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Therapeutic communication has an important role to help the recovery process of People With Schizophrenia (ODS) who have symptoms of hallucinations and delusions that can lead to a tendency to have difficulty communicating to withdraw from the social environment. Therapeutic communication is a form of communication aimed at the therapeutic process and patient healing. Phenomenology is used as a method and therapeutic communication as a theory in this study. The data collection method was carried out through online interviews using WhatsApp voice calls to 6 ODS family caregiver informants. The results of this study indicate that the experience of therapeutic communication carried out by family caregivers in the form of interpersonal communication can help the ODS awareness process regarding schizophrenia as indicated by ODS' willingness to take medication regularly, as well as communication in the form of showing acceptance, listening carefully, and emotional regulation when communicating with ODS can provide appropriate treatment when ODS has relapse symptoms so that it can help the process of developing ODS.

Children with special needs (ABK) who have dyslexia can cause children to have difficulties in learning, including difficulties in spelling, reading, writing and communicating with others. The subjects in this study were dyslexic students with the initials DH at one of the Inclusive Elementary Schools in Sleman. The results showed that parents only realized dyslexic children when the children entered their teens, the environment also affects the learning motivation of dyslexic children, and the efforts made by teachers and parents in overcoming the learning difficulties of dyslexic students. From the results of the study, DH experienced dyslexia in the form of difficulty in speaking, hesitation when answering the interlocutor's questions, spelling word for word slowly with a soft or low voice or intonation, and difficulties in writing and difficulty communicating with the surrounding environment. The method used in this research is descriptive qualitative. Data collection techniques were carried out by indepth interviews, observation and literature review. By providing maximum learning assistance between teachers and parents, it will increase learning motivation for dyslexic children.Keywords: dyslexia children, learning motivation, learning difficulties

Objective To review existing publications in order to evaluate the effect of hearing loss on social isolation and loneliness in the pediatric population. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines were followed. Eight databases were searched. Studies were independently screened and analyzed by two reviewers. Publications were included if pediatric hearing-impaired individuals and social isolation or loneliness were studied. Discrepancies were resolved by a team of five reviewers. Results Thirty-three studies were included in this review. Sixty percent of studies (12/20) found that hearing loss was related to loneliness and 64.7% found that children with hearing loss experienced more social isolation (11/17). The Asher Loneliness and Dissatisfaction Questionnaire was commonly used to assess loneliness. No commonly used tool for assessing social isolation was found. Six articles found that school type was not associated with loneliness. Difficulty communicating was the most mentioned factor leading to loneliness and social isolation. Frequent recommendations to improve social integration included facilitating interactions with the hearing-impaired and educating the nonhearing-impaired to normalize the disability. Conclusion The majority of studies found that hearing impairment results in a higher prevalence of social isolation and loneliness. However, an association cannot be definitively claimed due to the lack of uniform assessment tools. This review emphasizes the need for standardized methods to assess loneliness and social isolation and highlights methods to improve social integration for the hearing impaired. Laryngoscope, 131:1869-1875, 2021.

The hospital may be especially overwhelming to patients with Autism Spectrum Disorder (ASD) and their families. The characteristics and attributes inherently present in patients with ASD provide substantial challenges to nursing care if not recognized, identified and addressed. ASD is a complex disorder and requires preparation, education, and great assessment skills from the nurses for optimal outcomes. Nurses are often the front-line and direct care providers and need to attain the knowledge and skills necessary to understand, interact with and implement excellent care for these individuals. These patients with ASD can present with a range of social and behavioral challenges including difficulty with communication need for structure, and possible aggression and it is difficult to implement care at times. Nowadays the nursing professionals are being increasingly aware of their role in helping to ensure that patients with ASD receive the best possible care. These patients may have difficulty communicating or may find a break in their routine stressful. By understanding ASD-related challenges and devising ways to make patients as well as their parents or caregivers more comfortable, nurses can make a hospital stay, doctor visit or dental checkup less stressful and more effective. Outcomes improve dramatically when health care professionals obtain the education, expertise, and knowledge necessary to provide such care. In this paper we discuss the common challenges that the nursing staff face while dealing with patients with ASD as well as the difficulties families face. Emphasis will be on the role of nursing professionals in making hospital stay less stressful for individuals with ASD.

Purpose: The COVID-19 pandemic has introduced lifestyle changes that may negatively impact communication, including the pervasive use of face masks and videoconferencing technology. Here, we examine the effects of age and self-rated hearing on subjective measures of speech understanding via a survey accessed by adults residing in the United States. Method: Responses to an online survey were obtained from adults (21 years of age and older) during the summer and fall of 2020. The survey included questions about hearing and speech understanding in a variety of scenarios and different listening conditions, including when communicating with people using face masks in quiet and noisy environments and when using videoconferencing. Results: Data from 1,703 surveys were analyzed. In general, the use of face masks led to the perception of poorer speech understanding and greater need for concentration, especially in noisy environments. When responses from all participants were considered, poorer self-rated communication ability was noted as age increased. However, among people who categorized their overall hearing as “Excellent” or “Good,” younger adults rated their speech understanding ability in noisy situations as poorer than middle-age or older adults. Among people who rated their overall hearing as “Fair” or “Poor,” middle-age adults indicated having more difficulty communicating with people using face masks, as compared with older adults. Examination of open-ended responses suggested that the strategies individuals use when communicating with people wearing face masks vary by age and self-rated hearing. Notably, middle-age and older adults were more likely to report using strategies that could put them at risk (e.g., asking others to remove their face masks). Conclusions: Even younger adults with self-perceived good hearing are not immune to communication challenges brought about by face masks. Among individuals with similar degrees of self-rated hearing, the expected increase in communication difficulty with age was not noted among our respondents. Supplemental Material: https://doi.org/10.23641/asha.16528431

INTRODUCTION AND OBJECTIVE:Disabled patients are a unique minority population that may have lower literacy levels and difficulty communicating with physicians. Furthermore, their knowledge for canc...

