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"You Have to Find a Way for This Child to Be at the Center": Pediatric Cardiologists' Views on Triadic Communication in Consultations on Congenital Heart Defects. "你必须想办法让这个孩子处于中心位置":小儿心脏病专家对先天性心脏缺陷会诊中三方沟通的看法。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2025-01-01 Epub Date: 2024-04-01 DOI: 10.1080/10410236.2024.2329422
Yael Karni-Visel, Rachel Dekel, Yaara Sadeh, Liat Sherman, Uriel Katz

Congenital heart defects (CHDs) are present at birth and require ongoing management of personal, family, and medical aspects of care, including communication between family and medical staff. Effective communication is considered one of the main objectives of patient-centered care. Communication in pediatric medicine is especially challenging because it includes children and their parent(s), and children's cognitive and communication skills are still developing. Based on the model of behavior in pediatric communication , this study focused on pediatric cardiologists' views of the roles of children, parents, and physicians in the triadic encounter and their experiences in communicating information on pediatric CHDs in medical encounters. Semi-structured interviews were conducted with 17 experienced pediatric cardiologists and cardiac surgeons (five women and 12 men) at three medical centers in Israel. The grounded theory approach was used to identify three main categories: (1) the positioning (centrality) of the child in the setting (ideal vs. actual situation), (2) addressing parents' emotional needs, and (3) the physician's role as mediator between parent(s) and child. In each category, three elements are discussed: The physician's agenda, obstacles and challenges, and the physician's practical methods. Physicians strongly support children's involvement in triadic encounters yet face challenges in effectively integrating them into the information exchange process during cardiology consultations. Struggling to balance the principles of patient- and family-centered care, and without clear guidelines, they rely on their personal beliefs and experiences to formulate communication strategies that address parents' and children's needs.

先天性心脏缺陷(CHD)在出生时就已存在,需要持续管理个人、家庭和医疗方面的护理,包括家庭和医务人员之间的沟通。有效沟通被认为是以患者为中心的护理的主要目标之一。儿科医学中的沟通尤其具有挑战性,因为它包括儿童及其父母,而儿童的认知和沟通技能仍在发展之中。本研究以儿科沟通行为模式为基础,重点探讨儿科心脏病专家对儿童、家长和医生三方在医疗接触中的角色的看法,以及他们在医疗接触中沟通有关儿科先天性心脏病信息的经验。我们对以色列三家医疗中心的 17 名经验丰富的儿科心脏病专家和心脏外科医生(5 名女性和 12 名男性)进行了半结构化访谈。采用基础理论方法确定了三个主要类别:(1) 儿童在环境中的定位(中心地位)(理想情况与实际情况),(2) 满足父母的情感需求,(3) 医生作为父母与儿童之间的调解人的角色。在每个类别中,都讨论了三个要素:医生的议程、障碍和挑战,以及医生的实用方法。医生大力支持儿童参与三方会谈,但在心脏病会诊过程中,如何有效地将儿童纳入信息交流过程却面临挑战。他们努力平衡以患者和家庭为中心的护理原则,在没有明确指导原则的情况下,依靠个人信念和经验来制定满足家长和儿童需求的沟通策略。
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引用次数: 0
Editor's Note.
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2025-01-01 Epub Date: 2025-01-06 DOI: 10.1080/10410236.2024.2432671
Xiaoquan Zhao
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引用次数: 0
'It Feels Really Vulnerable and a Little Dangerous': When Words Are Not Enough. 感觉真的很脆弱,有点危险":当言语不足以表达时
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2025-01-01 Epub Date: 2024-03-19 DOI: 10.1080/10410236.2024.2329423
Olivia McAnirlin

Imagine being given the immense responsibility and gift as a researcher to deliver a person's final nature experience. People living with severe chronic obstructive pulmonary disease (COPD) are often sheltered from nature experiences due to their disease status; however, they have rich memories of past nature experiences. The goals of this overall journey of co-creation were two-fold: (1) co-create personalized nature-based utilizing immersive 360-degree virtual reality (VR) experiences based on participants' experiences in outdoor spaces; (2) utilize a narrative approach to explore the lived realities of people living with severe COPD. Throughout this collaborative research process, I made home visits, phone calls, and many trips to four people's personalized outdoor places in the Upstate of South Carolina. In doing so, I lived the experience of person-centered research. This essay focuses specifically on one participant, David, his wife and caregiver, Anne, and the co-creation of David's last virtual trip to his most cherished places in nature. Re-gifting David's last nature experience in his favorite outdoor places profoundly changed my research approach. This essay considers how I reconciled the disconnect between the "scientific" language used in health research and the lived experience of being a researcher during end-of-life processes, specifically attending to the terms: attrition, participant, and researcher.

