Showing papers in "Health Communication in 2003"
TL;DR: It is argued that the establishment of new medical problems in acute visits makes relevant an organized structure of social action that is composed of an ordered series of medical activities: establishing the reason for the visit, physicians gathering additional information, physicians delivering diagnoses, and physicians providing treatment recommendations.
Abstract: Within the context of primary-care, physician-patient visits, researchers have documented both patients' low levels of communicative participation (e.g., question asking) and the advantages of such...
316Â citations
TL;DR: A number of hypotheses were tested that addressed the impact of pro- and anti-smoking messages on a variety of outcomes, including participants' intended behaviors, evaluation of message sources, and seeking of disconfirming information, and the pattern of results supports the theoretically derived hypotheses.
Abstract: Children between the ages of 9 and 15 are a high-risk group for tobacco use. The Centers for Disease Control estimates that first use of cigarettes among adolescents has risen 30% over the past decade, and that more than 1.2 million people age <18 became daily smokers in 1996 alone. Moreover, research indicating that awareness and liking of cigarette advertisements is higher among adolescents than adults underscores the need to devote more effort to understanding reactions to tobacco-related messages. Adding to this problem is the fact that the early gains of some successful anti-tobacco interventions disappear as adolescents age. Drawing on the theory of psychological reactance, a number of hypotheses were tested that addressed the impact of pro- and anti-smoking messages on a variety of outcomes, including participants' intended behaviors, evaluation of message sources, and seeking of disconfirming information. All the messages were created and delivered to 4th-, 7th-, and 10th-grade students via person...
301Â citations
TL;DR: The avoidance of family communication was associated with several underlying thought processes: avoidance of psychological distress; desire for "mutual protection;" and belief in positive thinking.
Abstract: This study examined the phenomenon of avoidance of family communication about cancer. Thirty-seven Stage III or IV lung cancer patients and 40 caregivers, including 24 primary and 16 secondary caregivers, were interviewed; a total of 26 families were studied. The interviews were audiotaped and transcribed. Analysis of the interviews indicated that two thirds of the families (65%) experienced communication problems. The avoidance of family communication was associated with several underlying thought processes: avoidance of psychological distress; desire for "mutual protection;" and belief in positive thinking. Family communication was further hindered by the increasing difficulty of issues inherent to late-stage cancer. The adverse impact of communication avoidance and the implications of our findings are discussed.
221Â citations
TL;DR: Results indicate that drinking behavior is positively related to perceptions of friends' drinking as suggested by the theory of planned behavior, which emphasizes subjective as opposed to social norms.
Abstract: In an attempt to curb excessive drinking on college campuses, many universities have turned to "social norms" marketing campaigns. Despite widespread acceptance among health educators, empirical results are clouded by measurement problems. This study, based on a random sample of 550 students, examined the effects of misperceptions of friends' and typical college students' drinking on one's drinking behavior. Results indicate that drinking behavior is positively related to perceptions of friends' drinking as suggested by the theory of planned behavior, which emphasizes subjective as opposed to social norms.
134Â citations
TL;DR: Messages matched to an individual's NFC were better at motivating mammography 6 months later among high-NFCwomen, and the differential influence of these brief, tailored communications diminished after 12 months, however.
Abstract: The use of tailored health communications has become a favored technique for persuading individuals to engage in health behaviors, such as screening mammography. This experiment examined the impact of tailoring persuasive health communications to one aspect of individuals' information-processing styles, that of the need for cognition (NFC), the enjoyment of thinking deeply about issues. To determine whether messages matched to an individual's NFC are more influential than mismatched messages, 602 women who called the Cancer Information Service (CIS) of the National Cancer Institute were asked to participate in an experiment at the end of their service call. They were assigned randomly to receive 1 of 2 phone messages promoting mammography use and a similarly tailored pamphlet 1 month later. Messages matched to an individual's NFC were better at motivating mammography 6 months later among high-NFC women. After controlling for prior mammography utilization, age, worry, intentions, perceived norms, suggestions to get a mammogram, and marital status, the interaction between participant NFC and message type also approached statistical significance. The differential influence of these brief, tailored communications diminished after 12 months, however.
