IU Indianapolis ScholarWorks :: Browsing by Subject "communication"

Browsing by Subject "communication"

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Advance Care Planning in the United States: A 2023 review
(Elsevier, 2023-08) Fromme, Erik K.; Montgomery, Carole; Hickman, Susan; School of Nursing
Advance Care Planning (ACP) in the US is complex due in part to a lack of a unified health care system, though more recent policy changes permitting reimbursement for ACP conversations offer some hope. One key barrier to ACP is public perceptions of ACP, made worse by a historical focus on messaging that is unappealing and does not meet people’s need to focus on the present before contemplating the future. As we learn more about how to engage the public, there is also increasing recognition that the previous focus on making very specific decisions about the future needs to shift to a focus on preparing people for communication and decision making. Numerous programs exist for health care professionals to support meaningful explorations of goals, values, and preferences, and there is growing availability of resources to support this work, both in the community and health care setting. Further research is needed to understand the full complexity of ACP implementation and to identify person-centred outcomes to support high quality ACP.
Am I Broken?: A mixed-method analysis of an ethnotheatrical performance about women’s experiences with infertility and friendship
(Taylor & Francis, 2024) Binion, Kelsey E.; Brann, Maria; Longtin, Krista J.; Health Policy and Management, School of Public Health
Background This study evaluated an ethnotheatrical performance about infertility to bring awareness to the health condition and its impact on friendships. Methods After each performance (N = 2), attendees participated in a talkback session to express thoughts and ask questions about the production; then, they completed a survey describing their overall experience. Analyses included descriptive statistics for Likert questions and a thematic analysis for open-ended responses. Results Eighty-six percent of attendees found the performance informative about the challenges infertility imposes on everyday life, and more than 60% gained new information and advice on how to talk about infertility. The thematic analysis revealed three themes: learn about the complexities of infertility experiences, develop empathy towards individuals with infertility, and respond appropriately to individuals coping with infertility. Conclusion The performance offered a safe environment for attendees to learn, understand, and process infertility’s complex nature. Creating awareness influenced participants’ perceptions and communicative behaviors.
Assessing the Profiles through Written Reflections of Engaged Learning Experiences Using the AAC&U Written Communication and Integrative Learning VALUE Rubrics
(2021-08-18) Hahn, Thomas
This report describes an assessment activity within the IUPUI Institute for Engaged Learning (IEL) for students participating in IEL programs and the Life Health Sciences Internship (LHSI) Program during AY 2020-2021. The IEL Assessment Workgroup assessed written reflection artifacts of 124 students from 14 co-curricular programs. Using selected rows from the Written Communication and Integrative Learning VALUE Rubrics, the raters assessed the Communicator and Problem Solver Profiles of Undergraduate Learning. For Written Communication, overall results indicate that all of the student reflection artifacts at least met the benchmark for Control of Syntax and Mechanics. Nearly all (123 of 124) of the student reflection artifacts at least met the benchmark for Content Development. Overall, 99.6% of the scores for Written Communication met the benchmark. For Integrative Learning, nearly all of the student reflection artifacts (122 of 124) at least met the benchmark for Connections to Experiences. Likewise, nearly all of the student reflection artifacts (123 of 124) at least met the benchmark for Reflection and Self-Assessment. Overall, 98.8% of the scores for Integrative Learning met the benchmark.
Communicating with Clinicians: The Experiences of Surrogate Decision‐Makers for Hospitalized Older Adults
(2012-08) Torke, Alexia M.; Petronio, Sandra; Purnell, Christianna E.; Sachs, Greg A.; Helft, Paul R.; Callahan, Christopher M.
OBJECTIVES: To describe communication experiences of surrogates who had recently made a major medical decision for a hospitalized older adult. DESIGN: Semistructured interviews about a recent hospitalization. SETTING: Two hospitals affiliated with one large medical school: an urban public hospital and a university-affiliated tertiary referral hospital. PARTICIPANTS: Surrogates were eligible if they had recently made a major medical decision for a hospitalized individual aged 65 and older and were available for an interview within 1 month (2-5 months if the patient died). MEASUREMENTS: Interviews were audio-recorded, transcribed, and analyzed using methods of grounded theory. RESULTS: Thirty-five surrogates were interviewed (80% female, 44% white, 56% African American). Three primary themes emerged. First, it was found that the nature of surrogate-clinician relationships was best characterized as a relationship with a "team" of clinicians rather than individual clinicians because of frequent staff changes and multiple clinicians. Second, surrogates reported their communication needs, including frequent communication, information, and emotional support. Surrogates valued communication from any member of the clinical team, including nurses, social workers, and physicians. Third, surrogates described trust and mistrust, which were formed largely through surrogates' communication experiences. CONCLUSION: In the hospital, surrogates form relationships with a "team" of clinicians rather than with individuals, yet effective communication and expressions of emotional support frequently occur, which surrogates value highly. Future interventions should focus on meeting surrogates' needs for frequent communication and high levels of information and emotional support.
