scholarly journals Communication between Audiologist, Patient, and Patient’s Family Members during Initial Audiology Consultation and Rehabilitation Planning Sessions: A Descriptive Review

2019 ◽  
Vol 30 (09) ◽  
pp. 810-819 ◽  
Author(s):  
Vinaya Manchaiah ◽  
Monica L. Bellon-Harn ◽  
Ashley L. Dockens ◽  
Jamie H. Azios ◽  
William E. Harn
Keyword(s):  
Decision Making ◽  
Literature Review ◽  
Hearing Aids ◽  
Empirical Studies ◽  
Family Members ◽  
Patient Centered ◽  
Missed Opportunities ◽  
Management Planning ◽  
Rehabilitation Planning ◽  
The Mean

AbstractCommunication during clinical consultations is an important factor that facilitates decision-making by patients and family members. For clinicians, these interactions are opportunities to build rapport and to facilitate appropriate decision-making.This article presents the literature review of studies focusing on communication between audiologist, patients, and their family members during initial audiology consultations and rehabilitation planning sessions.A literature review was conducted.The review included eight empirical studies.A systematic search of the CINAHL Complete, MEDLINE, and PsychInfo databases was used to identify relevant articles for review. Quality of the included studies was assessed using the Rating of Qualitative Research (RQR) scale.The average consultation length was 57.4 min (ranged 27.3–111 min), in which the mean length of case history discussion was 8.8 min (ranged 1.7–22.6 min) and the mean length of diagnosis and management planning was 29 min (ranged 2.2–78.5 min). Utterances spoken by audiologists were greater (about 51%) than patients (37%), whereas family members spoke the fewest utterances (12%) during interactions. Patients raised concerns (typically psychological in nature with negative emotional stance) about hearing aids in half of the appointments where hearing aids were recommended as the rehabilitation option. However, audiologists missed opportunities to build relationships as these concerns of patients were not typically addressed. Also, audiologists’ language was associated with hearing aid uptake (i.e., patients were less likely to uptake hearing aids when audiologists used complex language).The review highlights that audiologists dominate the conversation during audiology consultations and rehabilitation planning sessions. Audiologists did not take advantage of the opportunity to develop patient-centered communication and shared decision-making. Implications of these findings to both clinical practice and to audiology education and training are discussed.

Comparisons of Client and Clinician Views of the Importance of Factors in Client-Clinician Interaction in Hearing Aid Purchase Decisions

2015 ◽  
Vol 26 (03) ◽  
pp. 247-259 ◽  
Author(s):  
Laya Poost-Foroosh ◽  
Mary Beth Jennings ◽  
Margaret F. Cheesman
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Purchase Decisions ◽  
Shared Decision ◽  
Centered Care ◽  
Importance Ratings ◽  
The Mean ◽  
Client Needs

Background: Despite clinical recognition of the adverse effects of acquired hearing loss, only a small proportion of adults who could benefit use hearing aids. Hearing aid adoption has been studied in relationship to client-related and hearing aid technology–related factors. The influence of the client-clinician interaction in the decision to purchase hearing aids has not been explored in any depth. Purpose: Importance ratings of a sample of adults having a recent hearing aid recommendation (clients) and hearing healthcare professionals (clinicians) from across Canada were compared on factors in client-clinician interactions that influence hearing aid purchase decisions. Research Design: A cross-sectional approach was used to obtain online and paper-based concept ratings. Data Collection and Analysis: Participants were 43 adults (age range, 45–85 yr) who had received a first hearing aid recommendation in the 3 mo before participation. A total of 54 audiologists and 20 hearing instrument practitioners from a variety of clinical settings who prescribed or dispensed hearing aids completed the concept-rating task. The task consisted of 122 items that had been generated via concept mapping in a previous study and which resulted in the identification of eight concepts that may influence hearing aid purchase decisions. Participants rated “the importance of each of the statements in a person’s decision to purchase a hearing aid” on a 5-point Likert scale, from 1 = minimally important to 5 = extremely important. For the initial data analysis, the ratings for each of the items included in each concept were averaged for each participant to provide an estimate of the overall importance rating of each concept. Multivariate analysis of variance was used to compare the mean importance ratings of the clients to the clinicians. Ratings of individual statements were also compared in order to investigate the directionality of the importance ratings within concepts. Results: There was a significant difference in the mean ratings for clients and clinicians for the concepts understanding and meeting client needs, conveying device information by clinician, supporting choices and shared decision making, and factors in client readiness. Three concepts—understanding and meeting client needs, conveying device information by clinician, and supporting choices and shared decision making—were rated as more important by clients than by clinicians. One concept (ie, factors in client readiness) was rated as more important by clinicians than by clients. Conclusions: The concepts rated as most important by clients and clinicians are consistent with components of several existing models of client-centered and patient-centered care. These concepts reflect the clients’ perception of the importance of their involvement in the decision-making process. A preliminary model of client-centered care within the hearing aid uptake process and implications for clinical audiology are described.