120Â citations
TL;DR: The ways in which group identifications and stereotypes can inform the authors' understanding of cancer prevention and treatment as well as more general social processes surrounding the experience of cancer are described.
Abstract: This article describes the ways in which group identifications and stereotypes can inform our understanding of cancer prevention and treatment as well as more general social processes surrounding the experience of cancer. From a perspective grounded in social identity theory, we describe the ways in which understanding primary identities (i.e., those associated with large social collectives such as cultural groups), secondary identities (i.e., those associated with health behaviors), and tertiary identities (i.e., those associated with cancer) can help explain certain cancer-related social processes. We forward a series of propositions to stimulate further research on this topic.
88Â citations
TL;DR: The influences of health communication in confronting cancer and promoting important health outcomes are examined and implications are drawn for directing informed cancer communication research and practice.
Abstract: Health communication has great potential to help reduce cancer risks, incidence, morbidity, and mortality while enhancing quality of life across the continuum of cancer care (prevention, detection, diagnosis, treatment, survivorship, and end-of-life care). Effective health communication can encourage cancer prevention, inform cancer detection and diagnosis, guide cancer treatment, support successful cancer survivorship, and promote the best end-of-life care. This article examines the influences of health communication in confronting cancer and promoting important health outcomes. Implications of this analysis are drawn for directing informed cancer communication research and practice.
87Â citations
TL;DR: Encouraging integration into practice to enhance time-saving aspects and improve patient education might lead to more sustained use of this promising communication tool.
Abstract: Despite its potential, the use of e-mail for physician-patient communication has not been widely adopted. Our purpose was to survey the experiences of physicians who are early adopters of the technology. Physicians, identified through a professional Internet information portal, completed a survey, including an assessment of satisfaction with using e-mail with patients. We identified 204 physicians who reported using e-mail with patients on a daily basis. Average age of the respondents was 49 years, 82% were male, and 35% were primary-care physicians. Among the 204 frequent users, commonly reported e-mail topics were new, nonurgent symptoms, and questions about lab results. Despite their daily use, 25% were not satisfied with physician-patient e-mail. The most important reasons for using e-mail with patients among those who were satisfied were "time saving" (33%) and "helps deliver better care" (28%) compared with "patient requested" (80%) among those who were not satisfied (p <.01). Dissatisfied physicians reported concerns about time demands, medicolegal risks, and ability of patients to use e-mail appropriately. Although the majority of these "vanguard" physicians reported benefits, some did not recommend that colleagues adopt this new technology. Increasing integration into practice to enhance time-saving aspects and improve patient education might lead to more sustained use of this promising communication tool.
82Â citations
TL;DR: The narratives of one couple who lived through life-changing events following a cancer diagnosis are explored as they struggle to cope with their situation, provide support for one another, and consider their changing personal identities.
Abstract: This study investigates the narratives of one couple who lived through life-changing events following a cancer diagnosis. The narratives of the cancer survivor and her husband are explored as they struggle to cope with their situation, provide support for one another, and consider their changing personal identities. This research addresses the communication dilemmas that often occur when family members, friends, and providers do not know how to respond to an individual diagnosed with cancer. The rationale for this study is threefold. First, this study advocates the need for learning about the composition of survivor identities over the course of a life-threatening illness. Second, this study seeks to understand how illness survivors and their family members use narratives as a method of communicating their changing identities. Finally, communicating about illness is often perceived as 'taboo', and this study may encourage others to be a part of the participants' stories and learn more about why those stor...
75Â citations
TL;DR: The results indicated partial support for Kreps's (1988) relational health communication model as participants who were more communicatively competent were found to have lower levels of perceived stress, and they were more satisfied with the support offered by members of their support network.