Background: Cognitive impairment is a prominent feature of multiple sclerosis (MS). However, the impact that cognitive symptoms have on daily life, and the effect this has on persons with MS and their relationships with spouses/partners, remains unclear. This qualitative study sought information on the nature of cognitive impairments experienced and the impact of cognitive impairments on the daily lives of adults with MS and their partners to gain further insights into how health care professionals can best support families. Methods: Fifteen persons with MS and their spouses/partners participated in separate semistructured telephone interviews. Results: Six themes and several subthemes were identified: the social impact of cognitive impairments in MS, changes to daily living, relationship quality, communication, ways of coping with MS, and the desire for help in managing MS. Conclusions: These results identified types of support that couples needed and wanted; ways that MS affects couples’ social lives; that there are difficulties negotiating changes in roles due to cognitive challenges; that there are difficulties coping with the impact of cognitive challenges on daily living; that couples often have difficulty communicating about the impact of cognitive changes on daily living and related issues, which also contributes to relationship strain; and finally, that most participants felt that they did not understand enough about the cognitive symptoms of MS. We outline key areas to address these identified needs.

OBJECTIVES To explore patterns of parafunction, and bruxism, and its relationships with genotype and snoring in individuals with Rett syndrome (RTT). METHODS Retrospective observational data of those with confirmed MECP2 mutations in the InterRett database (n = 216) were used to investigate experience of parafunctional habits, and bruxism and their relationships with genotype and snoring using multivariable linear regression. RESULTS The prevalence of parafunction was 98.2%. Bruxism was reported (66.2%) with the patterns mostly both diurnal and nocturnal (44.1%) and exclusively diurnal (42.7%). Compared to individuals with C-terminal deletion, individuals with p.Arg106Trp mutations were less likely to have bruxism reported (aOR = 0.15; 95% CI 0.02-0.98, p = 0.05) and those with p.Arg168* mutation were more likely to have frequent bruxism than none or occasional bruxism reported (aROR 3.4; 95% CI 1.1-10.7 p = 0.04). The relative odds of having nocturnal bruxism constantly, compared to none/occasionally, were higher among those 'always' snoring (aROR 6.24; 95% CI 2.1-18.2, p = 0.001) than those with no snoring. CONCLUSIONS There appeared to be genotypic association with bruxism in p.Arg168* and p.Arg106Trp mutations and association between nocturnal bruxism and frequent snoring in an international sample of individuals with RTT. Clinical significance of the high prevalence of bruxism should be highlighted in relation to difficulty communicating pain and increased dental treatment need in RTT.

Generasi Y merupakan generasi yang memiliki kecakapan dalam penggunaan teknologi, termasuk dalam penggunaan media sosial. Dalam penggunaannya, generasi Y menghabiskan lebih banyak waktunya untuk mengakses media sosial dibandingkan generasi sebelumnya. Penggunaan media sosial yang telalu sering dapat mengakibatkan hilangnya kemampuan berinteraksi secara langsung. Fenomena menunjukkan bahwa generasi Y mengalami kesulitan dalam berkomunikasi serta kurang memiliki pendekatan yang kurang pantas ketika berbicara. Penelitian ini bertujuan untuk mengetahui hubungan frekuensi penggunaan media sosial dengan komunikasi interpersonal pada karyawan generasi Y. Sampel dalam penelitian ini adalah 131 karyawan generasi Y berusia 22-38 tahun yang bekerja di DKI Jakarta dan memiliki media sosial lebih dari satu. Penelitian ini menggunakan alat ukur The Media and Technology Usage and Attitude Scale (Rosen, 2013) dan Interpersonal Communication Inventory (Graham, 1998) yang telah diadaptasi. Hasil uji korelasi menunjukkan bahwa frekuensi penggunaan media sosial memiliki hubungan negatif yang signifikan dengan dimensi awareness of others pada komunikasi interpersonal. Namun, frekuensi penggunaan media sosial tidak memiliki hubungan dengan kedua dimensi yang lainnya pada komunikasi interpersonal, yaitu awareness of self & self disclosure dan coping with feeling & differences.

O ruído consiste em um importante risco ambiental presente na rotina dos trabalhadores em uma Unidade de Beneficiamento e Armazenagem de Grãos (UBAG). Seus efeitos mais comuns sobre o trabalhador envolvem a perda de audição, problemas no sono, problemas cardíacos, estresse tanto em casa quanto no trabalho e a dificuldade de comunicação durante suas atividades. Sendo assim, buscou-se neste trabalho investigar os níveis de ruído aos quais estão expostos trabalhadores em uma empresa de médio porte, que atua na armazenagem de grãos na região sul do Rio Grande do Sul. Para tanto, realizou-se primeiramente o levantamento e caracterização do local objeto de estudo. A seguir, procedeu-se à coleta dos índices de ruído. Por fim, foi feito o tratamento dos dados coletados e a discussão dos resultados. As evidências indicam que encaminhamentos de melhorias voltadas à redução da exposição a ruídos devem considerar prioritariamente elementos externos à infraestrutura da empresa, neste caso representados pelo fluxo de veículos pesados (caminhões) em suas instalações.

Children with complex disabilities sometimes have difficulty communicating with their parents, caregivers, and teachers. For these children, eye gaze assistive technology can be used to facilitate communication. Eye gaze assistive technology outcomes for children and youth were analyzed in this systematic review. Database and hand-searches yielded 4412 unduplicated results, of which 11 articles were eligible for this review. Outcome measures, as well as environmental and personal factors, were mapped to the World Health Organization's International Classification of Functioning, Disability and Health framework. Communication outcomes were most prevalent and co-occurred with outcomes in all reported activities and participation domains. Environmental and personal factors were classified as either facilitators or as barriers in relation to device uptake and success. Although comprehensive professional and caregiver support was the primary facilitator for success, barriers could lead to rejection of the technology even when children were successful using the system.

