Lisa Sparks

Health literacy and cancer communication with older adults

OBJECTIVE The physiological, cognitive, language and communicative changes that take place as we enter into old age have become quite well documented within the social scientific literature. Many of these changes lead in some way to a lessening of previous interactive abilities and competencies. The new mantra for gerontologists attempting to help older adults compensate for these potential losses is to develop strategies to maintain existing abilities as long as possible. METHODS A literature review using online databases was performed. RESULTS Older adults who are diagnosed with cancer or help care for an individual coping with cancer must confront a health care system that demands a high level of health literacy to successfully manage the disease. Older adults may be at a distinct disadvantage in their ability to successfully cope with cancer because of age-related physiological, cognitive, psychological and communicative factors. CONCLUSION This paper highlights the relevant research findings and theoretical positioning that points not only to possible pragmatic dilemmas faced by those adapting to cancer but also highlights streams of research that scholars may wish to focus upon to better understand how older adults and their formal and informal caregivers can improve their cancer health literacy. PRACTICE IMPLICATIONS Providers, patients, and caregivers must all participate in creating a health care environment of shared meaning and understanding of health messages tailored to the aging patient diagnosed with cancer. Health communication scholars have various theoretical, methodological, and pragmatic communication-based approaches that provide important contributions to the complexities of caring for the aging patient.

Social Identity and Health: An Intergroup Communication Approach to Cancer

This article describes the ways in which group identifications and stereotypes can inform our understanding of cancer prevention and treatment as well as more general social processes surrounding the experience of cancer. From a perspective grounded in social identity theory, we describe the ways in which understanding primary identities (i.e., those associated with large social collectives such as cultural groups), secondary identities (i.e., those associated with health behaviors), and tertiary identities (i.e., those associated with cancer) can help explain certain cancer-related social processes. We forward a series of propositions to stimulate further research on this topic.

Health Information Sources of Individuals With Cancer and Their Family Members

The purpose of this study was to understand health information sources of individuals and families impacted by a cancer diagnosis. Overall, the findings support the Freimuth, Stein, and Kean (1989) model of health information acquisition. The cancer patients and family members who participated reported having significantly more health information along the continuum of cancer care, from causes to prevention, after a cancer diagnosis. Although a wide variety of interpersonal and mediated information sources are available, participants reported that the only consistently (88.1%) used source of information was doctors. The most important information sources were, in descending order, doctors, family members, nurses, friends, the Internet, other medical personnel, and other patients. Individuals, however, were most satisfied with family and friends as sources of information, followed by nurses, other patients, and doctors. Patients and family members rated the importance of and their satisfaction with various information sources differently. Patients rated nurses, other medical personnel, and support groups as more important than did family members, and patients were significantly more satisfied with doctors and nurses, whereas family members were significantly more satisfied with the Internet.

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.

Humorous Communication Within the Lives of Older Adults: The Relationships Among Humor, Coping Efficacy, Age, and Life Satisfaction

This study explores humorous communication within the lives of older adults by testing the relationships among humor, coping efficacy, age, and life satisfaction. Results overall indicate these four variables function in communicatively complex ways for older adults. As predicted, humor-oriented individuals were more likely to use humor as a coping mechanism and reported greater coping efficacy. In a comparison of individuals who varied in age (under 50, 50–74, and 75 + ), differences in humor orientation scores emerged among the 3 groups. As predicted by Folkman and Lazaruss transactional theory of coping and emotion, the relationship between self-reported humor orientation and life satisfaction was mediated by coping efficacy. In attempting to determine which variables best predicted life satisfaction, coping efficacy and health status explained unique variance in life satisfaction scores. Study implications and limitations are addressed.