试想一下,作为一名研究人员,我们被赋予了巨大的责任和天赋,为一个人提供最后的自然体验。患有严重慢性阻塞性肺病(COPD)的人往往因为疾病而远离自然体验;然而,他们对过去的自然体验有着丰富的记忆。这次共同创造之旅的总体目标有两个:(1)根据参与者在户外空间的体验,共同创造基于自然的个性化沉浸式 360 度虚拟现实(VR)体验;(2)利用叙事方法探索严重慢性阻塞性肺病患者的生活现实。在整个合作研究过程中,我进行了家访、打电话,并多次前往南卡罗来纳州北部四位参与者的个性化户外场所。在此过程中,我体验了以人为本的研究。这篇文章特别关注一位参与者戴维、他的妻子兼照顾者安妮,以及戴维最后一次前往他最珍爱的自然景点的虚拟旅行。重新赋予戴维在他最喜欢的户外场所的最后一次自然体验深刻地改变了我的研究方法。这篇文章探讨了我是如何调和健康研究中使用的 "科学 "语言与生命终结过程中作为研究者的生活体验之间的脱节的,特别关注了以下术语:损耗、参与者和研究者。
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引用次数: 0
Negative Social Exchanges During the Pandemic, Loneliness, and the Mediating Role of Stress and Feeling Misunderstood Among People at High-Risk for COVID-19 Related Complications. 在 COVID-19 相关并发症的高危人群中,大流行期间的消极社交、孤独感以及压力和感觉被误解的中介作用。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2025-01-01 Epub Date: 2024-03-21 DOI: 10.1080/10410236.2024.2332004
Timothy Curran, John S Seiter, Rebecca E Elwood, MaKayla Chadwick Lindsay

The goal of this study was to investigate the links between social interactions and mental health for people who are high-risk for COVID-19 complications. Specifically, we tested the relationships between negative social exchanges during the pandemic and loneliness through two mediators: stress and feeling misunderstood about one's health status. Data were collected via Amazon's MTurk from participants (N = 271) who self-identified as being high-risk for COVID-19. The results from our model showed both a direct association between negative social interactions and loneliness, and an indirect link between these variables through stress. Overall, these results highlight the importance of understanding social interactions for people who are at high-risk for COVID-19 and their mental well-being. The results and implications are discussed.

本研究旨在调查 COVID-19 并发症高危人群的社会交往与心理健康之间的联系。具体来说,我们通过压力和感觉自己的健康状况被误解这两个中介因素来检验大流行期间的负面社交交流与孤独感之间的关系。我们通过亚马逊的 MTurk 收集了自我认同为 COVID-19 高危人群的参与者(N = 271)的数据。我们的模型结果显示,负面社交互动与孤独感之间存在直接联系,而这些变量之间则通过压力存在间接联系。总之,这些结果凸显了了解社交互动对 COVID-19 高危人群及其心理健康的重要性。本文讨论了这些结果及其影响。
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引用次数: 0
"A Victim of Our Own Success:" Testing Jenny's First Sleepover's Dark Satire to Improve Attitudes Toward Childhood Vaccination. "我们成功的受害者:"测试《珍妮的第一次过夜》的黑暗讽刺,以改善人们对儿童疫苗接种的态度。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2025-01-01 Epub Date: 2024-03-21 DOI: 10.1080/10410236.2024.2330121
Robert McKeever, Beth Sundstrom, Matthew E Rhodes, Emily Ritter, Brooke W McKeever

