Elaine Hsieh

The Social Meanings of Traditional Chinese Medicine: Elderly Chinese Immigrants’ Health Practice in the United States

We situate elderly Chinese immigrants’ utilization of traditional Chinese medicine (TCM) in social contexts (e.g., family and social networks), exploring how TCM is used as a tool, a resource, and a product of meaning-construction in their everyday life. We conducted in in-depth interviews with 20 elderly Chinese immigrants in the United State, exploring the complexity of their understanding and practice of TCM. We used grounded theory to identify the set of meanings that are particular to elderly Chinese immigrants’ use of TCM as a part of their health practice. For our participants, TCM is not just a resource for illness management. Instead, incorporating TCM in their health practice allows them to: (a) perform and reaffirm their cultural identity as Chinese, (b) maintain their moral status and fulfill their social roles, and (c) pass down health knowledge and cultural heritage. Clinical implications were discussed.

Health as Submission and Social Responsibilities Embodied Experiences of Javanese Women With Type II Diabetes

By examining women’s experiences with type II diabetes, we explore how illness can provide resources to construct meanings of everyday life in Javanese culture. We conducted in-depth interviews with 30 female participants in Central Java, Indonesia, and adopted grounded theory for data analysis. We identified four themes that diabetes serves as resources for women in Indonesia to (a) normalize suffering, (b) resist social control, (c) accept fate, and (d) validate faith. We concluded by noting three unique aspects of Javanese women’s illness management. First, through the performance of submission, our participants demonstrated spirituality and religiosity as essential elements of health. Second, diabetes empowers individuals in everyday suffering through two divergent processes: embracing submission and resisting control. Finally, diabetes provides opportunities for individuals within a social network to (re)negotiate social responsibilities. In summary, diabetes provides unique resources to empower our participants to obtain voices that they otherwise would not have had.

“It’s Not Like You Need to Live 10 or 20 Years”: Challenges to Patient-Centered Care in Gynecologic Oncologist–Patient Interactions

The literature suggests that the patient-perspective approach (i.e., eliciting and responding to patients’ perspectives, including beliefs, preferences, values, and attitudes) to patient-centered care (PCC) is not a reliable predictor of positive outcomes; however, little is known about why the patient-perspective approach does not necessarily lead to positive outcomes. By using discourse analysis to examine 44 segments of oncologist–patient interactions, we found that providers’ use of patient-perspective contextualization can affect the quality of care through (a) constructing the meanings of patient conditions, (b) controlling interpreting frames for patient conditions, and (c) manipulating patient preferences through strategic information sharing. We concluded that providers’ use of patient-perspective contextualization is an insufficient indicator of PCC because these discursive strategies can be used to control and manipulate patient preferences and perspectives. At times, providers’ patient-perspective contextualization can silence patients’ voice and appear discriminatory.

Reconceptulizing Language Discordance: Meanings and Experiences of Language Barriers in the U.S. and Taiwan

Individuals with language barriers may face challenges unique to a host society. By examining and comparing the sociocultural conditions that can result in providers and patients not sharing the same language in the United States and in Taiwan, I argue that (a) language discordance is a social phenomenon that may entail diverging meanings and experiences in different countries; (b) language-discordant patients may not share similar experiences even if they are in the same country; and (c) disparities in language concordance may be confounded with other disparities and cultural particulars that are unique to a host society. In addition, because English is a dominant language in medicine, language-discordant patients’ quality of care in Taiwan can be moderated by their fluency in English.

Surviving Violence in Everyday Life: A Communicative Approach to Homelessness.

In this narrative review, the author synthesizes the literature on homelessness across various disciplines (e.g., public health, social work, sociology, and communication) to demonstrate how the experiences of homelessness can be created, maintained, and reinforced through communication, including interpersonal interactions and public discourse. By conceptualizing homelessness as a culturally constructed and socially situated phenomenon, the author examines (a) the complex conceptualization of homelessness, (b) everyday violence faced by people who are homeless, and (c) coping strategies of people who are homeless. In summary, homelessness is a complex social phenomenon, involving tensions between individuals, families, and social systems, all of which are situated in the larger sociocultural and sociopolitical contexts of a specific time and place.

“Not Homeless Yet. I'm Kind of Couch Surfing”: Finding Identities for People at a Homeless Shelter

The meanings of homelessness are fluid and socially constructed, providing resources and limitations for individuals to negotiate their identities and relationships in everyday life. In this study, we examine the strategies and corresponding resources utilized by people who are homeless to cope with the labeling of a homeless identity and to redefine their identities. We used constant comparative analysis to examine in-depth interviews with 16 participants (male = 11, female = 5) who access a local homeless shelter in the southwest United States for resources. We identified three strategies that homeless people adopt to cope with the labeling of homeless identity: (a) differentiating oneself from others who are homeless, (b) prioritizing certain aspects of life, and (c) embracing the status of homelessness. Although these strategies have been identified in previous literature, the authors extend this line of research by identifying the common resources people who are homeless utilize when adopting these strategies, which entail important implications for theory development and practical implications.

