Practical Exploration of Strengthening Team Communication and Cooperation in Head Nurse Nursing Management

This study explores the practical application of nursing management led by head nurses to enhance team communication and collaboration within clinical settings.By integrating leadership theories with nursing practice,this research adopts a qualitative methodology to examine the effects of strategic communication and teamwork enhancement initiatives.Through interviews,observations,and the analysis of case studies in various hospital departments,the study identifies key barriers to effective team communication and collaboration,including hierarchical structures,lack of standardized communication protocols,and insufficient training.Solutions implemented involve targeted communication skills training,the establishment of interdisciplinary teamwork protocols,and leadership workshops for head nurses.The outcomes indicate significant improvements in team efficiency,patient care quality,and staff satisfaction.This research underscores the importance of head nurses in fostering an environment conducive to open communication and collaborative practice,thereby advancing patient care and team performance.

Study on the Relationship between Psychological Stress and Doctor-Patient Relationship of Cancer Patients and Their Families

Objective: To research the relationship between psychological stress and doctor-patient relationship of cancer patients and their families. Methods: The patients were randomly divided into the intervention group and the control group, and PDRQ-15, pcl-c, SAS and SDS scales were selected as evaluation indexes, and the levels of norepinephrine and dopamine were compared between the patients diagnosed with PTSD cancer and those without PTSD. Results: 1) The total score of PCL-C, SAS, SDS, PDRQ-15 scale of the cancer patients and their families after the intervention of clinical psychological care was significantly lower than that of before intervention and the control group. 2) The correlation coefficients between PCL-C, SAS, SDS and PDRQ-15 of cancer patients and their relatives were 0.971, 0.952 and 0.939 respectively. The significant test P value was less than 0.05 and the difference was statistically significant. 3) The plasma levels of dopamine and norepinephrine in cancer patients under stress were significantly higher than those in cancer patients without stress (P Conclusion: After psychological Intervention of cancer patients and their families, post-traumatic stress disorder, anxiety, depression and doctor-patient relationship were all improved.

Doctor,Ease My Mind!Associations between Cancer Patients’Emotional Distress and Their Perception of Patient-Centeredness during Oncology Consultations

Objective: To investigate whether perceived patient-centered communication during oncology consultations relates to patient satisfaction and degree of emotional distress following the medical encounter. Methods: 226 cancer patients attending an oncology outpatient clinic completed questionnaires before and after a consultation including the Physician-Patient Relationship Inventory, the brief Profile of Mood States, and the Information satisfaction questionnaire. Results: Patients who perceived the communication during the consultations to be highly patient-centered were more likely to be maximally satisfied with information provided by the oncologist. Additionally, adjusting for pre-consultation distress, as well as sociodemographic, clinical, and consultation-related variables, patients who perceived the oncologist to communicate in a highly patient-centered manner, experienced lower levels of emotional distress after the consultation. Conclusion: Patient-centered communication may be an important quality in oncology as an approach to positively influence patient outcomes, including emotional distress. However, the findings in the present study of an effect of PCC on patient satisfaction and emotional distress are modest, and no firm conclusions can thus be drawn. Practice Implications: Oncology settings may benefit from the positive effects of patient-centered care and physicians should acknowledge the potential of their own relational competence in order to facilitate patient-centered communication.

Reflection on the cognitive differences between doctors and patients

As we all know, the doctor-patient relationship in China is in a very tense state. There are many reasons for this situation, an important factor among them is the cognitive differences between doctors and patients.Here we analyze the reasons for the cognitive differences between doctors and patients from the perspective of both doctors and patients cognition of diseases, the motives of both parties and the expectations of curing diseases.We will also discuss a: "patient-centered" concept, strengthening effective communication between doctors and patients, as well as how they can respect each other's personality and rights.

Under the narrative medicine theory to establish the evidence-based medical record written by doctors and patients through integrated therapy of traditional Chinese and western on digestive system diseases

目的:遵循叙事循证医学理念,抽提医患共建式循证病历的理论,建立医患共建式循证病历的范本.方法:检索Pubmed等重要医学数据库,参照叙事医学的理念,咨询中西医消化内科及循证医学专家,初步达成共识.结果:本研究是一次叙事循证医学指导下医患共建式循证病历建立的有益尝试.思考与展望:医患共建式病历有可能成为叙事医学指导下的中西医合作治疗脾胃病相关疗效评价方法学体系的内容.