Communication skills and moral education are key in social interaction with others. Mentally retarded students experience a disruption in developing communication and the need to provide moral education to retarded mental students. This study aims to analyze the communication skills and moral education of mental retardation students in elementary schools. This research is a descriptive study with a qualitative approach. This study used three types of data collection techniques, including observation, documentation, and interviews. The technique used to analyze data in this study is interactive data analysis consisting of the stages of data reduction, data presentation, and conclusion drawing. Based on the implementation of the study in addition to experiencing learning difficulties, mental retardation students also experience a disruption in communication. Retarded mental students have difficulty communicating with their friends and also with their teachers. The mentally retarded Shiva also has not received the maximum moral education.

Supplementary and replacement communication or augmentative and alternative communication (AAC) is needed to replace the voices of autistic pupils who have difficulty communicating throughout the learning and facilitating process (PdPC) in the classroom. The teacher’s proficiency in communication skills can enhance and develop positive learning behaviours of autistic pupils throughout the learning process. This research aims to identify augmentative and alternative communication skills among special education teachers for autistic pupils in the classroom. A total of 73 special education teachers throughout Malaysia were selected as the respondents for thy research. The data obtained in the form of percentage shows the knowledge and skills of teachers in implementing AAC. Overall, this research shows that the level of knowledge and skills of teachers in implementing AAC in the classroom is still moderate and requires training.

Purpose To use the ICF to classify characteristics and aspirations of multilingual university students and faculty who seek speech-language pathologists’ support for intelligibility in English and to identify activities, facilitators, and barriers that impact participation in society. Method A retrospective record review was conducted on files of 175 clients attending a university clinic for intelligibility enhancement (accent modification). Participants came from 35 countries and spoke 28 different home languages. Results Assessment and intervention for intelligibility enhancement involved consideration of ICF components of Body Functions and Structures (e.g., articulating phonemes, rate, prosody), Environmental Factors (e.g., support), and Personal Factors (e.g., motivation). Consonant substitutions and deletions were common, although participants were often unaware of these. For example, only 25.6% of participants reported English dental fricatives (/θ/ and /ð/) were difficult to pronounce; however, 94.9% substituted them with other phonemes such as [t] and [d]. The combination of substitutions/deletions, fast speech rate, low speaking volume, and differences in word stress exacerbated poor intelligibility. More time conversing in English was associated with greater confidence and less difficulty communicating in English, although more time knowing English was not. Difficult communication situations were reported to be conversing over the phone, talking to strangers, and communicating in English on professional fieldwork placements. Participants were motivated to seek intelligibility enhancement for academic, employment, and social reasons. Conclusions To ensure multilingual speakers are able to participate fully in society, intelligibility enhancement requires a multi-pronged approach where speech and environmental characteristics interweave.

Humans change not only words but also facial expressions to express various emotions, which are factors that promote rich communication. However, it is difficult for users, such as the elderly or visually impaired, who have difficulty obtaining non-verbal information from others or who have difficulty communicating their feelings to others (i.e., those who have difficulty reading feelings) to use expressions to communicate with them. Therefore, in the communication of the user who has difficulty in recognizing the expression of the other party, the support to estimate the emotion of the other party is very useful. In addition, humans change the shape of the face part in one emotion and form various facial expressions. In this paper, we describe the effectiveness of the emotion estimation support system using the recognition of the facial part shape.

Resumo O avanço da medicina aprimorou o tratamento de enfermidades, modificando o padrão de morbimortalidade da população, com aumento de doenças crônicas. Esse fenômeno tornou urgente interpretar adequadamente a terminalidade da vida. Considerando essa necessidade, este estudo, de corte transversal, descritivo e analítico, analisou dados sobre a percepção de 111 estudantes do sexto ano de medicina acerca dos cuidados paliativos no fim da vida. Os dados foram coletados entre agosto e novembro de 2016, por meio de questionário e analisados por testes estatísticos com o programa Iramuteq. 37,3% dos estudantes relataram dificuldade em comunicar a morte do paciente à família; 60% sentem-se despreparados ou com dúvidas sobre como lidar com óbitos em serviço de urgência; 25% desconheciam o termo “eutanásia”, 53% “ortotanásia”, e 56% “distanásia”. Os resultados mostram que ainda há lacunas no conhecimento desses estudantes, explicitando a necessidade de que escolas médicas reforcem práticas pedagógicas sobre a morte. Abstract The advancement of medicine has improved the treatment of diseases, modifying the population’s morbidity and mortality pattern, with an increase in chronic diseases. This phenomenon made it urgent to properly interpret the termination of life. Considering this need, this cross–sectional, descriptive and analytical study analyzed data regarding the perceptions of 111 students from the sixth year of the medical school about end-of-life palliative care. Data were collected between August and November 2016 through a questionnaire and analyzed by statistical tests using the Iramuteq software. 37.3% of students reported difficulty communicating a patient’s death to their family; 60% of them felt unprepared or had doubts regarding how to deal with death in the emergency department; 25% of students reported not knowing the term Euthanasia; 53%, Orthothanasia; and, 56%, Dysthanasia. Results show that there are still gaps in the knowledge of medical students making evident the need for medical schools to reinforce educational practices regarding death. Resumen El avance de la medicina mejoró el tratamiento de enfermedades, modificando el patrón de morbimortalidad de la población, con un aumento de enfermedades crónicas. Este fenómeno tornó urgente interpretar adecuadamente la terminalidad de la vida. Considerando esta necesidad, este estudio, de corte transversal, descriptivo y analítico, analizó datos sobre la percepción de 111 estudiantes de sexto año de medicina acerca de los cuidados paliativos en el final de la vida. Los datos fueron recogidos entre agosto y noviembre de 2016, por medio de un cuestionario, y fueron analizados con pruebas estadísticas y con el programa Iramuteq. El 37.3% de los estudiantes informó dificultad para comunicar la muerte de un paciente a su familia, el 60% no se siente preparado o con dudas respecto de cómo lidiar con las muertes en el servicio de urgencia, el 25% desconocía el término “eutanasia”, el 53%, “ortotanasia”, y el 56%, “distanasia”. Los resultados muestran que aún existen lagunas en el conocimiento de estos estudiantes, explicitando la necesidad de que las facultades de medicina refuercen prácticas pedagógicas sobre la muerte.

