Showing papers in "Health Communication in 1999"
TL;DR: It appeared that many of the support messages directly redressed limitations and challenges associated with disability-related mobility, socialization, and self-care as well as the unique features of social support in mediated environments.
Abstract: This study documented the types and extent of social support messages exchanged by persons with disabilities who participated in a computer-based support group. A modified version of Cutrona & Suhr's (1992) social support category system was used to code 1,472 support messages. The largest percentage of these messages offered emotional and informational support, whereas network support and tangible assistance were least frequently offered. It appeared that many of the support messages directly redressed limitations and challenges associated with disability-related mobility, socialization, and self-care. Results are discussed in terms of the generalizability of existing category systems for coding support to this mediated context, the relative importance of different types of support in the communication of support group members, and the unique features of social support in mediated environments. The implications of this study for social support researchers, persons with disabilities, and human services professionals are also discussed.
519Â citations
TL;DR: The stages-of-change model (Prochaska, DiClemente, & Norcross, 1992) provides a framework for integrating theories of media effects such as agenda setting and multistep flow; theories of persuasion, such as the elaboration likelihood model and protection motivation theory; and theories of behavior change as mentioned in this paper.
Abstract: A central problem in the planning of communication campaigns to change health behaviors is how to identify and apply appropriate communication, persuasion, and behavior change theories to overcome obstacles to behavior change. The stages-of-change model (Prochaska, DiClemente, & Norcross, 1992) provides a framework for integrating theories of media effects, such as agenda setting and multistep flow; theories of persuasion, such as the elaboration likelihood model and protection motivation theory; and theories of behavior change, such as the theory of reasoned action, social cognitive theory, and attitude accessibility, for communication campaign purposes. Implications for audience segmentation, selection of objectives, campaign strategy, and message design are discussed.
176Â citations
TL;DR: This study tests the reliability and validity of a measure of patient activism-the Patient Self-Advocacy Scale (PSAS)--designed to assess the dimensions of increased illness and treatment education, increased assertiveness in health care interactions, and increased potential for nonadherence.
Abstract: Despite the fact that many individuals express a desire for more information and involvement in the health care process, it remains to be seen if they have adopted a more participative approach by becoming involved in decisions made about their health. Research indicates that, in actual practice, individuals are differentially willing or able to be active patients. AIDS patient activists are 1 group of individuals who have become more involved in their health care decision making. This study tests the reliability and validity of a measure of patient activism-the Patient Self-Advocacy Scale (PSAS)--designed to assess the dimensions of (a) increased illness and treatment education, (b) increased assertiveness in health care interactions, and (c) increased potential for nonadherence. Tests administered to 2 samples of participants (174 adults from an HIV-AIDS population and 21 8 adults from a general population) demonstrated that the PSAS was a reliable and valid measure of patient involvement in health care decision making.
143Â citations
TL;DR: In this article, the role of to whom students are talking, with whom they are affiliated, and how frequently they are discussing potential effects of risky behaviors on the excessive use of alcohol.
Abstract: Despite the empirical and anecdotal evidence of the growing problem of alcohol use and abuse on college campuses, there exists a high level of uncertainty regarding factors contributing to this particularly risky behavior. This article adopts a network approach to the study of risky behaviors exhibited among college students, particularly the excessive use of alcohol. Specifically, this investigation examines the role of to whom students are talking, with whom they are affiliated, and how frequently they are discussing potential effects of risky behaviors on the excessive use of alcohol. Two hundred thirty-nine undergraduate students completed a survey 1 week following an unofficial university-wide event celebrating the end of spring semester that traditionally revolves around the overconsumption of alcohol. Students were asked to report on a number of things, including their typical behaviors, behaviors they participated in at this particular event, and features of their social networks. Membership in Gr...
75Â citations
TL;DR: This study analyzed women's narratives of their breast cancer treatment to uncover conceptualizations of patient satisfaction with physician-patient communication.
Abstract: Traditional health communication research often has ignored sex and gender and has employed a quantitative biomedical perspective to predict behavior. In contrast, this study analyzed women's narratives of their breast cancer treatment to uncover conceptualizations of patient satisfaction with physician-patient communication. In their unfolding (nonlinear) narratives, patients viewed satisfaction as a negotiation process with physicians in which themes of respect, caring, and reassurance of expertise were prominent. Two root themes (dialogic approach to power and contextualization) acted as underlying dynamics or tensions throughout their narratives. Patients' ways of knowing and preferences for feminine communication styles influenced perceptions of physician-patient communication satisfaction.
74Â citations
TL;DR: Questions are raised about the socially significant portrayal of the meanings of disease in the media about the men who have been diagnosed with prostate cancer, have symptoms of prostatecancer, or about all men, because any man might at some time be diagnosed with Prostate cancer.