Communication in the context of long-distance family caregiving: An integrated review and practical applications

OBJECTIVE Understanding how geographic distance impacts how individuals communicatively negotiate family caregiving is important for a number of reasons. Though long-distance caregiving (LDC) is a growing phenomenon with serious relational and health implications, this topic has yet to be approached from a communication perspective. In this review, LDC is thus considered as a communication context to offer caregiving scholars practical applications for contributing to this emerging research area. METHODS Review of the literature from 1999 to 2009 that studied aspects of distance caregiving communication obtained through searching Academic Search Premier, EBSCO, Communication and Mass Media Complete, PsycArticles, PsycInfo, PubMed/Medline, and Health Source: Nursing/Academic Edition online databases. RESULTS Eight published original research studies were included in the review. CONCLUSION The extent to which LDC communication is studied by caregiving researchers has the potential to provide helpful guidance for distant caregivers and care recipients to achieve successful health and relational outcomes. PRACTICE IMPLICATIONS Upon reviewing distance caregiving communication research findings, four applications are discussed: (1) defining distance as a subjective experience; (2) encouraging the use of mediated communication in LDC; and examining (3) interpersonal conflict and (4) topic avoidance processes in the LDC context.

Information diffusion, Facebook clusters, and the simplicial model of social aggregation: a computational simulation of simplicial diffusers for community health interventions

Abstract By integrating the simplicial model of social aggregation with existing research on opinion leadership and diffusion networks, this article introduces the constructs of simplicial diffusers (mathematically defined as nodes embedded in simplexes; a simplex is a socially bonded cluster) and simplicial diffusing sets (mathematically defined as minimal covers of a simplicial complex; a simplicial complex is a social aggregation in which socially bonded clusters are embedded) to propose a strategic approach for information diffusion of cancer screenings as a health intervention on Facebook for community cancer prevention and control. This approach is novel in its incorporation of interpersonally bonded clusters, culturally distinct subgroups, and different united social entities that coexist within a larger community into a computational simulation to select sets of simplicial diffusers with the highest degree of information diffusion for health intervention dissemination. The unique contributions of the article also include seven propositions and five algorithmic steps for computationally modeling the simplicial model with Facebook data.

Social Groups, Social Media, and Higher Dimensional Social Structures: A Simplicial Model of Social Aggregation for Computational Communication Research

By building on classical communication network literature, we present a computational approach to modeling tightly bound groups and social aggregations as higher dimensional social structures. Using the mathematical theory of simplicial complexes, these groups can be represented by geometric spatial elements (or simplexes) and a social aggregation a collection of simplexes (i.e., a simplicial complex). We discuss the uniting conditions that define a tightly bound group as a higher-dimensional group, which can be mathematically treated as nodes in a network of social aggregation. We utilize Facebook as a particularly relevant example to demonstrate innovative ways researchers can tap into digital data, in addition to traditional self-reported data, to advance communication research using the simplicial model, although the approach is applicable to many questions not involving communication technology.

An Introduction to Cancer Communication and Aging: Theoretical and Research Insights

This special issue of Health Communication (HC) stemmed from a Health, Communication, and Aging Research Symposium on Cancer Communication held near Washington, DC, at George Mason University in February 2002. The symposium examined health communication issues with an emphasis on older adults in cancer communication contexts. As most communication scholars know, effective health communication can help reduce cancer risk, incidence, morbidity, and mortality and improve quality of life. However, understanding the unique nuances involved when older adults are considered had not yet been adequately addressed in the cancer communication area. The authors of articles in this issue participated in that special day and, as a result, this issue was begun. The idea for this symposium grew from informal conversations at George Mason University. Over the last several years, Dr. Gary Kreps of the National Cancer Institute visited my research methods course at George Mason University to talk about his research. Dean Daniele Struppa, a mathematician, and Associate Dean Vikas Chandhoke, a biologist, visited class one day when Gary was lecturing. They were impressed. They encouraged me to create a symposium on cancer communication and aging here at George Mason University. At the time, they knew relatively little about the exciting work being done in cancer communication, but they believed in the value of communication scholarship, particularly on this important applied topic. With their support and funding, I was able to coordinate the symposium. Then, with the help of HC editor Teri Thompson, as well as Gary Kreps, Dan HEALTH COMMUNICATION, 15(2), 123–131 Copyright

How (not) to inform patients about drug use: use and effects of negations in Dutch patient information leaflets

Under EU regulations, patient information leaflets (PILs) are required to be clear and understandable. Negations (e.g., not, no) are a linguistic aspect that may impact PIL comprehension, yet go unmentioned in these regulations. We conducted two studies to determine (1) how negations are used in Dutch PILs (study 1) and (2) the effects of negations on readers (study 2).