Student teachers struggle to identify themselves as teachers in their field placement during their student teaching year, and some of the difficulty can be attributed to the change they encounter when they must communicate scientific ideas to students in a language that differs from how they recently learned science at the university level. Using developmental levels of student teaching (Drafall and Grant in Music Educators Journal, 81(1), 35−38, 1995), we explore how three cases differ in their use of verbal classroom discourse over the course of their student teaching year. We use data from six observations, post-observation debriefs, reflections associated with the observations, and responses to assignments from the student teachers’ teaching classes as data to demonstrate how the cases differ in the proficiency of their verbal communication in their classroom placement. We find that when student teachers have difficulty communicating science to their students, they struggle to use lectures effectively or engage students in meaningful conversation or questioning. This work suggests a need for more study as to the causes of different communication proficiencies and how methods instructors can help teachers develop awareness of the value of their verbal discourse interactions with students.

Objectives: To assess the experiences of people with hearing loss in healthcare environments to characterize miscommunication and unmet needs, and guide recommendations for improving outcomes and access. Methods: Anonymous survey developed by subject-matter experts was posted on a large national hearing-loss consumer and advocacy organization website and email listserv. Data were collected and managed via RedCAP. Results: Responses were received from 1581 individuals. Respondents reported moderate or significant difficulty communicating with all listed providers. Three communication situations emerged as often presenting communication difficulties: hearing one's name when called in the waiting room, hearing when the speaker's back was turned, and hearing when communicating by telephone. Despite 93% of respondents indicating they sometimes or often let providers know about their hearing loss, 29.3% of all respondents still reported that no arrangements were made to improve communication. Conclusions: This study clearly demonstrates the ongoing difficulties faced by individuals with hearing loss, particularly older adults, as they attempt to navigate both providers and situations associated with a typical primary care office visit. Clinical Implications: Inexpensive and efficient changes to improve communication include (1) Improving one-on-one provider communication by facing the individual with good lighting, clear speaking, and not obstructing one's mouth; (2) Environmental changes such as using visual or tactile alerting devices in waiting rooms and adding noise-dampening carpeting and curtains; and (3) Avoiding telephones and conveying health information in writing.

Background As patient advocates, oncology nurses must attend to varying levels of health literacy among patients and families. However, little is known about nurses' experiences and comfort with health literacy assessment and providing health literacy support. . Objectives The purpose of this study is to explore nurse communication and patient health literacy. . Methods A cross-sectional survey design (N = 74) was used to explore nurse communication challenges with low-literacy patients and to measure nurses' frequency of assisting with patient literacy needs, perceived degree of difficulty communicating with low-literacy populations, and perceived comfort with health literacy support. . Findings A majority of the nurses reported communication challenges with patients who spoke English as a second language. Oncology nurses did not identify patient communication behaviors that indicated low health literacy. Nurses were least comfortable identifying low-literacy patients and assessing a patient's health literacy level. More experienced nurses reported more difficulty with low-literacy populations than less experienced nurses. Providing health literacy support to patients should be a core nursing skill.

Reverberation is a source of acoustic degradation, present to varying extents in many everyday listening environments. The presence of reverberation decreases speech intelligibility, especially for listeners with hearing impairment. There is substantial variability in how susceptible individuals with hearing impairment are to the effects of reverberation (i.e., how intelligible reverberant speech is to a listener). Relatively little is known about the listener factors which drive that susceptibility.To identify listener factors that are associated with an individual’s susceptibility to reverberation. Another purpose was to investigate how these listener factors are associated with reverberant susceptibility in relation to the amount of reverberation. The listener factors investigated were degree of hearing loss, age, temporal envelope sensitivity, and working memory capacity.This study used a correlational design to investigate the association between different listener factors and speech intelligibility with varying amounts of reverberation.Thirty-three older adults with sensorineural hearing loss participated in the study.Listener temporal envelope sensitivity was measured using a gap detection threshold task. Listener working memory capacity was measured using the Reading Span Test. Intelligibility of reverberant speech was measured using a set of low-context sentence materials presented at 70 dB SPL without individual frequency shaping. Sentences were presented at a range of realistic reverberation times, including no reverberation (0.0 sec), moderate reverberation (1.0 sec), and severe reverberation (4.0 sec). Stepwise linear regression analyses were conducted to model speech intelligibility using individual degree of hearing loss, age, temporal envelope sensitivity, and working memory capacity. A separate stepwise linear regression model was conducted to model listener speech intelligibility at each of the three levels of reverberation.As the amount of reverberation increased, listener speech intelligibility decreased and variability in scores among individuals increased. Temporal envelope sensitivity was most closely associated with speech intelligibility in the no reverberation condition. Both listener age and degree of hearing loss were significantly associated with speech intelligibility in the moderate reverberation condition. Both listener working memory capacity and age were significantly associated with speech intelligibility in the severe reverberation condition.The results suggest that suprathreshold listener factors can be used to best predict speech intelligibility across a range of reverberant conditions. However, which listener factor(s) to consider when predicting a listener’s susceptibility to reverberation depends on the amount of reverberation in an environment. Clinicians may be able to use different listener factors to identify individuals who are more susceptible to reverberation and would be more likely to have difficulty communicating in reverberant environments.