Listen and talk to the older patients:a critical emancipatory reflection on the practice of communication issues

Objective: Reflection is a process of deliberating thinking and examining one's practice in the past and thereby encouraging nurses to make improvements in future care delivery. This work outlines a piece of reflection involving the practice of communication between nurses and the elderly, to emancipate the authors from their constraints, help to find values as practitioners, and gain a greater understanding of the nurse-patient relationship.Methods: Using Smyth's four-stage model as a guide, as well as empirical and theoretical knowledge on nurse-patient relationships, this paper presents a deep reflection on the relationship that the authors developed with elderly patients and their families, encountered during the practice as a nurse. By applying the four main stages consisting of describe, inform, confront, and reconstruct, this model enabled the authors to frame, describe the practice issue, and explore the meaning behind it, which helps to facilitate a structured reflection.Results: Critical emancipatory reflection, in association with the Espoused theory and Theory-in-use, as well as reflexivity, critical social theory, and hegemony, was applied to uncover the various power relationships and constraining forces in the authors' practice involved in communicating with the elderly, such as the underlying false consciousness, hegemony, hidden assumptions, influential values, and dominant power structure, which are subtle and persuasive. By applying this process of critical reflection, transformative practice could be achieved.Conclusions: The process of critical reflection facilitated the development of the abilities required to develop and maintain the nursepatient relationship. It helps to enhance the care of old patients and their families, which illuminates the future nursing practice.

Functional Health Literacy and Doctor-Patient Communication: Experiences of HIV/AIDS Patients in Homa Bay County, Kenya

Patient involvement in the health care process has been documented as a critical component of successful disease management. However, inadequate functional health literacy among patients is a well-known barrier to effective doctor-patient communication, which has an adverse effect on health outcomes. This study aimed at investigating the association of functional health literacy and doctor-patient communication among HIV/AIDS patients in Homa Bay County, Kenya. It was a cross-sectional hospital-based survey conducted among 362 HIV/AIDS patients receiving care at the eight sub-county hospitals of Homa Bay county. Data was collected using a self-administered structured questionnaire. Cronbach’s alpha and confirmatory factor analysis tests were used to ascertain the reliability and validity of study instruments, while Logistic regression logistic analysis was used to measure the association between functional health literacy and doctor-patient communication. 51% of the respondents were females, and the majority (30.9%) of respondents fell in the age group of 45 years and above. The respondents’ functional health literacy levels were inadequate at weighted means scores of 3.23 [SD 1.31]. The study further established that functional health literacy significantly influenced doctor-patient communication [Nagelkerke R square = 0.318]. There is, therefore, a need to document the determinants of functional health literacy to improve it and make doctor-patient interaction an enjoyable and meaningful experience.

Evidence of Linkages between Patient Safety and Person-Centred Care in the Maternity and Obstetric Context—An Integrative Review

The aim was to evaluate the current state of knowledge pertaining to patient safety and its link to person-centred care. The international relevance of patient safety has expanded, as have the models of person-centred care. Inspired by this new trend, we collated and summarized the literature for evidence of the two topics. The study was guided by Russell, Whittemore and Knafl’s integrative review framework. An electronic database search was conducted for relevant articles from 2005 to 2016. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The structure and process of the evaluation of the evidence are described and the findings interpreted by means of a thematic synthesis. One theme emerged: trustful, safe communication in the relationship between the patient, family members and healthcare professionals and two domains;safety culture and multidisciplinary capacity building. The dominant dimension in the safety culture domain is respectful communication, which implies sharing experiences that lead to a sense of control during labour and birth and is related to the women’s feeling of personal capacity. The dominant dimensions in the multidisciplinary capacity building domain are collaborative teamwork, coordination and risk management, knowledge sharing and patient-centred communication. In conclusion, to enhance patient safety, it is necessary to develop patient-focused, evidence-based skills and guidelines as well as a supportive organization. Due to their interaction with patients, midwives’ communication competence on the part of midwives is essential for supporting the birth and fulfilling the women’s needs and expectations.

