Comm 321 Final Study guide
Sensational Stories (in relation to Agenda Setting Theory)
bias in the media, "if it bleeds it leads" the more likely the story is to make the front page of the paper
Goal of palliative care
curing disease and prolonging life.
Sufficient
guaranteed outcome . to get drunk you need to drink.
has allowed doctors to consult with one another and their patients rather easily -Email (ADV) allows efficient, cost-effective communication over geographic distance -Email (DIS) can be impersonal, lacks nonverbal cues and immediate feedback
2nd process of Hospice Care
hospice staff meet with the patient and their family to discuss the hospice philosophy, available services and expectations
Hospice developed
in England
Positivists
individuals who feel that they have largely achieved the goals they have set for themselves in life and who reflect positively upon their lives.
First order effects in relation to cultivation theory
information gained from media consumption; the things you actually learn, objectively learn by consuming media, objective real facts, medical information; Ex: Grey's Anatomy - if you watch a lot you might pick up some medical information on the way
Unbounded Networks
internet communities; free of time constraints, geographical restraints and social constraints
Telemedicine
is the "use of communication technologies to facilitate the delivery of healthcare at a distance for the direct benefit of patients"; tools that allow you to have interaction provider in a geographically distance way
Issue of understanding health information
just because someone can locate information does not mean they will understand it or apply it correctly; just because you can find something on the Internet doesn't necessarily mean that you are going to understand it, there is a high probability that you will find information that you won't understand
Advanced Care Directives
legal documents that instruct family members and other loved ones about the wishes of an individual after he or she dies
3rd process Hospice Care
making a plan, comfort levels, support systems, financial and insurance resources, medications and equipment needs, the plan for care is regularly reviewed and revised according to the patients condition
Issue of accessibility health information
many people do not have access to computer information. Health literacy also affects some people's ability to understand; not everyone has access to the Internet, literacy issues
Issue of credibility health information
many websites allow anonymous posting/crowdsourcing of data; crowdsourcing information, Wikipedia, health websites that are trying to promote something but are really just trying to sell you something
Process of hospice care
meeting is held with the patients primary physicians and a hospice physician to discuss the patients' history, physical symptoms, and life expectancy. Hospice staff will then meet with the patient and their family. A plan is developed for the patient.
What is grief?
normal process of reacting both internally and externally to the perception of loss
Advantages of online support groups
online support groups provide a reasonable alternative when FtF groups are not possible; one of the biggest advantages in health care over the last 10-15 years that social media has gotten bigger and these online support groups have been created; sometimes face-to-face groups or interaction is not available or someone doesn't want to talk face-to-face, online support groups are easier
definition of the "sandwich generation"
people who are middle aged and care for both their parents and their children
Mainstream in relation to cultivation theory
people who consume a great deal of media have attitudes consistent with those depicted in the media; if you consume a lot of media, likely to have attitudes consistent with the media that you consume, ex: Fox News - skews conservative, MSNBC - skews liberal, depending on what you watch you are more likely to be influenced more and act more like it
Prevalence
proportion of people in a population who already have a condition (e.g., the number of children who already have an ASD diagnosis: 1 in 88)
What has informed consent become?
providers in the US often pressure family members to make decisions about treatment options relatively quickly.
Palliative care barriers financial
quality palliative care in the US has been limited by insurance reimbursement requirements as well as by a shortage of well-trained healthcare providers who are knowledgeable about end of life issues.
Hospice
refers to programs that provide support and care for people in the last phases of an incurable disease, with a focus on maintain the quality of their remaining life by providing services that both aid physical comfort and address psychological and spiritual needs.
Palliative care
refers to the comprehensive care of terminally ill individuals and their family members using an interdisciplinary approach. palliation refers to any treatment, care, or support that relieves symptoms and suffering
What is Bereavement?
refers to the period of time in which an individual experiences grief and mourns the death of a loved one
Underreporting (relation to Agenda Setting Theory)
the HIV pandemic was underreported; underreporting of health problems tends to occur even more often when the problems affect minority populations in the US
Disadvantages of support groups
the lack of salient social cues means that some people might make different relationships
How media influence occurs
the reality portrayed in the mass media influences our perceptions of reality in the real world over an extended period of time. In other words, long-term repeated exposure to mass media messages shapes our understanding of the world in ways that are consistent with how reality is portrayed in the media.