Background Since few studies have characterized painful diabetic peripheral neuropathy (pDPN) symptoms in multicultural populations, this study fielded a survey to better understand pDPN and its impact in African-American, Caucasian, and Hispanic populations. Methods Kelton fielded a survey by phone or Internet, in English or Spanish, among adults with pDPN symptoms in the United States between August and October 2015; African-Americans and Hispanics were oversampled to achieve at least 500 subjects for each group. Patients were required to have been diagnosed with pDPN or score ≥ 3 on ID Pain validated screening tool. The survey elicited information on pDPN symptoms and interactions with healthcare providers (HCPs), and included the Brief Pain Inventory and pain-specific Work Productivity and Assessment Questionnaire (WPAI:SHP). Results Respondents included 823 Caucasians, 525 African-Americans, and 537 Hispanics; approximately half of African-Americans and Hispanics were

e17000 Background: Disabled patients are a unique minority population that may have lower literacy levels and difficulty communicating with physicians. Furthermore, their knowledge for cancer prevention recommendations is unknown. Herein, we aim to compare prostate-specific antigen (PSA) testing rates and associated predictors among disabled men and non-disabled men in the USA. Methods: We performed a cross-sectional study utilizing the Health Information National Trends Survey (HINTS) to analyze factors predicting PSA testing rates in men with disabilities (disabled, deaf, blind). Multivariable logistic regression models were used to determine clinically significant predictors of PSA testing in men with disabilities compared to that of the healthy cohort. Results: A total of 782 (14.6%) disabled men were compared to 4,569 (85.4%) non-disabled men. Disabled men were older with a mean age of 65.0 ± 14.2 vs. 55.0 ± 15.9 years (p < 0.001). On multivariable analysis, after adjusting for all available confounders including race, age, geographical region, survey year, marital status, health insurance, healthcare provider, amongst others, men with any disability were less likely to undergo PSA screening (OR 0.772, 95% CI 0.623-0.956, p = 0.018). Variables associated with increased PSA screening rates included age, having a healthcare provider or health insurance, and living with a partner. Although prostate cancer detection rates were shown to be higher among disabled men, this did not reach statistical significance. Conclusions: Our data suggests that significant inequalities in PSA screening exist among men with disabilities in the USA, with disabled men, especially the deaf and the blind, being less likely to be offered PSA screening. There is a clear need to implement strategies to reduce existing gaps in the care of disabled men and strive to reach equality in PSA screening in this unique population.

More than a few pediatric nurses experience difficulty in communicating with children's family members. However, effective means of providing communication support for pediatric nurses have not been examined sufficiently. This study aimed to develop and implement a communication support program for nurses to facilitate improved communication with families of hospitalized children, and to clarify changes in nurses' recognition and behavior toward communication with families in clinical settings. The program lasted 6 months and consisted of lectures, role-play, 4 communication models in which nurses experienced difficulty communicating with family members, and continued individual support. The effects of the program were evaluated qualitatively and descriptively using semi-structured interviews. A total of 7 nurses with less than 5 years of pediatric nursing experience completed the program. Subsequent to program completion, nurses' awareness of careful communication with families increased, and they began to approach families actively using thoughtful words. Furthermore, as nurses received favorable reactions from families, they realized that communication was interactive and recognized that their perception of their communication skills as poor had changed. This program could contribute in reducing nurses' difficulty in communicating with families and encourage them to improve their communication.

Background: Effective communication between health professionals and patients is essential for safe, efficacious, patient-centred care. Communication difficulties, including aphasia, present seriou...

Speech-language pathologists (SLPs) may be approached by multilingual speakers wishing to improve their intelligibility in English. Intelligibility is an essential element of spoken language proficiency and is particularly important for multilingual international students given their need to express complex ideas in an additional language. Intelligibility Enhancement aims to improve the intelligibility and acceptability of consonants, vowels and prosody with multilingual speakers who are learning to speak English. This study aimed to describe the Intelligibility Enhancement Assessment and Intervention Protocols and determine whether the intervention changed multilingual university students' English intelligibility. A multiple-baseline single-case experimental design was applied with direct inter-subject replication across two female participants whose home languages were Vietnamese and Putonghua (Mandarin). English intelligibility was assessed at multiple intervals pre, post and during intervention. The intervention protocol consisted of 11 weekly 1-h sessions with an SLP targeting English consonants, vowels and prosody. Following intervention, both participants displayed increased performance across most measures. For example, the Vietnamese participant's percentage of consonants correct (PCC) increased from 62.5% to 85.0% in probe keywords. Effect sizes, when comparing baseline and withdrawal phases, were 5.5 for PCC, 4.6 for final consonants, 2.3 for consonant clusters and 1.6 for syllables indicating improvements in all variables measured. Her speech rate reduced, word stress increased in accuracy and she perceived less difficulty communicating in English. These promising results suggest further testing of the Intelligibility Enhancement Protocols is warranted to determine effectiveness as an intervention for multilingual speakers.

Pain is a subjective experience, unfortunately, some patients cannot provide a self-report of pain verbally, in writing, or by other means. In patients who are unable to self-report pain, other strategies must be used to infer pain and evaluate interventions. In support of the ASPMN position statement "Pain Assessment in the Patient Unable to Self-Report", this paper provides clinical practice recommendations for five populations in which difficulty communicating pain often exists: neonates, toddlers and young children, persons with intellectual disabilities, critically ill/unconscious patients, older adults with advanced dementia, and patients at the end of life. Nurses are integral to ensuring assessment and treatment of these vulnerable populations.

Despite recent advances in cancer control, numerous disparities exist in the areas of patient access to care, self-management, and quality of life. However, mobile health technology shows promise as a tool to reduce disparities among patients with cancer and cancer survivors by overcoming such barriers as limited access to providers, difficulty communicating with providers, and inadequate communication between patients and providers regarding symptoms. This narrative review draws on the literature in cancer and noncancer populations to identify factors that create or maintain disparities and to describe opportunities for mobile health technology to reduce disparities.

Mathematical communication skills are one of the important future competencies possessed by students. Based on a preliminary study conducted on students in one of the Madrasah Ibtidaiyah shows that most students have difficulty communicating mathematical ideas. This study aims to figure out students’ mathematical communication skills on the subject of the volume of cubes and cuboids for the students taught withe the Relating, Experiencing, Applying, Cooperating and Transferring (REACT) strategy were better than those who taught with conventional learning. The research method used was a quasi-experimental design of The Nonequivalent Pretest-Posttest Control Group Design conducted on fifth grade students in one of the Ibtidaiyah Madrasahs in Bandung Regency. Based on the results of the study concluded that the mathematical communication skills of students who get learning with REACT strategies are better than mathematical communication skills of students who obtain conventional learning.

