The Influence of Medical Orientation on Perceived Physician Credibility

This study assessed whether two medical orientations of physicians—biomedical vs biopsychosocial—influenced individuals’ perceptions of physician credibility. Participants read a vignette describing a physician communicating either a predominantly biomedical or a predominantly biopsychosocial orientation and then completed the Measure of Source Credibility in reference to the physician. Results indicate that physicians who display a biopsychosocial orientation were rated higher in perceived competence, character, and caring. Future researchers should address various effects of the medical context on physician credibility and how patients’ preferences regarding physicians’ medical orientation influence choice of and communication with physicians, patient satisfaction, and compliance.     

A Patient-centered Approach to Breaking Bad News: Communication Guidelines for Health Care Providers

This investigation takes a patient-centered approach to examining strategies physicians use to deliver bad news to patients. Qualitative data were obtained from 68 patients who had received a message they perceived as negative information from a health care provider. Through grounded theory methodology, patient accounts were examined to reveal four provider strategies for breaking bad news. This investigation underscores the importance of using effective communication strategies to achieve patient satisfaction and compliance.     

Intergroup,Interpersonal, and Intercultural Nature of Patient–Provider Communication: A Comparison of IMG and USMG Physicians

Using communication accommodation theory as a framework, this study explores and compares communication patterns of international medical graduate (IMG) physicians and United States medical graduate (USMG) physicians in intergroup, interpersonal, and intercultural context. Given that every fourth doctor practicing medicine in the U.S. is an internationally trained physician (AMA-IMG, 2010) an examination of the influence on patient-provider communication involving IMG physician and comparison with USMG physician is warranted. In a national survey of IMG and USMG physicians, the participants self-reported their perceptions of communication behaviors they used during a medical interaction. Although no difference was found between IMG and USMG physicians use of communication accommodation strategies during medical interaction, IMG physicians reported practicing significantly more relational communication than their U.S. counterparts. USMG physicians reported greater difficulty in communication owing to differences in culture than IMG physicians. Implication of findings for patient-centered communication, patient-physician relationship, and communication skills training is discussed.     

A Patient-centered Approach to Breaking Bad News: Communication Guidelines for Health Care Providers

This investigation takes a patient-centered approach to examining strategies physicians use to deliver bad news to patients. Qualitative data were obtained from 68 patients who had received a message they perceived as negative information from a health care provider. Through grounded theory methodology, patient accounts were examined to reveal four provider strategies for breaking bad news. This investigation underscores the importance of using effective communication strategies to achieve patient satisfaction and compliance.     

What makes local governments' online communications successful? Insights from a multi-method analysis of Facebook

Little is known about how public sector organisations capitalise on the potential of social networking sites (SNSs) as communication channels. Previous research is short on theoretical models and managerial insights into the success of local governments' online communication strategies. The purpose of this study is to explore how successfully local governments utilise SNSs for managing their external communication with citizens. Using a multi-method analysis of 15,941 posts and 19,290 comments on the Facebook pages of the 25 largest German cities, we make five contributions to research and practice. First, we analyse the properties and topics of government posts to draw a rich picture of how local governments use Facebook as a communications channel. Second, we conceptualise success in governments' online communications in terms of the frequency and polarity of citizens' reactions, which we use for third, evaluating government communication behaviour in SNSs. Fourth, we identify which benefits SNSs offer that traditional communication channels do not provide. Fifth, we offer guidelines for improving the online communication strategies of local governments using SNSs.     

Negotiating Understanding in “Intercultural Moments” in Immigrant Family Interactions

This article aims to advance an interactionally sensitive, emic view of intercultural communication by exploring the organization of “intercultural moments” in conversation—moments during which cultural and linguistic differences between people become exposed. Field video recordings of ordinary face-to-face interactions in Russian–American immigrant families are analyzed using the methodology of conversation analysis. The article focuses on sequences in which participants deal with actual or anticipated understanding problems and examines how participants' assumptions about their asymmetric cultural and linguistic expertise are revealed in their actions. Some interactional payoffs in adopting the role of a cultural expert vis-à-vis a novice are described to show how an ostensible non-understanding is both a participants' problem to be solved and a resource for social action.     

