Managing Patient-centered Communication across the Type 2 Diabetes Illness Trajectory: A Grounded Practical Theory of Interactional Sensitivity     

Christopher J. Koenig  Leah M. Wingard  Christina Sabee  David Olsher  Ilona Vandergriff 《Journal of Applied Communication Research》2014,42(3):244-267

This article uses the theoretical and methodological framework of Grounded Practical Theory (GPT) to provide a lens for analyzing and interpreting discourse as a situated form of social action in routine Type 2 diabetes visits. Drawing on a total data-set of 400 audio-recorded routine visits, we randomly selected 55 visits for qualitative analysis. In this article, we use Conversation Analysis to document communication techniques, which we in turn use as evidence to ground our claims within the GPT framework. We use two single cases of interaction to analyze communication techniques physicians use when recommending a change from oral medication to insulin. We argue treatment intensification is a key moment in health communication to reflect about patient centeredness because physicians can find themselves in an interactional dilemma: while insulin may effectively help control unstable disease, an insulin recommendation may simultaneously counter patient values and treatment preferences. Our analysis suggests that physicians use what we call interactional sensitivity to balance medical need and patient preferences when making medical decisions by tailoring their communication according to the local situation and the patient's larger illness trajectory. We propose that interactional sensitivity is a type of communication work and a quality of patient-centered communication characterized by the theoretical relationship between tailoring communication to the contingencies of the local interaction and the global illness trajectory. Overall, this article contributes to health communication scholarship by proposing a normative model for reflecting on how physicians negotiate challenging interactions with patients during routine chronic illness visits.  相似文献   

Developing heritage climatology for collection preservation in changing sub-tropical climates through a trapping survey in Hong Kong     

Peter Brimblecombe  Christopher Mattison 《文物保护研究》2014,59(5):S9-S12

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The persuasiveness of persuasive discourse     

Patricia A.  Michelle M.  Christopher T. 《International Journal of Educational Research》2001,35(7-8)

This investigation explored why and how persuasion occurs. Toward this end, we examined the processing of two articles under conditions called for in the persuasion and conceptual change literatures. One unique aspect of the current study was the use of topic-specific measures of beliefs, knowledge (i.e., perceived and demonstrated), and interest. The performance of members of three educational communities (i.e., undergraduates, graduate students, and faculty) was compared, as was the knowledge and interest of more or less persuaded readers. One article argued that there are prenatal similarities among humans and other mammals, while the second presented a favorable view of same-sex marriages. Although both articles produced significant changes in readers’ beliefs, knowledge, and interest, there were performance differences by text, educational community, and persuasion group. Results showed that readers’ perceptions of their knowledge played a more significant role in persuasion outcomes than the knowledge they actually demonstrated. Outcomes suggest the need to look more closely at the relationship between knowledge and interest in subsequent studies of persuasion.  相似文献   

Dons as Lobbyists     

Christopher Price 《Higher Education Quarterly》1987,41(3):257-267

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Correspondence     

Christopher Hampton 《Higher Education Quarterly》1984,38(4):359-365

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Opren deaths kept secret, admits Lilly     

Joyce C  Lesser F 《New scientist (1971)》1985,107(1471):15-16

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Endurance training adherence in elite junior netball athletes: a test of the theory of planned behaviour and a revised theory of planned behaviour     

Palmer CL  Burwitz L  Dyer AN  Spray CM 《Journal of sports sciences》2005,23(3):277-288

This study examined the utility of Ajzen's (1985) theory of planned behaviour and Maddux's (1993) revised theory of planned behaviour to predict endurance training intentions and adherence of elite junior netball athletes. One hundred and fifteen athletes from the England Netball World Class Start Programme were assessed on constructs central to the predictions of the two theories. Adherence to a recommended endurance training programme was recorded in self-report diaries across a 9-week period. Validity for the diaries was supported by significant correlations (P < 0.001) with recalls across 7 days and 9 weeks. Adherence was moderate and variable between athletes (mean = 66.05, s = 25.75%). Two separate path analyses were conducted to examine the predictions of the theories. Goodness-of-fit indices suggested acceptable fit of the data to the models. Analyses showed that attitude towards the new behaviour, subjective norms and perceived behavioural control predicted training intentions. The relationship between intention and adherence was weak. The present results suggest that the constructs of the theory of planned behaviour offer some insight into the explanation of intentions to follow an endurance training programme. Constructs unique to the revised theory of planned behaviour did not significantly predict training intentions or behaviour. Implications for practitioners working with team sport performers are provided.  相似文献   

Effects of competition, exercise, and mental stress on secretory immunity   总被引：2，自引：0，他引：2  

Ring C  Carroll D  Hoving J  Ormerod J  Harrison LK  Drayson M 《Journal of sports sciences》2005,23(5):501-508

It has been suggested that the psychological stress associated with competitive sports events may help to explain the increased susceptibility to respiratory infections due to reductions in secretory immunity. In the current study, we investigated the influence of competitive exercise and psychological stress on secretory immunoglobulin A (s-IgA). Salivary s-IgA and heart rate were measured in 62 healthy young recreationally active men at rest and, in a between-subjects design, following one of four 8-min tasks: mental arithmetic, cycling at workloads of 60 to 180 W (mean = 146 W), mental arithmetic while cycling, or competitive cycling. Mental arithmetic was associated with significant increases in s-IgA concentration (mean = 49 microg.min(-1)) and s-IgA secretion rate (mean = 25 microg.ml(-1)) compared with rest, while mental arithmetic combined with exercise was associated with a significant increase in s-IgA concentration only (mean = 124 microg.min(-1)). In contrast, competitive exercise and exercise alone did not influence s-IgA concentration or secretion rate. Heart rate increased modestly to mental arithmetic (mean = 7 beats.min(-1)) and substantially, and similarly, to the three exercise tasks (mean = 56(62 beats.min(-1)). The hypothesis that the psychological stress of competitive exercise contributes to increased susceptibility to infection via reductions in s-IgA requires further investigation.  相似文献   

Poetry and the market-place     

Christopher Hampton 《Higher Education Quarterly》1980,34(2):187-198

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Fault reconstruction using a LPV sliding mode observer for a class of LPV systems     

Halim Alwi  Christopher Edwards  Andrés Marcos 《Journal of The Franklin Institute》2012,349(2):510-530

This paper proposes a new sliding mode observer for fault reconstruction, applicable for a class of linear parameter varying (LPV) systems. Observer schemes for actuator and sensor fault reconstruction are presented. For the actuator fault reconstruction scheme, a virtual system comprising the system matrix and a fixed input distribution matrix is used for the design of the observer. The fixed input distribution matrix is instrumental in simplifying the synthesis procedure to create the observer gains to ensure a stable closed-loop reduced order sliding motion. The ‘output error injection signals’ from the observer are used as the basis for reconstructing the fault signals. For the sensor fault observer design, augmenting the LPV system with a filtered version of the faulty measurements allows the sensor fault reconstruction problem to be posed as an actuator fault reconstruction scenario. Simulation tests based on a high-fidelity nonlinear model of a transport aircraft have been used to demonstrate the proposed actuator and sensor FDI schemes. The simulation results show their efficacy.  相似文献