A Literature Review in Immuno-Oncology: Pathophysiological and Clinical Features of Colorectal Cancer and the Role of the Doctor-Patient Interaction

This review is intended to describe the features of colorectal cancer both in terms of pathophysiology and clinical features of the pathology. It also describes the anatomical and clinical features of different primary tumor locations in colorectal cancer. It is also to note how relevant it is to identify rectal cancer and colon cancer as different pathologies due to the clinical, pathophysiological and immuno-oncological features of rectal cancer compared to the ones of colon cancer while remarking the importance of medical doctors in the interaction with oncological patients. Background: Colorectal Cancer (CRC) is a major public health problem, representing the third most commonly diagnosed cancer in males and the second in females and it is fundamental to note and discuss doctor-patient interaction, fundamental for proper adherence and psychological status of the oncological patient, when discussing such important and impactful pathologies. Conclusions: This review highlights the possibility of an update in the terminology of Colorectal Cancer (CRC) into different clinically relevant pathologies within the umbrella term colorectal cancer (for instance rectal and colon cancer as different tumors). It also remarks on the importance of medical doctors in the interaction with oncological patients.

Management of gastroesophageal reflux disease: Patient and physician communication challenges and shared decision making

Gastroesophageal reflux disease(GERD) is a common upper esophageal condition and typical symptoms can include heartburn and sensation of regurgitation while atypical symptoms include chronic cough, asthma, hoarseness, dyspepsia and nausea. Typically, diag-nosis is presumptive given the presence of typical and atypical symptoms and is an indication for empiric therapy. Treatment management can include lifestyle modifications and/or medication therapy with proton pump inhibitor(PPI) class being the preferred and most effective. Complete symptom resolution is not always achieved and long-term PPI therapy can put patients at risk for serious side effects and needless expense. The brain-gut connection and hypervigilance plays an important role in symptom resolution and treatment success, especially in the case of non-PPI responders. Hypervigilance is a combination of increased esophageal sensory sensitivity in combination with exaggerated threat perception surrounding esophageal symptoms. Hypervigilance requires a different approach to GERD managements, where continued PPI therapy and surgery are usually not recommended. Rather, helping physicians and patients understand the brain-gut connection can guide and improve care.Education and reassurance should be the main pillars or treatment. However, it is important not to suggest the symptoms are due to anxiety alone, this often leads to patient dissatisfaction. Patient dissatisfaction with treatment reveals the need for a more patient-centered approach to GERD management and better communication between patients and providers. Shared decision making(SDM) with the incorporation of patient-reported outcomes(PRO) promotes patient adherence and satisfaction. SDM is a joint discussion between clinician and patient in which a mutually shared solution is explored for GERD symptoms. For SDM to work the physician needs to capture patients' perceptions which may not be obtained in the standard interview. This can be done through the use of PROs which promote a dialogue with patients about their symptoms and treatment priorities in the context of the SDM patient encounter. SDM could potentially help in the management of patient expectations for GERD treatment, ultimately positively impacting their health-related quality of life.

Doctor-patient communication starts from medical students

Currently,with the increasing tensionin doctor-patient relationship and medical disputes,it is of great practical importance to train medical students’communication skills in order to establisha harmonious doctor-patient relationship to improve the quality of clinical teaching.This paper emphasizes the importance of cultivation of communication skills in medical education and suggests ways to improve communication skills among medical students.

Clinical Communication, Cancer Patients &Considerations to Minimize the Challenges

Clinical communication is a multidimensional concept, which encompasses the core of effective clinical practice. Communication in cancer patients is particularly challenging and yet a less focused area in cancer care. Various barriers and challenges in communication may affect the management protocol of cancer patients. Challenges may arise in various dimensions of cancer care including breaking bad news to delivery of complex clinical information, determination of appropriate treatment strategies, dealing with uncertainties, end of life counseling as well as cultural and language barriers affecting the whole communication dynamics. Effective communication is the basic foundation for responsive treatment decisions, positive health outcome, patient driven compliance and overall high quality of care. Thus, there is a need for acknowledging and actively deciphering the challenges and developing and promoting various protocols of effective communication skills in cancer patients.