Virtually Working: Communicative and Structural Predictors of Media Use and Key Outcomes in Virtual Work Teams1 A previous version of this work was presented as a Top 3 Paper in the Organizational Communication Division at the International Communication Association Annual Conference,New Orleans,LA (May 2004).

Organizational trends toward team-based structures, globalization, and reliance on communication technology have spurred research addressing the communication processes of virtual teams. However, much of the extant research focuses on the ways virtual teams differ from conventional, face-to-face teams and fails to examine variations in virtual team characteristics that may impact team communication behaviors and experiences. The study reported here identifies two categories of virtual team characteristics (communicative and structural) and uses these to explore their relationships to team communication technology use and team outcomes. Analysis of data from 98 virtual teams reveals that structural features primarily relate to media use, whereas communication considerations are associated with team outcomes. Additional analyses indicate that various communicative predictors moderate the relationships between technology use and outcomes. These results point to theoretical and practical implications for researchers, team members, managers, and organizations related to virtual team design and communication processes.     

Communication anxiety and signing effectiveness: Testing an interference model among deaf communicators

Couples coping with cancer are often told to talk about feelings, yet there is limited theoretical, empirical, or intervention research to justify this advice. We interviewed 19 patients and 16 partners about their communication. In a mixed methods analysis, we found talk about feelings was associated with distress and functioning, even after controlling for marital satisfaction, perceived constraint from discussing cancer, or physical functioning; however, patients and partners who focused on feelings and personal issues had worse outcomes than those who focused on facts and medical issues. Through qualitative analysis, we found multiple ways to cope that did not require talking about feelings as well as ways that higher levels of distress affected talk about feelings. Our findings suggest we should reconsider advice to couples, encouraging multiple ways of communicating, and considering contextual factors that influence the timing and desirability of talk about feelings.     

Parent-Provider Communication and Antibiotic Prescribing for Pediatric Ear Infections

Rising rates of antibiotic-resistant infections make reducing unnecessary antibiotic use for outpatient illness a key public health issue. This study examines the association between parent-provider communication and rates of antibiotic prescribing for their children’s ear infections. Participants (N = 70) were recruited from parents of patients (6 months–12 years) at a medical center whose children were diagnosed with ear infections or had ear symptoms with an upper respiratory tract diagnosis. Results showed that parent self-reports of going into great detail and asking many questions about their children’s symptoms were associated with greater antibiotic prescribing, as was not insisting on a particular test or treatment. Further, antibiotic prescribing was less likely when parents reported that providers encouraged them to offer opinions about the child’s medical treatment. Findings suggest that communication skills training is needed for both patients and providers to minimize potential misinterpretations and thereby avoid unnecessary antibiotic prescribing.     

Rethinking “Difficult” Conversations in Communication Instruction From an Intercultural Lens: Pedagogical Strategies for “SWAP-ping” the Communication Classroom

Intercultural communication offers both theoretical and pedagogical implications for communication instruction. As such, we interweave theories and concepts of intercultural communication and instructional communication in (re)thinking “difficult,” “sensitive,” or “uncomfortable” classroom conversations that involve privilege, power, and intersecting cultural identities (e.g., racism). In juxtaposing these areas side by side, we first interrogate why intercultural and instructional communication scholars have neglected what the other takes as central: pedagogy and diversity. In particular, we ask: Why are certain conversations deemed “difficult” in the mainstream communication classroom? To whom are they difficult conversations? Why might these conversations feel “uncomfortable or risky”? Second, we crystalize how intercultural communication makes strides toward feeling/thinking/understanding difficult conversations in ways that promote social justice by proposing a pedagogy of “SWAP-ping” the communication classroom.     