The COVID-19 pandemic resulted in substantially lower uptake of childhood vaccinations in the U.S. As vaccination rates struggle to rebound, childhood vaccine hesitancy continues to grow. Addressing vaccine disinformation and increasing catch-up vaccination is an urgent public health priority. The purpose of this study was to evaluate the effectiveness of "Jenny's First Sleepover," a darkly humorous satirical book about childhood vaccinations, to influence attitudes of vaccine hesitant parents. This study implemented a randomized pretest - posttest experimental design using a web-based survey with one intervention and one control. "Jenny's First Sleepover" improved attitudes toward vaccination among vaccine hesitant parents. Negative emotions were an important mediator of attitudes toward vaccinations. Findings identify mechanisms that increase effectiveness of satirical approaches, including the presentation of novel information about serious vaccine-preventable diseases with a dark narrative twist. Health communicators may consider a darkly humorous satirical approach to improve attitudes toward childhood vaccination among vaccine hesitant parents.

COVID-19 大流行导致美国儿童疫苗接种率大幅下降。解决疫苗虚假信息和增加补种疫苗是公共卫生的当务之急。本研究旨在评估《珍妮的第一次过夜》--一本关于儿童疫苗接种的黑色幽默讽刺书籍--对疫苗接种犹豫不决的家长的态度产生影响的效果。本研究采用随机的前测-后测实验设计,通过网络调查的方式进行,干预和对照各占一项。"珍妮的第一次过夜》改善了疫苗接种犹豫不决的家长对疫苗接种的态度。负面情绪是影响疫苗接种态度的重要中介因素。研究结果确定了提高讽刺方法有效性的机制,包括以黑暗的叙事手法展示有关疫苗可预防的严重疾病的新信息。健康传播者可以考虑用黑色幽默的讽刺手法来改善对儿童接种疫苗持犹豫态度的家长的态度。
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引用次数: 0
"Make Sure You Wash Your Monkey": Multigenerational Vaginal Hygiene Messages from Black Women. "一定要洗干净你的猴子":黑人妇女的多代阴道卫生信息。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2025-01-01 Epub Date: 2024-04-01 DOI: 10.1080/10410236.2024.2335057
Shemeka Thorpe, Kasey Vigil, Praise Iyiewuare, Natalie Malone, Rayven L Peterson, Candice N Hargons

In the United States, the messages Black women receive about vaginal hygiene are often rooted in misogynoir. As a result, Black women across multiple generations may engage in extensive vaginal hygiene practices that are harmful to their health as a means of decreasing the potential for dehumanization or confirming racist stereotypes. The purpose of the current qualitative study is to explore the messages four generations of Black women (n = 12) received about genital hygiene and grooming and the sociocultural factors that influence these messages. Reflexive thematic analysis was used to analyze the semi-structured interview data. The following themes were identified: (1) a culture of silence, (2) knowledge acquisition, (3) pressure to maintain Black cleanliness standards, and (4) gendered racist messaging. Subthemes emerged within the knowledge acquisition theme, including learning through word-of-mouth, observation, deduction, trial and error, and direct messaging. Overall, themes and subthemes were consistent across generations; however, some differences were discussed. Participants highlighted the importance of intergenerational conversations in promoting safe vaginal hygiene practices. Recommendations for sexuality educators and healthcare professionals are discussed.

在美国,黑人妇女接收到的有关阴道卫生的信息往往植根于厌女情绪。因此,多代黑人妇女可能会采取大量有害健康的阴道卫生做法,以此来减少非人化的可能性或证实种族主义的陈规定型观念。本定性研究旨在探讨四代黑人妇女(n = 12)所接受的有关生殖器卫生和打扮的信息,以及影响这些信息的社会文化因素。研究采用了反思性主题分析法来分析半结构式访谈数据。确定了以下主题:(1) 沉默文化,(2) 知识获取,(3) 保持黑人清洁标准的压力,以及 (4) 性别种族主义信息。在知识获取主题中出现了一些次主题,包括通过口口相传、观察、推理、试错和直接信息进行学习。总体而言,各代人的主题和次主题是一致的,但也讨论了一些差异。参与者强调了代际对话对推广安全阴道卫生习惯的重要性。讨论了对性教育工作者和医疗保健专业人员的建议。
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引用次数: 0
Making Sense of Gynecologic Cancer: A Relational Dialectics Approach. 了解妇科癌症:关系辩证法
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2025-01-01 Epub Date: 2024-03-25 DOI: 10.1080/10410236.2024.2333112
Dinah A Tetteh, Zehui Dai