Communication Between Registered Nurses and Family Members of Intensive Care Unit Patients
(AACN, 2022-12-01) Dees, Mandy L.; Carpenter, Janet S.; Hoffman-Longtin, Krista; School of Nursing
Background Effective communication between intensive care unit patients and their families and nurses promotes relationship-centered care and improves nurses’ ability to meet patient and family needs. However, communication with these patients is challenging because of their critical illness. Families often become surrogate decision makers for adult intensive care unit patients. Objective To systematically assess available evidence on communication between adult intensive care unit patients and their families and nurses as the initial step in developing nursing strategies to strengthen communication skills. Methods In this integrative review, the method of Whittemore and Knafl was used to synthesize findings from qualitative and quantitative (descriptive and experimental) research. Results The review revealed a variety of research designs, measurement tools, and types of interventions. The qualitative findings suggest that nurses can strengthen relationship-centered care by regularly updating patients’ families and providing information that can assist with decision-making. The quantitative findings suggest that nurses should be mindful of family members’ needs for assurance, comfort, and support. Providing information on patient status can help alleviate family concerns. Conclusions Improved communication between patients and families and intensive care unit nurses is essential to strengthen relationship-centered care. Additional research is needed to better understand the communication needs of adult patients and their families in the intensive care unit.
Comparison of Undergraduate Student Writing in Engineering Disciplines at Campuses with Varying Demographics
(ASEE PEER, 2022-08-23) Edinbarough, Immanuel; Gonzalez, Jesus; Bodenhamer, Johanna; Pflueger, Ruth Camille; Weissbach, Robert; Engineering Technology, School of Engineering and Technology
Writing is generally recognized as fundamental to the formation and communication of scientific and technical knowledge to peer groups and general audiences. Often, persuasive writing is an essential attribute emphasized by industries and businesses for a successful career in STEM fields. Nevertheless, the current scenario is that students in STEM fields, with their increased demand for more specialized skills in fewer credit hours combined with a lack of emphasis on writing from engineering faculty members, make addressing this need difficult. In addition, students in engineering fields often do not value writing skills and underestimate the amount of writing they will do in their careers. Hence, it is essential to understand and quantify the level of writing skills STEM students exhibit in their technical courses so that mitigation efforts can be designed using commonly available resources to enhance this important skillset among the students, including university writing centers. A research question was posed to study this aspect of technical writing: How do STEM students at institutions conceive of writing and its role in classroom laboratories? This research was conducted at three different universities with students of varied demographics, including one which is designated as a Hispanic-serving institution, via a sequential mixed-methods design. The demography variation among the institutions includes the level of college preparation among students and the mix of ethnicity to see if there are variations among certain groups. Although the sample size is small, the goal was to establish a methodology and a preliminary outcome set that could be used in further research with larger populations. Research data in the form of reports and surveys, were collected from groups of students from four distinct campuses to ascertain the technical writing capability of each group and provide a comparison to better understand the level of intervention required. The quantitative data was collected throughout the academic year through Likert scale surveys as well as rubric-based evaluation of reports. The research design, methodology, and results of the research findings and the proposed mitigation efforts to improve student writing in STEM fields are presented in the paper.
A Conceptual Model of the Role of Communication in Surrogate Decision Making for Hospitalized Adults
(2012-04) Torke, Alexia M.; Petronio, Sandra; Sachs, Greg A.; Helft, Paul R.; Purnell, Christianna E.
OBJECTIVE: To build a conceptual model of the role of communication in decision making, based on literature from medicine, communication studies and medical ethics. METHODS: We proposed a model and described each construct in detail. We review what is known about interpersonal and patient-physician communication, described literature about surrogate-clinician communication, and discussed implications for our developing model. RESULTS: The communication literature proposes two major elements of interpersonal communication: information processing and relationship building. These elements are composed of constructs such as information disclosure and emotional support that are likely to be relevant to decision making. We propose these elements of communication impact decision making, which in turn affects outcomes for both patients and surrogates. Decision making quality may also mediate the relationship between communication and outcomes. CONCLUSION: Although many elements of the model have been studied in relation to patient-clinician communication, there is limited data about surrogate decision making. There is evidence of high surrogate distress associated with decision making that may be alleviated by communication-focused interventions. More research is needed to test the relationships proposed in the model. PRACTICE IMPLICATIONS: Good communication with surrogates may improve both the quality of medical decisions and outcomes for the patient and surrogate.
