Emily B. Peterson

A practitioner's guide to interpersonal communication theory: An overview and exploration of selected theories

OBJECTIVE To provide a brief overview of selected interpersonal theories and models, and to present examples of their use in healthcare communication research. RESULTS Nine interpersonal communication theories and their application to healthcare communication are discussed. CONCLUSION As healthcare communication interactions often occur at an interpersonal level, familiarity with theories of interpersonal communication may reinforce existing best practices and lead to the development of novel communication approaches with patients. PRACTICE IMPLICATIONS This article serves as an introductory primer to theories of interpersonal communication that have been or could be applied to healthcare communication research. Understanding key constructs and general formulations of these theories may provide practitioners with additional theoretical frameworks to use when interacting with patients.

Communicating Social Support in Computer-mediated Contexts: A Meta-analytic Review of Content Analyses Examining Support Messages Shared Online among Individuals Coping with Illness

Research on social support during the past two decades has been marked by a growth in scholarship examining supportive communication in computer-mediated contexts among individuals coping with illness. In an effort to summarize and advance this body of research, a meta-analytic review of content analyses was conducted. Across the 41 content analyses examining social support messages shared in health-related contexts online, informational and emotional support messages were most prevalent. Additionally, the prevalence of particular types of support messages varied based on several stressor dimensions relevant to illness. Nurturant forms of support were more common among content analyses examining health conditions likely to threaten personal relationships as well as among content analyses focusing on health conditions with a greater potential for loss in the form of death. Action-facilitating types of support were more common among content analyses examining more chronic conditions. The findings from this project offer insights about the nuanced ways in which computer-mediated communication is used as a resource for coping with illness.

Impact of provider-patient communication on cancer screening adherence: A systematic review.

Cancer screening is critical for early detection and a lack of screening is associated with late-stage diagnosis and lower survival rates. The goal of this review was to analyze studies that focused on the role of provider-patient communication in screening behavior for cervical, breast, and colorectal cancer. A comprehensive search was conducted in four online databases between 1992 and 2016. Studies were included when the provider being studied was a primary care provider and the communication was face-to-face. The search resulted in 3252 records for review and 35 articles were included in the review. Studies were divided into three categories: studies comparing recommendation status to screening compliance; studies examining the relationship between communication quality and screening behavior; and intervention studies that used provider communication to improve screening behavior. There is overwhelming evidence that provider recommendation significantly improves screening rates. Studies examining quality of communication are heterogeneous in method, operationalization and results, but suggest giving information and shared decision making had a significant relationship with screening behavior. Intervention studies were similarly heterogeneous and showed positive results of communication interventions on screening behavior. Overall, results suggest that provider recommendation is necessary but not sufficient for optimal adherence to cancer screening guidelines. Quality studies suggest that provider-patient communication is more nuanced than just a simple recommendation. Discussions surrounding the recommendation may have an important bearing on a persons decision to get screened. Research needs to move beyond studies examining recommendations and adherence and focus more on the relationship between communication quality and screening adherence.

Communication and culture: Predictors of treatment adherence among Mexican immigrant patients:

This study examined communication and culture in clinicians’ interactions with Mexican immigrants in Texas. Specifically, we explore the unique interplay among levels of acculturation, beliefs about culturally-based medical practices, perceptions of medical encounters, and the likelihood of adherence to medical therapy recommendations from US providers. Results suggest that: (a) acculturation predicts perceptions of out-group membership in the patient-provider interaction; (b) beliefs about complementary and alternative medicine are negatively related to medical adherence; (c) quality of care mediates the relationship between physician accommodation and medical adherence; and (d) there exists a complex relationship between out-group perceptions and adherence.

Effects of Self-Affirmation on Daily Versus Occasional Smokers’ Responses to Graphic Warning Labels

There is growing evidence that self-affirmation can reduce defensive processing of threatening health messages among high risk individuals. However, how self-affirmation might influence low risk individuals is less clear. This study examined the effect of self-affirmation on daily versus occasional smokers’ reactions to graphic on-pack warning labels. Results showed a relatively consistent pattern of interaction wherein self-affirmation decreased favorable reactions to the warning labels among occasional smokers, whereas its effect on daily smokers was mostly nonsignificant. Potential explanations of these findings are offered and their practical implications are discussed.

Structurational divergence theory as explanation for troublesome outcomes in nursing communication.

Structurational divergence (SD) theory captures negative communication cycles resulting from interpenetration of incompatible meaning structures. It is estimated that 12–15% of practicing nurses suffer from a problematic level of SD. With a sample of 713 nurses (57 departments) in a large hospital, this study tests a model positing SD as a root explanation of nursing job satisfaction and turnover. A number of variables long presumed to be explanations for job satisfaction and turnover were hypothesized as mediators between SD and those outcomes. Path analysis showed support for burnout, role conflict, bullying, and organizational identification as useful mediators, explaining 68% of the variance in job satisfaction, and 45% in intentions to leave. The study also explores relationships between SD and hospital quality indicators. SD is a concern because it powerfully explains a number of poor outcomes and provides an underlying explanation for a number of factors that predict job satisfaction and turnover.

Constructing and Communicating Privacy Boundaries: How Family Medicine Physicians Manage Patient Requests for Religious Disclosure in the Clinical Interaction

Religion/spirituality (R/S) is an important component of some patients’ psychosocial framework when facing illness. While many patients report an increased desire for R/S dialogue in clinical interaction, especially when facing a frightening diagnosis, some physicians report discomfort talking about R/S and hold various beliefs regarding the appropriateness of such discussions. Not only do physicians manage conversations centering on patient disclosures in the clinical visit, they must also navigate requests to share their own personal information. Farber et al. (2000) found that over a 12-month period nearly 40% of physicians reported that patients asked questions that transgressed professional boundaries. This article uses Petronio’s communication privacy management theory as a lens through which to situate our understanding of how family medicine physicians construct and communicate privacy boundaries in response to patient requests for religious disclosure. Results provide an in-depth theoretical understanding of issues surrounding religious disclosure in the medical visit and expand the discussion on health care providers’ personal and professional privacy boundaries as documented by Petronio and Sargent (2011). Implications for health care training and practice are discussed.

Effects of Temporal Framing on Response to Antismoking Messages: The Mediating Role of Perceived Relevance

This study tested the effect of temporal framing on young adult smokers’ response to antismoking communication messages. In two studies using largely identical designs, young adult smokers recruited from a large university (n = 52) and Amazon Mechanical Turk (n = 210) were exposed to either no messages or messages featuring different temporal frames. Analysis of the combined data (N = 262) showed that framing the health consequences of smoking in a proximal (vs. distal) time frame led to greater perceived message relevance, less use of heuristic processing, greater use of systematic processing, greater positive affect, and more intense fear. Mediation analysis showed that perceived relevance was a significant mediator of the effect of temporal framing on message processing and emotional responses. In separate analysis of the Amazon Mechanical Turk data, the proximal frame also showed a consistent pattern of stronger impact on behavioral intentions compared to the distal frame, but the difference was only significant on the measure of intending to try to quit. Overall, findings of this study suggest that using proximal (vs. distal) frames may enhance receptivity to antismoking messages among young adult smokers, although the behavioral impact of this framing strategy still awaits further research.