The Nature of Communication throughout Diagnosis and Management Planning in Initial Audiologic Rehabilitation Consultations

2015 ◽  
Vol 26 (01) ◽  
pp. 036-050 ◽  
Author(s):  
Caitlin Grenness ◽  
Louise Hickson ◽  
Ariane Laplante-Lévesque ◽  
Carly Meyer ◽  
Bronwyn Davidson
Keyword(s):  
Patient Outcomes ◽  
Hearing Aids ◽  
Patient Involvement ◽  
Interaction Analysis ◽  
Patient Centered ◽  
Management Planning ◽  
Diagnosis And Management ◽  
Analysis System ◽  
Communication Dynamics ◽  
Communication Control

Background: Effective practitioner-patient communication throughout diagnosis and management planning positively influences patient outcomes. A patient-centered approach whereby patient involvement in decision making is facilitated, a therapeutic relationship is developed, and information is bilaterally exchanged in an appropriate manner, leads to improved patient satisfaction, adherence to treatment, and self-management. Despite this knowledge, little is known about the nature of audiologist-patient communication throughout diagnosis and management planning. Purpose: This research aimed to explore verbal communication between audiologists and patients/companions throughout diagnosis and management planning in initial audiology consultations. Specifically, this study aimed to describe the nature and dynamics of communication by examining the number, proportion, and type of verbal utterances by all speakers (audiologist, patient, and companion when present). In addition, this study aimed to investigate the influence of audiologist, patient, and consultation factors, such as verbal dominance, content balance, and communication control, on the dynamics of communication. Study Sample: A total of 62 initial audiological rehabilitation consultations (involving 26 different audiologists) were filmed and analyzed using the Roter Interaction Analysis System. All patients were older than 55 yr, and a companion was present in 17 consultations. Data Collection and Analysis: This study focused solely on the communication relating to diagnosis and management planning (referred to as the “counseling phase”). Diagnosis, recommendations, rehabilitation options, and patient decisions were recorded along with the communication profiles and communication dynamics measured using the Roter Interaction Analysis System. Associations between communication dynamics (content balance, communication control, and verbal dominance) and eight variables were evaluated with Linear Mixed Model methods. Results: The mean length of time for diagnosis and management planning was 29.0 min (range, 2.2–78.5 min). Communication profiles revealed that patient-centered communication was infrequently observed. First, opportunities to build a relationship were missed, such that patients’ psychosocial concerns were rarely addressed and patients/companions showed little involvement in management planning. Second, the amount of talk was asymmetrical and the majority of audiologists’ education and counseling utterances related to hearing aids; yet, only 56% of patients decided to obtain hearing aids at the conclusion of the consultation. Hearing aids were recommended in 83% of consultations where a hearing loss was diagnosed and alternative options were rarely provided. Thus, shared decision making rarely occurred, and audiologists often diagnosed a hearing loss and recommended hearing aids without patient involvement. In addition, when a greater proportion of time was dedicated to diagnosis and management planning, patients had greater input and control by asking more questions and requesting further information. Conclusions: Patient-centered communication was rarely observed in the 62 consultations. Thus, although not measured in this study, patient outcomes are likely to be affected. Future research should examine the influence of audiologist communication on outcomes and encourage a shift toward patient-centered audiological rehabilitation.