The impact of communication apprehension and fear of talking with a physician on perceived medical outcomes

This study examined the relationships among trait CA, state CA (fear of interacting with a physician), and patient perceived satisfaction with quality of medical care and physician. The results indicated that trait CA and fear of the physician were positively related. However, trait CA was not significantly related to patient perceived satisfaction with quality of medical care or physician. State CA, in contrast, was significantly negatively related to both patient perceived satisfaction with medical care and satisfaction with physician. It is concluded that future research should investigate the impact of physicians’ engaging in positive communication behaviors on patients’ apprehension and medical outcomes.     

美国的人际传播研究及代表性理论

本文在前人研究的基础上,对美国人际传播的研究视角进行了划分,并梳理出每种视角的代表性理论。本文认为,美国人际传播研究的视角有情境、能力、关系、过程、规则、功能、文化和心理八个方面的视角。这些研究视角对我国学者从事人际传播研究,建立具有中国特色的人际传播理论具有重要的借鉴价值。     

Online Searching for Information on Medical Devices

Librarians located in a 560-bed, inner city academic medical center with 25,000 + admissions per year planned and opened a Patient and Family Education Center (PFEC) in the lobby of a new patient care pavilion. A review of use in the first 19 months revealed that expected needs were being met while a variety of unexpected needs were identified. Ongoing use continues to be monitored by a detailed log of patron visits maintained by library staff. This article describes the evolution of the Patient and Family Education Center, outreach to the hospital community, and plans for the future.     

疾病题材文学书籍的选择及其相关问题研究

本文在分析疾病题材文学书籍对于患者、医学界影响的基础上,就该类书籍在阅读治疗中的选择、使用等问题展开讨论。     

Physician information seeking: improving relevance through research

Health sciences libraries have considerable potential as resources for both formal continuing professional education, as well as the informal continuing education that results from the professional's efforts to solve problems in daily practice. While there is a growing interest in making the resources of health sciences libraries more accessible to practitioners on a routine, day-to-day basis, there also needs to be more awareness of how, when, where, and why professionals look for information in the context of practical problems. This paper reviews recent research that identifies the context in which physicians seek information and advice from external sources, the information sources that physicians access, and the factors that influence which particular sources are sought. The results indicate that physicians vary in their information needs, preferences, motivations, and strategies for seeking information. This diversity suggests that health sciences libraries, in their efforts to be more accessible, should consider "market research" to determine the needs, preferences, and use patterns of the library's targeted users. Libraries may also benefit from exploring alternative methods of improving access to their resources.     

A hospital-based patient and family education center: if you build it, will they come?

Librarians located in a 560-bed, inner city academic medical center with 25,000?+ admissions per year planned and opened a Patient and Family Education Center (PFEC) in the lobby of a new patient care pavilion. A review of use in the first 19 months revealed that expected needs were being met while a variety of unexpected needs were identified. Ongoing use continues to be monitored by a detailed log of patron visits maintained by library staff. This article describes the evolution of the Patient and Family Education Center, outreach to the hospital community, and plans for the future.     

Communication in Emergency Medicine: Implications for Patient Safety1 This study was funded by a generous grant from the National Patient Safety Foundation.

Emergency medicine is largely a communicative activity, and medical mishaps that occur in this context are too often the result of vulnerable communication processes. In this year-long qualitative study of two academic emergency departments, an interdisciplinary research team identified four such processes: triage, testing and evaluation, handoffs, and admitting. In each case, we found that narrative rationality (the patient's story) was consistently subjugated to technical rationality (actionable lists). Process changes are proposed to encourage caregivers to either reconsider their course of action or request additional contextual information. A heightened awareness of the bias for technical over narrative rationality and a better recognition of uncertainty in emergency medicine communication are important first steps toward anticipating potential failures and ensuring patient safety.