medical students were significantly lower than nursing students, but the simulation event closed the confidence in SA assessment gap. This interprofessional simulation event resulted in SA interview competence, communication skills competence, and improved confidence scores. Combined, these findings support the efficacy of simulation to train emerging healthcare providers to properly assess SA.

Measuring disorganized speech in schizophrenia: automated analysis explains variance in cognitive deficits beyond clinician-rated scales.

Conveying information cohesively is an essential element of communication that is disrupted in schizophrenia. These disruptions are typically expressed through disorganized symptoms, which have been linked to neurocognitive, social cognitive, and metacognitive deficits. Automated analysis can objectively assess disorganization within sentences, between sentences, and across paragraphs by comparing explicit communication to a large text corpus. Little work in schizophrenia has tested: (1) links between disorganized symptoms measured via automated analysis and neurocognition, social cognition, or metacognition; and (2) if automated analysis explains incremental variance in cognitive processes beyond clinician-rated scales. Disorganization was measured in schizophrenia (n = 81) with Coh-Metrix 3.0, an automated program that calculates basic and complex language indices. Trained staff also assessed neurocognition, social cognition, metacognition, and clinician-rated disorganization. Findings showed that all three cognitive processes were significantly associated with at least one automated index of disorganization. When automated analysis was compared with a clinician-rated scale, it accounted for significant variance in neurocognition and metacognition beyond the clinician-rated measure. When combined, these two methods explained 28-31% of the variance in neurocognition, social cognition, and metacognition. This study illustrated how automated analysis can highlight the specific role of disorganization in neurocognition, social cognition, and metacognition. Generally, those with poor cognition also displayed more disorganization in their speech-making it difficult for listeners to process essential information needed to tie the speaker's ideas together. Our findings showcase how implementing a mixed-methods approach in schizophrenia can explain substantial variance in cognitive processes.

Factors Influencing the Adoption of Location Based Identification in Kurdistan Regional of Iraq

Location Based Identification (LBI) can be defined as a string of numeric or alphanumeric characters that are used to define a specific location. Virtually, it is the most compact data element capable of specifying the location of a mail addressee with high precision (Raper, Rhind, & Shepherd, 1992; Zandbergen, 2008). LBI is an essential element of communication between people, public, governmental organisations and business sectors. It plays a significant role in postal services and consequently it is a significant element of social communication and economic development. LBI is a significantly important concept that has been implemented in developed countries. Examples include the American zip code and the UK postcode. LBI is used by governments, organisations, institutions and retailers to keep track of their customers and participants. Today, as a result of continuous development and expansion, LBI needs to be devised to include a more robust sense of adaptation for the growing urban sprawl. The lack of use of LBI in developing countries is the key point of this research. However, an issue surrounding the designed LBI systems in developed countries is the non-existence of justified design techniques. Hence, the designed LBI systems around the world lack intelligent features such as directional impressions of the codes. In this regard, this study presents a new technique to design LBI systems, where the codes give a view of how far a point is from the centre, in addition to the direction with respect to the centre. The technique is based on a transverse division of the area being designed. Each area is classified numerically, with respect to the four main directions or the compass (North, South, East and West). Moreover, the method indicates the approximate distance from the central point of the area being designed, by dividing the area into concentric zones. The Kurdistan Region of Iraq has been chosen as a case study to validate the technique. The study begins with a quantitative study and many factors have been considered and examined, which may affect the adoption of LBI in developing countries - specifically within the Kurdistan Region of Iraq. Furthermore, empirically, the main effective factors of LBI adoption have been found. In this regard, the Technology Acceptance Model (TAM) and the Decomposed Theory of Planned Behaviour (DTPB) have been used as base models to test the factors that cause the adoption of LBI system in the region. The latent variables used in this study are government support (GS), self-efficacy (SE), perceived usefulness (PU), perceived ease of use (PEU), compatibility (COM), family and friends (FF), attitude (A), subjective norm (SN), perceived behaviour control (PBC) and behaviour intention (BI). Then another study has been conducted based on an open-ended questionnaire. The aim of this study is to ascertain the impacts of the LBI system in daily life. The study focused on five important points related to the accepted design of the LBI system by the users. The code format, the impact on technology, the necessity of having the system, the impact on the economy and the impact of policy, have all been studied and analysed based on the participants’ views. The final study was based on interviews to assess the outcomes of the current research. The participants have been chosen based on their experience and career position. Experts and decision makers in fields related to LBI systems have been chosen. The assessment is based on four different aspects, which are novelty, applicability, scalability and the flexibility of the proposed ideas of this research. The study is based on the positivism philosophy to observe individuals behaviour toward using the LBI system. However, a deductive research approach has been applied to provide the research hypothesis. In the first and second questionnaire, 236 and 153 respondents are involved respectively. In addition, 7 interviewers have been participated for the study assessment. The results encourage the Kurdistan Regional Government (KRG) decision makers to develop strategies that may lead to the adoption of LBI in the region. The selection of the design has been analysed to be based on the impact of the proposed system on the different sectors of the daily life. Furthermore, this proposed SR_LBI has been positively assessed by the interviewees and will be beneficial for developing countries that have the desire to start designing their own system.