Doctors talking about death
they feel they will be perceived as giving up on the patient, and that if they talk about death it will eliminate the patients sense of hope and lead to depression
Goals of Hospice
to provide a dignified, comfortable death for the terminally ill and to care for the patient and family together.
1st process of Hospice Care
when a candidate for the program is identified, hospice staff members generally hold an initial meeting with the patients primary physician and hospice physician to discuss the patients history, physical symptoms and life expectancy
Incidence
(incidence rate): the number of new cases of a condition in a population in a fixed A(usually per year)
How supportive relationships can help caregivers
(pg 49) Caregivers communication with their social network and providers can have a positive impact on their stress levels, particularly when they are able to use their communication skills to obtain assistance and emotional support. Humor provides relief from stresses of caregiving.
Sex Ed as health literacy
-"appropriate" sexual education is highly contested in the United States -ROLE OF EDUCATORS: -treatment of males and females- how we view how many partners each gender has; heteronormativity - ROLE OF MEDIA: -Families are an important source of information for adolescents - Families set expectations for children - Children learn from watching parents -Teenage pregnancy is one issue on which both parents and educators focus; teen pregnancies are decreasing -Overall, 37 states require that abstinence is a part of sexual education -26 require that abstinence be "stressed" -11 require that abstinence be presented along with method of contraception -By comparison, only 18 states (and DC) require that information on contraception be provided -Only 21 states (and DC) legally require sex education as part of school curriculum -Only 2 states (CA and LA) require that sexual education be free from religion
Telemedicare
-(ADV) helps doctors stay in touch with patients, delivery of services to geographically isolated patients. Telemedicare -(DIS) patients might be excluded from conversations
Probabilistic
-(statistical) causes - odds that we get a certain health problem EX: Smoking 3 packs a day increases your chances of getting cancer by 30%. Yet, we still know people who smoked all their lives and lived to be old. * Most health information is "probabilistic".
Technologies have changed continuing education for providers
-A variety of web-based continuing education courses have appeared, and many allow providers to complete the course at their own pace, some even allowing providers to download a certificate of completion at the end of the cours -Web-based continuing education courses support the use of the multimedia, and they are relatively inexpensive to design, implement, and maintain -However, the variety and quality of Internet-based continuing education courses vary and this needs to be assessed in future research along with the other cost-cutting benefits these courses offer to the healthcare system
Adolescent risky behaviors
-Adolescents frequently experiment with risky behaviors. -37% of adolescence experiment with drugs before the age of 18. -The average age of "first use" is 13 years of age. -Most popular drug is weed. (3%) -The percentage of adolescents abusing alcohol increases steadily with age: -.5% among 12 year olds -17.2% among 19 year olds
Paternalism
-Attempt to "help" patient -Healthcare providers sometimes withhold information; In most cases to help the situation, don't want to tell the patient the truth and do what they think is best which is not to tell them that they are going to die or that they are very sick -Knowledge gap between health care providers and patients Patients become more reliant on the healthcare providers
What are the four factors that contribute to health literacy (T, L)?
