Introduction to Health Communication Exam #2

Intersectionality theory

Person’s social positive w/in the interface of micro-level personal identities and macro level sociocultural patterns

• Personal Identity: Age, race, sexual orientation, physical ability, education

• Sociocultural variables: sexism, racism, power, resources, public policies.

Socioeconomic status

Social standing or class of a group or individual

• Combination of education, income, or occupation

What is the link between socio-economic status and health

Implicit biases, gaps in communication, structural inequities, limited access to healthcare.

Race and ethnicity in Healthcare

• People of different races respond to medical care differently.

  • Distrust of medical establishment

  • High risk, low knowledge

  • Limited access to medical facilities

  • Underrepresentation

    • Concordance: Perception of similarities between self and other based on culture and ethnicity.

    • Patient-caregiver communication: Stereotypes affect physician’s judgement

Moral theories

Systemic accounts of moral life. These strive to:

• Provide framework on right and wrong

• Develop general principles for action, behavior, and character based on our values

• Provide account of right & good

Action

Right & Wrong

Character

Good & bad

Language gap:

• Growing

• These gaps increase a patient’s risk factor

• Need for interpreters

Gender & Sex

• Sex: set of biological attributes primarily associated with physical and physiological features

• Gender: Socially connected identities, roles, expresssions, & behaviors of women, men, or gender diverse people.

Assumptions of gender

Institutional notions of gender are largely heteronormative

Risks of silence

• Fear of judgement

• Less info/counsel

• Denial of visiting priveledges/info during health crises

Suggestions for health professionals to build trust

• Proactive, feel comfortable with topics

• Use preferred pronouns and names

• Paperwork changes

• Don’t ignore sexual identity issues

Disabilities

• Largely treated as central or tragic

• Regarded as heroic or tragic

• People with invisible disabilites may encounter unique difficulties

Ways that individuals with disabilities are marginalized

• Words

  • The word disability is accepted and preferred

• Intrusive questions

• Avoidance of sensitive topics

• Treated as childlike, overhelping

Ableist language

Terms and expressions that present disabilities in a negative way

Phases of illness conceptualization for children

• Prelogical conceptualization

• Concrete logical

• Formal logical

Prelogical conceptualization

• Define illness as caused by tangible external agent

Concrete logical

Differentiate between external causes and internal manifestation

Formal Logical

Envision complete influence of agents not readily seen

Ageism

Discrimination based on a person’s age

Seen in older adults

Social beliefs about growing older have implications for identity

• Notion that feminity is beautiful

• Idea that getting older is a process of decline

Ethnocentrism

Attitude that ones culture is better than others

Culturally sensitive approach

Create health messages responsible to values and beliefs of culture

Health as organic, germ theory

• Disease is caused by microscopic organisms

• Organic model of health: Assumes that health can be understood in terms of presence or absence of physical indicators

Limitations:

• Inability to account for conditions that can’t be physically verified

• Excludes social factors

Health as a harmonic balance

Health is a sense of overall well-being equilibrium

• Many cultures regard mind and body as linked

• Therapeutic value of living in harmony with nature

  • Biophilia hypothesis

• Thermal metaphors of hot and cold

• Conception of health in terms of energy

  • Karma: Energy from deeds in past

  • Yin and Yang: Connected get opposite elements

  • Qi: Central life energy

Making sense of health experiences

• Health conditions as a social asset

• Health conditions as a social liability

  • Belief that illness is a curse

  • Stigma: social rejection in which a person is treated as dishonorable is ignored

Social roles & Health

• Sex, gender, and health: Gendered cultural expectations can be restrictive

Female identity and health

• Assumed to be emotional

• Assumed that are less powerful

• Domestic and sexual violence

Male identity and health

• Expected to be stoic and strong

• Pressure to be a provider

• Homicides

Illness and coping mechanisms

• Metaphors on responding to illness

• Battle metaphor of ill health

  • Scientific perspective

  • Death represents defeat

  • Making peace with the body

• Evidence to support both

Roles

Set of expectations that applies to people performing functions in the culture.

Caregivers as mechanics, patients as machines

• Focus on finding physical abnormalities and fixing them

• Does not encourage emotional communication

Patients as children and caregivers as parents

• Doctors issue directives that patients are expected to obey

• High power distance (defer to those of greater status)

Caregiver as spiritualists and patients as believers

• A religious like faith in caregivers

• Placebo effects

Providers and consumers

• Patients/shoppers pay caregivers to provide info and carry out wishes (consumerism)

Holistic care

Emphasizes overall well-being (Physical and emotional) w/ an emphasis on maintaining health

• Ex. acupuncture, meditation, chiropractic

• Based on simple principles

• More personal, focused on health and maintenance

Disadvantages of Holistic medicine

• Many supplements not thoroughly researched

• Scams

• Environmental threats

• Lack of communication

Coping

• Process of maintaining stressful situations

• Involves 2 efforts

  • Problem solving

  • Emotional adjustment (adapting to what cannot change)

Sense of control

• Health self-efficacy: A person’s belief that they can manage their labels

  • Internal locus of control: Belief that people control their own desires

  • External locus of control: More fatalistic

Crisis

Occurrence that exceeds a person’s normal coping ability

Normalcy

Sense that things are comfortable, familiar, and predictable

Social support:

Behaviors that communicate that a person is valued and cared for

Direct-effect model

Social support is helps buffer people from negative effects of stressful experiences.

Link between social ties and good health: Learn from others, physical benefits, support decision making.

Types of social support

• Instrumental

• informational

• Esteem

• Emotional

Support

Instrumental Support

Performing tasks and favors

Informational support

Providing information

Esteem support

Make a person feel valid/competent

Emotional Support

Acknowledge/understand what a person is feeling

Social network theory

We experience strong ties with people whose social networks overlap w/ ours & weak ties w/ people whose social networks don’t overlap as much

Oversupport

Excessive/unnecessary help

Overhelping: Too much instrumental assistance

Overinforming: Forcing info

Family caregiver profile

• Avg. Age: 40s

• 2/3rds are women

Stress and burnout

• Stress, exhaustion, emotional strain, feeling unprepared, jeopardize own health

End of life experiences

• Life at all costs

  • Death as the enemy of life. Life = victory. Death = defeat. Medicine as savior.

• Death with dignity.

  • Maintain dignity, comforting surroundings w/ loved ones. A good death.

Hospice

• Org. that provides support/care for dying individuals and their families

• Provide palliative care (keep person comfortable and fulfilled at end of life

How do deliver bad news

• Foreshadow, appropriate setting, acknowledge emotions, follow up

Advanced Care Directives

• Describe in advance the medical care someone wants to receive if they become too ill to communicate

E-Health

Involves use of tech to transcend geographical distance in promoting good health

M-Health

Involves the use of devices such as mobile phones, tablet computers, and personal digital assistants.

Health apps, health monitoring, mental health.

SMS: Mobile health like texts and tweets.

Telehealth:

Uses tech to facilitate long distance healthcare, education, admin teamwork, disaster responses.

Telemedicine

Subset of telehealth that offers clinical services to patients at a distance

Advantages of telehealth

In-Depth info, practical/timely/meets goals, social support

Disadvantages of telehealth

Unreliable information, conflicting information, information overload

Digital divide in healthcare

Low education and low income groups have more restricted access to communication technologies

Telemedicine

Two-way, real time, interactive communication between the patient and physician or practicioner at the distant site. Is a place for conventional hospitals and virtual care.

Patient portals

password protected websites

Telehealth Advantages

• Accepts to care and communication

• Efficiency and accessible information

Disadvantages of telehealth

• Restricted communication

• Liability and privacy concerns.