This study used the relational dialectics theory (RDT) as a theoretical lens to examine how the interplay of competing discourses shaped meaning making about gynecologic cancer. A reflexive thematic analysis of the narratives of 12 survivors of cervical cancer, ovarian cancer, and uterine cancer in Arkansas showed two discursive struggles at play, including continuity of care versus change, and voicing versus repressing of feelings. The findings showed that long history of care with physicians contributed to how participants privileged the discourse of continuity of care when faced with a decision to travel for care or receive care locally. We also found that cultural discourses about concealing women's cancer-afflicted bodies, lack of supportive spaces for women to discuss side effects of cancer treatments, and appropriate communication behavior between patients and physicians shaped the interplay of the discursive struggle of voicing versus repressing. The findings extend the RDT by showing that geographic location, disease characteristics, history of care between patients and physicians, and prevailing cultural discourses can contribute to the interplay of discursive struggles in the gynecologic cancer context. Further, the findings suggest to healthcare professionals to address harmful discourses about gynecologic cancer to help create support avenues for survivors.

本研究以关系辩证法理论(RDT)为理论视角,研究相互竞争的话语如何影响妇科癌症的意义生成。通过对阿肯色州 12 名宫颈癌、卵巢癌和子宫癌幸存者的叙述进行反思性专题分析,发现了两种话语之间的斗争,包括护理的连续性与变化,以及表达情感与压抑情感。研究结果表明,与医生长期合作的历史有助于参与者在面临旅行就医还是在当地就医的决定时,如何优先考虑持续性治疗的话语。我们还发现,关于隐藏女性癌症患者身体的文化论述、缺乏供女性讨论癌症治疗副作用的支持性空间以及患者与医生之间适当的沟通行为,塑造了表达与压抑的话语斗争的相互作用。研究结果扩展了 RDT,表明地理位置、疾病特征、患者与医生之间的护理历史以及流行的文化话语都会促进妇科癌症语境中话语斗争的相互作用。此外,研究结果还建议医疗保健专业人员解决有关妇科癌症的有害言论,以帮助为幸存者创造支持途径。
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引用次数: 0
Recapturing Communicative Erasure: Black Women Farmers' Lived Experience, Political Voice and Cultural Knowledge as Critical Health Communication Praxis. 重新捕捉传播中的抹杀:黑人女农民的生活经验、政治声音和文化知识作为批判性健康传播实践。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2025-01-01 Epub Date: 2024-03-17 DOI: 10.1080/10410236.2024.2328919
Andrew Carter, Garrett Broad, Vanessa Reeves

In this paper, we conduct a case study analysis of the National Women in Agriculture Association (NWIAA), an international, Black women-led farm assistance organization founded in 2008 and based in Oklahoma City, Oklahoma. Drawing on the Culture-Centered Approach (CCA) and grounded in interviews and observational fieldwork, we center the perspectives of NWIAA chapter leaders (n = 16) to examine how they describe motivations for farming, challenge power inequities, engage with intersectional barriers, and develop locally situated solutions across agricultural and community health contexts. The analysis argues that Black women farmer's historical lived experiences, political voice, and shared deep-rooted agricultural knowledge provide an innovative and emancipatory praxis for rethinking health communication intervention approaches that address food system-generated disparities. This study contributes important takeaways for health communication practitioners, policymakers, and advocates addressing food inequities. It extends the CCA as a first step in developing community-driven, context-specific food insecurity health communication interventions within marginalized communities across the United States and beyond.

