The entry-level physical therapist: a case for COMFORT communication training.

Entry-level physical therapists provide clinical care for patients with functional mobility limitations. Their care spans the continuum of settings, disease processes, and diagnoses. Although effective communication skills are required to conduct physical therapy work, there is limited instruction provided in physical therapy education and students receive little exposure to seriously or chronically ill patients. The goal of this study was to assess the effects of communication training for the entry-level physical therapist facing palliative and end-of-life communication with patients/families. A pre-post survey design and narrative writing were used to assess the effect of the COMFORT communication training curriculum provided to doctorally trained, graduating physical therapists. The study demonstrated decreased student apprehension about communicating with dying patients and their families, and a comparison of mean scores reflecting the students' communication knowledge, confidence, and behaviors increased in a positive direction. As students became more willing to communicate, they were also more adept at integrating task and relational messages, as well as assimilating emotional support messages for patients and families. This study shows promise for the feasibility and utilization of the COMFORT curriculum for entry-level physical therapists. Further research should address the integration of COMFORT earlier into physical therapy education, as well as assess evidence of COMFORT communication skills in the clinical context.

Vitamin D: an examination of physician and patient management of health and uncertainty.

Vitamin D has been a topic of much research interest and controversy, and evidence is mixed concerning its preventive effects and health benefits. The purpose of our study was to explore the decision-making strategies used by both primary care providers and community members surrounding vitamin D in relation to uncertainty management theory. We conducted semistructured interviews with primary care providers (n = 7) and focus groups with community members (n = 89), and transcribed and coded using the constant comparative method. Themes for providers included awareness, uncertainty, patient role, responsibility, skepticism, uncertainty management, and evolving perceptions. Community member focus group themes included uncertainty, information sources, awareness/knowledge, barriers, and patient-provider relationship. Both providers and community members expressed uncertainty about vitamin D but used conflicting strategies to manage uncertainty. Awareness of this disconnect might facilitate improved patient-provider communication.

Instructional messages during health-related crises: essential content for self-protection.

Mediated instructional messages have the potential to enhance individuals' knowledge and self-efficacy to take self-protective actions during a food-related health crisis. This two-phased study used content analysis to examine the presence of instructions during an actual egg recall crisis (n = 566 television broadcasts). Next, these messages were used in a pretest-posttest experiment to explore changes in participants' (n = 651) foodborne illness knowledge and self-efficacy after watching a standard media message or a high instruction media message. In general, actual broadcasts only provided self-protective instructions between 3% and 17% of the time. Standard messages slightly increased viewer knowledge, but decreased viewer efficacy. Conversely, the high instructional message significantly increased both knowledge and efficacy.