Care and Understanding of the Dying: A Patient-Centered Approach

1975 ◽  
Vol 6 (2) ◽  
pp. 81-94 ◽  
Author(s):  
Loma Feigenberg
Keyword(s):  
Decision Making ◽  
Cancer Patient ◽  
Family Members ◽  
Terminally Ill ◽  
Medical Facility ◽  
Truth Telling ◽  
Patient Centered ◽  
Similarities And Differences

The author describes the approach he has developed both to provide support to the individuality of the terminally ill cancer patient, and to deepen our understanding of dying and death. This approach emerged through his experiences first as a radiotherapist, then as a psychiatrist serving in the same medical facility. It is vital in this approach to offer one's self exclusively to the patient in a flexible, trusting, and confidential relationship. Similarities and differences with conventional psychotherapy are discussed. The typical course of these contacts is described, along with the considerations that have led to one kind of decision-making as compared with another. Among the specific topics encompassed are indications and contraindications for establishing and maintaining contact, hope, truth-telling, responsiveness to changes in the patient's condition, and relationship with family members. Objectives of working with the terminally ill are explored, with particular emphasis given on support of the patient's dignity and individuality.

scholarly journals Measuring Family Satisfaction With Care Delivered in the Intensive Care Unit

2016 ◽  
Vol 36 (6) ◽  
pp. e8-e14 ◽  
Author(s):  
Kathleen Clark ◽  
Kerry A. Milner ◽  
Marlene Beck ◽  
Virginia Mason
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Family Members ◽  
Family Satisfaction ◽  
Surgical Intensive Care Unit ◽  
Satisfaction With Care ◽  
Free Text ◽  
The Mean

BackgroundIn our competitive health care environment, measuring the experience of family members of patients in the intensive care unit to ensure that health care providers are meeting families’ needs is critical. Surveys from Press Ganey and the Centers for Medicare and Medicaid Services are unable to capture families’ satisfaction with care in this setting.ObjectiveTo implement a sustainable measure for family satisfaction in a 12-bed medical and surgical intensive care unit. To assess the feasibility of the selected tool for measuring family satisfaction and to make recommendations that are based on the results.MethodA descriptive survey design using the Family Satisfaction in the Intensive Care Unit 24-item questionnaire to measure satisfaction with care and decision-making.ResultsForty family members completed the survey. Overall, the mean score for families’ satisfaction with care was 72.24% (SD, 14.87%) and the mean score for families’ satisfaction with decision-making was 72.03% (SD, 16.61%). Families reported that nurses put them at ease and provided understandable explanations. Collaboration, inclusion of families in clinical discussions, and timely information regarding changes in the patient’s condition were the most common points brought up in free-text responses from family members. Written communication, including directions and expectations, would have improved the families’ experience.ConclusionAlthough patients’ family members reported being satisfied with their experience in the intensive care unit, there is room for improvement. Effective communication among the health care team, patients’ families, and patients will be targeted for quality improvement initiatives.

scholarly journals Examining the Utility of Photovoice as an Audiological Counseling Tool

2019 ◽  
Vol 30 (05) ◽  
pp. 406-416
Author(s):  
Gabrielle H. Saunders ◽  
Lauren K. Dillard ◽  
Melissa T. Frederick ◽  
ShienPei C. Silverman
Keyword(s):  
Hearing Loss ◽  
Feasibility Study ◽  
Hearing Aids ◽  
Communication Strategy ◽  
Data Repository ◽  
Patient Centered ◽  
The Mean ◽  
Tailored Counseling ◽  
Insight Into ◽  
Hearing Problems

AbstractPhotovoice is a participatory action research method in which people take photographs to represent real-world experiences, so that issues of interest/concern can be documented. There are no published studies in which photovoice has been used in audiological rehabilitation (AR). The purpose of this feasibility study was to examine whether photovoice could have application in audiology.A feasibility study was designed to determine whether photovoice could be adapted for use as a clinical auditory rehabilitation tool (1) to facilitate provision of tailored communication strategy counseling, (2) as a post–hearing aid fitting counseling tool, (3) to enhance communication between partners regarding hearing loss, and (4) to provide an understanding of the emotional impacts of hearing loss.In this combined qualitative and quantitative feasibility study, a photovoice intervention was given to four groups of participants.Twenty-four individuals were recruited from a research subject data repository at the National Center for Rehabilitative Auditory Research.The study involved two visits to the laboratory during which participants received instruction in photovoice methodology (visit 1) and then, one to two weeks later, discussed their photographs during a debriefing session (visit 2).The mean number of photographs taken by participants was 12.6 (range: 4–29); the mean duration of the debriefing sessions was 40:39 min:sec (range: 14:30–66:22 min:sec). Participants reported that participating had made them think more about their hearing problems, appreciate their hearing aids more, and be more aware of the situations in which their hearing aids did and did not help. The taking and discussion of the photographs was also described as a learning tool, and it had facilitated conversations with others about hearing problems. Participants who completed the study with their communication partner (use case 3) said it had assisted with problem-solving and gave insight into the perspective of their partner. The research team noted that photovoice facilitated highly tailored counseling and provision of evidence-based recommendations for hearing assistive technology, enhanced interaction between communication partners, provided insight into participants’ lifestyle and communication needs, and seemed to generate rapport and trust.This feasibility study indicated that participants were willing to engage in photovoice and that it could be used to guide selection of rehabilitation recommendations and for postfitting counseling. Its application in audiological practice would seem timely and valuable for improving patient-centered and family-centered AR.

