Throughout history, men have played a significant role in the field of nursing. However, they currently represent only 12% of nursing students and 9.6% of Registered Nurses. As a minority in their occupation, male nurses experience gender-based barriers and negative stereotypes that female nurses do not. Research has addressed these barriers and stereotypes, but has lagged in identifying the consequences of exposure to them other than men's reluctance to enter or stay in the field. With the nurse-patient relationship at the core of quality healthcare, it is important to further clarify the consequences of stereotype exposure for male nurses in the clinical setting. The purpose of this dissertation was to investigate the communicative consequences of exposure to gender-based stereotypes among male nurses through the theoretical lens of stereotype threat (Steele & Aronson, 1995). Stereotype threat describes the apprehension individuals experience from the prospect of confirming a negative self-relevant stereotype. In the reported experiment, the salience of gender-based stereotypes (women are more empathic than men; men are better managers than women) was controlled for while male and female nursing students completed a simulated nurse-patient interaction task. Findings from this study highlight the influence of subtle stereotyping in simulated nurse-patient interactions. Specifically, men were less grammatically accurate when participating under conditions of threat than when not under conditions of threat. This finding provides a need for caution as healthcare is experiencing a shift towards e-health, which will rely heavily on both the spoken and written word. Additionally, findings suggest that the disruptive potential of making salient stereotyped attributes (e.g., empathy) may be offset by patient gender. For example, male participants were less tentative under conditions of threat with a female patient than a male patient. The influence of patient gender provides optimism that a shift in gender-based stereotyping is occurring. Therefore, it is an optimal time to increase recruitment and retention efforts of men in the field of nursing. Recommendations for such efforts are offered as well as future directions for stereotype threat research in interpersonal communication and healthcare. / text

Obesity is an epidemic that causes physical, emotional, and financial tolls for both individuals and communities. The United States experienced a dramatic increase in obesity rate from 1990-2010 (Flegal, Carroll, Ogden, & Curtin, 2010), with more than one-third of adults and 17% of children in the United States now considered obese (Ogden, Carroll, Kit, & Flegal, 2012). Although most people agree obesity is a problem (Oliver & Lee, 2005), it is a disease with multiple causes (Wake & Reeves, 2012) and no straightforward solution (Phil & Heuer, 2009). Informed by theory and research on agency and attributions, the current study examined effects of explicit arguments and linguistic agency assignment on attributions of responsibility for obesity and support for public obesity policies. Participants (N = 211) were randomly assigned to read one of six versions of a health flyer defined by a 3 x 2 (Explicit Argument x Agency Assignment) factorial design and thereafter completed a questionnaire derived from previous research. Respondents across conditions agreed that obesity is a serious health threat, but differed in how they attributed responsibility for the illness. Those who read a message that consistently assigned agency to the disease (e.g., Obesity causes health problems) endorsed genetics as the cause to a greater degree than others who read a different version assigning agency to humans (e.g., Obese people develop health problems). In contrast, the human agency version prompted higher attributions of individual responsibility and greater support for upstream public policies aimed at reducing obesity (e.g., a snack tax on junk food, eliminating soft drinks from public schools, adding warning labels to foods with high sugar content). Results suggest explicit arguments are less effective in shifting perceptions of a stigmatized health threat than the implicit arguments created by linguistic agency assignment. The findings demonstrate specific message features that affect social attributions of illness (Heider, 1958; Weiner, 2006) and perceptions of responsibility for the onset and solution of health problems (Barry, Brescoll, Brownell, & Schlesigner, 2009; Niederdeppe, Shapiro, & Porticella, 2011). Theoretical implications, practical applications, and future research directions are discussed. / text

Unsafe injection practices put patients and healthcare providers at risk of infectious disease and have been associated with a wide variety of procedures and settings. Safe Injection Practices are part of Standard Precautions and are aimed at maintaining basic levels of patient safety and provider protections. However, from 1999 - 2009, more than 30 outbreaks of Hepatitis B or Hepatitis C from unsafe injection practices have occurred resulting in more than 150,000 patients being notified of potential exposure. Breaches in injection safety have the potential to be high profile and sensitive, and although individual incidents may vary, the actions that follow are consistent and predictable. Therefore, in collaboration with the Centers for Disease Control and Prevention (CDC), Division of Healthcare Quality Promotion (DHQP), I have compiled resources and templates to assist state and local health departments and individual healthcare facilities in their efforts to effectively communicate with the public and media about these incidents. Once the decision to notify patients has been made, this toolkit will serve as a guide to help the intended users through the notification process. Its purpose will be to help organizations notify patients, establish communication resources to support patient notifications, plan media and communication strategies, and plan the release of notification letters and other media. This toolkit will suggest practical ways to achieve effective communication using a stepwise approach. Resources and example materials are provided in this toolkit to facilitate the implementation of some essential tips and strategies. Once finalized and cleared by the CDC, this toolkit will be available to users through the CDC’s Injection Safety homepage.

