Observed Communication Behaviors Research Articles

An Examination of Nurses' Empowerment and Speaking Up During Postanesthesia Clinical Hand Overs.

Hierarchical relationships can negatively affect nurses' psychological empowerment and interprofessional hand overs. We explored nurses' perceptions of their psychological empowerment, teamwork, and work engagement; relationships between these concepts during interprofessional clinical hand overs; and observed interactive communication behaviors during hand overs. We used surveys and observations of interprofessional clinical hand overs to collect data from 39 nurses in a postanesthesia care unit in Australia. Nurses reported high scores for psychological empowerment and work engagement. Relationships between empowerment and teamwork (r = 0.41, P = .01) and empowerment and work engagement (r = 0.65, P < .001) were positive and significant. Relationships between nurses' observed communication behaviors and perceptions of empowerment, teamwork, and work engagement were nonsignificant. Additional research is needed to better understand how empowerment, teamwork, and work engagement affect nurses' interactive communication behaviors during interprofessional clinical hand overs in the postanesthesia care unit.

The link between oxytocin plasma levels and observed communication behaviors during sexual and nonsexual couple discussions: An exploratory study

The role of oxytocin (OT) in close relationships is complex, as both positive and negative associations have been found between OT and relationship processes. Also, with most research focusing on the effects of exogenous OT administration on communication and couple behaviors, our knowledge about the association between endogenous OT and couple dynamics remains limited. This study is the first to assess the link between peripheral OT levels and observed communication behaviors during sexual and nonsexual conflict discussions in romantic relationships. A sample of 126 young, heterosexual couples (Mean age = 23.3, SD = 2.4; average relationship duration = 1.9 years, SD = 0.9) participated in videotaped sexual and nonsexual couple conflict discussions of 7 min each. Communication behaviors were coded using an adaptation of the Specific Affect Coding System (SPAFF) and the System for Coding Interactions and Family Functioning (SCIFF). Blood samples were collected prior to the couple discussions, during a separate lab visit, and OT plasma levels were determined using enzyme-linked immunosorbent assays (ELISA). Plasma OT levels were positively associated with validating behaviors during sexual discussions in both women (r = +.24, p = .008) and men (r = +.18, p = .052). No significant associations were found between OT levels and validating behaviors during nonsexual discussions and between OT and affectionate and negative behaviors during either sexual or nonsexual discussions. Analyses revealed significant associations between OT levels and one’s own validating behaviors during sexual discussions (b = 47.82, t(201.16) = 3.81, p < .001) and one’s partner’s (b = 32.12, t(216.35) = 2.62, p = .009). The results highlight the biobehavioral aspects of couples’ sexual communication and may contribute to a better understanding of the processes involved in individual and relational well-being. This study is the first to report an association between peripheral OT levels and validating behaviors during sexual communication, indicating neurophysiological involvement in dyadic sexual communication patterns.

Improvement of Conflict Handling: Hand-Holding During and After Conflict Discussions Affects Heart Rate, Mood, and Observed Communication Behavior in Romantic Partners

Improved conflict handling is important to reduce relational discord. Touch potentially has beneficial effects on three important characteristics of conflict discussions, i.e., physiological reactivity, affect and communication behavior. We studied effects of hand-holding between partners during conflict discussions (N = 47 student couples) and after conflict discussions (N = 53 student and N = 45 clinical couples). During conflict discussions hand-holding caused lower heart rate reactivity, higher positive affect and improved communication in men, and in women lower positive affect but improved communication. After conflict discussions hand-holding resulted in lower heart rate reactivity and higher heart rate variability in student couples and higher positive affect in student and clinical couples. Touch seems a promising add-on intervention in couple therapy.

Couples’ Communication Behaviors and Diurnal Cortisol Patterns

Previous research suggests that more negative or less positive couple communication can be stressful and that chronic stress can lead to less healthy patterns of physiological stress functioning. Our goal was to investigate whether couples’ observed communication behaviors and reported relationship conflict were related to diurnal cortisol patterns, an important indicator of hypothalamic–pituitary–adrenal axis functioning. Sixty-two couples ( n = 124 individuals) reported marital conflict and were video-recorded engaging in a coded conflict discussion. Diurnal cortisol samples were collected. Results suggested that men’s greater observed communication quality predicted women’s higher awakening cortisol levels as well as men’s steeper decreases in cortisol across the day (i.e., slopes), men’s greater reported conflict predicted women’s lower awakening levels, and, in some models, women’s greater reported resolution predicted women’s lower awakening levels and men’s steeper slopes. These findings suggest that less positive and more negative marital conflict contribute to dysfunction of the hypothalamic–pituitary–adrenal axis.

Effects of Simulated Interdisciplinary Communication Training for Nursing Students on Self-confidence in Communication, Communication Behavior and Technical Skill Performance

Purpose: Ineffective communication between healthcare professionals leads to medical errors and puts patients at risk of harm. The aim of this study was to examine the effects of interdisciplinary communication training in simulated settings on self-confidence in communication, observed communication behavior, and technical skill performances of nursing students. Methods: A repeated measures design with one group was conducted. Data was collected from 92 nursing students through a self-administered questionnaire and an observed behavior checklist. Data analysis was performed using descriptive statistics, a paired t-test, the Wilcoxon signed rank test, the Friedmann test, a Repeated Measures ANOVA, and the Spearman correlation coefficient. Results: Self-confidence in communication, observed Identification-Situation-Background-Assessment-Recommendation-Read Back communication behavior, and technical skill performances of nursing students were significantly improved. In observed communication behavior, the performance of Assessment and Read Back communication significantly improved. However, communication of Background, Assessment, and Recommendation did not improve to a satisfactory level. Observed communication behavior was not correlated with the overall technical skill performance. Conclusion: These results indicate that interdisciplinary communication training in simulated settings was effective in improving nursing students' confidence and communication skills with physicians. Longitudinal studies with larger samples are recommended in order to verify the effects of interdisciplinary communication training on clinical outcomes as well as communication competence.

