RISULTATI RICERCA

Un’efficace comunicazione è un importante indicatore della qualità dei servizi ospedalieri. Questo contributo presenta i risultati di una ricerca-intervento sulle abilità comunicative dei membri di un’équipe reumatologica ospedaliera dopo un corso di formazione sulla comunicazione. L’esperienza ha coinvolto ventitré operatori sanitari (78.3% femmine, età media 38.3 ± 9.7 anni) della Clinica Reumatologica dell’Università Politecnica delle Marche (52.2% infermieri, 30.4% medici, 13% OSS, 4% biologi) in un corso di aggiornamento basato sulla tecnica del Gruppo Operativo di E. Pichon Rivière. Gli operatori hanno valutato le proprie capacità comunicative, prima e dopo il corso, con il Health Care Communication Questionnaire (HCCQ). Il HCCQ è stato inoltre compilato da trentatré pazienti della Clinica all’inizio del corso e da trentaquattro alla fine, per riportare l’esperienza comunicativa con gli operatori. I risultati mostrano una tendenza al miglioramento nella maggior parte delle dimensioni del HCCQ-P auto-valutate dagli operatori e un miglioramento significativo (p < 0.05) nella valutazione dei pazienti con il HCCQ. Tale risultato incoraggia la formazione degli operatori delle équipe ospedaliere nell’ambito della comunicazione con il paziente.

Communicating with sick child: preparation to surgery and hospitalization. A review of empirical literature - Through the analysis of the literature about the subject of hospitalization and surgery in paediatric field, the objective of this work is to individualize some effective technique of communication with child to reduce anxiety associated with medical process and surgery, and to identify main factors that affect the child’s answer to this communication. The considered literature was found by data banks PsycInfo, Medline and Cochrane Library and includes empirical studies on the theme of child communication during hospitalization. The studies suggest that giving to a child some explanation with a language appropriated to the age could reduces the anxiety for an unfamiliar environment, helps him to elaborate the information on the illness and on the hospital and to cooperate with the treatments. A good communication could allow the child to manage worry and to activate some thought about threatening situation in advance, this permits to activate some defense mechanisms and some resources to face the illness. Nevertheless, some studies show how the thecniques to reduce the anxiety are not always useful to lower the stress. This could depend on the age, on different coping styles and on the individual difference of the response to the stress situation. The communication with child about the subject of hospitalization and surgery is historically considered from clinic and dynamic area, but remains object of a poor number of empirical studies. Academy education and vocational training are also limitated for the health worker that takes care of this kind of patients.

Comunicare con il vecchio in difficoltà - Increase aged produces more specific dangers about health and autonomy for many old people; it is possibile to see in aged a life dicotomy: from one side autonomies, creatives, enterprising, propositives old people, from other side old people present loose of physical and mental autonomy. There are many factors that may cause with years disabilities conditions: from changes of living organism in males and females climacteric, from loneliness to alienation, from illness to institutionalized. In old age happen traumatic events, more than other phases of life, as situations about (affective, social, professional and healthy loses) that may produce clinical pain, an affecctive and cognitive decline. In old age depression and dementia represent the more frequent mental and behavioral disturbances. Of course becomes more important to learn, to analyse knolewdge and communication, suffering aged and wih his family. The relationship especially with dement, requires attention, sensitiveness, the decodification of messages, of his identity and of social relationship. Some health workers mind always to some meanings in communication that are to be analysed especially in suffering aged, with dement. Communication and understanding of old people mean give opportunities of support, of changing, of relieving painful and of its clinical symptoms.

I modi di invecchiare e di percepire il processo di invecchiamento sono fortemente differenziati, ne consegue che l’approccio con la persona anziana deve essere fortemente individualizzato. La competenza comunicativa costituisce quindi il prerequisito essenziale a costruire una risposta che sia centrata sulla persona e tale da rispondere ai suoi effettivi bisogni. Di seguito e proposta una sintesi della ricerca attuale sugli aspetti piu rilevanti della comunicazione verbale e non-verbale con la persona anziana. Sono descritti in particolare i correlati tra la qualita della relazione interpersonale e funzioni quali l’uso dello sguardo, le espressioni del volto, la postura, il contatto fisico, la prossemica. Sono inoltre proposti in sintesi gli atteggiamenti comunicativi da adottare con pazienti affetti da demenza. In generale, nella relazione con l’anziano, la letteratura suggerisce di formulare domande brevi e verificarne la comprensione, usare un tono di voce pacato, parlare lentamente, mantenendo un atteggiamento calmo, lasciare del tempo per formulare la risposta, ripetere se necessario, condividere il piu possibile lo stile linguistico (scelta delle parole, uso del dialetto). Spesso e buona norma raccogliere informazioni dai familiari relativamente alle abitudini di vita dell’anziano, al suo contesto ambientale, alle sue preferenze. E essenziale valorizzare le competenze residue e cercare di utilizzare i sensi piu integri e preferiti dall’anziano.

This work concentrates on the link between ways and means of political campaigning and political action and Silvio Berlusconi’s government, ten year after his political success. The importance of such a link is emphasised in two ways. First: the marketing strategies, employed by the Cavaliere (which focus on the supreme importance of the leader and his direct connection with the people) recall models of political culture and use of historical facts, which are completely alien to traditional political cultures, including the liberal one. Second: institutional transformations represent the most suitable territory on which to rebuild features and objectives mostly associated with the dynamics of political communication. Typical of this model and communication strategy is, in fact, the inclination to radicalise political conflict and to redefine, principally on a symbolic level, the relationships amongst institutions, such as the magistrates and the President of the Republic. compol1/2004 25-02-2004 19:28 Pagina 193 194

New luxury is not related to status symbol anymore, but to values characterized by self-referred meanings. It appears, therefore, as the sublimation of individual choices directed to one’s fulfilment. Two different dynamics of luxury emerge. One, downward, is focussed on the esthetic/emotional valorisation of commodities and is addressed to a wide range of consumers, even though for sporadic purchases. The other, upward, is a synonym of exceptional and tailor made goods, as well as handcrafts masterpieces, and is a privilege of an extremely narrow target. A qualitative analysis of advertising campaigns shows that the communication strategies of a traditional market such as jewellery has embraced new languages and values, after considering emergent behaviours and targets, especially young people and men.

La comunicazione in genere è considerata la cenerentola delle azioni dell’Unione europea, nonostante la sua sempre maggiore importanza, soprattutto nell’ambito della politica di coesione europea o politica regionale. La principale finalità del Progetto ESFU, di cui si dà conto in questo volume, è l’istituzione della rete REFORE (Rete sui fondi regionali europei), quale meccanismo permanente per acquisire e diffondere informazioni capaci di rendere più efficace la politica di coesione regionale, a partire dal caso di studio della Regione Umbria.

One of the most controversial facets of the present individualized society has to do with self identity construction. The present flexibility that concerns professional roles and the multiplicity of social belongings make its stabilization very problematic. Social actors can create a sort of imaginative sociability in a particular way of communication with their bodies, devoting to them most of their cares. Their bodies become the actual factor of individuation because these are the loci of actors’ realm on an ever fluctuant social world. Contemporary society has in itself a controversial perception of corporeity too, whenever virtual reality and its rules demand the performing skill of multiple identities devoid of actors’ bodies. This ambivalence puts the focus of attention on the old dicothomy between mind and body especially concerning virtual realities.