Abstract: The meanings associated with prostate cancer were studied in contemporary mass print media. The study includes both manifest and latent content analysis of a period of approximately 2 decades, from 1974 to 1995. The manifest analysis revealed a primary emphasis on the importance of early detection. The latent analysis found that prostate cancer's presentation is gendered. Its description is embedded in themes related to masculinity, sexuality, competition, brotherhood, and machismo. This small, qualitative, and inductive study raises questions about the socially significant portrayal of the meanings of disease in the media, about the men who have been diagnosed with prostate cancer, have symptoms of prostate cancer, or about all men, because any man might at some time be diagnosed with prostate cancer. Stereotypical imaging could alienate men who either do not or do not want to fit into the stereotypical ideal as it is protrayed in the media. Such a portrayal also may have inplications for the potential willingness of men to engage in early detection, avail themselves of treatment, act preventatively, or become involved in lobbying for monies for research into the early prevention, detection, and treatment of prostate cancer.
62Â citations
TL;DR: The authors examined the level of interactivity at health-related sites on the Internet and found that sites most likely to utilize the interactive capacity of the medium were those created by nonprofit or government organizations, those in which the content focused on diseases or medical practice, and those designed primarily for the purpose of dialogue or information dissemination.
Abstract: This article examines the level of interactivity at health-related sites on the Internet. Sites most likely to utilize the interactive capacity of the medium were those created by nonprofit or government organizations, those in which the content focused on diseases or medical practice, and those designed primarily for the purpose of dialogue or information dissemination. Sites least likely to use the interactive capacity of the Internet were those created by for-profit organizations; those in which the content focused on wellness, alternative medicine, public service, or industry service; and those designed primarily for the purpose of education, sales, or publicity. Measures of interactivity that show the greatest promise for further studies of computer-mediated communication are Complexity of Choice, Responsiveness, and Interpersonal Communication.
55Â citations
TL;DR: Investigators analyzed transcripts of 178 counseling sessions with female clients in Kenya and developed coding guides that focus on client participation, showing that providers dominate most counseling sessions, and clients rarely take an active role.
Abstract: To examine how much and in what ways clients participate in family planning consultations, and how providers influence their behavior, investigators analyzed transcripts of 178 counseling sessions with female clients in Kenya and developed coding guides that focus on client participation. The results show that providers dominate most counseling sessions, and clients rarely take an active role. The most common way for clients to participate is by volunteering additional information when they respond to providers' questions. Providers may encourage clients to play a more active role by building a sense of rapport, by relating contraceptive information specific to each client's personal situation, and by rewarding clients' attempts to participate.
45Â citations
TL;DR: Assessment of whether self-construals, as individual-level correlates of individualism and collectivism, had an impact on how Chinese patients prefer to make decisions about their medical care found that Chinese from both Hong Kong and Beijing preferred joint decision making to either patient or doctor decision making.
Abstract: This study tested the effects of patients' cultural orientations on preferences for medical decision making among patients from Hong Kong and Beijing. Specifically, this study aimed to assess whether self-construals, as individual-level correlates of individualism and collectivism, had an impact on how Chinese patients prefer to make decisions about their medical care. A family decision option was added to the revised form of the Autonomy Preference Index (Ende, Kazis, Ash, & Moskowitz, 1989; Smith, Garko, Bennett, Irwin, & Schofield, 1994). This was administered along with a set of items to assess the self-construal of participants. Consistent with previous findings, Chinese from both Hong Kong and Beijing preferred joint decision making to either patient or doctor decision making. Participants' levels of interdependent self-construal positively predicted preferences for decisions made by the physician, joint decision making, and decisions made by family, but not decisions made by patients. On the other ...
35Â citations
TL;DR: Four studies of patient preferences for participation in medical decision making presented a modified Autonomy Preference Index to adults in Hong Kong and 3 mainland Chinese cities, and to students in Australia, the United States, Hong Kong, and mainland China, showed a consistent preference for participation for doctors in all groups regardless of nationality or cultural differences.
Abstract: Four studies of patient preferences for participation in medical decision making presented a modified Autonomy Preference Index (Ende, Kazis, Ash, & Moskowitz, 1989; D. Smith, Garko, Bennett, Irwin, & Schofield, 1994) to adults in Hong Kong and 3 mainland Chinese cities, and to students in Australia, the United States, Hong Kong, and mainland China. The results showed a consistent preference for participation in medical decision making in all groups regardless of nationality or cultural differences. Australians and Hong Kong and U.S. students preferred patient decision making to delegating decisions to doctors, but all others preferred doctor decision making to deciding alone. The results show that patients across cultures have a strong preference for a mutually participative relationship with doctors.