Anticulture and aging

In this chapter, we synthesize two powerful theories: the theory of symbolic violence and the theory of social death. The result is a new concept, a new way to conceptualize social structures, institutions that breed social and physical death, what I call anticultures.

Cynthia E. Roat: Healthcare Interpreting in Small Bites: 50 Nourishing Selections from the Pacific Interpreters Newsletter, 2002–2010

Interpreters have been viewed as an essential resource to improve the quality of care for patients with LimitedEnglish-Proficiency (LEP). Despite the increasing attention to the complexity of bilingual and cross-cultural health care, recent studies have highlighted two major challenges. First, few providers have received training on working with interpreters [1], a needed element in ensuring quality of care for LEP populations [2]. Second, interpreters often are frustrated by interpersonal and communicative dilemmas that are not limited to linguistic or cultural differences during medical encounters [3]. Cynthia Roat’s recent book, Healthcare Interpreting in Small Bites, is an excellent response to these challenges. As one of the pioneering figures in the professionalization of medical interpreters, Roat’s reflections on the roles and functions of medical interpreters have great theoretical and practical significance. Originally published as the monthly columns for the Pacific Interpreters Newsletter, Roat’s writing was intended for interpreters in health care settings. Her writing comprises vivid scenarios to which both telephone and onsite interpreters can easily relate and offers solutions that can be easily incorporated into interpreters’ practices. In addition, with this book, Roat successfully demonstrates the relevance of these topics to any healthcare professionals who work with LEP populations, including physicians, nurses, and even social workers. The book is organized thematically. Part I includes four sections, exploring the complexity of interpreter-mediated provider-patient interactions. Section 1, ‘‘Tips and Tricks of the Trade,’’ may first appear to be most useful to interpreters as it explains interpreting standards and protocols, including controlling the flow of communication and conveying cultural and pragmatic equivalences. However, Section 1 also is valuable in educating providers to understand the complexity of bilingual health care. For example, cultural differences in conveying politeness (Chap. 3) and conceptualizing confidentiality (Chap. 6) may lead to inherent conflicts between the provider and the patient. By understanding interpreters’ roles and strategies in managing transparency (Chap. 4), helpfulness (Chap. 5), and cultural/ linguistic differences (Chap. 7), providers and interpreters can collaborate on effective and appropriate strategies that best meet the challenges of the situation. Section 2, ‘‘The Key to Success is Being Prepared,’’ answers specialty-specific knowledge and communicative needs for interpreting in pediatrics, the asthma clinic, pharmacy, genetic counseling, and behavior health. Section 2 highlights many issues that have been largely ignored in the literature on bilingual health care. Traditionally, interpreters are conceptualized as ‘‘linguistic robots’’ who convey information neutrally and faithfully [4]. In other words, there should be minimal differences in interpreters’ performances and communicative strategies across various settings and contexts. In this section, Roat educates interpreters to be familiar with the diverse expectations and procedures of different specialties. She eloquently points out the therapeutic objectives embedded in pediatricians’ and mental health providers’ subtle but purposeful communicative strategies (Chaps. 14, 19–22); legal implications in providing informed consent (Chap. 17); and cultural differences in understanding end-of-life care (Chaps. 22–23). More importantly, Roat also recognizes interpreters’ emotional labor and vulnerability when providing services to patients in behavioral health settings (e.g., counter-transference) (Chaps. 19–21) and end-of-life care E. Hsieh (&) Department of Communication, University of Oklahoma, 610 Elm Ave., Room 101, Norman, OK 73019, USA e-mail: ehsieh@ou.edu

Remembering the Legacy of Dale E. Brashers and His Contributions to Health Communication

On July 5, 2010, Dale E. Brashers, head of the Departmentof Communication at the University of Illinois at Urbana-Champaign and key figure in the field of health commu-nication, passed away in his university office. He was 50years old.Theimpactofthislossisstillexpanding,ripplingthroughthe field and the vast network of people who knew him ascolleague, mentor, or friend. For some, his death was noless painful than losing a parent, so special was this manto them. Equally severe is the loss to the field of healthcommunication, in which Brashers was a central and highlyvisible figure. His scholarly contributions, applied clinicalwork, mentorship of junior health communication scholars,and leadership in our national and international professionalorganizations all helped advance our discipline, broaden-ing its reach and increasing its visibility among the healthsciences. Although Brashers held some interest in groupsand argumentation (Jacobs, Brashers, & Dawson, 1996;Meyers & Brashers, 1999; Meyers, Brashers, & Hanner,2000; Rintamaki & Brashers, 2010), he is best known forhis methodological research and theoretical advancement ofuncertainty management. For these reasons, the 100