The aim of this project was to examine which factors are important in influencing communication between health professionals and patients. Communication Accommodation Theory (CAT) was the theoretical framework adopted in this project. CAT proposes that individuals are influenced by their personal and social identities and that, in many cases, it is an individual's group or social identity that is most salient in an interaction. The underlying theoretical assumption in this project was that communication between health professionals and patients is characterised by intergroup rather than interpersonal salience and convergent methodologies were used to test this proposition. In addition to CAT, the linguistic category model (LCM), which is also used to investigate individuals' perceptions of intergroup salience, was adopted to complement the findings derived from CAT. There were seven studies in this project. The first study described the methodology for obtaining the data set used in Part 1 of the thesis. Participants wrote retrospective descriptions of a satisfactory and unsatisfactory conversation with a hospital staff member which they had experienced as a hospital in-patient. Study 1 provided a profile of the participants. In Study 2 the stimuli were participants' written recollections of 69 unsatisfactory and 79 satisfactory conversations. The LCM was used to test for differences in participants' perceptions of differing levels of intergroup salience between the two types of descriptions. While intergroup bias was evident, the results were complex. In Study 3 a qualitative and quantitative analysis of the same data set was conducted. This study explored differences between patients' and health professionals' goals, sociolinguistic strategies, and the patients' descriptions of the health professionals across the two types of conversational descriptions. Results revealed differences in goals, strategies, and descriptions. In the descriptions of satisfactory conversations, participants reported goals concerning reassurance and developing relationships. These two goals were not evident in the descriptions of unsatisfactory conversations, where attending to role relations was of greater importance. Participants reported the use of different sociolinguistic strategies for themselves and for health professionals across the different conversation types, which indicated that, for reports of satisfactory conversations, participants viewed their interactions with health professionals as more personal and positive than in the unsatisfactory ones. Participants described the health professionals in their descriptions of satisfactory conversations in more undifferentiated terms than the health professionals in the descriptions of unsatisfactory ones. Study 4 comprised two parts. First, using the data set from Studies 2 and 3, a qualitative analysis was conducted which explored thematic differences between the descriptions of satisfactory and unsatisfactory conversations. This analysis indicated more interpersonal themes for the satisfactory interactions and more negative intergroup themes for the unsatisfactory ones. Second, 134 participants rated 16 exemplar descriptions from the data set on 13 items derived from CAT. In general, the exemplars of satisfactory descriptions were rated as containing accommodative use of discourse management, emotional expression, and interpersonal control strategies. Exemplars of the unsatisfactory interactions were rated as more overaccommodative or counteraccommodative on these strategies. Study 5 introduced Part 2 of the thesis and involved a second data set. The stimuli were real-time videotaped interactions between health professionals and patients. Participants rated 25 videotaped interactions on 28 questions developed to tap the intergroup and interpersonal salience of the interaction. Of these 25 interactions, participants rated seven as highly intergroup and seven as highly interpersonal. These 14 interactions formed the stimuli for the Study 6. In Study 6 an LCM analysis of these 14 videotaped interactions compared the intergroup with the interpersonally rated interactions for levels of intergroup bias. The interpersonally salient interactions suggested lower intergroup bias than did the intergroup ones. This and other findings from the LCM analysis are discussed. Study 7 used a CAT perspective to examine six of the 14 videotaped interactions used in Study 6. These six interactions represented three videotaped interactions that were rated as highly intergroup, and three that were rated as highly interpersonal.. Participants provided ratings on both interactants' strategies, and health professionals' goals. They also rated the interactions for outcome measures, including patient satisfaction, and effective communication. Results indicated that the interactions rated as interpersonally salient were perceived as attending to relationship needs and emotional needs. Generally the interpersonal interactions were also rated as providing a more satisfactory outcome than the intergroup interactions. Together the seven studies provide evidence that interactions between health professionals and patients are essentially intergroup interactions. However, such interactions have the potential to move through dimensions of high intergroup and high interpersonal to dimensions of low intergroup and low interpersonal. Each pair of combinations provides different outcomes of communication effectiveness and satisfaction for the patient. Further, this research project demonstrates the ability of CAT to pick up on the dynamics of health provider and patient communication. It also highlights the usefulness of convergent methodologies to understand the complexities of patient and health professional interactions.

