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What to do when children clam up in psychotherapy : interventions to facilitate communication
\"Therapists who work with children and adolescents are frequently faced with nonresponsive, reticent, or completely nonverbal clients. This volume brings together expert clinicians who explore why 4- to 16-year-olds may have difficulty talking and provide creative ways to facilitate communication. A variety of play, art, movement, and animal-assisted therapies, as well as trauma-focused therapy with adolescents, are illustrated with vivid clinical material. Contributors give particular attention to the neurobiological effects of trauma, how they manifest in the body when children \"clam up,\" and how to help children self-regulate and feel safe. Most chapters conclude with succinct lists of recommended practices for engaging hard-to-reach children that therapists can immediately try out in their own work\"-- Provided by publisher.
Book
Barriers to discussing fatigue in oncological care: a comparative study of patient perspectives after two decades
Purpose
Healthcare providers and oncology patients may assess fatigue differently without direct communication. This study was performed to compare patient barriers to discussing cancer-related fatigue with healthcare providers in 2002 and 2023/24 using the Polish adaptation of the Fatigue Management Barriers Questionnaire (FMBQ). The FMBQ measures the intensity of barriers in communicating with medical staff about fatigue.
Methods
This cross-sectional study with a historical comparison utilized the FMBQ, the Chalder Fatigue Questionnaire (CFQ-PL), the Multidimensional Scale of Perceived Social Support (MSPSS), and a custom-designed questionnaire. The study was conducted at the turn of 2023 and 2024, with participants recruited during hospitalization in the preoperative period as part of their treatment process.
Results
The study included 54 women with histopathologically confirmed reproductive organ malignancies (68% ovarian cancer, 28% endometrial and cervical cancer). The Polish adaptation of the FMBQ demonstrated good psychometric properties, which have been preliminarily confirmed. No significant correlations were found between barriers to communication and fatigue intensity, illness duration, or length of treatment.
Two decades after the first study on barriers to discussing fatigue, these barriers persist and have intensified. This is particularly evident in concerns regarding the futility of addressing fatigue, the fear of jeopardizing cancer treatment, and the avoidance of the topic due to concerns that fatigue may signal disease progression. Additionally, patients report an increased need to maintain the image of a “good patient” by avoiding complaints, along with growing concerns about excessive medication use.
The percentage of patients not asked about fatigue by medical staff has remained consistent over time (25%–33%). Present-day key barriers to discussing fatigue include the desire to limit medication intake (53%), the effort to maintain a “good patient” image (49%), the belief that fatigue is a less important issue (42%), and fears that it is either a side effect of treatment (38%) or an indicator of disease progression (36%).
Conclusions
Barriers to discussing fatigue remain a significant issue in cancer care. Addressing these barriers through education and structured communication strategies could enhance supportive care for oncology patients.
Journal Article
Exploring the scope of communication content of mechanically ventilated patients
Ineffective communication during mechanical ventilation (MV) and critical illness is distressing to many patients. This study aimed to describe the scope of communication content of ventilated critically ill patients.
We performed a prospective qualitative interview study in a multidisciplinary intensive care unit. Ten alert, orientated adult patients who previously underwent MV for at least 24h and were able to speak at the time of interview were recruited. Semi-structured interviews with stimulated recall technique were conducted. A descriptive thematic analysis was performed of the patient-generated content using a free coding technique, where recurrent themes and subthemes were noted, coded and analyzed.
Patients' communication content included medical discussions with clinicians; communication with family to provide advice or comfort, make requests and plans, express feelings and convey personal perspectives on medical care; and expression of their own psychoemotional needs.
The scope of communication content of ventilated ICU patients was broad, extending far beyond task-focused subject matter. Content ranged from conveying symptom-related messages to active participation in medical discussions, to conversing with family about a range of complex multi-dimensional issues, to sharing their own psychoemotional experiences. These patient-centered needs should be recognized and addressed in communication strategies.
•Mechanically ventilated critically ill patients' scope of communication is broad.•Ventilated patients want to communicate complex personal and psychoemotional issues.•Communication during this non-vocal period can be frustrating.•Communication strategies should recognize and address these needs.
Journal Article
Pediatric Nurses’ Experiences in Refugee Children Care: A Qualitative Research
Communication is one of the main foundations for providing nursing care. Due to intercountry mobility, nurses encounter communication barriers with patients and their families, such as language and sociocultural differences.
This study was conducted to investigate the experiences of pediatric nurses in caring for refugee children. The phenomenological study was conducted between November 2023 and February 2024 with 16 pediatric nurses working in the inpatient wards of Istanbul Prof. Dr. Cemil Tascioglu City Hospital Pediatrics Clinic who agreed to participate in the study. Data were collected through face-to-face interviews and voice recordings. After the interviews were transcribed, the MAXQDA 2022 program was used for coding, creating themes, and analyzing the relationship between codes and sub-codes.
The nurses revealed themes of the care process, difficulties related to the patient, communication methods, risks in patient safety, feelings experienced about the ineffective communication, and suggestions. The main codes obtained from the themes were loss of time, difficulties in communication and training, difficulties arising from cultural practices, using body language, wrong practices regarding patient safety, sadness and fatigue experienced when there is no communication, and the need for learning Turkish.