Military Sexual Assault Provider OSCE: Agreement of Self-reported Assessment and Standardized Patient Evaluation in Medical and Graduate Nursing Students

BACKGROUND: Sexual assault is one of the most underreported crimes in the U.S. military. Sexual trauma education programs have been successful in increasing awareness of this problem throughout the DoD, however now more emphasis is being placed on provider education early in training. Educators at USU have developed a sexual assault education module in order to improve provider comfort and communication in a crisis situation. METHODS: Surveys were designed to evaluate students on the eight essential elements of communication (EEC). A cohort of 179 USU medical and graduate nursing students completed these surveys after participating in an interview with a simulated sexual assault victim. The standardized patient portraying the victim also completed a mirrored survey evaluating student's communication. RESULTS: No significant differences in means between medical and graduate nursing student OSCE responses were discovered. Students similarly underrated themselves on encounters. Weighted kappas were calculated and showed fair agreement between self-assessment and standardized patients. DISCUSSION: No significant differences in interactions between medical and graduate nursing students were identified. OSCE is an important teaching modality for hands-on application of knowledge; student feedback was helpful in planning future simulations and identified some areas for improvement with this simulation. Exposing students to sensitive encounters and emphasizing importance of communication, especially in these situations, will assist students in their clinical growth and development.

Measuring communication competence and effectiveness of ASHAs (accredited social health activist) in their leadership role at rural settings of Uttar Pradesh (India).

Purpose - This paper aims to find out accredited social health activists' (ASHA) communication competence and effectiveness while working as leaders with groups in the rural setting. ASHA, as the "first point of contact" for pregnant women in rural areas, plays a significant role in building awareness and disseminating key information at critical times (e.g. antenatal and post-natal period), promotes healthy maternal and newborn care practices and facilitates identification and referral of maternal and newborn complications. ASHA plays critical role of a leader in bridging the gap between health system and community. In the entire process, effective communication competency is the key to her effectiveness. Design/methodology/approach - The study adopts seven items from the farmers communication (FACOM) scale of communication measures developed by Udai Pareek and Y.P Singh. Preliminary editing of the items was done keeping certain points in mind such as the items should not be judgemental, should be acts of behaviour, should be observable and should be simple. This scale was adopted for the study, as it was designed to measure farmers' communication competence and suited the context. The evaluation criteria included the seven essential elements of communication identified in the FACOM scale. Findings - Results from the study identified a need to sensitise ASHAs on the critical role of effective communication and need for investing more in building her capacity for health communication. The trainings being imparted to ASHAs have to be strengthened in terms of communication skills. They should focus upon developing all three variables of communication skills equally and integrating them to get desired results. Research limitations/implications - The study was conducted in one state while the programme is running across the country. The sample size was small. Practical implications - The learning of the study will help in developing a better understanding of the beneficiaries' perspectives and their expectations regarding ASHAs communication process in the leadership role which she performs. Such understanding will not only be instructive but may also prove transformative for the benefit of both ASHAs and her community, whose support is critical to the success of the programme. This learning will feed into the policy planning and communication and capacity building strategy of the ASHA programme and may lead to better and more effective strategies and tools of communication. Originality/value - Research study is original. Keeping the observers' status in mind, questionnaire was translated in Hindi language. Twenty ASHAs were selected randomly from small villages of Uttar Pradesh, the largest state in India. The scale was presented to at least five observers (all females) for one ASHA. These observers/judges were the ones who knew ASHA well and with whom she had communicated at some point of time as part of her work.

Longitudinal effects of medical students' communication skills on future performance.

The Essential Elements of Communication (EEC) were developed from the Kalamazoo consensus statement on physician-patient communication. The Uniformed Services University of the Health Sciences (USU) has adopted a longitudinal curriculum to use the EEC both as a learning tool during standardized patient encounters and as an evaluation tool culminating with the end of preclerkship objective-structured clinical examinations (OSCE). Medical educators have recently emphasized the importance of teaching communication skills, as evidenced by the United States Medical Licensing Examination testing both the integrated clinical encounter (ICE) and communication and interpersonal skills (CIS) within the Step 2 Clinical Skills exam (CS). To determine the associations between students' EEC OSCE performance at the end of the preclerkship period with later communication skills assessment and evaluation outcomes in the context of a longitudinal curriculum spanning both undergraduate medical education and graduate medical education. Retrospective data from preclerkship (overall OSCE scores and EEC OSCE scores) and clerkship outcomes (internal medicine [IM] clinical points and average clerkship National Board of Medical Examiners [NBME] scores) were collected from 167 USU medical students from the class of 2011 and compared to individual scores on the CIS and ICE components of Step 2 CS, as well as to the communication skills component of the program directors' evaluation of trainees during their postgraduate year 1 (PGY-1) residency. In addition to bivariate Pearson correlation analysis, we conducted multiple linear regression analysis to examine the predictive power of the EEC score beyond the IM clerkship clinical points and the average NBME Subject Exams score on the outcome measures. The EEC score was a significant predictor of the CIS score and the PGY-1 communication skills score. Beyond the average NBME Subject Exams score and the IM clerkship clinical points, the EEC score explained an additional 13% of the variance in the Step 2 CIS score and an additional 6% of the variance in the PGY-1 communication skills score. In addition, the EEC score was more closely associated with the CIS score than the ICE score. The use of a standardized approach with a communication tool like the EEC can help explain future performance in communication skills independent of other education outcomes. In the context of a longitudinal curriculum, this information may better inform medical educators on learners' communication capabilities and more accurately direct future remediation efforts.