Abstract: Employing quantitative and qualitative measures, online and paper versions, we tested Kreps's (1988) relational health communication model by examining relations among social support, communication competence, and perceived stress in a study of well-elders, elderly individuals with cancer, and their lay caregivers (N = 76). Grounding the qualitative part of the study in the narrative paradigm (Fisher, 1984), we used the critical incident technique (Flanagan, 1954) to collect participant narratives focusing on positive and negative expressions of social support. The results indicated partial support for the relational health communication model. In particular, participants who were more communicatively competent were found to have lower levels of perceived stress, and they were more satisfied with the support offered by members of their support network. In addition, the critical incidents revealed that participants received significantly more emotional and esteem support from their network than other socia...
68Â citations
TL;DR: It is argued that computer-mediated social support can be superior to face-to-face social support and that the types of social support offered are extended to include the type of relationship between the communicants.
Abstract: Although cancer occurs throughout the life span, many of the most frequently occurring types of cancer increase as we grow older. In fact, only cardiovascular disease accounts for more deaths in adults 65 years of age and older. One of the ways that cancer patients cope or adapt to their illness is through socially supportive communicative interactions and relationships. Cutrona and Russell (1990) argued that social support is multidimensional and suggested that social support is most effective when the support needs of the individual are consistent with the type of social support being offered by the support provider. From the communicative perspective, the notion of optimal matching between the types of social support desired and the type of social support offered is extended to include the type of relationship between the communicants. In addition, it is argued that computer-mediated social support can be superior to face-to-face social support. This article attempts to identify some of the conditions under which this is true.
TL;DR: The cancer survivorship and agency model (CSAM) proposes both general and specific strategies that serve as options for patients seeking to take greater control of the decision-making process related to their treatment and care of cancer.
Abstract: Relative to other types of health communication research (acute care physician patient communication, communication campaigns, compliance episodes, etc), investigations of patient communication following the diagnosis of cancer are infrequent Theoretically driven, empirical research is desperately needed in such postdiagnostic communication processes as survivorship, quality of life, palliative and hospice care, and loss, bereavement, and grief for those millions of people who have been diagnosed with the second leading cause of death in our nation An organizational model of patient communication is needed that identifies and describes salient issues and processes involved when cancer patients attempt to negotiate the difficult courses of action following the diagnosis of cancer The cancer survivorship and agency model (CSAM) proposes both general and specific strategies that serve as options for patients seeking to take greater control of the decision-making process related to their treatment and care of cancer Although seemingly practical in its offering, CSAM is intended to serve as a heuristic springboard for theoretically based, applied communication research focusing exclusively on post diagnostic cancer processes
TL;DR: This pilot study examined the covariation of patients' self-reports of instrumental and affective aspects of communication during physician-patient visits with 2 other sources of data: medical chart records and audio/videotapes.
Abstract: This pilot study examined the covariation of patients' self-reports of instrumental and affective aspects of communication during physician-patient visits with 2 other sources of data: medical chart records and audio/videotapes. Participants were 17 community-based (nonuniversity) primary-care physicians and 77 of their patients, ages 50 to 80. Patients were interviewed by telephone within 1 week after their medical visits. Thirty-five of these visits were audio- and videotaped. Patients were asked to report on their receipt of specific cancer screening in the previous 2 years, the occurrence of instrumental communication events during the visit (e.g., recommendations), their affect, and their visit experiences and communication with their physicians. Results showed (a) noteworthy disagreements between patients' self-reports and medical charts regarding cancer screening; (b) better agreement of patients' self-reports with videotape records than with chart records regarding physicians' recommendations; (c)...
TL;DR: It is suggested that low and high idiocentrics differ from each other in the way they respond to appeal types, and a linear interaction model is proposed to document the combined effects of self-monitoring and idiocentrism.