The global health system is ill prepared to handle communicable health crises, much less effectively communicate about them, as evidenced by the West African Ebola outbreak. Although some critics have argued that the delay in international response contributed to the fast spread of the disease, others place greater blame on local cultural practices. The current study investigated how risk/crisis communication was produced, deployed, and received. This is particularly critical as the World Health Organization guidance on crisis/risk communication is not based on systematic evidence-based research Again, risk communication on communicable diseases is still relatively new and the body of research lacks both rigorous empirical evidence and evaluation research on event-specific risk communication efforts. Guided by the protection motivation theory and social mobilization theory, and using a comparative case study approach, this study sought to examine how crisis risk communication was undertaken and received in Liberia and Ghana and the implications for health crisis risk communication. Data was collected via interviews with communication and social mobilization team representatives in the two countries, document reviews, surveys of a cross section of inhabitants in Margibi and Shai Osudoku districts, and focus group discussions with purposively selected participants in the two countries. The study finds that expert-led top-bottom communication interventions used at the start of the outbreak were ineffective in getting target audiences to make the recommended behavior changes in Liberia. Messages developed induced fear rather than action. Furthermore, one in five respondents today, cannot identify the main signs and symptoms of Ebola. Again, the more worried people were about Ebola, the more vulnerable they felt. Finally, respondents moved through a cycle from equilibrium to defense to protection and then back to equilibrium as they sought to make sense of the disease and the communication they received about Ebola. It is recommended that risk communication include bottom-up community-led communication approaches and systems that are embedded within community culture and reality and used by community members. Again, the research challenged the assumption in risk perception studies that increasing knowledge and self-efficacy lowers risk perception thus suggesting the need for further studies in this area. / 10000-01-01

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2013-09-04T11:21:45Z No. of bitstreams: 1 Diss Magali Sampaio. 2013.pdf: 967465 bytes, checksum: 94cb3fefc1c1d43d8a6bca373bdfb3e6 (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-09-04T11:22:25Z (GMT) No. of bitstreams: 1 Diss Magali Sampaio. 2013.pdf: 967465 bytes, checksum: 94cb3fefc1c1d43d8a6bca373bdfb3e6 (MD5) / Made available in DSpace on 2013-09-04T11:22:25Z (GMT). No. of bitstreams: 1 Diss Magali Sampaio. 2013.pdf: 967465 bytes, checksum: 94cb3fefc1c1d43d8a6bca373bdfb3e6 (MD5) Previous issue date: 2013 / Torna-se cada vez mais pertinente investir em estudos que focalizem práticas dialógicas entre os atores sociais envolvidos no processo saúde-doença-cuidado. Parte-se do entendimento da comunicação e educação em saúde como processos que ultrapassam os esforços de abordagens com enfoque puramente informativo, e que se julgam capazes de influenciar comportamentos saudáveis, leva-se em conta os saberes circulantes, as representações e as crenças locais acerca de doenças de difícil controle, uma vez que estes são aspectos que podem influenciar no sucesso das abordagens em saúde, especialmente no caso da tuberculose - uma doença antiga, com forte estigma associado, e cujos índices epidemiológicos são alarmantes, apesar dos recursos disponíveis para seu tratamento e cura. As práticas de comunicação e educação em saúde que abordam esta doença devem levar em conta os aspectos supracitados, sendo necessário horizontalizar as relações e promover o diálogo entre os diversos saberes (popular e técnico) a fim de aumentar a busca pelos serviços de saúde e a adesão ao tratamento. Seguindo esta concepção, uma tecnologia de comunicação em saúde foi desenvolvida - o “Guia de Comunicação e Saúde: melhorando a interação comunicativa entre profissionais de saúde e comunidade no controle da tuberculose” (GCS-Tb) -, e disponibilizada aos participantes de um curso de extensão que visou transferir esta tecnologia. Esta pesquisa objetivou analisar o desenvolvimento de competências necessárias para a utilização do GCS-Tb, definindo-se como uma abordagem qualitativa de um processo de transferência dessa tecnologia. Considera-se que a aplicação do GCS-Tb permitiu o desenvolvimento das competências técnicas, organizacionais, comunicativas, pessoais e sociopolíticas, necessárias à utilização das estratégias propostas, além de estimular a reflexão acerca das práticas de intervenção sobre tuberculose em comunidades. / Salvador

