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   

Enacted Goal Attention in Family Conversations about End-of-life Health Decisions     

Allison M. Scott  John P. Caughlin 《Communication monographs》2014,81(3):261-284

Most extant research on end-of-life communication in families has been based on the assumption that more communication is better communication. We used a multiple goals theoretical perspective to demonstrate that the quality of communication about end-of-life decisions matters. Members of 121 older parent/adult child dyads (N = 242) engaged in an elicited conversation about end-of-life health choices and reported their assessments of the conversation. Using multilevel linear modeling, we found that outside ratings of a person's communication quality (i.e., attention to task, identity, and relational goals) as well as outside ratings of the partner's communication quality were positively associated with the person's reported conversational satisfaction and hopefulness and negatively associated with the person's hurt feelings and relational distancing.  相似文献   

An Experimental Test of Medical Disclosure and Consent Documentation: Assessing Patient Comprehension,Self-Efficacy,and Uncertainty     

Erin E. Donovan  Brittani Crook  Laura E. Brown  Angie E. Pastorek  Camille A. Hall  Michael S. Mackert 《Communication monographs》2014,81(2):239-260

Effectively conveying risks and hazards in medical disclosure and informed consent documentation is a crucial type of communication. However, existing protocols typically do not meet the needs of patients or practitioners. In the present study, we advance a reconceptualization of obtaining written informed consent by analyzing it as a process of uncertainty management rather than a matter of document readability and recall. Results of this randomized trial indicated that patients who reviewed a simplified consent document reported greater comprehension of medico-legal terminology and lower uncertainty about the document, although they did not evince greater self-efficacy. Health literacy was a significant moderator of the relationship between consent form version and comprehension.  相似文献   

医学生心理健康问题与图书馆阅读疗法     

敬丹榕 《高校图书馆工作》2014,(3):80-83

文章对医学生心理健康与心理健康教育的现状进行了分析,认为目前我国大学生的心理健康教育缺乏专业的心理健康教育团队,心理健康教育课程也不完善,并且缺乏综合性的管理机制;论证了图书馆阅读疗法对于当今的医学生心理健康教育的可行性,提出了开展阅读疗法的具体措施。  相似文献   

正确解读《体育与健康课程标准》--兼谈在实施体育课程改革中存在的误区   总被引：1，自引：0，他引：1  

侯广斌  张泽刚 《河北体育学院学报》2005,19(3):58-59,77

从新的教学理念、指导思想、目标体系和评价体系等方面，对《体育与健康课程标准》进行了正确的解读。同时对部分地区中学对《体育与健康课程标准》的实施情况进行了调查，指出了当前体育与健康课程改革中存在的问题和误区，并提出了对策。  相似文献   

构建学分制下《体育与健康课程》体系的研究     

杨黎明 《福建体育科技》2006,25(3):59-61

采用文献资料法、问卷调查法、实验法、逻辑分析法,对“学分制体育与健康课程体系”进行研究,提出了构建“学分制体育与健康课程体系”的依据和思路,确立了其课程性质与目的,并对其课程设置、教学内容、教法方法、组织形式、教学管理体制、教学评价、教学效果等进行了详实的阐述。  相似文献   

高校女生健美操健康功能因素模型的构建与实践研究     

王艳 《首都体育学院学报》2006,18(1):64-65

运用教学实验、问卷调查、数理统计和回归分析等方法,对实验所获取的实验测试指标进行定量定性分析与研究,以探求健美操健康功能对高校女生健康状况的影响程度,并构建健美操健康功能因素模。健美操健康功能因素模分别由健身功能、健心功能和美育功能构成。  相似文献   

试论雷杰·米勒的投篮心态与篮球运动员投篮时的心理调控     

王长琦 《福建体育科技》2006,25(5):34-35,38

通过对NBA优秀篮球运动员“雷杰.米勒”的资料分析,展现其投篮时的优秀心理品质和心理状态的特点,寻找现代“神投手”心理训练的特点和方法,认为“专注、自信、自强、自控”是现代篮球运动员投篮时的主要心理调控策略。  相似文献   

关于高校体育与健康课素质教育改革的思考   总被引：1，自引：0，他引：1  

须晓东 《南京体育学院学报(社会科学版)》2003,17(1):117-119

以教育部颁布的《全国普通高等学校体育与健康课教学指导纲要》为依据 ,分析了体育与健康课教学指导纲要的基本特征及新变化 ,提出了 2 1世纪高校体育教师在实施指导纲要的要求时应注意的问题 ,以提高教育行政部门及教育工作者对高校体育与健康课的正确认识 ,更好地贯彻落实“素质教育”和“健康第一”的指导思想。  相似文献   

大学生心理健康状况调查研究   总被引：2，自引：0，他引：2  

白广明  周靖 《烟台职业学院学报》2003,9(1):94-96

目的:研究分析烟台市大学生心理健康状况。方法:采用精神症状自评量表(SCL-90)对烟台市555名大学生进行测试。结果:SCL-90各项因子得分至少有一项超过3分的大学生共70人。烟台市大学生心理健康水平低于全国常模,但优于国内大学生常模。结论:烟台市大学生的心理问题主要集中在一年级和四年级,男女生心理问题的表现和程度也存在差异。  相似文献