Abstract: The recent growth of research in message tailoring has opened up new avenues for researchers to use personality variables for message delivery. This article builds on research on idiocentrism and self-monitoring to propose a framework for message appeal construction. Based on a scheme for appeal categorization borrowed from commercial marketing, the article suggests that low and high idiocentrics differ from each other in the way they respond to appeal types. Similarly, significant differences are demonstrated between low and high self-monitors in the realm of their response to message appeals. A linear interaction model is proposed to document the combined effects of self-monitoring and idiocentrism.
TL;DR: Pharmacists' discussion about antibiotics in general was predicted primarily by attitudes about their role and efficacy, by their autonomy, and by enabling measures-such as pamphlets-that would better aid them in participating in a judicious antibiotic use campaign.
Abstract: A national study was conducted of community pharmacists to examine influences on their communication with consumers about antibiotics and antibiotic resistance. The objective was twofold: to explore the nature of barriers that might be changed to allow pharmacists greater participation in educational campaigns, and to discover which variables would best predict communication using a modification of the Theory of Reasoned Action model. Whereas most pharmacists agreed that their role in educating patients is important, they also noted several barriers prevent them from engaging in campaigns, such as time constraints, lack of educational materials, and fear of harming relations with physicians. Pharmacists' discussion about antibiotics in general was predicted primarily by attitudes about their role and efficacy, by their autonomy, and by enabling measures-such as pamphlets-that would better aid them in participating in a judicious antibiotic use campaign. Discussion about resistance was predicted by attitudes and enabling measures.
TL;DR: The significant interpersonal communication and relationship issues that affect the overall quality of life for an older individual who has been diagnosed with cancer are highlighted.
Abstract: The diagnosis of cancer is devastating to the patient as well as to the formal and informal relationship support networks of the individual who must now cope with the disease. This article highlights the significant interpersonal communication and relationship issues that affect the overall quality of life for an older individual who has been diagnosed with cancer. Scholars who study the interpersonal behavior of older adults and those who study the consequences of a devastating diagnosis within the overall health communication context can make a significant contribution to our understanding of the process of cancer communication. Not only is the diagnosis of cancer life changing for the patient, but it also changes the dynamics of each relationship between the older adult who has cancer and those who will help to care for the cancer patient both in a formal institutional setting and at home. Our understanding of communication and aging for healthy as well as ill individuals can help us to better predict and explain the complexities of cancer communication.
TL;DR: It is suggested that humor in these activity sessions was mainly a by-product of more predominant effects, such as patients' positive attitude and happiness, which appeared secondary to the primary outcome of promoting patients' happiness and well being.
Abstract: Humor within the health care setting apparently can serve to facilitate positive patient-provider interactions and to create a patient-centered environment. This article provides an ethnographic account of patient-provider interactions held during therapeutic activity sessions within a hospital unit (MIRTH) designed to promote therapeutic humor. This study's findings suggest that humor in these activity sessions was mainly a by-product of more predominant effects, such as patients' positive attitude and happiness. Whereas MIRTH used contrived humor to portray its identity as a humor unit, staff and patients also took advantage of spontaneous humor that emerged out of interactions. Humor appeared secondary to the primary outcome of promoting patients' happiness and well being.
TL;DR: Investigation of individuals' identities after disclosure of invisible illness revealed that illness instilled insight and that disclosure of illness provoked comments from others that led invisibly ill individuals to identify with older individuals.
Abstract: This study explored the impact invisible illness has on identity, specifically contextual age, throughout the life span. It was grounded in the assumption that an individual's identity is formed through communicative interaction. Using social identity theory (Tajfel & Turner, 1986) as a framework, individuals' identities after disclosure of invisible illness were explored. Rubin and Rubin's (1986) Contextual Age Questionnaire was used to determine self-perceived as well as other-perceived contextual age. Invisibly ill individuals reported significantly "higher" contextual age scores than did same chronologically aged, matched non-ill individuals. In addition, the friends of invisibly ill individuals reported "higher" contextual age scores for the invisibly ill individuals than the self-reported scores of the same chronologically aged non-ill individuals. Interviews further revealed that illness instilled insight and that disclosure of illness provoked comments from others that led invisibly ill individuals to identify with older individuals. Future directions and limitations of this study are also discussed.