-Cultural knowledge (baby under rocking chair) -Oral literacy (listening and speaking ability) -Print literacy (reading ability) -Numeracy (math ability)
Diagram (Parker & Ratzan)
-Health Literacy occurs when the skills and ability of those requiring health information and services are aligned with the demand and complexity of information and services. It demonstrates that health literacy reflects the dual nature of communication, as it represents the alignment of skills and abilities with the complexity and demands of what needs to be done for health -Framework indicates that the lack of skills and ability of individuals can slow one down as they approach tasks, as many do not understand what they can and need to do for their health (Left side arrow). But, it is the demands and complexity of health information and tasks that stop many from being able to achieve optimal health (Right side arrow). -Interventions to simplify and improve the demands and complexity of the health systems and information are the top priority for action, and we must work to systematically communicate "health" so that it becomes more understandable for patients. Achieving alignment with both sides will make us health literate (Middle). -Skills & Ability --> Health Literacy <-- Demands/Complexity
Consequences associated with health info
-Inconsistent messages create confusion and mistrust -some revelations spark public outcry are problems internal (person) or external (environmental)
Causality
-It is a cause that something is produced towards a specific outcome. -Can be defined along two dimensions: necessary vs. sufficient cause
Scholar arguments of media portrayal of eating disorders
-Many medical shows feature unrealistic portrayals of health and illness -Media also promote unhealthy behaviors: -Eating disorders -Body image fixation / desire for cosmetic surgery -Alcohol consumption -Tobacco use -Sexual behavior
Media consumption and desire for cosmetic surgery
-Many reality TV programs promote the idea that women need cosmetic surgery in order to achieve high sense of self-esteem & happiness. Stereotypical notions of beauty are promoted (i.e being ultra thin, having small nose, large lips) while downplaying risks of cosmetic surgery. -Risks include: -Bad reactions to anesthesia -Technical problems that may arise during surgery -Many people w/ cosmetic surgery are dissatisfied w/ results (esp. when they don't look like the celebrity they admire) -As a result, some individuals opt for additional surgery to "correct" dissatisfactions which may result in body dysmorphic disorder in where individual has cosmetic surgery multiple times in an effort to achieve an unrealistic ideal of beauty
Unrealistic depiction of health issues in the media
-Media also promote unhealthy behaviors: -Eating disorders -Body image fixation / desire for cosmetic surgery -Alcohol consumption -Tobacco use -Sexual behavior
Statistics that identify the Health Literacy problem in the U.S.
-More than 1/3 of adults in the U.S. cannot determine the proper way to take prescription medicine based on typical instructions found on container labels -Over 85% cannot calculate an employee share of health insurance costs using a table -1 in 10 Americans scored in the "proficient" range of health literacy skills and would be able to successfully negotiate the wide array of tasks required to navigate healthcare in our country today
How most health care transactions are processed (SOAP)
-Patient provider encounters tend to follow a formulated script -(S)ubjective: patient; most health care encounters start with the patient - narrative format, what they are worried about, subjective experience -(O)bjective: physician; physician then objectifies it - talks to you like you are a machine -(A)ssessment: physician; physician then makes an assessment from what they were told -(P)lans: physician, maybe patient; physician will then come up with a plan of what they need to do or to take; not a lot of wiggle room for health care consumers, can't really take control of their own health
How technologies have changed patient provider dynamic
-Patients now have potentially greater access to physicians and other providers via the Internet than in the past, particularly through email and online health-related websites such as WebMD -Online access to physicians alters the traditional provider-patient interaction in a variety of other ways, so it is important for health communication scholars to study this trend -Access to email, high-speed Internet, education, and computer literacy continues to limit patient access to the Internet and the ability to interact with physicians online -Physicians often view the idea of interacting with patients via email or through other web-based means in a negative light -Many physicians are reluctant to transcend traditional provider-patient relational boundaries because of such issues as patient privacy, the reduced ability to provide psychological dimensions of healthcare, and increased vulnerability of medical malpractice litigation -Scholars have found that email exchanges between providers and patients are associated with patient satisfaction, feelings of safety, and quality of care -Some health websites, such as WebMD, occasionally schedule chats with physicians and other providers or allow consumers to pose questions through the use of bulletin boards -The advice consumers receive may help them to allay fears or manage uncertainties about their health status, and it may lead them to seek additional information or explore treatment options
Media depictions of sexual practice
-Popular media portrayals of sexual behavior often emphasize its positive aspects while ignoring the potential consequences (i.e. pregnancy & STDs) -Sexual activity w/ multiple partners is often associated w/ popular characters & rewards (popularity, being macho, etc.) in television shows & films
Three components of message tailoring
-Tailored messages are more relevant -Tailored messages gain more attention -Tailored messages eliminate unnecessary information
Media depictions of tobacco
-Tobacco product advertising is glamorized as "macho" or masculine -Characters on TV/films that smoke are portrayed as romantically and sexually active than nonsmokers -Tobacco advertisers present argument that cigar smoking is less dangerous than other types of behaviors (i.e eating junk food), reduces stress, is fine in moderation, and also makes claims refuting scientific evidence that links smoking w/ cancer
Media depictions of violence
-Violence is the norm in television and movies such as "The Sopranos." -Researchers have estimated that most children will witness 8000 murders & 100 000 other types of violent acts before finishing elementary school -a number of other factors such as cognitive and emotional maturity, intelligence, gender, and viewing habits, mediate the effects of violent content on aggressive behaviors
Cultivation Theory
-explains the effects of mass media; what do people learn from the media -argues that media plays a primary role in informing individual's perceptions of reality.