The pediatric nurses had problems with communication and felt sadness about caring for refugee children. The problem of loss of time in giving care due to language and sociocultural differences, and the suggestion of learning Turkish as the solution come to the fore. It is necessary to carry out comprehensive research on this subject.
Journal Article
The Potential of AI in Information Provision in Energy-Efficient Renovations: A Narrative Review of Literature
Energy-efficient renovation (EER) is a complex process essential for reducing emissions in the built environment. This research identifies homeowners as the main decision-makers, whereas intermediaries and social interactions between peers are highly influential in home renovations. It investigates information and communication barriers encountered during the initial phases of EERs. The study reviews AI tools developed within the EERs domain to assess their capabilities in overcoming these barriers and identifies areas needing improvement. This research examines stakeholders, barriers, and the AI tools in the literature for EERs. The discussion compares the functionalities of these tools against stakeholder needs and the challenges they face. Findings show that tools often overlook methodologies in human–computer interaction and the potential of textual and visual AI methods. Digital tool development also lacks insights from social science and user feedback, potentially limiting the practical impact of these innovations. This article contributes to the EERs literature by proposing an AI-supported framework and outlining potential research areas for future exploration, particularly improving tool effectiveness and stakeholder engagement to scale up the EER practice.
Journal Article
Challenges in Thirst Management for Intubated Patients in the ICU: A Qualitative Study of Healthcare Provider and Patient Perspectives
This study aims to examine the challenges associated with thirst management among patients undergoing tracheal intubation in intensive care units (ICUs), and to inform the development of more effective clinical strategies.
A qualitative research design was employed using semi-structured interviews with 32 participants, including healthcare professionals and patients who had experienced tracheal intubation and associated thirst in the ICU. Interview content addressed themes such as the expression, recognition, and management of thirst. Thematic analysis was used to identify key patterns within the data.
Four major themes emerged from the analysis: (1) communication barriers in the expression and recognition of thirst; (2) difficulty distinguishing between physiological and psychological thirst; (3) limitations and deficiencies in current thirst management practices; and (4) cognitive disparities between healthcare providers and patients regarding thirst perception. These findings underscore the multifaceted nature of thirst management in tracheal intubation.
Thirst management for patients undergoing tracheal intubation in the ICU involves complex, multidimensional challenges. The findings offer clinically relevant insights that may enhance the ability of healthcare providers to recognize and assess thirst, support the development of targeted communication strategies and interventions, and facilitate greater patient involvement in care decisions, thereby contributing to improved treatment adherence and nursing quality.
Journal Article
Digital Divides in Local Democracy: Size, Resources, and Facebook Adoption in Czech Municipalities
This study examines how organizational capacity and environmental pressures shape social media adoption in local government. Using a mixed‐methods approach, we analyze Facebook adoption patterns across 6,254 Czech municipalities by scanning their official websites for Facebook links, a questionnaire survey ( = 330), and thematic analysis of posts from municipalities with extended powers. Results reveal a strong relationship between municipal size and Facebook adoption, with rates ranging from 14.1% in the smallest municipalities (fewer than 200 inhabitants) to 88.6% in the largest (10,000+). Primary adoption motivations include communication speed, ensuring citizen awareness, and meeting public expectations for a modern online presence, while resource constraints and fear of negativity constitute major barriers. Thematic analysis reveals dominance of practical information and community event promotion over dialogic engagement. The findings demonstrate how resource limitations create a digital divide in local government communication, with smaller municipalities facing structural barriers to social media adoption. This research contributes to understanding technology diffusion dynamics in fragmented administrative systems and the gap between social media’s dialogic potential and actual government communication practices.
Journal Article
Languages Are Still a Major Barrier to Global Science
While it is recognized that language can pose a barrier to the transfer of scientific knowledge, the convergence on English as the global language of science may suggest that this problem has been resolved. However, our survey searching Google Scholar in 16 languages revealed that 35.6% of 75,513 scientific documents on biodiversity conservation published in 2014 were not in English. Ignoring such non-English knowledge can cause biases in our understanding of study systems. Furthermore, as publication in English has become prevalent, scientific knowledge is often unavailable in local languages. This hinders its use by field practitioners and policy makers for local environmental issues; 54% of protected area directors in Spain identified languages as a barrier. We urge scientific communities to make a more concerted effort to tackle this problem and propose potential approaches both for compiling non-English scientific knowledge effectively and for enhancing the multilingualization of new and existing knowledge available only in English for the users of such knowledge.
Journal Article
Communicating Against the Current
Communicating with patients who speak different languages in health care environments is a well-known challenge, for which there are myriad solutions to provide increased access for patients with low proficiency in the language of care. Clinicians often overlook communication challenges with patients for whom language is not a barrier, but mismatches in cultural and personal communication styles can lead to poor communication between doctor and patient that can negatively affect the clinical relationship and patient care. Just as patients who require interpreters require more time, clinicians must expect to spend more time to navigate different communication styles. Physicians should have a high index of suspicion for communication challenges, and hospitals and clinics must provide flexible clinic environments that allow clinicians the time required to overcome them.
Journal Article