30Â citations
TL;DR: Exploratory analyses revealed that verbal emotional-cognitive support generally was more predictive of mental health than was tangible, less communicative support.
Abstract: The role of social support was examined in Chronic Fatigue Syndrome (CFS) Social support has been shown to affect illness outcome in medical disorders, likely due in part to communication between patient and support giver on illness-related concerns Forty-one participants, 25 of whom had a primary support giver, completed the Beck Depression Inventory, the Perceived Stress Scale, the Profile of Mood States, and the Inventory of Socially Supportive Behaviors (ISSB); the primary support giver completed a modified version of the ISSB indicating the level of support he or she provided and a questionnaire assessing beliefs about CFS Results indicated that there were no differences among individuals with CFS with or without support on measures of mood and perceived stress Individuals with CFS and their support givers agreed on the amount of support offered, and extent of support was independent of beliefs concerning etiology Exploratory analyses revealed that verbal emotional-cognitive support generally wa
TL;DR: Canonical and zero-order correlations indicated that specific utterances made by both mothers and pediatricians can be predicted from the mother's personality and social skills, providing support for a dynamic mutuality model of medical communication.
Abstract: Maternal personality and social skills were used to predict both maternal and pediatrician communication patterns during pediatric well-child examinations. Audiotape recordings of mother-pediatrician interaction were collected and analyzed from 78 mothers of children less than 2 years of age at 5 private practice pediatric offices; questionnaires were completed at home by the mothers. Canonical and zero-order correlations indicated that specific utterances made by both mothers and pediatricians can be predicted from the mother's personality (particularly with regard to openness to experience, extraversion, and neuroticism) and from the mother's social skills, providing support for a dynamic mutuality model of medical communication. Theoretical and applied implications for doctor training and development of parent education programs are discussed.
TL;DR: An evocative account of the internship context based on observations of an intern, who was shadowed during 2 of his nights on call, suggests that the experiences of internship year offer little opportunity to develop the communication skills necessary for a physician's later clinical career.
Abstract: Internship year is the first year of a medical residency, and often the hardest due to an intern's amount of work and lack of experience. This research provides an evocative account of the internship context based on observations of an intern, who was shadowed during 2 of his nights on call. The author describes the fragmented, chaotic, and exhausting experiences of an intern. This descriptive account contrasts with current health communication literature, in that it recognizes a specific context rather than assuming a nondescript clinical setting. Conclusions suggest that the experiences of internship year offer little opportunity to develop the communication skills necessary for a physician's later clinical career. In addition, health communication researchers must strive to better understand medical training by more frequently entering the trenches in which interns work. Such research will serve to advance interpersonal communication within specific health care contexts.
TL;DR: A fundamental asymmetry was discovered in the ways doctors and patients carried out their conversations and doctors employed mitigation strategies like phatic openings, small talk, and the negotiation of instructions as ways of lessening the relational impact of their dominance.
Abstract: Discourse analysis was used to examine audio recordings of doctor-patient interviews in a clinic in Suzhou, China. A fundamental asymmetry was discovered in the ways doctors and patients carried out their conversations. Sequencing, topic development, and diagnostic information revealed this asymmetry. The asymmetry allowed doctors to control the interviews and kept patients more passive. But the doctors also employed mitigation strategies like phatic openings, small talk, and the negotiation of instructions as ways of lessening the relational impact of their dominance. Asymmetry may be acceptable in communication if it is mitigated appropriately.
TL;DR: When given the choice, Hong Kong patients strongly preferred the patient-centered interviewing style despite a health care system that is strongly doctor centered.
Abstract: Participants in Hong Kong viewed pairs of doctor-patient interviews, each pair with 1 doctor-centered and 1 patient-centered interview. They evaluated each doctor and selected 1 doctor of the pair they would prefer for themselves and family members. Seventy-eight percent preferred the patient-centered physician. When the evaluations were compared, participants rated the patient-centered doctor in the pair significantly higher than the doctor-centered doctor on 31 of 32 behaviors. Patient-centered doctors were rated significantly higher on all 6 subscales assessing differing dimensions of doctor behavior. When given the choice, Hong Kong patients strongly preferred the patient-centered interviewing style despite a health care system that is strongly doctor centered.
TL;DR: The Chinese health care system is changing in response to the rapid changes in Chinese society as a whole, but several constants are helpful in understanding it.
Abstract: The Chinese health care system is changing in response to the rapid changes in Chinese society as a whole, but several constants are helpful in understanding it. Preventive health care receives considerable attention. It is believed to be cost effective as well as health promoting. Medical health care involves Western medicine, traditional Chinese medicine, and combinations of the two. Fee-free patients and fee-paying patients have differing options in the system. Care options also vary between the cities and the countryside. Recuperative health care plays a much more important role in China than it does in the West. Chinese media offer many magazines and broadcast programs attempting to meet the public's interest in better health.
