Health Communication in the 21 st Century

1. Health Communication in the 21st Century Kevin B. Wright Lisa Sparks H. Dan O’Hair

2. Overview of Communication and Health Chapter One

3. Overview of Communication and Health • Arguments for the need to study health communication. • U.S. spends over $1 trillion per year on healthcare. • Over half of all U.S. deaths can be attributed to preventable behavioral and social factors (e.g. diet, exercise, etc.) • Lack of health maintenance behaviors in U.S. linked to mortality rates.

4. Overview of Communication and Health • Arguments for the need to study health communication. • The majority of health campaigns in the U.S. have only had limited success in terms of influencing health behaviors. • The rise of global health issues, terrorism, and other concerns. • The increased use of new technologies in health care.

5. Overview of Communication and Health • Defining health communication. • World Health Organization defines health is a state of completed physical, mental, and social well-being. • Communication is more difficult to define, but it possess characteristics such as a sender, receiver, message, channel. Health communication can be assessed at many levels (interpersonal, organizational, mass, etc.).

6. A Brief History of Health Communication Research

7. History of Health Communication Research • Early research in the communication discipline began in the 1960’s • Korsch & Negrete’s (1972) “Doctor-Patient Communication” is often cited as the founding article. • ICA formed the health communication division in 1975.

8. History of Health Communication Research • The journal Health Communication was first published in 1989. • The Journal of Health Communication was first published in 1996. • Since the 1990’s health communication continues to grow and diversify. • There are now many regional, national, and international health communication associations and conferences.

9. Current Challenges to the U.S. Healthcare System Role of Health Communication Research

10. Current Challenges/Role of Health Communication Research • Aging population • Cultural diversity and healthcare • Tension between traditional and new approaches • Biomedical model • Biopsychosocial model

11. Current Challenges/Role of Health Communication Research • Funding for health research • Changes to health insurance and managed care • The impact of new technologies on healthcare

12. Provider-Patient Interaction Chapter Two

13. Provider and Patient Views of Health and Healthcare • Provider perspective • Provider training • Provider communication skills training • Challenges providers face in healthcare delivery • Rising costs of healthcare and competition • Impact of managed care on provider-patient communication

14. Provider and Patient Views of Health and Healthcare • Provider perceptions of patients and communication • General perceptions • Assessing patient cues

15. Patient Perspective • Patient socialization • Everyday experiences • Mass media • Patient perceptions and expectations • Patient uncertainty • Problematic integration theory (Babrow, 2001) • Patient needs and goals

16. Provider-Patient Interaction • Communication accommodation theory (Giles, Mulac, Bradac, & Johnson, 1987) • Divergence • Convergence • Overaccommodation • Underaccommodation

17. Provider-Patient Interaction • Characteristics of problematic provider-patient communication • Provider workload/time constraints • Questions, directives, blocking • Relational control/provider dominance

18. Improving Provider-Patient Communication • Addressing patient concerns • Recognizing provider perspectives and needs

19. Outcomes of Provider-Patient Communication • Satisfaction with healthcare • Adherence to treatment • Physical and psychological health outcomes

20. Communication and Medical Malpractice Lawsuits • Rise and cost of medical malpractice litigation • Provider-patient communication and medical malpractice litigation

21. Caregiving and Communication Chapter Three

22. Caregiving • Caregiver roles • Caregiving and changes in relationships • Communication issues surrounding symptom management • Communication challenges associated with caregiving • Willingness to communicate concerns • Communication of emotional support

23. Hospice and Palliative Care • History of hospice and palliative care • Dame Cicely Saunders—founder of hospice movement • Hospice services and care • Barriers to hospice care • Palliative care • Palliation refers to any treatment, care, or support that relieves symptoms and suffering • Barriers to palliative care

24. Attitudes Towards Death and Dying • Communicating with others about death and dying • Advanced care directives • Coping with the death of a loved one • Reactions to grief • Organ donation