This research examines information flow in online, interest-based networks to determine if existing models of information dissemination are adequate to describe the communication processes that occur in online publics. This study finds that a small number of primary influencers from within online communities are central to information collection, collation, and distribution in online, interest-based networks. This finding is inconsistent with one-step, two-step, and multi-step flow models, which privilege mass media as the central source of information. To more accurately depict online information flow in interest-based networks, this study introduces the radial model of information flow. Furthermore, the results of this study show that communication processes in online publics are best explained using a combination of the transmissive paradigm of communication, on which information flow models are based, and a ritual view of communication. This research also contributes to the ongoing development of the situational theory of publics by identifying organized publics as a key subgroup of active publics. Organized publics are networks of individuals within active publics who frequently and consistently communicate on a shared interest or concern. Organized publics form active online communication networks and prepare for advocacy related to a shared interest, making them of particular interest to public relations professionals. Using a case study approach, this dissertation uses online network analysis and qualitative cluster analysis to study the role of community influencers in information flow and cultural development within the online young adult cancer community. Instead of focusing exclusively on social media as channel for message dissemination, the results of this study indicate that successful relationship building can best by achieved by public relations practitioners who work to develop authentic presences in online communities. This research shows that embracing a participatory model of public relations that actively engages primary influencers in the planning and campaign implementation processes can promote authentic online presences.

abstract: Currently, there has been limited research on evaluating the social media use and competency level of registered dietitian/nutritionists (RD/N). With health information increasingly sought on social media, it is imperative to understand the social media competency of health professionals. The social media use, reach, and competency level of a nationwide RD/N sample was assessed utilizing an online survey. The sample (n=500) while mostly female (97%) was representative of RD/Ns compared to the nationwide statistics from the Commission on Dietetic Registration. The sample included RD/Ns from forty-six states with California (n=44), New York (n=42), and Texas (n=34) having the largest proportion of respondents. The majority of RD/Ns engage in social media for personal use (92.4%) and 39.2% engage for professional use. One hundred and twenty-five RD/Ns reported 777 ± 1063 (mean ± SD) social media followers. As compared to non-millennial RD/Ns, millennial RD/Ns engaged significantly more in social media for personal and professional use (+10% and +13.5% respectively, p<0.001) and scored significantly higher for social media competency (p<0.001). Additionally, food and nutrition management and consultant/private practice/industry RD/Ns had significantly higher competency scores than clinical RD/Ns (p=0.015 and p=0.046, respectively). RD/Ns who use social media personally and professionally had a significantly higher competency score than RD/Ns who did not (p<0.001). There were significant associations of Facebook, Twitter, total followers and total average followers with the social media competency score (r=0.265, 0.404, 0.338, & 0.320, respectively) in RD/Ns. Specifically, the social media competency score, was found to explain 16% of the variation in the number of Twitter followers and 10% of the variation in the average number of followers by platform. These data suggest an opportunity to increase RD/Ns’ social media reach (i.e. following) by improving competency level. / Dissertation/Thesis / Doctoral Dissertation Physical Activity, Nutrition and Wellness 2017