TL;DR: Much, if not all, of the theory and research in this area focuses on explaining the etiology and biology of illness to children, which may be the central factor inhibiting theory, research, and understanding of effective illness explanation to children.
Abstract: Numerous scholars have suggested the importance of explaining illness to children and empirical efforts have been made to determine effective illness explanation strategies. However, the studies have been few and provide little advancement of theory and practical advice for health practitioners. Much, if not all, of the theory and research in this area focuses on explaining the etiology and biology of illness to children. This practice, as argued here, may be the central factor inhibiting theory, research, and understanding of effective illness explanation to children. Specifically, children may find this knowledge of little use and may prefer explanations that adhere to psychosocial concerns. As such, suggestions for future research are offered.
TL;DR: It is observed that the rhetorical features of the traditional medical interview mirror those found in the traditional case presentation, which signals a failure in the adjustment of communication practice to suit the unique rhetorical requirements of the physician-patient encounter.
Abstract: Responding to the well-documented communication problems within physician-patient encounters, in this article we propose a rhetorical perspective for viewing the collective functions of medical discourse. We observe that the rhetorical features of the traditional medical interview mirror those found in the traditional case presentation. Such resemblance among genres of medical discourse signals a failure in the adjustment of communication practice to suit the unique rhetorical requirements of the physician-patient encounter. Optimal communication between physician and patient results when the medical interview is viewed as a counterpart, rather than an offshoot, of the case presentation.
TL;DR: The communication behaviors most valued by Hong Kong patients seem to be doctor centered, which is different from other studies which show a preference for participation and patient-centered communication.
Abstract: Two studies surveyed what Hong Kong patients expect and want in relationships with physicians. The 1st asked about patient satisfaction with doctor manner, consideration, and concern. Patients were more satisfied with doctor manner than with doctor consideration. Doctor concern was seldom expressed. Overall patients were not dissatisfied with their doctors, however. Other factors like convenience and cost seemed more important. The second study asked participants to note which doctor behaviors they expected, were the basis for choosing a doctor, caused satisfaction, and caused dissatisfaction, and they wanted doctors to change. The behaviors were grouped into 4 categories: patient centered, doctor centered, doctor technical skill, and other. Participants consistently chose patient centered least frequently. The communication behaviors most valued by Hong Kong patients seem to be doctor centered. Other studies show a preference for participation and patient-centered communication, but these studies show th...
TL;DR: Individuals in mainland China rated their doctors' communication, asking for information, explaining, encouraging patient talk, and sharing decisions higher than those in either Hong Kong or the United States.
Abstract: Older individuals in Hong Kong, Beijing, Harbin, and Suzhou completed a questionnaire (Smith, Cunningham, & Hale, 1994) previously used in the United States about their communication about medicines. Like their U.S. counterparts, they reported only moderately frequent talk about medicines with their doctors and that they introduced the topic more often than their doctors. They also relied heavily on Western-trained doctors for information about medicines, wanted most to know about side effects, and found print on Rx labels too small. Individuals in mainland China rated their doctors' communication, asking for information, explaining, encouraging patient talk, and sharing decisions higher than those in either Hong Kong or the United States. Doctors and patients in China, like those in the United States, apparently need more communication about medicines.
TL;DR: The discourse in doctor-patient interviews in China was analyzed to assess the way Leech's (1983) 4 maxims for cooperation play out in the medical context, and there was no evidence that the violation of these maxims undermined the cooperativeness of doctor and patient.
Abstract: The discourse in doctor-patient interviews in China was analyzed to assess the way Leech's (1983) 4 maxims for cooperation play out in the medical context. Some violations of the maxim of quantity were found. Violations of the maxim of quality were common for both doctors and patients. The maxim of relation and the maxim of manner were more closely followed. There was no evidence, however, that the violation of these maxims undermined the cooperativeness of doctor and patient. The medical interview may provide a context in which Leech's maxims hold more in the general than in the particular.
TL;DR: This study used narratives about the hospice experience by patients and nurses in a Hong Kong hospice to look at attitudes about end-of-life choices in Hong Kong and to assess the process of hospice care.
Abstract: The hospice option for the terminally ill receives much praise, but there is little evaluation of whether it meets its goal of more humane care. Even though Hong Kong has been regarded as a death-denying society, hospices are present there. This study used narratives about the hospice experience by patients and nurses in a Hong Kong hospice to look at attitudes about end-of-life choices in Hong Kong and to assess the process of hospice care. Few patients chose hospice care. They simply acquiesced in their physicians' decisions to place them there. They described the hospice as a place to rest rather than a place to die. Their description of the care they received was highly laudatory, praising the friendliness, helpfulness, and compassion of the hospice staff.