Research on psychological factors which influence Doctor-Patient communications among outpatients

An Outpatient Department is the first point of contact with the hospital, and good Doctor-Patient communication would improve the service quality of the hospital, so it is important to construct a harmonious Doctor-Patient relationship. This article, from the perspective of psychology, investigates into the common psychological factors which affect the Doctor-Patient communication, the appearance of the communication problem, and make suggestions on possible solutions accordingly.

Effective doctor-patient communication skills training optimizes functional organization of intrinsic brain architecture:a restingstate functional MRI study

We studied the influence of doctor-patient communication skills training on brain functional architecture using resting-state functional MRI（rs-fMRI） with a regional homogeneity（ReHo） method. Ten medical students participated in the study. A 1-year long doctor-patient communication skills training program was conducted. RsfMRI data were collected at baseline, one month and one year after training. There was a significant increase in the communication skills test average scores between baseline and 1-month duration of training（P〈0.001）. After one month of communication skills training, medical students had decreased ReHo in the right superior temporal gyrus compared with the baseline. After one year of communication skills training, students had increased ReHo in multiple regions and decreased ReHo in several regions（P 〈0.05, Alphasim corrected）. The change of ReHo values in the superior temporal gyrus negatively correlated with the change of communication skills scale score between one month after communication skills training and baseline（r=-0.734, P= 0.036）. The training program we used can be an effective approach of improving doctor-patient communication skills, and the training resulted in functional plasticity of the brain’s architecture toward optimizing locally functional organization.

Communication after cancellations in orthopaedics: The patient perspective

AIM: To examine patients' perceptions on communication surrounding the cancellation of orthopaedic operations and to identify areas for improvement in communication.METHODS: A prospective survey was undertaken at a university teaching hospital within the department of Trauma and Orthopaedics. Patients admitted to an acute orthopaedic unit, whose operations were cancelled, were surveyed to assess patient satisfaction and preferences for notification of cancellation of their operations. Patients with an abbreviated mental test score of < 9, patients unable to complete the survey independently, those under 16 years of age, and any patient notified of the cancellation by any of the authors were excluded from this study. Patients were surveyed themorning after their operation had been cancelled thus ensuring that every opportunity was given for the medical staff to discuss the cancellation with the patient. The survey included questions on whether or not patients were notified of the cancellation of their surgery, the qualifications of the person discussing the cancellation, and patient preferences on the process. Satisfaction was assessed via 5-point Likert scale questions.RESULTS: Sixty-five consecutive patients had their operations cancelled on 75 occasions. Fifty-four point seven percent of the patients who had cancellations were notified by a nurse and 32% by a doctor. No formal communication occurred for 13.3% cancellations and no explanation was provided for a further 16%. Patients reported that they were dissatisfied with the explanation provided for 36 of the 75(48%) cancellations. Of those patients who were dissatisfied, 25(69.4%) were notified by a nurse. Twenty-three of the 24(96%) patients notified by a doctor were satisfied with the explanation and that communication. Of those patients who were notified by a nurse 83% patients reported that they would have preferred it if a doctor had discussed the cancellation with them. There was a significant difference in satisfaction between those counselled by a nurse and those notified by a doctor(P < 0.0001).CONCLUSION: Communication surrounding cancellations does not meet patient expectations. Patients prefer to be notified by a doctor, illustrating the importance of communication in the doctor-patient relationship.

