Journal of Communication in Healthcare最新文献

Background: Research on the associations between medical communication competence (MCC) and physicians' psychological adjustment and therapeutic relationships is warranted. This study aimed to analyze the associations between MCC and both physicians' psychological adjustment outcomes (i.e. burnout and flourishing) and therapeutic relationships via barriers to compassion and expressive suppression.

Methods: A sample of 221 physicians completed an online survey, which assessed MCC, barriers to compassion, expressive suppression, burnout, flourishing and therapeutic relationships. Structural equation modeling was used to explore direct and indirect associations between variables. Multigroup analyses were performed to ascertain the invariance of the obtained model between groups of physicians with more (≥14) or fewer (<14) years of professional experience.

Results: Barriers to compassion and expressive suppression were indirectly associated with the relationship between MCC and both physician burnout (β = -.01, 95% CI [-.03, -.00] and β = -.01, 95% CI [-.02, -.00], respectively) and flourishing (β = .04, 95% CI [.01, .10] and β = .07, 95% CI [.03, .13], respectively). The association between MCC and therapeutic relationship was exclusively explained by barriers to compassion (β = .03, 95% CI [.01, .06]). The mediation model was invariant across groups of physicians with more or fewer years of professional experience.

Conclusions: Regardless of professional experience, MCC training should address physicians' barriers to compassion and emotion regulation skills to improve their psychological adjustment and the quality of their therapeutic relationships. Interventions at the physician level may impact the quality of health care at an organizational level.

Background: Extended Parallel Process Model, behavioral model, and empathetic approach proposed different theoretical assumptions in explaining why people take vaccines. Yet no single reviewed empirical study tried to compare their theoretical effectiveness in motivating people to join the vaccination campaign. This study therefore tried to fill this gap via examining the persuasiveness of different promotion materials to the participants in a hypothetical vaccination campaign, while controlling a number of personal factors and writing styles of the materials.

Methods: A total of 216 adult participants were recruited for this questionnaire-based study. All participants were firstly introduced to a hypothetical scenario and then randomly assigned into 4 different groups. They were asked to read corresponding promotion materials before deciding their likeness to receive a vaccination.

Results: All promotion materials were effective in enhancing the likeliness of taking the vaccination, compared with the control condition. After controlling participants' age, their vaccination records, and health efficacy, participants were more likely to join the vaccination campaign after reading the promotion materials related with efficacies and caring for others, than reading the materials about positive reinforcements, regardless of the writing styles.

Conclusion: These exploratory findings provide empirical evidence in further understanding the ways of delivering the important messages in public communication. The current research suggests that the feasibility of the effective resources and empathetic gestures to the needy should be prominently emphasized in the promotion of vaccination campaigns, whereas participants might feel a diminution of their prosocial behaviors when money rewards were associated. Limitation of the research design is also discussed.

Background: Zambia's Copperbelt Province maintains HIV prevalence of 11.9% among adults. PMC-Zambia conducted formative research in five districts (Ndola, Kitwe, Chingola, Kalulushi, Mpongwe) to inform a Radio Talk Show (RTS) addressing HIV prevention and pre-exposure prophylaxis (PrEP) uptake.

Methods: We employed focus group discussions (FGDs) and key informant interviews (KIIs) across the districts. Semi-structured guides explored HIV perceptions, stigma, and PrEP awareness. Thematic and narrative analyses identified patterns and stakeholder perspectives.

Results: Significant perception gaps emerged between healthcare workers reporting decreased stigma and community members describing persistent discrimination. PrEP awareness remained critically low with widespread misconceptions confusing prevention with lifelong treatment. Youth particularly feared partner suspicion and peer judgment, while older adults cited religious influences and relationship concerns as barriers.

Conclusions: Findings reveal urgent need for targeted health communication bridging provider-community perception gaps, addressing misconceptions through expert dialogue, and leveraging interactive formats to reduce stigma while promoting informed HIV prevention decision-making.

Background: This study focused on how narratives with hypothyroidism are rhetorically constructed in online spaces, specifically, on Instagram. Currently, hypothyroid patients represent the majority of the approximately 20 million Americans with thyroid disease, and the use of Instagram as a platform allows for unique, multimodal rhetorical constructions that focus on visual narratives and reveal how thyroid patients understand themselves, their condition, and their standing in institutional settings.

Methods: Using a phenomenological approach, five public Instagram accounts owned and maintained by thyroid patient advocates who have 'influencer' status were identified. From these accounts, 100 posts were analyzed that specifically discuss major phenomena in the life of a thyroid patient.

Results: Although each patient-advocate had their own style when creating posts, they are united in their pursuit of promoting community-building and institutional change through digital activism founded on narrating experiences dealing with hypothyroidism. Furthermore, their choice to focus on visual story-telling through Instagram posts emphasizes the way that invisible illnesses are continuously mischaracterized.