One of the goals of mathematics is to communicate ideas by using symbols, tables, diagrams, or other media to explain problems or circumstances. Based on the objectives of mathematics learning, the mathematical communication skills of students need to be considered. But many students have difficulty communicating to their mathematical understanding. This is influenced by several factors, one of them is the emotional intelligence of students.This type of research is descriptive with a qualitative approach that aims to describe how students' mathematical communication skills in solving mathematical problems based on the level of emotional intelligence. The subjects of this research are the IVC grade students elementary school of Muhammadiyah Manyar in the academic year 2019 - 2020. This study consists of three students consisting of one student who has high emotional intelligence, one student who has moderate emotional intelligence, and one student who has low emotional intelligence. The methods used in this study are emotional intelligence questionnaire, students' mathematical communication skills test, and interviews. The results of the study indicate that students who have high emotional intelligence have high mathematical communication skills that are also able to illustrate the picture completely, solve coherently and correctly, and provide conclusions correctly. Students with a moderate level of emotional intelligence, have moderate mathematical communication skills, are able to illustrate almost exact and complete images, are able to finish coherently, and are not careful about answers that have been written. Students with low levels of emotional intelligence, have low mathematical communication skills, are able to illustrate almost exact images, find it difficult to write down information that is known and asked, and do not provide conclusions on answers.Keywords: Emotional Intelligence, Mathematical Communication Skills

An inability or difficulty communicating can have a profound impact on a child's future ability to participate in society as a productive adult. Over the past few years the number of interventions for children with speech and language problems has almost doubled; the majority are targeted interventions delivered by speech pathologists. In this paper we examine the distribution of speech pathology services in metropolitan Melbourne and how these are aligned with need as defined by vulnerability in language and social disadvantage. We identified three times as many private sector services compared to public services for the 0-5 year age group. Overall there was poorer availability of services in some of the most vulnerable areas. The profound and long-term impact of impoverished childhood language, coupled with the considerable limitations on public spending, provide a strong impetus to deliver more equitably distributed speech pathology services.

Many patients have difficulty communicating about their healthcare. At present there is no tool to identify these patients. This research investigated whether the Inpatient Functional Communication Interview Staff Questionnaire (IFCI SQ) could detect patients who have difficulty communicating their healthcare needs by investigating the sensitivity, specificity and internal consistency of the IFCI SQ.Fifty patients and their nurses participated in this research. Every second consecutive admission on the general medical ward of a hospital was assessed for communication difficulty by a speech-language pathologist on the IFCI and screened for communication difficulty by a nurse using the IFCI SQ.At a cut off score of 2, the IFCI SQ had a sensitivity of 95% and a specificity of 77% compared with the IFCI. The IFCI SQ is a useful test in identifying patients who have communication difficulty and is an extremely good test at ruling out patients who do not have communication difficulty. The internal consistency of the IFCI SQ was also high at 0.954.The IFCI SQ is a promising tool to detect patients in hospital with communication difficulty. Further research is required to explore the psychometric properties of the IFCI SQ in more detail.

Despite providing a consistent and comprehensible format for over-the-counter (OTC) drug communication, research suggests important limitations in the communication effectiveness of the Drug Facts Label required on OTC drugs in the United States. This literature is reviewed and some of these critical limitations of the Drug Facts Label (DFL) highlighted. These include difficulty communicating complex information that requires integration of multiple pieces of label information and limited adaptability to serve the unique needs of individual populations (e.g., low literacy or older consumers). Potential ways to improve the DFL’s communication effectiveness are identified along with complementary opportunities to improve OTC drug communication by leveraging the role of pharmacists and use of adjunctive technologies.

ObjectiveRecently, rehabilitation therapists have become involved in cancer rehabilitation; however, no communication skills training that increases the ability to provide emotional support for cancer patients has been developed for rehabilitation therapists. In addition, no study has examined associations between rehabilitation therapists’ communication skills and their level of autistic-like traits (ALT), which are in-born characteristics including specific communication styles and difficulty communicating with patients. In this study, we aimed to investigate whether confidence in communicating with patients mitigates communication difficulties experienced by rehabilitation therapists who have high levels of ALT.MethodRehabilitation therapists who treat patients with cancer completed self-administered postal questionnaires anonymously. Scores were obtained on the Autism-Spectrum Quotient short form, confidence in communication, and communication difficulties. We used covariance structure analyses to test hypothetical models, and confirmed that confidence in communication mediates the relationship between ALT and perceived communication difficulties.ResultsParticipants included 1,343 respondents (49.6%). Autism-Spectrum Quotient scores were positively correlated with communication difficulties (r = 0.16, p < 0.001). The correlation was mitigated by confidence in communication in the fit model. However, higher confidence in creating a supportive atmosphere was associated with more difficulty in communication (r = 0.16, p < 0.001).Significance of resultsCommunication difficulty was linked to rehabilitation therapists’ ALTs. By increasing confidence in areas of communication other than creation of a supportive atmosphere, ALT-related difficulties in communication may be ameliorated. Confidence to create supportive environments correlated positively with difficulty. Communication skills training to increase confidence in communication for rehabilitation therapists should be developed with vigilance regarding ALT levels.

Purpose Using a multi-dimensional measure of perfectionism: the Frost Multi-dimensional Perfectionism Scale (FMPS: Frost, Marten, Lahart, & Rosenblate, 1990 ), this study investigates: (a) whether adults who stutter (AWS) display more perfectionistic attitudes and beliefs than those who do not stutter, and (b) whether, in AWS, more perfectionistic attitudes and beliefs are associated with greater self-reported difficulty communicating verbally and speaking fluently. Method In the first analysis, FMPS responses from 81 AWS and 81 matched, normally-fluent controls were analyzed using logistic regression to investigate the relative contributions of four FMPS perfectionism-subscale self-ratings to the likelihood of being in the AWS group. In the subsequent analyses, data from the 81 AWS were analyzed using linear multiple regression to determine which FMPS subscale self-ratings best predicted their Communication-Difficulty and Fluency-Difficulty scores. Results Both the likelihood of being a member of the AWS group, and also the magnitude of the AWS group's Communication-Difficulty and Fluency-Difficulty scores, were positively part-correlated to respondents’ Concern over Mistakes-Doubts about Actions (CMD) subscale self-ratings but negatively part-correlated to their Personal Standards (PS) subscale self-ratings. Conclusions The FMPS profiles of respondents who stutter suggest that, as a group, they are not abnormally perfectionistic overall, but may be (or perceive themselves to be) abnormally error-prone. Also, AWS who are more concerned about their errors and uncertain of their actions experience more difficulty communicating verbally and speaking fluently. Educational Objectives: After reading this article, participants will be able to: (a) describe the findings of previous research investigating the role of perfectionism in stuttering and psychopathologies; (b) discuss why a multidimensional assessment of perfectionism is important in relation to stuttering; (c) discuss ways in which data from perfectionism assessments can contribute to the planning of therapy for adults who stutter.