TL;DR: It is argued that a holistic, patient-centered approach must guide research in PC, including the treatment of elderly patients as "active interpreters, managers, and creators of the meaning of their health and illness" and of the mean of their lives.
Abstract: Palliative care (PC) is often recommended by physicians for their elderly patients who are terminally ill. In contrast to hospice care, which precludes the use of any curative treatment at life's end stages, PC seeks primarily to comfort patients and to keep them pain free, yet it does not necessarily preclude medical treatment. It does seek to attend to patients' physical as well as psychological, emotional, spiritual, and existential needs in an attempt to enhance overall quality of life. A review of current literature in PC for oncology patients, elderly and otherwise, reveals a curious irony: Although PC plausibly entails a holistic, patient-centered approach to health care, much of the research on PC and, apparently, many of the practices in PC focus almost exclusively on the biomedical approach to patient care, particularly in regard to pain and symptom management. Furthermore, few methods in PC research incorporate patients' narratives and lived experiences in the final stages of their lives. We argue that a holistic, patient-centered approach must guide research in PC, including the treatment of elderly patients as "active interpreters, managers, and creators of the meaning of their health and illness" (Vanderford, Jenks, & Sharf, 1997, p.14) and of the meaning of their lives.
TL;DR: The association of novelty-seeking personality and tobacco advertising receptivity was most pronounced among adolescents who had never had a puff of a cigarette, because novelty-seekers may be most receptive to tobacco industry promotional campaigns.
Abstract: This study sought to identify adolescents most receptive to tobacco advertising based on individual differences in novelty-seeking personality and other key variables. Confidential self-report surveys were completed by 1,071 high school freshmen at 5 public high schools. The survey included validated measures of novelty-seeking personality, smoking habits, peer and family smoking, and tobacco advertising receptivity. Multiple logistic regression analysis was used to evaluate the independent associations of these variables and demographics with receptivity to tobacco advertising. Of the ninth graders, 44% had moderate to high levels of advertising receptivity and 54% had minimal to low levels of receptivity. Higher levels of receptivity were associated with ever smoking (odds ratio [OR] = 2.59, confidence interval [CI] = 1.99-3.39) and novelty-seeking personality (OR = 2.14, CI = 1.57-2.93). The association of novelty-seeking personality and tobacco advertising receptivity was most pronounced among adolescents who had never had a puff of a cigarette. Counter-advertising messages should consider individual differences in novelty-seeking, because novelty-seekers may be most receptive to tobacco industry promotional campaigns.
TL;DR: There was little support for unattributed warnings and that smokers, when presented with actual warnings, tended to favor the attribution to "medical studies," and it was suggested that warning messages should be matched with selected sources.
Abstract: The history of cigarette warning labels is fraught with dispute, and in many instances official anti-smoking warnings that appear on cigarette packets are the result of political compromise. Despite mixed findings on the effectiveness of these warning labels, they are viewed as a cost-effective anti-smoking measure by their mere presence and as an important part of larger anti-smoking efforts. Israel's Ministry of Health, in its recent initiative to introduce a new series of warning labels, has grappled with the attribution issue. A committee established by the Ministry to revise the warnings decided to survey public opinion to guide its decision regarding to whom warnings should be attributed and to counter tobacco lobby oppositions. Two surveys were conducted: a limited phone survey of the adult population (n = 1000) and a face-to-face survey of 200 adult smokers. Findings indicate there was little support for unattributed warnings and that smokers, when presented with actual warnings, tended to favor t...