The rise of participatory despotism: a systematic review of online platforms for political engagement

2019 ◽  
Vol 17 (4) ◽  
pp. 422-437
Author(s):  
Rose Marie Santini ◽  
Hanna Carvalho
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Literature Review ◽  
Political Participation ◽  
Systematic Literature Review ◽  
Empirical Studies ◽  
Content Type ◽  
Online Platforms ◽  
Administrative Change ◽  
The Impact

Purpose The purpose of this paper is to present a systematic literature review of empirical studies into online platforms for political participation. The objective was to diagnose the relationship between different types of digital participatory platforms, the real possibilities of participation generated by those initiatives and the impact of such participation on the decision-making process of governmental representatives. Design/methodology/approach A systematic literature review was conducted using pre-defined terms, expressions and criteria. A total of 434 articles from 1995 to 2015 were gathered from the Web of Science database. And, 32 studies were selected from those articles for meta-synthesis, and the cases investigated were evaluated according to the e-participation ladder model (Smyth, 2001). Findings The results indicated that online political participation worldwide remains timid both in quantity and quality. We have witnessed the growth of a kind of “rhetorical participation” promoted by policy-makers and the rise of a “participatory despotism”, in which only the privileged partake, while the majority remains silent. Practical implications The solutions found to promote increased participation and ensure its effectiveness ranged from shaping the platform design in accordance with citizens’ capacities and interests to a need for profound political–administrative change, which includes the world’s public agencies adopting a more transparent, inclusive and collaborative approach to decision-making. Originality/value This paper proposes a systematic review, mapping the studies on online platforms for political participation, analysing the questions, methods and conclusions found by the authors and evaluating each case study with a participation ladder.

On the Planning and Design of Hospital Circulation Zones

2016 ◽  
Vol 10 (2) ◽  
pp. 124-146 ◽  
Author(s):  
Shan Jiang ◽  
Stephen Verderber
Keyword(s):  
Literature Review ◽  
Empirical Studies ◽  
Healthcare Delivery ◽  
Research Literature ◽  
Future Research ◽  
Healthcare Delivery System ◽  
Patient Centered ◽  
Spatial Disorientation ◽  
Planning And Design ◽  
Health Related

Objective: This present literature review explores current issues and research inconsistencies regarding the design of hospital circulation zones and the associated health-related outcomes. Background: Large general hospitals are immense, highly sophisticated institutions. Empirical studies have indicated excessively institutional environments in large medical centers are a cause of negative effects to occupants, including stress, anxiety, wayfinding difficulties and spatial disorientation, lack of cognitional control, and stress associated with inadequate access to nature. The rise of patient-centered and evidence-based movements in healthcare planning and design has resulted in a general rise in the quality of hospital physical environments. However, as a core component of any healthcare delivery system, hospital circulation zones have tended to remain neglected within the comparatively broad palette of research conducted and reported to date. Method: A systematic literature review was conducted based upon combinations of key words developed vis-à-vis a literature search in 11 major databases in the realm of the health sciences and the planning and design of built environments for healthcare. Results: Eleven peer-reviewed articles were included in the analysis. Six research themes were identified according to associated health-related outcomes, including wayfinding difficulties and spatial disorientation, communication and socialization patterns, measures and control of excessive noise, patient fall incidents, and occupants’ stress and satisfaction levels. Conclusions: Several knowledge gaps as well as commonalities in the pertinent research literature were identified. Perhaps the overriding finding is that occupants’ meaningful exposure to views of nature from within hospital circulation zones can potentially enhance wayfinding and spatial navigation. Future research priories on this subject are discussed.