Conclusion: The results indicated that patient-advocates' narrative posts highlight the variance in which hypothyroidism presents, which may contribute to misunderstandings surrounding the condition and others like it in and out of clinical spaces. The choice to use social media to present these messages to the thyroid community and the public is significant because it illustrates the desire for change through a participatory culture mediated through digital activism. Furthermore, using social media presents a way to relay these narratives outside of institutional barriers and rebuke.

Background: Managing uncertainty is an essential element of patient-centered communication (PCC) and shared decision making (SDM), yet we know little about how residents' reactions to uncertainty are related to their perceptions of their ability to engage in these important activities. This longitudinal study assesses whether residents' self-perceived PCC and SDM skills are associated with their reactions to uncertainty throughout residency.

Methods: Data were collected using a three-year, longitudinal survey of two cohorts of pediatric residents. Before each year of residency, residents self-reported PCC behaviors (information exchange and socioemotional communication), SDM skills, and general intolerance of uncertainty, and context-specific reactions to uncertainty in patient care. 100 residents completed Phase I (intern year), 61 residents completed Phase II (second year), and 53 residents completed Phase III (third year).

Results: Anxiety from uncertainty and reluctance to disclose uncertainty to parents were significant, negative predictors of SDM perceptions at each phase. Anxiety from uncertainty negatively predicted PCC information-related behaviors (seeking, giving, and verifying) at each phase, but not socioemotional communication. At each phase, concerns for bad outcomes only significantly predicted information giving. Tolerance of uncertainty was not a significant predictor of SDM perceptions or any of the four dimensions of PCC.

Conclusions: Residents with stronger negative reactions to uncertainty reported poorer self-perceptions of patient-centered communication and shared decision making over the course of residency. Thus, residency programs should implement training that normalizes conversations about uncertainty and identifies strategies for PCC and SDM in situations of clinical uncertainty.

Background: The Veterans Health Administration (VHA), the largest integrated health system in the United States, has made Organizational Health Literacy (OHL) a priority for assessment and improvement.

Methods: Beginning in 2021, the VHA assembled a project team that utilized strategies for assessment and improvement. VHA is using the Health Literate Care Model as a foundational framework to operationalize health literacy across the organization. The team developed a 16-question environmental assessment about patient education and health literacy, which was sent to 120 VHA national programs. The team then hosted a planning and visioning session for VHA leaders. In 2022, they created workgroups of national experts and hosted a 2-day symposium and workshop.

Results: The environmental assessment (n = 55 responses) found substantial heterogeneity across programs in the development, dissemination, maintenance, evaluation and delivery of patient education content and materials. The leadership planning session and the symposium and workshop each had over 70 participants. They identified essential activities, including establishing leadership support, workforce preparation, development of national health literacy standards, and measurement. Since beginning this initiative, VHA has made significant strides in implementation of these efforts, initiating a new national program (Patient Centered Learning) and a Community of Practice focused on health literacy.

Conclusions: To create meaningful improvement in OHL, significant planning needs to occur with support from the highest levels of an organization. VHA can serve as an example for incorporating OHL into a large, multi-faceted healthcare organization.

Background: Distressful clinician-to-patient dialogue such as a pre-cancer diagnosis of cervical dysplasia may interfere with information retention. Patient education material provided as an online resource offers a suitable option to review relevant health information outside the clinic. The aim of this study was to evaluate online resources (ORs) affiliated with healthcare institutions across Australia and the United Kingdom (UK) on their effectiveness to translate accessible and current knowledge to patients referred for loop electrosurgical excision procedure (LEEP) treatment.

Methods: A comprehensive directory of ORs related to LEEP was compiled from public hospital websites across Australia and the UK. Quantitative and qualitative methods were applied to evaluate resource reading-level (measured using three validated readability indices); actionability and understandability (measured using the Patient Education Material Assessment Tool [PEMAT]); and content (described using content analysis to assess disclosure practices associated with LEEP-related complications).

Results: All ORs (n = 39) exceeded the recommended reading level (Australia: x̄ = 10.07, σ = 1.01; UK: x̄ = 10.17, σ = 0.96). PEMAT results indicated higher percentages of ORs scored as understandable (Australia: 50.0%; UK: 69.7%) versus actionable (Australia: 33.3%; UK: 6.1%). Content analysis revealed widespread discordance in the disclosure of longer-term LEEP complications associated with pregnancy, fertility, and sexual function in both countries.

Conclusions: Disclosures with significant health and wellness implications should be made with clear reference to peer reviewed science. Wider application of purpose-designed health literacy tools could improve measures of readability, actionability and understandability. International collaborations may provide opportunities to develop more comprehensive and patient-centred education materials to improve provider-to-patient knowledge translation.