Bibliography: leaves 113-117. / The medical interview is often the first point of contact between doctors and patients. For patients who have suffered a stroke, this interaction is often a frustrating attempt to tell the doctor how they are feeling and a struggle on the part of the doctor, to obtain the necessary facts. In this study, a group of 6th year medical students were trained to use supportive communication strategies for the specific purpose of obtaining a case history from an adult with aphasia. These strategies were based on principles of Supported Conversation for Adults with Aphasia (SCA [TM]) (Kagan, 1998b). Results showed that students who received communication skills training as opposed to a theory lecture improved significantly in their abilities to acknowledge the abilities of their patient, reveal their competence through different modalities and verify patient responses. In addition, students in the experimental group were significantly better at establishing initial and developing rapport with their patients, exploring their patients' problems and providing structure to the interview as compared to the students in the control group. Further, the experimental group rated their post-training interviews and the quality of their interactions with their patients as significantly better following their training. The results of this study provide strong evidence that medical students show significant improvements in a number of skills following supportive communication training. These findings have implications for medical education and service delivery.

Includes bibliographical references. / The challenges of communication in the multilingual and multicultural South African health care context are exacerbated by the complexities and demands introduced by HIV/AIDS. Despite the wealth of information on aspects related to the doctor-patient relationship, communication in HIV/AIDS care settings has received very little attention in the literature. South Africa leads the HIV/AlDS pandemic in numbers, yet almost no locally relevant information is available on the nature of communication in HIV/AIDS care settings. The study has aimed to address this need. A qualitative research design within an interpretive paradigm was followed. The primary aim of the study was to describe and explain communication in a paediatric outpatient HIV I AIDS clinic from the multiple perspectives of caregivers, counsellors and doctors. Semi-structured interviews with 11 caregivers of HIV positive children, four NGO trained HIVI AIDS counsellors and four doc1Drs were conducted. A phenomenological data analysis procedure was followed. Rich descriptions of the communication experiences of the three groups of participants were constructed and five central themes were identified. Communication in the clinic meant sharing meaning across differences. The language and cultural divide between caregivers and doc1Drs could be successfully bridged by a doctor facilitative conversational style and the participation of counsellors in communication. Effective communication was dependant on systemic support and infrastructure. Communication in the clinic involved more 1I1an words, was shaped by context, required the collective effort of all role players, and was transactional in nature and powerful to affect the lives of caregivers, counsellors and doctors. Recommendations regarding practice and education were made.

Includes abstract. Includes bibliographical references.

Includes bibliographical references (leaves 115-126). / The study aimed to describe the needs of Grade 1, 2 and 3 educators at government schools in the Cape Metropolitan area working with English-second (or other) language (ESOL) learners, in order to inform the practice of speech-language therapists in meeting these needs.

Includes abstract. / Includes bibliographical references (leaves [157]-178). / The aims of this study were to (a) explore health literacy and information recall/memory of clients receiving Speech-Language Pathology treatment in Cape Town, and (b) to explore ways of maximising these factors in clients with dysphagia, voice disorders (including laryngectomies) and cleft lip and/or palate.

Bibliography : leaves 68-75.

Includes bibliographical references (leaves 77-85). / This study aimed to investigate the conversational practices used by nursing staff interacting with patients with aphasia in a rehabilitation health care setting. Six dyads, each comprising of a qualified nurse and an adult with moderate to severe aphasia, were videotaped conversing in the hospital, yielding an hour of data. The conversations were transcribed in detail and subjected to conversation analysis (the ethnomethodological type), in order to identify the practices used by the partnership to negotiate meaning and achieve social satisfaction. An emphasis was placed during analysis on the strategies used by the nurses, in order to generate insights that could be applied to partner training. Analysis of the data revealed a pattern of nurses avoiding visible trouble in the conversations, which was accomplished by minimizing the interactive consequences of repair, glossing over potential sources of trouble, and managing the conversation in a manner that limited the potential for trouble to occur. The interactive advantages and disadvantages of this strategy of are discussed, along with theoretical and clinical implications.

Bibliography: leaves 144-158.

Includes bibliographical references. / There has been a global increase in survival rates of premature infants due to advances in medical technology. Premature infants are known to be at risk for developmental problems including communication delays and disorders. Speech- Language Pathologists have an important role to play in the assessment and management of premature infants, especially due to the high prevalence of premature births in South Africa. The bonding and attachment experiences of premature infants and their mothers are often challenged, further placing these infants at risk for communication difficulties. This study aimed to explore the communication between low-risk low birth weight premature infants and their mothers at three points in the first year of life. A longitudinal study was conducted where four mother-infant dyads were investigated.

Includes abstract. / Includes bibliographical references (leaves 181-195). / This study investigated the current performance, values, present and further opportunities and barriers to written language in ordinary, linguistically diverse intermediate phase classrooms in the Western Cape. A single, within-site case study was conducted in one grade 5 and one grade 6 classroom in an urban school.