Environmental Affordances: Designing for Family Presence and Involvement in Patient Care

2013 ◽  
Vol 6 (4) ◽  
pp. 53-75 ◽  
Author(s):  
Young-Seon Choi ◽  
Sheila J. Bosch
Keyword(s):  
Patient Care ◽  
Family Involvement ◽  
Empirical Studies ◽  
Family Members ◽  
Patient Centered ◽  
Family Presence ◽  
Significant Difference ◽  
Unit Design ◽  
Centered Care ◽  
The Impact

OBJECTIVE: This comparative study in two ICUs examines the impact of the patient-centered unit design on family involvement, operationalized as percentages of family presence and family–patient/family–staff interaction in patient rooms. BACKGROUND: As hospitals have become more patient-centered, there has been a trend toward including a family area inside the patient area to promote family presence, support, and involvement in patient care. There is growing evidence that family members play an important role in supporting patient care, and that the physical environment affects family involvement. However, few empirical studies have attempted to show the effectiveness of the patient-centered design on family members' presence and their behavior. METHODS: This study compared the degree of family presence and family–patient and family–staff interactions in two intensive care units (ICUs) with different physical environmental conditions, but housing patients of similar acuity and disease type. RESULTS: The analysis identified a significant difference in family presence in patient rooms ( t = −2.176; df = 79.0; p = 0.03) between the traditional and the patient-centered units. Patients in the family-centered care unit ( M = 37.77; SD = 34.02) spent significantly more time with their family members in patient rooms than did patients in the traditional unit ( M = 23.89; SD = 21.90). Patient-related variables other than unit design had no significant impact on family presence and interactions. CONCLUSIONS: Findings demonstrated that the patient-centered unit (5K) was associated with increased family presence in the patient rooms and increased family interaction with patients, when compared with the traditionally designed unit.

scholarly journals Research-Based Guidelines for Marketing Information Systems

2021 ◽  
Vol 2 (1) ◽  
pp. 1-16
Author(s):  
Albérico Travassos Rosário
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Information Systems ◽  
Literature Review ◽  
Best Practices ◽  
Empirical Studies ◽  
Internet Marketing ◽  
Review Of The Literature ◽  
Marketing Intelligence ◽  
Marketing Information

Marketing information systems (MKIS) are decision support systems focused on specific marketing decisions, providing a more efficient and effective framework for analyzing and identifying changes in the market environment. The literature review reveals that there are gaps in theoretical and empirical studies about which specific steps and best practices should be considered in MKIS implementation efforts. Is it intended to synthesize the knowledge and perceptions generated by existing MKIS studies and identify the generic and particular guidelines that can be derived from the existing body of MKIS research. A review of the literature leads the authors to a thematic synthesis that generates five core guidelines for MKIS: (1) developing, implementing, and measuring the effectiveness of the MKIS; (2) how to align the MKIS with organizational strategy and decision-making; (3) leveraging the MKIS resources in internet marketing; (4) generating and applying marketing intelligence; and, finally, (5) leveraging the benefits of the MKIS in terms of accumulating knowledge and marketing intelligence.

scholarly journals Framing and Bias: A Literature Review of Recent Findings

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Adriana Beratšová ◽  
Kristína Krchová ◽  
Nikola Gažová ◽  
Michal Jirásek
Keyword(s):  
Decision Making ◽  
Literature Review ◽  
Empirical Studies ◽  
Individual Decision ◽  
Decision Situation ◽  
Individual Decision Making ◽  
Amount Of Information ◽  
Surrounding World ◽  
Subjective Opinion ◽  
Decision Frame

Framing bias is an individual decision-making misconception caused by the fact that a person interprets the surrounding world according to a decision frame chosen by her or his subjective opinion. This article aims to review various kinds of factors that cause and affect framing or lead to debiasing, i.e. a decrease in the resulting framing bias. The objective of the study is carried out using a literature review that analyzes recent empirical studies. As a result, numerous factors are identified that according to the studies have an impact on framing. It transpires that four broader groups of these factors can be established – decision situation setup (amount of information, additional presentation of options), experience (knowledge, engagement), effort (attention, complexity, the amount of information to process) and demographics (gender, nationality).

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