TL;DR: Both personal and observed experiences are important influencing factors in individuals' schema regarding alcohol use, and those who had passed out from drinking were less likely to conclude their stories with a moral tale discouraging drinking.
Abstract: Two hundred college students participated in an experiment investigating how individuals use television and real world experiences to construct alcohol use schema. Students were asked to write a story about a student who had a difficult day and, on arriving home, fixed himself a drink. In randomly assigned conditions, directions led the student to believe this was to be either a real world scenario or the setting for a television episode. Stories were coded for setting and social nature of use, quantity of use, consequences (both severity and valence), and overall tone. In general, stories characterized alcohol use as heavy, social, relaxing, and resulting in mostly minor consequences. Story characteristics did not differ based on direction type (real world vs. TV scenario). Students also completed a series of measures regarding television viewing habits, attitudes about alcohol use, and past experiences with use. Regarding television viewing patterns, those who watched more television overall created stories with more alcohol use. Viewing of dramas in particular was associated with less severe consequences as a result of use. In terms of personal experience with use, individuals who had driven under the influence of alcohol were more likely to construct a story with a positive tone and those who had passed out from drinking were less likely to conclude their stories with a moral tale discouraging drinking. The conclusion of this research is that both personal and observed experiences are important influencing factors in individuals' schema regarding alcohol use.
TL;DR: The pattern of health behavior embeddedness should be analyzed prior to developing intervention communication strategies, and researchers can produce more focused communication interventions by examining how health-endangering behaviors are embedded among benign behaviors or among other potentially dangerous behaviors.
Abstract: Prevention of cancer risk behaviors before they become embedded in an individual's life is crucial. Health-related behaviors should be viewed for their embeddedness, critical aspects of which are (a) the complexity of the behavior itself; (b) factors, both biological and psychological, within the individual communicator; (c) and external situational or sociocultural factors. The more extensively a behavior is embedded, the more difficult it will be to alter. Relative levels of embeddedness of the risk behavior and its entanglement with other nonrisky behaviors will evolve and change throughout one's life course. Smoking across the life span provides an excellent example of a thoroughly integrated, embedded behavior. How smoking is embedded with other behaviors changes from adolescence, where biological factors may be less salient and habit strength less pronounced, through adulthood, where habit strength is greater but health concerns are a more predictive factor. Researchers can produce more focused comm...
TL;DR: A model that integrates key aspects of the communication predicament and enhancement models of aging with other potent constructs (e.g., group vitality, mindfulness) is introduced to illuminate how intergenerational communication may be facilitated or hindered by communicative processes born out of categorization and stereotyping.
Abstract: This article addresses issues of diversity in intergenerational communication by introducing a model that integrates key aspects of the communication predicament and enhancement models of aging with other potent constructs (e.g., group vitality, mindfulness). The model is then applied to the health care experience of an understudied population-older Native Americans. Specifically, it is used to illuminate how intergenerational communication may be facilitated or, indeed, hindered by communicative processes born out of categorization and stereotyping. Health care professionals (in particular), whose working environment is increasingly populated by older economically, culturally, and ethnically diverse patients, should be made aware of some of the strengths and weaknesses of their communicative practices in such intergenerational interactions.
TL;DR: The CAUSE model assists physicians in anticipating common barriers to effective communication and overcoming them to establish credibility, create awareness and understanding, gain agreement about solutions, and help patients enact solutions for the prevention of cancer.
Abstract: "Talk to your doctor" may be one of the most common pieces of advice given to help patients manage cancer risk. In fact, though, the support given to physicians for talking with patients about cancer prevention is not extensive. To address this need, we propose a decision aid for physicians. The CAUSE model draws on existing research, identifying common sources of tension or confusion in physician patient interaction. Specifically, the model assists physicians in anticipating common barriers to effective communication and overcoming them to establish credibility, create awareness and understanding, gain agreement about solutions, and help patients enact solutions for the prevention of cancer.