25. Social Support and Health Chapter Four

26. Types and Functions of Social Support • Types of support • Instrumental support • Emotional support • Esteem or appraisal support • Informational support • Proactive and reactive support • Positive and negative functions of support

27. Models of Social Support and Health • Stress and health • Physiological processes • Stress and negative health outcomes • Stress and social support • Buffering model (Cohen & Wills, 1985) • Direct effects model (Aneshensel & Stone, 1982)

28. Models of Social Support and Health • Coping strategies and health outcomes • Problem-focused coping • Emotional-focused coping • Avoidance-focused coping

29. Perceptions of Support Providers • Social comparison theory (Festinger, 1954) and social support • Lateral comparisons • Upward comparisons • Downward comparisons • Reciprocity and social support • Underbenefitted • Overbenefitted

30. Strong Tie Versus Weak Tie Support Networks • Theory of weak ties (Granovetter, 1973) • Communicating about illness in weak tie vs. strong tie networks

31. The Role of Communication in the Social Support Process • Cognitive complexity and support provision (Burleson, 1994) • Cognitive complexity and comforting messages • Interactive nature of support provision (Barbee, 1990) • Solve person’s problem • Support person emotionally • Dismiss person’s problem • Escape from dealing with issue

32. Support Groups for People with Health Concerns • Prevalence of support groups • Reasons why people join support groups • Difficulties communicating about illness within traditional social networks • Other factors influencing support group participation

33. Communication Processes within Support Groups • Use of narrative • Being helped by helping

34. Culture and Diversity Issues in Healthcare Chapter Five

35. Patient Diversity • Increase in a variety of co-cultures in the U.S. due to immigration • Cultural and language barriers to healthcare. • Impact on healthcare system

36. Cultural Differences in Concepts of Health and Medicine • Cultural differences in attributions of illness/health • Acculturation • Informed consent • Cultural differences of people born in the United States.

37. Recognizing Cultural Diversity in Health Beliefs • Effectively communicating with patients from diverse cultural backgrounds • Barriers to providing culturally sensitive health care

38. Alternative Medicine • History of alternative medicine in the U.S. • Types of alternative medicine • Perceptions of alternative medicine • Benefits/limitations of alternative medicine

39. Spirituality, Culture, and Health • Associations among spirituality, culture, and health • Religion and psychological/physical health outcomes • Religion and social support

40. Social Implications of Illness • Stigma and disease • HIV/AIDS • Cancer • Alcoholism • Mental illness

41. Changing Social Perceptions of Health Issues through Comm. • Language usage • Use of narrative • Advocacy

42. Provider Diversity • Specialization and unique provider cultures • Socialization processes and provider diversity

43. Communication and Health Organizations Chapter Six

44. Health Organizations as Systems • Characteristics of systems • Interdependence • Homeostasis • Equifinality

45. Types of Healthcare Organizations • Organizations concerned with financing and regulating health services and products • Centers for Medicare and Medicaid • Insurance and managed care • Organizations concerned with healthcare delivery • Hospitals • Nursing homes • Pharmaceutical companies • Professional organizations that influence other healthcare organizations • Accreditation organizations

46. Communication within Healthcare Organizations • Organizational information theory (Weick, 1979) and healthcare organization • Cycles • Double interact loops • Formal/informal communication networks • Upward/downward communication

47. Healthcare Organizational Culture • Cultural belief systems of healthcare organizations • Promoting new healthcare organizational environments

48. Influences on Healthcare Organizational Communication • Pharmaceutical and biotechnology companies • Direct-to-consumer marketing • Preceptorships • HIPPA • Patient Privacy • HIPPA’s effect on medical research • HIPPA’s effect on providers and patients

49. Influences on Healthcare Organizational Communication • Medicare and Medicaid • Insurance and managed care • Traditional health insurance • Health maintenance organizations (HMO’s) • Preferred provider organizations (PPO’s) • Effects of managed care on provider-patient relationships

50. Provider Stress, Conflict, and Support within Healthcare Organizations • Stress and conflict • Effects of job stress • Social support and stress in the workplace