La France n’a pas encore de système de collecte d’informations sur les immigrants standardisé. Ainsi, l’état de santé des immigrants est, aujourd’hui encore, déterminé de manière irrégulière. La seule information de santé des immigrants disponible correspond au statut de santé déclaré par l’immigrant. Ceci est à la fois problématique et surprenant car la France est considérée comme une des nations au monde à avoir le meilleur système de santé malgré le manque de données concrètes sur l’état de santé des immigrants. Une question se pose alors : « comment les immigrants se fraient un chemin dans le système de soin français ? ».Les Philippins vivant dans le sud de la France sont la cible de cette étude. Cette étude utilise le sondage, le « Key Informant Interview » et l’observation directe pour rassembler des données afin de comprendre comment leur culture et leur langage maternel interfèrent avec le système de soin français.Dans cette étude, l’hypothèse émise était que le langage est une barrière pour les immigrants Philippins cherchant l’accès aux soins médicaux. De plus, la culture traditionnelle de santé joue aussi un rôle important dans la pratique de santé des Philippins, même si ces derniers sont en France depuis de nombreuses années. Ils ont réussi malgré tout, à s’adapter au système de soin français. Cependant, cette adaptation doit être clairement identifiée et décrite. A l’interface de la culture, du langage et du système de sin de santé du pays d’accueil, les immigrants, consciemment ou non, créent une culture de santé émergente, différente de leur culture d’origine, qui identifie mieux un bon ou un mauvais état de santé ainsi que la manière de l’exprimer.Cette étude révèle que malgré le temps passé dans le sud de la France, la culture de santé traditionnelle des Philippins joue toujours un rôle dans leur pratique de santé. Les problèmes de santé sont toujours une affaire de famille. Ainsi certains médicaments sont importés des Philippines. D’un autre côté, ils profitent aussi des avantages du système de soin de santé français. Ils rendent visite à leur docteur plus souvent, ils prennent religieusement leurs médicaments et ils profitent des nombreuses options de traitements disponibles en France. Ils peuvent profiter de tout cela parce qu’ils sont couverts par le système universel d’assurance maladie français.D’un autre côté, les immigrants Philippins restent des patients passifs. A cause de la langue qui reste encore une barrière, leur comportement vis à vis de médecin est fait de hauts et de bas. Les Philippins sont d’un naturel timide. Ainsi ils essayent toujours de ne pas avoir de longues conversations. Ceci reste un défi pour les professionnels de santé qui ne sont ni formés ni préparés à gérer des patients parlant un langage étranger. / France is yet to have a standardized immigrant health data collectionsystem. As such, data of immigrants’ health is still irregularly determined. Theclosest immigrant health data available is the self-reported status of health. Thisis a both a problematic state and surprising because France enjoyed the title ofbeing one of the countries in the world with best health care system despite thelack of concrete immigrant health data. This put into question how immigrants aremoving around the health care system of France.Filipino immigrants living in the South of France are the main respondentsof this research. Focusing on how their native culture and language interplay withthe health system of France, this study utilized Survey, Key Informant Interviewand Direct Observation to gather data.This research hypothesized that language is still a barrier for Filipinoimmigrants seeking medical care. In addition to this, the traditional health culturealso plays a very important part in the Filipino immigrants’ practice of healthdespite their long years of stay in France. Despite this however, they were ableto adopt to the French health care system however, this adoption needs to beproperly identified and described. Within the interplay of culture, language andthe health system of the host country, immigrants –knowingly or unknowinglycreatean emerging health culture that is distinct to their cultural origin,understanding of a good or bad state of health and manner of expression.This study revealed that despite the fact that Filipino immigrants in theSouth of France have been living here for a considerable amount of time,traditional health beliefs are still part of their health practices. Health matters arestill a family affair and there some of their medicines are imported from thePhilippines. On the other hand, they have also adopted some ways to takeadvantage of the French health care system. They visit their doctors more often,they religiously take their medications and they enjoy more treatment options.They were able to enjoy all these because they are covered by the UniversalHealth Insurance System of France.On the other hand, Filipino immigrants remain a passive patient. Hemaintains a come and go attitude with their medical providers because languageremains a barrier. In addition, Filipinos are natural shy people and they always trynot to have long conversations. This remains a challenge for healthprofessionals for they themselves are not properly trained and prepared tohandle patients speaking another language.