在本文中,我们对全国农业妇女协会(NWIAA)进行了案例研究分析,这是一个由黑人妇女领导的国际农业援助组织,成立于 2008 年,总部设在俄克拉荷马州俄克拉荷马城。我们借鉴以文化为中心的方法 (CCA),以访谈和实地观察为基础,以 NWIAA 分会领导人(n = 16)的视角为中心,研究她们如何描述务农动机、挑战权力不平等、应对交叉障碍,以及在农业和社区健康背景下制定符合当地情况的解决方案。分析认为,黑人女农民的历史生活经历、政治话语权和共同的根深蒂固的农业知识为重新思考健康传播干预方法提供了创新和解放的实践,从而解决食品系统产生的差异。这项研究为健康传播从业者、政策制定者和解决食品不平等问题的倡导者提供了重要启示。它将 CCA 作为第一步进行扩展,以便在美国及其他地区的边缘化社区内制定以社区为导向、针对具体情况的粮食不安全健康传播干预措施。
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引用次数: 0
Temporal Distance, Message Framing, and Consideration of Future Consequences: Parents' Willingness to Vaccinate Children Aged 5-11 Against COVID-19. 时间距离、信息框架和对未来后果的考虑:父母为 5-11 岁儿童接种 COVID-19 疫苗的意愿。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2025-01-01 Epub Date: 2024-03-21 DOI: 10.1080/10410236.2024.2331998
Jie Xu, Xiao Wang

Based on the construal level theory (CLT), this experiment employed a 2 (message framing: gain vs. loss) × 2 (temporal framing: proximal vs. distal) × 2 (consideration of future consequences: low vs. high) between-subjects factorial design. Parents (N = 409) of 5- to 11-year-old children in the United States from a pool of candidates pre-screened by Qualtrics participated in this study. Results indicated that parents with high CFC-Future were more receptive to messages advocating getting their children vaccinated against COVID-19. Parents with high CFC-Future reported higher risk perception in response to the proximal messages compared to the distal messages. For parents focusing on more distant outcomes, proximal messages generated more positive attitude and greater intention compared to distal messages in the loss-framed condition. The difference was not significant in the gain-framed condition. Theoretical and practical implications were discussed. Limitations and directions for future research were outlined.

基于构想水平理论(CLT),本实验采用了 2(信息框架:收益与损失)×2(时间框架:近端与远端)×2(未来后果考虑:低与高)的主体间因子设计。美国 5 至 11 岁儿童的家长(N = 409)从 Qualtrics 预先筛选出的候选人库中参与了本研究。结果表明,CFC-Future 值高的家长更容易接受倡导其子女接种 COVID-19 疫苗的信息。与远距离信息相比,CFC-未来指数高的家长对近距离信息的风险认知度更高。对于关注远期结果的家长来说,在损失框架条件下,近距离信息与远距离信息相比,能产生更积极的态度和更大的意向。而在收益框架条件下,两者的差异并不明显。研究讨论了理论和实践意义。还概述了未来研究的局限性和方向。
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引用次数: 0
"Don't Walk in There": The Challenges Birthing Persons Face at the Clinic. "别走进去":分娩者在诊所面临的挑战。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2025-01-01 Epub Date: 2024-03-25 DOI: 10.1080/10410236.2024.2334088
Cody M Clemens

During the summer of 2021, the author spent a week at an abortion clinic in the southern United States with two of his undergraduate students. In this piece, he engages in autoethnography and writing as a therapeutic process to show how his experience with his students changed his outlook on what abortion clinic workers, volunteers, and birthing persons go through every day. What has been happening outside abortion clinics across the country for decades needs to stop, and as someone who was not well-informed or involved before his trip to the abortion clinic, the author encourages others like him to take action to support abortion clinics with their important mission to protect the healthcare rights of birthing persons.

2021 年夏天,作者与他的两名本科生在美国南部的一家堕胎诊所度过了一周。在这篇文章中,他将自述和写作作为一种治疗过程,展示了他与学生们的经历如何改变了他对堕胎诊所工作人员、志愿者和分娩者每天所经历的一切的看法。几十年来发生在全国各地堕胎诊所外的事情必须停止,作为一个在前往堕胎诊所之前并不了解情况或没有参与其中的人,作者鼓励其他像他一样的人采取行动,支持堕胎诊所履行其保护分娩者医疗保健权利的重要使命。
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引用次数: 0
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Health Communication
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