TL;DR: It is found that most respondents viewed KC informatics tools as elevating the information exchange that occurs between patients and caregivers-increasing the extent to which patients are "heard and understood" by caregivers and come to "know and understand" what is ailing them.
Abstract: The use of various "informatics tools" for routine patient care promises to radically alter the ways whereby medical knowledge and information are processed and applied. In so doing, it can also change the nature of the information exchange and relational communication that occurs between patients and caregivers. This investigation examines how patients view "knowledge coupling" (KC) tools as they are routinely used in a "coupler-centered" family practice (CCP). How do patients view these tools as influencing information exchange and their relationship with caregivers? Based upon close- and open-ended questions of a random sample of patients in the CCP, this study found that most respondents viewed KC informatics tools as elevating the information exchange that occurs between patients and caregivers-increasing the extent to which patients are "heard and understood" by caregivers and come to "know and understand" what is ailing them. Many respondents report being empowered by the use of the tools, and havi...
TL;DR: Three radio public service announcements were created to increase knowledge of 10 gun-safety practices in a mid-Michigan county and results of a telephone survey indicate that those who were exposed to the PSA were able to name significantly more gun- safety practices.
Abstract: Three radio public service announcements (PSA) were created to increase knowledge of 10 gun-safety practices in a mid-Michigan county. Concurrently, a direct-mail coupon highlighting the same gun-safety practices was disseminated to over 70,000 households in the same county. Results of a telephone survey indicate that, compared to unexposed individuals, those who were exposed to the PSA were able to name significantly more gun-safety practices. Specifically, significant differences between those exposed to the PSA versus those not exposed were found for 5 gun-safety practices, as well as for a 4-item index measuring gun locking and storage behaviors, and a 9-item index that included all gun-safety practices.
TL;DR: This special issue of Health Communication stemmed from a Health, Communication, and Aging Research Symposium on Cancer Communication held near Washington, DC, at George Mason University in February 2002, and examined health communication issues with an emphasis on older adults in cancer communication contexts.
Abstract: (2003). An Introduction to Cancer Communication and Aging: Theoretical and Research Insights. Health Communication: Vol. 15, No. 2, pp. 123-131.
TL;DR: Cigar Aficionado supplies readers with 7 persuasive strategies aimed at rebuking dominant anti-smoking health assertions to relieve the cognitive dissonance associated with the consumption of a potentially deadly product and to maintain a loyal readership, free from guilt or anxiety.
Abstract: Since its first issue in 1992, few periodicals have enjoyed the rapid growth and international popularity of Cigar Aficionado. Although the magazine professes to simply celebrate "the good life and the joys of cigar smoking," we argue that it serves a more insidious function; specifically, the periodical supplies readers with 7 persuasive strategies aimed at rebuking dominant anti-smoking health assertions: (a) the cigars- are-not-cigarettes argument, (b) the life-is-dangerous argument, (c) the health-benefits argument, (d) the moderation argument, (e) the old-smokers argument, (f) the bad-science argument, and (g) the good-science argument. These pro-smoking arguments ultimately serve to relieve the cognitive dissonance associated with the consumption of a potentially deadly product and to maintain a loyal readership, free from guilt or anxiety.
TL;DR: Patients and providers who differ in training, specialty, and experience should have different perceptions and expectations of communication through nurse call center interaction, and a reasonable picture of communication quality emerged.
Abstract: The purpose of this study was to examine characteristics of communication quality in a managed care context in which a nurse call center was used as the patient point of entry to the health system. The study sought to determine the level of communication quality among patients, health care providers, and nurses in the call center. Having measured the timeliness, accuracy, usefulness, and quantity of communication variables, a reasonable picture of communication quality emerged. The study explored patient differences in their perception of communication quality due to socioeconomic status, needs, experience, age, and various other factors. Likewise, providers who differ in training, specialty, and experience should have different perceptions and expectations of communication through nurse call center interaction.