Development of a Theory-Informed Patient Decision Aid to Facilitate Consent to Genetic Testing in the Neonatal Intensive Care Unit
(2024-05) Higley, Keeley; Head, Katharine J.; Brann, Maria; Bute, Jennifer J.
Genetic testing is an essential diagnostic tool in the neonatal intensive care unit (NICU) that can shorten infants’ stays, improve accuracy and effectiveness of medical care, and overall improve quality of life. However, there are challenges involved in the process of recommending life-saving and care-changing genetic testing in the NICU, including parental concerns around issues of paternity, guardians’ decisional anxiety, low health literacy, limited understanding of genetic testing, and receiving conflicting information from different healthcare providers. These challenges are exacerbated by the urgency guardians face in the NICU; guardians’ first exposure to genetic testing often occurs immediately before they are asked to decline or consent to it while in an extremely emotional state and fraught environment, creating a sense of urgency that affects decision-making. Current patient-provider communication practices in the NICU could benefit from improved, streamlined communication tools to help guardians make thoughtful decisions about genetic testing for their hospitalized infants. One potential strategy to streamline communication about genetic testing in the NICU is incorporating self-determination theory into patient decision aids. A series of three iterative interview rounds with NICU guardians and new guardians of infants younger than three years old were conducted. Following each round of interviews, recordings were transcribed, and feedback from participants was used to revise a patient decision aid guided by self-determination theory. After completing all three rounds of interviews and revisions, thematic analysis was conducted on all transcribed interviews to identify salient themes to NICU genetic testing decision-making. The final version of the patient decision aid developed from this study will serve as a starting point for integrating this important tool into the NICU.
Disclosing Medical Mistakes: A Communication Management Plan for Physicians
(2013-04) Petronio, Sandra; Torke, Alexia M.; Bosslet, Gabriel T.; Isenberg, Steven; Wocial, Lucia D.; Helft, Paul R.
Introduction: There is a growing consensus that disclosure of medical mistakes is ethically and legally appropriate, but such disclosures are made difficult by medical traditions of concern about medical malpractice suits and by physicians’ own emotional reactions. Because the physician may have compelling reasons both to keep the information private and to disclose it to the patient or family, these situations can be conceptualized as privacy dilemmas. These dilemmas may create barriers to effectively addressing the mistake and its consequences. Although a number of interventions exist to address privacy dilemmas that physicians face, current evidence suggests that physicians tend to be slow to adopt the practice of disclosing medical mistakes. Methods: This discussion proposes a theoretically based, streamlined, two-step plan that physicians can use as an initial guide for conversations with patients about medical mistakes. The mistake disclosure management plan uses the communication privacy management theory. Results: The steps are 1) physician preparation, such as talking about the physician’s emotions and seeking information about the mistake, and 2) use of mistake disclosure strategies that protect the physician-patient relationship. These include the optimal timing, context of disclosure delivery, content of mistake messages, sequencing, and apology. A case study highlighted the disclosure process. Conclusion: This Mistake Disclosure Management Plan may help physicians in the early stages after mistake discovery to prepare for the initial disclosure of a medical mistakes. The next step is testing implementation of the procedures suggested.
The Discursive Dynamics of Disclosure and Avoidance: Evidence from a Study of Infertility
(2013-02) Bute, Jennifer J.; Brann, Maria
Recent research and theorizing about privacy management suggests a need to consider discursive dynamics and interpretations of meaning in conversations involving disclosure, topic avoidance, secret-keeping, and other privacy management processes. In the following study, I drew on a specific set of theoretical assumptions as the basis for an investigation of privacy management in the context of infertility. Based on in-depth interviews with 23 women coping with infertility, results reveal the varied ways that private topics arose in conversations (e.g., discloser initiated conversations, responses to requests for information), the diverse ways that women concealed or revealed their struggles with infertility, and the multiple dilemmas they faced in managing private information about their fertility problem. I discuss the results in light of the extant literature on managing private information about sensitive issues and suggest that scholars must continue to focus on conversational dynamics to understand fully how privacy management processes unfold in everyday conversations.

Browsing by Subject "communication"

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