Introdução: A comunicação é o processo pelo qual ocorrem compreensão e compartilhamento de mensagens enviadas e recebidas, sendo que o conteúdo destas mensagens exerce influência no comportamento das pessoas envolvidas. Atualmente, a área da saúde tem utilizado ferramentas de cuidado à distância para prestar assistência aos pacientes em diversos contextos - a chamada Telessaúde. A influência desta modalidade de cuidado sobre a natureza e o conteúdo da comunicação deve ser muito bem compreendida, visto que o processo de comunicação humana adequado é essencial na assistência à saúde com qualidade. Objetivos: avaliar a percepção do profissional da saúde referente a elementos de Comunicação Humana no cuidado por Telessaúde. Os objetivos específicos foram: verificar que elementos de Comunicação Humana o enfermeiro e o médico identificam no cuidado por Telessaúde, e discutir, por meio dos achados, em que aspectos essa modalidade de cuidado pode impactar na comunicação interpessoal entre os profissionais de saúde e, consequentemente, na assistência aos pacientes. Método: pesquisa descritiva, com abordagem qualitativa, realizada com 20 profissionais que atuam em telessaúde no Brasil. Os dados foram coletados com médicos e enfermeiros por meio de sistema de vídeo ou áudio, no período de junho a outubro de 2014. O número de participantes foi determinado pela saturação de dados, conforme metodologia adotada. Os dados foram analisados pela proposta de análise de conteúdo de Bardin. Resultados: Dos discursos emergiram quatro categorias principais, sendo a maioria composta de subcategorias: Entendendo a importância da comunicação (Comunicação adequada é fundamental, pois interfere na conduta; Identificando as barreiras de comunicação); O relacionamento interpessoal interferindo na comunicação; Comunicando-se por meio da tecnologia (Tecnologia facilita a prática; Entendendo os fatores que dificultam a comunicação à distância; Identificar o não verbal por telessaúde é mais difícil) e Aprendendo o processo de comunicação (Não há dificuldades em comunicar-se; Importância do aprendizado da comunicação verbal e não verbal; Importância do aprendizado da telessaúde). Conclusão: Concluímos com este estudo que a comunicação interpessoal adequada na área da saúde é considerada primordial por médicos e enfermeiros que atuam em Telessaúde no Brasil porque acreditam interferir em sua conduta profissional. O relacionamento interpessoal é o principal fator de interferência nesse processo. A tecnologia tem facilitado a prática profissional, porém, do ponto de vista comunicacional, o cuidado à distância apresenta nuances que dificultam o processo de comunicação, principalmente devido à dificuldade de percepção do não verbal na assistência por telessaúde. Para superar estas dificuldades, médicos e enfermeiros concordam que a comunicação é uma competência que deve ser lecionada aos profissionais durante sua formação e, especificamente para atuação à distância, esta habilidade deve ser ensinada considerando as nuances que a distância pode trazer no processo comunicacional entre as pessoas. / Introduction: Communication is the process through which understanding and sharing of sent and received messages occur, considering that the content of these messages influences the behaviour of people involved. Nowadays, the health care segment has used distance care tools to serve patients in different contexts - the so-called Telehealth. The influence of this type of care on the nature and content of communication must be well understood, since the adequate process of human communication is essential in quality health assistance. Objectives: evaluate the perception of the health care professional regarding Human Communication elements in Telehealth care. The specific objectives were: verifying which elements of Human Communication the nurse and the doctor identify in Telehealth care, and dissussing, through findings, in which aspects this type of care can impact the interpersonal communication among health care professionals and, consequently, patients care. Method: descriptive research, with qualitative approach, performed with 20 professionals who work in Telehealth in Brazil. Data were collected from doctors and nurses through audio or video system, from June to October 2014. The number of participants was determined by saturation of data, according to adopted methodology. Data were analyzed by the content analysis proposal of Bardin. Results: From the discourses, four main categories emerged, and most are composed of subcategories: understanding the importance of communication (dequate communication is fundamental, because it interferes in behaviour; Identifying the limitations of communication); The interpersonal relationship interfering in the communication; Communicating through technology (Technologies facilitates practice; Understanding the factors that make distance communication difficult; Identifying the non-verbal through Telehealth is more difficult) and Learning the process of communication (There are no difficulties in communicating; The Importance of learnig verbal and non-verbal communication; The importance of Telehealth learning). Conclusion: We have concluded in this study that adequate interpersonal communication in health care is considered fundamental by doctors and nurses that work in Telehealth in Brazil because it is believed that it interferes with their professional behaviour. Interpersonal relationship is the main factor of interference in this process. Technology has facilitated professional practice, however, from a communicational perspective, distance health care presents nuances that make the process of communication difficult , maily due to the difficulty of perception of non-verbal aspects in Telehealth care. To overcome these difficulties, doctors and nurses agree that communication is a competence that must be taught to professionals during their professional education and, especifically to work at distance, this ability must be taught taking into consideration the nuances that distance may bring in the communication process among people.