Obesity communication among patients by health professionals: Findings from the Weight Care Project

Obesity is on the increase worldwide and is a major global public health problem. In an increasingly obesogenic environment, it’s important that health professionals are equipped to identify and address obesity issues within their clinical practice. As part of the Weight Care Project, the aim of this study was to explore the obesity-related communication issues for primary care and community-based health professionals. The study design was a quantitative survey, which was completed by 382 primary care and community-based health professionals across Northern Ireland and Republic of Ireland working with adults and children. Key findings included that the majority of the health professionals (86%) recognized having a role in giving obesity advice, acknowledged that in clinical practice communication of obesity messages is both complex and challenging (81%), and reported difficulty in sensitively addressing obesity issues (27%). The health professionals surveyed stated that they communicate obesity messages to their patients using a range of different methods, mainly verbally to individuals, leaflets and factsheets. Numerous benefits of communicating obesity messages were reported;the main one was interacting with patients to build trust. Identified barriers to commu nication were: limited time in patient consultations, restricted access to appropriate information, and not sure where to access appropriate resources. Communication needed be reported by the health professionals included provision of greater resources, more information on obesity management and prevention, followed by health communication training, and clear and consistent messages. Significant differences were observed, including significantly much younger health professionals considered their role to provide obesity advice (P = 0.025). It is clear from this study that health professionals view as important the need to be given information on “what” and “how” to communicate with their patients on obesity. This study highlights that health professionals need continued support to enable them to effectively address weight-related issues in a sensitive manner that is acceptable to the patient.

Evaluation of undergraduate students’nursing assessment and communication skills through an objective structured clinical examination within a high-fidelity simulation using a student-simulated patient

Objective:To evaluate nursing students’assessment and communication skills through an objective structured clinical examination(OSCE)within a high-fidelity simulation using a student-simulated patient(SSP)and analyze the validity,reliability,degree of difficulty,and discriminability of the OSCE.Methods:A descriptive study was conducted at one nursing school in Macao.All scenarios were designed using a high-fidelity simulator combined with SSPs.A convenience sample of 54 baccalaureate nursing students completed the OSCE.The nursing assessment OSCE checklist(NAOC)and the communication evaluation rubric(CER)were used as observational measurements with three-point Likert scales(2=Achieved,1=Partly achieved,0=Not completed/Incorrect).Results:Difficulty coefficients of the exam were 0.63 for nursing assessment skills and 0.56 for communication skills.The discrimination index of the majority items of the NAOC(86.4%)was>0.20,showing a better to good discriminability.The items of the CER had satisfactory indexes of item discrimination(from 0.38 to 0.84).Students received high scores in conducting blood oxygen saturation and cardiac and lung auscultation but low scores in vomiting and diarrhea assessment.Students presented good communication skills in eye contacting and listening,but culture assessment needs to be improved.The students with experiences in simulation or simulated patient(SP)interactions had better assessment and communication skills than students without those experiences.There was a positive relationship between nursing assessment and communication skills(r=0.67,P=0.000).Conclusions:SSPs were involved in enhancing the realism of interactions in simulated scenarios.Nursing students can conduct nursing assessments specific to patient conditions,explain the conditions to the patient,and ensure that the patient remains informed at all times of the precautions to be taken.However,students’cultural awareness and some communication skills need further training.With moderate difficulty and high discrimination index,OSCE showed satisfactory reliability and validity.

The Application of Conversational Implicature in Doctor-Patient Conversation

The doctor-patient conversation is the major way of communication between doctors and patients.A good conversation helps to construct a harmonious doctor-patient relationship.This paper attempts to analyze the doctor-patient conversation by applying the Theory of Conversational Implicature.The theory is accepted as the cooperative principle consisting of four maxims:quantity,quality,relation,manner.This paper will analyse how the four maxims work and the violating of the maxims in the doctor-patient conversation.Through linguistic study of the conversation,we try to find out the problems in the doctor-patient conversation and to provide some directive linguistic suggestions to doctors and patients.

A Pragmatic Study on Non-aggressive Doctor-patient Conflict Talk-From the Ecolinguistic Perspective

Doctor-patient relationship is a very important relationship between doctor and patient and patient’s family member.In interpersonal communication,non-aggressive discourse often leads to conflicting response.It is the most common doctor–patient relationship between doctor and patient.There are limited studies on non-aggressive conflicting response.Language used is the most important basis in conflicting response to non-aggressive discourse.Language and culture are broad and diverse.Different speech methods and language content lead to different response.Based on this,this paper explains response to non-aggressive conflict talk between doctor and patient in the perspective of ecolinguistics,to provide reference.