Some of the highest rates of sexually transmitted infections (STIs) are reported in the Arctic. For example, the Inuit youth of Greenland have the highest STI rates in the circumpolar region. In this study, we used a mixed method approach to examine parent/guardian–youth communication about STIs and other sexual health topics. The quantitative component of the study involved the parents/guardians completing a brief questionnaire while the qualitative component involved their participation in focus groups. Parents/guardians reported that, although they found little difficulty communicating with youth in general, this was not the case for sexual topics. Similarly, parents/guardians reported a lack of communication about topics such as masturbation, why people engage in sex, and what it feels like to have sex. In general parents/guardians stated that it is uncomfortable for them to talk with their youth about sexual matters. At the same time, they are concerned about the high rates of unwanted pregnancy in their communities, and they would like to see more collaborative partnerships aimed at increasing sexual health education for youth. Future STI prevention efforts in Greenland would benefit from involving Greenlandic youth and their families in the design of community-based sexual health education programs that increase communication skills in families about topics related to sex. Community based efforts that involve families and empower them to educate their youth around STI risk-prevention behaviours is a necessary area of future development in Greenland.

Multiple System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP) are atypical Parkinsonian disorders with extended morbidity and reduced lifespan, known to have marked and early impact upon quality of life (QoL). This study aimed to address the lack of studies in the literature regarding personal perspectives on QoL in MSA and PSP in both patients and carers. Participants took part in qualitative, in-depth interviews in the North East of England, exploring what impacts their QoL and their experiences of living with these complex conditions. Connection to others was found to be a prevailing theme, encompassing difficulty communicating, social isolation, impact on personal relationships, and stigma. This work is helpful in that it emphasises the personal experiences of these patients and carers, which can provide insights into important areas for clinical service planning and best clinical management of individual patients as well as considerations for future research into QoL in these rare disorders.

Deaf people have difficulty communicating with the hearing people around them, but little research has addressed how new technology may help address this issue. The current research objectives were to (1) survey research on communication barriers encountered by deaf people; (2) survey the available communication applications (apps) and features designed for deaf people; (3) recommend the best existing communication apps for Deaf people; and, (4) identify the best designs and features of these apps for developers. A total of 55 communication apps were examined, but only six were found to be designed specifically as communication apps for deaf people. The survey outlines useful features of available communication apps for this population, examines the needs and preferences of the users, and compares these with existing features. We see that there is a serious need to develop more communication apps that meet the needs of deaf people.

Education makes the needs of every human being, as an effort to maximize all the potential of the creator in order to become our human being. No exception for individuals who physically and psychologically have deficiencies and weaknesses called Children with Special Needs (ABK). To optimize the potential of these individuals, an appropriate learning pattern is needed, especially in the learning process of Islamic Religious Education. Al Aufa SDIT is an educational institution that provides Inclusive education services for ABK. Implement learning at SDIT Al Aufa using teacher and media learning patterns. Where this learning activity begins with compiling learning objectives, determining teaching material, establishing learning methods and media and evaluation instruments arranged simply. While learning activities in the classroom encountered several obstacles, namely the characteristics of ABK who were hyperactive, had difficulty communicating/ socializing and were slow in responding to the stimulus provided.

Individuals with autism spectrum disorders (ASDs) have difficulty communicating in ways that are primarily for initiating and maintaining social relatedness (i.e., social communication). We hypothesized that the way researchers measured social communication would affect whether treatment effects were found. Using a best evidence review method, we found that treatments were shown to improve social communication outcomes approximately 54% of the time. The probability that a treatment affected social communication varied greatly depending on whether social communication was directly targeted (63%) or not (39%). Finally, the probability that a treatment affected social communication also varied greatly depending on whether social communication as measured in (a) contexts very similar to treatment sessions (82%) or (b) contexts that differed from treatment on at least setting, materials, and communication partner (33%). This paper also provides several methodological contributions.

OBJECTIVES The effects of directing, switching, and misdirecting auditory spatial attention in a complex listening situation were investigated in 8 younger and 8 older listeners with normal-hearing sensitivity below 4 kHz. DESIGN In two companion experiments, a target sentence was presented from one spatial location and two competing sentences were presented simultaneously, one from each of two different locations. Pretrial, listeners were informed of the call-sign cue that identified which of the three sentences was the target and of the probability of the target sentence being presented from each of the three possible locations. Four different probability conditions varied in the likelihood of the target being presented at the left, center, and right locations. In Experiment 1, four timing conditions were tested: the original (unedited) sentences (which contained about 300 msec of filler speech between the call-sign cue and the onset of the target words), or modified (edited) sentences with silent pauses of 0, 150, or 300 msec replacing the filler speech. In Experiment 2, when the cued sentence was presented from an unlikely (side) listening location, for half of the trials the listener's task was to report target words from the cued sentence (cue condition); for the remaining trials, the listener's task was to report target words from the sentence presented from the opposite, unlikely (side) listening location (anticue condition). RESULTS In Experiment 1, for targets presented from the likely (center) location, word identification was better for the unedited than for modified sentences. For targets presented from unlikely (side) locations, word identification was better when there was more time between the call-sign cue and target words. All listeners benefited similarly from the availability of more compared with less time and the presentation of continuous compared with interrupted speech. In Experiment 2, the key finding was that age-related performance deficits were observed in conditions requiring anticue but not cue responses. CONCLUSIONS The findings from Experiment 1 suggest that for both age groups, stream continuity mediates the process of allocating and maintaining auditory spatial attention when the target originates at an expected location, but that time is needed for the reallocation of auditory spatial attention when the target originates at an unexpected location. The findings from Experiment 2 suggest that when attention is momentarily misdirected, difficulties disengaging attention may help explain why older adults with good hearing report difficulty communicating in multi-talker listening situations.