Competency 1. Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds

The ability to communicate effectively with patients, families, and the public is a critical skill for the medical professional and has been directly related to the outcomes of clinical care. 1 Stewart M. Effective physician–patient communication and health outcomes: a review. Can Med Assoc J. 1995; : 152-159 Google Scholar The importance of this is reflected in the medical education literature in consensus statements on essential elements of communication, 2 Simpson M. Buckman R. Stewart M. et al. Doctor–patient communication: the Toronto consensus statement. BMJ. 1991; 303: 1385-1387 Crossref PubMed Scopus (599) Google Scholar , 3 Participants in the Bayer-Fetzer Conference on Physician–Patient Communication in Med Educ Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Acad Med. 2001; 76: 390-393 Crossref PubMed Scopus (584) Google Scholar in guidelines for medical school curriculum development, 4 Association of American Medical Colleges Medical School Objectives Project, Report III. Contemporary Issues in Medicine: Communication in Medicine. Association of American Medical Colleges, Washington, DC1999 Google Scholar , 5 General Medical Council Tomorrow's Doctors: Recommendations on Undergraduate Med Educ. General Medical Council, London, UK1993 Google Scholar and through increased emphasis placed on communication skills by professional practice organizations and accrediting bodies. 6 Communications Self-Evaluation Process (COM-SEP) Committee Minutes. American Board of Internal Medicine, Philadelphia, Pa1999 Google Scholar , 7 Tate P. Foulkes J. Neighbour R. et al. Assessing physicians' interpersonal skills via videotaped encounters: a new approach for the Royal College of General Practitioners membership examination. J Health Commun. 1999; 4: 143-152 Crossref PubMed Scopus (43) Google Scholar

The Meanings of Silence in Brazilian Women With Urinary Incontinence

We explored the meanings of silence for Brazilian women with urinary incontinence (UI). The sample consisted of 8 women, aged 30 to 45 years. Respondents worked as housekeepers or cleaning staff and were from lower social, economic, and educational strata. Their years of formal education varied from 0 to 8 years and they earned up to 4.5 times the Brazilian minimum wage, which is equivalent to US$900. A qualitative method using semistructured interviews was employed to gather data. Individual semistructured interviews were recorded and subsequently transcribed, including researchers' observations of subjects' nonverbal behaviors. The interviews began with the question: "Can you tell me about your experience with urinary incontinence?" Data were analyzed using a content analysis technique. Respondents avoided discussing UI and initially resisted labeling themselves as incontinent, but their nonverbal behaviors provided clues to the psychosocial distress caused by urinary leakage. Results suggest that respondents' underprivileged social, economic, and cultural situation may aggravate their limitations when expressing their feelings. We found that the women employed silence as a means to contain the psychosocial distress created by their UI, and that the silence itself should be interpreted as an expression of distress associated with UI. The silence of Brazilian women with UI is an essential element of communication about incontinence. We believe that the silence used by these women expresses the pain and anxiety they experienced, and it acts as an adaptive psychosocial mechanism.

P02-293 - Psychological meanings of silence for Brazilian working women with urinary incontinence about their health problem: A clinical qualitative study

ObjectiveTo interpret the meanings of the silence from Brazilian working women about their urinary incontinence (UI).MethodA clinical-qualitative method was used with semi-directed interviews with open-ended questions. The sample consisted of eight women aged 30 to 45 from low-income brackets of the population with complaints of UI and who had never sought treatment. The resulting data was analyzed according to the thematic content analysis technique, based on psychosocial and psychodynamic approaches. The authors were aware of the polysemic character from the speeches in Human Science research.ResultsThe difficulty that women with urinary incontinence face in talking about the problem is an indication of the anxiety involved. They generally avoid discussing it due to embarrassment and from fear of being judged and misunderstood. In addition, their underprivileged social, economic and cultural situation may have aggravated their limitations in expressing their feelings. In terms of psychic processes, these women’s silence can be seen as a way for them to contain the physical symptom that their UI has brought on. Since it is so hard to express themselves in words, everything remains “unsaid,” but this silence can be interpreted as a way of expressing painful and unnameable feelings.ConclusionThe silence of Brazilian women with urinary incontinence proved to be an essential element of communication about this disorder and was as important as the words they uttered. Their silence evidenced the pain and anxiety they experienced, and it emerged as an adaptive psychosocial mechanism.