Two-Year Experience Implementing a Curriculum to Improve Residents’ Patient-Centered Communication Skills

Surgery milestones from The Accreditation Council for Graduate Medical Education have encouraged a focus on training and assessment of residents' nontechnical skills, including communication. We describe our 2-year experience implementing a simulation-based curriculum, results of annual communication performance assessments, and resident evaluations. Eight quarterly modules were conducted on various communication topics. Former patient volunteers served as simulation participants (SP) who completed annual assessments using the Communication Assessment Tool (CAT). During these 2 modules, communication skills were assessed in the following standardized scenarios: (1) delivering bad news to a caregiver of a patient with postoperative intracerebral hemorrhage and (2) primary care gallstone referral with contraindications for cholecystectomy. SP-CAT ratings were evaluated for correlations by individual and associations with trainee and SP characteristics. Surgical patient experience surveys are evaluated during the curriculum. Independent academic medical center surgical simulation center. Twenty-five surgery residents per year in 2015 to 2017. Residents have practiced skills in a variety of scenarios including bad news delivery, medical error disclosure, empathic communication, and end-of-life conversations. Residents report positive learning experiences from the curriculum (90% graded all modules A/A+). Confidence ratings rose following each module (p < 0.001) and in the second year (p < 0.001). Annual assessments yielded insights into skills level, and relationships to resident confidence levels and traits. Communication scores were not associated with resident gender or postgraduate year. Over the course of the curriculum implementation, surgical patients have reported that doctors provided explanations with improved clarity (p = 0.042). The simulation-based SP-CAT has shown initial evidence of usability, content validity, relationships to observed communication behaviors and residents' skills confidence. Evaluations of different scenarios may not be correlated for individuals over time. The communication curriculum paralleled improvements in patient experience concerning surgeons' clear explanations. An ongoing surgery resident communication curriculum has numerous educational, assessment, and institutional benefits.

Making communication research matter: What do patients notice, what do patients want, and what do patients need?

Objective To explore limitations of current communication theory by considering different perspectives of researchers, clinicians, patients and teachers of communication. Method Theory development based on limitations of the current communication research literature due to inconsistencies between patient reports and observed communication behavior. Results While researchers focus on the mechanics and techniques of communication, patients seek relationships in which they experience trust, the right amount of autonomy, caring, and expertise. Patients’, physicians’, and communication experts’ perspectives do not always define the same problems and often point to different solutions. Conclusions In addition to studying clinician behaviors and patient perceptions of care, communication research should focus on five additional factors: what patients notice, want and need, and how their perspectives differ from those of physicians and researchers; the context, including illness severity and type and family influences; how complex health systems facilitate and impede communication; patients’ influences on physician communication behavior; and habits of mind that promote attentive care.

Assessment of communication barriers in community pharmacies.

This study identified previously reported facilitators and barriers to pharmacist-client communication and then evaluated their impact on the observed communication behaviors of pharmacists. Pharmacists (n = 100) completed a seven-page questionnaire collecting information on 11 variables that had been organized according to the Policy, Regulatory and Organizational Constructs in Educational and Ecological Development (PROCEDE) model as predisposing, enabling, or reinforcing of pharmacist communication with their clients. Demographic variables also were included. "Communication quality" served as the study's dependent variable, whereas pharmacist responses served as the independent variables. Communication quality scores for each pharmacist were obtained from the analysis of 765 audiorecordings of verbal exchanges occurring between the study pharmacists and their consenting clients during 4-hour, on-site observation periods. Four of the variables examined in the study were found to share a unique relationship with communication quality (pharmacists' attitude, year of graduation, adherence expectations, and outcome expectations). Hierarchical multiple regression analysis revealed that the variables measured in the questionnaire accounted for 23% of the variance in communication quality scores. Plausible explanations for why the study was unable to capture more of the variance in its proposed relationships and future areas for research are provided.

Language and Words

Despite attention to effects of Confucianism on Asian communication, views of Confucian philosophy are hampered by predilection to look at its social implications rather than Confucius's many observations about words and speaking. Comprehensive examination of Confucian Analects yields four principles: (a) words define and reflect moral development, (b) beautiful words lacking substance are blameworthy, (c) actions are more important than words, and (d) appropriate speaking relies on rules of propriety. Five weaknesses are found in current views linking Confucianism and Asian communication: (a) collectivist metaphors are inappropriately foregrounded, (b) social position is assumed incompatible with individual will, (c) moral character is excluded from discussion of language in Confucian societies, (d) personal freedom is thought the essence of ability to reason and formulate messages, and (e) Confucianism is used retroactively to explain observed communication behaviors in Confucian societies. Research suggestions from several disciplines and methodologies are offered.

Situational Effects on the Accuracy of Self-Reported Organizational Communication Behavior

Debate about the appropriateness of using self-reported communication as a proxy for observable communication in studies of organizational communication networks has created a paradox for network researchers that diverges along classic lines of individualism and collectivism. The inability of either to resolve fundamental theoretical challenges of the other suggests need for an alternative approach. Working from a situationalist perspective, this laboratory study looked to two important characteristics of the collective context to explain divergences of self-reported from observed communication behavior. Members' perceived relationship to the group explained 59% of the variance in the average size of their commission errors, and the collective communication load on members explained 61% of the variance in their number of omission errors. A revised model of the relationship between the perceived network and observable communication is proposed. It includes social-cognitive processes that govern the perception of links and social activation processes that connect perceptions to concrete situations where messages are exchanged.