Parents often underestimate the degree to which their children engage in risky online activities such as cyberbullying, worrisome interactions with strangers, and exposure to sexual content. This study attempts to identify the underlying predictors of such parental misconceptions. A national sample survey nonrandom of 456 matched parent-child pairs revealed that a permissive parenting style, difficulty communicating about online risks, and household environmental variables such as having access to a private computing space play a role in parental underestimation of risky social interactions that their children encounter and experience online. Implications for scholars and caregivers are discussed.

The involvement of family factors in the problem of bullying is well documented, not only in terms of the various differential profiles presented by bullies and their victims in terms of parental socialization styles, but the implications are derived from the perception of family climate. Specifically, this study provides an analysis of the relationship between psychosocial perception of family social climate by a group of 550 adolescents of the Principality of Asturias (Spain) (278 girls and 272 boys 50.5%, 49.5%) and their attitudes to bullying according to a three-dimensional assessment model (planes cognitive, affective and dispositional) measures through Attitudes toward Social Aggression Scale constructed ad hoc by the authors (Moral, 2005). It has been confirmed that adolescents with more favorable attitudes to violence perceived peer more conflictual family climate, feel less affection in family relationships, express greater difficulty communicating with them, and less respect for their opinions and paternal highest demands and declared to be subject to physical and psychological punishment by their parents compared to those adolescents with more negative attitudes towards bullying violence.

Corporate entrepreneurship (CE) has emerged as an important strategy for hotels in recent years, allowing rejuvenation of internal processes and activities for improved performance. Although CE is instigated by senior management, middle managers carry out their instructions and hence have a critical role in its success. This conceptual paper evaluates the antecedents or factors that may impact on the middle manager's entrepreneurial role. Hotel middle managers are expected to be more entrepreneurial, but the findings indicate that centralised structures, although ensuring standardisation of systems and processes, result in a ‘top-down’ approach to leadership and decision making. The middle manager has difficulty communicating issues and ideas to senior management, affecting their ability to be innovative and to take risks on behalf of the hotel. Organisations appear not to be learning from their experiences, with a negative impact on performance.

People with special health care needs (PSHCN) often have difficulty communicating with providers in health care settings, including dental practices. This difficulty can affect access to care as well as the quality of care received. This article provides practical tips and tools dental professionals can use to facilitate communication for a diverse population of PSHCNs. The article discusses communication needs of patients with communication disorders; augmentative and alternative communication; and communication for patients with intellectual disability, psychiatric conditions; and dental fears. Examples are given of communication breakdowns, and descriptions of how communication challenges can be resolved.

Children undergoing surgical procedures may have difficulty communicating. Augmentative and alternative communication (AAC) picture communication may provide a standard communication strategy for postoperative children and facilitate nurse-patient communication. The study purposes were to (1) determine if inconsistency exists between nurse assessments of pain location versus identification of pain location using AAC picture communication aids and (2) determine parent satisfaction with use of AAC picture communication aids. A convenience sample of patients aged 3 to 9 years were recruited in a Midwestern freestanding pediatric hospital's postanesthesia care unit (PACU). The patient's pain location was assessed using an AAC picture communication aid and compared with the PACU nurses' pain assessment. Nurses did not consistently document location of pain, and, when documented, the surgical site was inaccurately identified as the location of pain. Parent satisfaction was measured through completion of a 10-item satisfaction survey. Respondents were satisfied with the use of AAC picture communication aids.

People with learning disability can suffer from the full range of medical problems but may have difficulty communicating their experience. The authors give advice on diagnosis, responsibility for medicine taking, obtaining consent and ensuring that the medication is taken as intended. Copyright © 2011 Wiley Interface Ltd

Many profoundly deaf signers have difficulty communicating with hearing people. This article describes a therapy called ‘Strategies and Measurable Interaction in Live English’ (smiLE; Schamroth and Threadgill, 2007a), an approach used to teach deaf children skills to become successful communicators in real-life situations. This study evaluates the effectiveness of smiLE in helping deaf pupils develop their ability to make successful requests in a specific communication situation and whether this generalized to another communication situation. Sixteen severely and profoundly deaf primary school pupils (7.2—11.0 years old) received an 11-week programme of therapy. Their performances in a trained and an untrained communication situation were compared pre- and post-therapy. In the trained task, the pupils’ interactions improved significantly. No differences were found in the untrained task, suggesting that the learnt skills did not generalize. Anecdotal findings suggest that some carry-over into a similar situation had occurred and that trained skills were maintained. The smiLE therapy approach is effective in providing deaf children with the communication skills and confidence to interact with English speakers in targeted situations. The lack of generalization of these skills to similar situations may be overcome by a longer therapy programme that specifically promote these skills across different situations.

Farmers experience higher rates of noise-induced hearing loss (NIHL) than workers in most other industries. We developed a model of farmers' use of hearing protection, and tested it with a random sample (n = 532) of farmers from the upper Midwest. Barriers to using hearing protection (e.g., difficulty communicating; OR = .44, p

In responding to stakeholders following a product-harm crises, employees and managers appear to have difficulty communicating in ways that are accommodative (e.g., apologizing, acknowledging responsibility, offering corrective action). Here, we argue that such communication has an inherent moral dimension, and accordingly, present an ethics module that is likely to increase the likelihood that individuals respond in accommodative ways. After explaining the theoretical foundations of this module, we present evidence of the effectiveness of this educational intervention. The results, limitations of the study, and directions for future research are then discussed.