Necessary
-not guaranteed Ex. necessary to have a drink to be intoxicated but drinking does not necessarily mean you get drunk
Information seeking need filled my media
-to reduce uncertainty about health issues by gathering information that will help us make better choices about how we respond to daily events -people watch TV, go online, read, to get information to find out what is going on
Media use to fill social needs
-with personal integrative function- tv & other mass media provide people with substances for conversations with members of their social group -with that we gain knowledge from media, current events, or happenings in the lives of media characters helps to enhance our credibility and status in convos. with others. interactive media can fulfill interpersonal needs- online health communities -commonality, tune in for a personal connection, tune in beach everyone will be talking about it the next day; media help us connect with other people; Ex: Super Bowl
Three main barriers to hospice care
1) lack of continuity of care between hospice team members, 2) the inability of hospice staff to meet the emotional and spiritual needs of patients 3) lack of adequate training among healthcare professional in taking care of those who are dying
Provider role in Advanced Care Directives
1. Important for provider to discuss the values with their patient so they give reassurance that they will be carried out 2. approach topics in warm, open, caring, manner 3. should care about the patients needs and take all aspects into consideration translate difficult terminology into something patients can understand
What Advanced Care Directives do for the patient
1.give individuals more control over how they will be treated by healthcare professionals 2.help determine settings for healthcare and limits for life sustaining treatments that may lengthen the dying process 3. gives people reassurance that they will be treated in ways that are consistent with their values
How was Health Literacy integrated into the affordable care act
1.includes definition of health literacy and integrates health literacy into law of the land 2.notes relevance to dissemination of research prescription medication labeling 3.education of healthcare providers, workplace wellness and shared decision making 4.institution of medicine and federal legislation later 5.adopted this definition and have it for advancing a health literate america 6.health literacy has grown from an under-recognized silent epidemic to an issue of health policy and reform understanding the nature of health literacy and its relevance to health outcomes has been under research to improve it.
Alzheimer's disease
A degenerative and fatal disease that is linked a specific pattern of neurological degeneration with symptoms of dementia. The disease is characterized in the brain by abnormal clumps and tangled bundles of fibers composed of misplaced proteins.
Polypharmacy
A situation that can lead to the need to take multiple medications and the interactions to treat certain conditions lead to polypharmacy, the problem that arises from the prescription of an excessive number of medications
The importance of competent communication in these relationships
Ability to use communication competence to mobilize support from social network Communication competence the ability to construct and use appropriate and effective messages to meet goals/needs and to successfully create and maintain satisfying relationships.
Know what being a "healthcare consumer" means in terms of responsibility, knowledge, and expectations
Being treated as a Consumer vs. Patient Questions of Responsibility: If you are a healthcare consumer, than YOU are responsible for making the right decisions Questions of Knowledge and Expertise: How are informed you are about the topic? Questions of Expectations: Ask your doctor!
How caregivers' willingness (or reluctance) to communicate with others affects their role and health
Caregivers often hesitate discussing their own distress with others Feel like they are putting a burden on someone else; may make your friends view you negatively; you may feel guilty/selfish to feel that way Significant toll on personal relationships Couples caring for an older adult have significantly less personal time, depleting their satisfaction, sometimes leading to divorce (63)
Caregivers for the ill: know about recent demographic trends
Caregiving is correlated with negative caregiver health with 17% of US caregivers reporting fair or poor health, compared with 13% of the general adult population As the length of the human life span increases individuals are living longer, and with advances in medicine it is now possible for ppl with a variety of long-term illnesses to live with their condition for many years. Only about 5% of older Americans currently experience institutional long term care, but this number is projected to grow in the next several decades with the aging of the baby boomer age cohort.
Know the two common outcomes associated with health information
Empowerment Feelings of being overwhelmed
Entertainment Education
Ex: HIV positive - a lot of people have heard of it but don't know much about it, you don't have to be afraid of people with HIV, you don't get it from sharing food with them or being around them
Dimension 2: Values
Health communication is not value-neutral -Guided by assessments of right/wrong, good/bad, etc. The concept "quality of life" is affected primarily by values Values are reflected in public health campaigns
Hyperpersonal
Hyperpersonal put their best self online, the person who gets that information makes it even better - makes an almost unrealistic person; heavily filtering what you put online and the person makes it better and end up being on an unrealistic situation Online users report more positive perceptions of partners and are more certain of their perceptions (compared to face-to-face)
Conversations about illness and identity: how they affect both patients and their families
Ill loved ones struggle to find a new identity as a patient - Identity shifts o Previously healthy and well to sick Important one for caregivers to consider o As a patient o As a survivor o People who are less involved and identified with their family may dissociate from the medical history and perhaps perceive themselves as less vulnerable.
Dimension 3: Accessibility
In most patient-provider interactions, access to health information is controlled by the provider HCPs sometimes withhold information Paternalism: attempt to "help" patient Information Control Knowledge Gap Healthcare providers are not the only source of information: Friends and family The media Entertainment-education Not-for-profit organizations Internet sources
Know what some groups are doing to combat low health literacy (examples from videos in lecture).
Labels for medications more understandable for the average person.
First main challenge associated with caregiving communication: Willingness to communicate concerns
Many family caregivers are reluctant to communicate problems they encounter during the caregiving process to the people they are caring for or to other within their social network because they do not want to burden them with the added stress of thinking about these concerns.
Where do hospice take place
Most hospice care takes place in the patient's home, although more and more inpatient hospice facilities are becoming available.
The importance of verbal and nonverbal issues in the caregiver/patient situation, esp. the role of nonverbal communication in caregivers' approach to pain management
Patients who aren't able to communicate verbally are at risk for underassessment and inadequate pain relief, those at highest risk being patients with cognitive impairment, intubated patients, infants, and patients older than 85 Family caregivers are important sources of information about patient behaviors, and they are often crucial in communicating information about pain to providers.
Be prepared to describe the financial and health related impacts of poor health literacy (video from lecture).
Patients who have a low health literacy may not understand the medication they are taking. -Ex: adult male not taking heart medication for hypertension because not feeling hyper -Woman takes double pills in morning to make up for not taking one at night
Why is informed consent important?
Patients would have full knowledge of their health situation, especially if they were at risk of dying from cancer or high blood pressure.
How health comm scholars should focus on health literacy reccomendations
Research, legislation, reducing health disparities, federal government, improving medical practice.
Second main challenge associated with caregiving communication: Communication of emotional support
Researchers have found that the provision of emotional support is one of the most time-consuming and challenging aspects of caregiving, often requiring more of a caregiver's time and effort than other daily caregiving task.
Challenges of informed consent
Some patients prefer to be informed if they have cancer and some prefer indirect communication which allows family members to be more hopeful about a loved one's recovery. But medical interpreters are required to interpret information for providers and patients without omitting or changing anything. This can make it difficult to convey information to patients in a culturally sensitive way, especially if the physician conveying information to the medical interpreter has little understanding of the health beliefs of the patient.
Agenda Setting Theory
Telling the public what to think about but not how to think about it.; framing stories in a certain way, which stories are shown and featured and presented; the media play a major role in what people think is important or not
Health literacy
The degree which individuals have the capacity to obtain, process, and understand basic health info and services needed to make appropriate health decisions.
Post-mortem decisions, esp. organ/tissue donation (pg. 82)
There are 96,000 Americans waiting for organ donations, unfortunately many of these people will not receive a life saving organ because of public resistance to donating organs and tissue after death and because family members are reluctant to donate organs from their deceased loved ones. There are different age limits on the donation of some organs and tissue, and a person's age and medical history are taken into consideration when an organ donation is made. There are a variety of reasons why people are reluctant to donate organs and tissue after death, including lack of knowledge about donation, religious and spiritual beliefs, concerns about body mutilation and the deservingness of potential recipients or organs and tissue, such as criminals.
Dimension 1: Quality and Quantity
Thinking of patients as "healthcare consumers" Questions of responsibility Questions of knowledge and expertise Questions of expectations Patient-provider encounters tend to follow a script: Subjective: patient Objective: physician Assessment: physician Plans: physician (maybe patient) Support groups give patients the opportunity to voice their concerns Patients share subjective experience with one another Another context to consider the quantity and quality of information is informed consent
Informed Consent
U.S. patients have the legal right to be fully informed about their health condition; tells you about the procedure, consenting about the benefits and the risks, what they have become are ways of providers to tell a patient everything that could go wrong, they are no longer making conformed consent, much more about covering the providers from lawsuits
Social Information Processing Theory
Walthers social information processing theory has been utilized to explain the ways that people interact online; can form different kinds of relationships online Communicators utilize the properties of the Internet to create and manage a favorable impression online; people use online communication for favorable impressions, online computer networks -communicators utilize the properties of the internet to create and manage a favorable impression online. Receivers of messages play into this through idealizing characteristics of the message sender
"Mycare team" as an example of telemedicine
Website where people with diabetes can track their levels and share them with their doctor
Gatekeeping (in relation to Agenda Setting Theory)
What is news worthy of making media; news agencies - which stories get featured and reporting on them
How demographic trends are affecting the role of senior care in the US
With the increase in older adult population, ages 85+ its estimated that the number of seniors requiring long term care will double by 2040, with the number of laycaregivers said to increase because of longer lifespan, growing segment of older adults and advances in medical technology
What is Anticipatory Grief?
a normal mourning that occurs when a patient or family is expecting a death, and many of the same symptoms experienced after a death has occurred
Presbycusis
an age-related hearing loss, and hearing problems do tend to increase after the age of 45
Message Tailoring
any combination of information and behavior change strategies intended to reach one specific person, based on characteristics that are unique to that person, related to the outcome of interest, and derived from an individual assessment.
Negativists
are people who reflect negatively upon their lives, especially those individuals who did not have the opportunity to fulfill dreams or who have regrets about their behavior, and these people may look on death with despair.
Electronic Medical Records
are replacing paper-based records in many clinics -Electronic Medical Records (ADV) can eliminate redundancies, records easily shared among in network providers, reduces medical errors -EMR (DIS) difficult to export information to different platforms, reduces face to face patient provider interaction.
Uses and gratification theory and what UGT argues in terms of the reasons people consume media
argues that people consume media to fulfill one or more psychological or information-seeking needs; an explanation why people consume media to begin with, at least four or more reasons, related to psychological or informational reasons The reasons why individuals choose one type of media over another or choose specific media content are as diverse as people themselves, but what we choose to view, read, and listen to mediates the influence of the mass media.
Second order effects in relation to cultivation theory
attitudes gained from media consumption; the attitudes you gain from the media, might think the doctors are really smart, resourceful, more of your opinions by watching these shows, your perceptions