Lecture Notes
Chapter 12: Health Communication
Outline and Key Terms
I. Patient and Provider Relationships
A. Patient-Provider Identities—Altercasting involves how a person’s communication
influences the identity of another. As a person attempts to create a particular identity, the
communication of another may affirm or negate that identity.
1. Machines and Mechanics: Relationship type in which providers are viewed as
competent experts and patients are viewed as passive recipients; minimal personal
involvement.
2. Children and Parents: Provider portrays dominant role of expert, and patients
assume submissive and dependent role; slight increased personal involvement. Most
common approach.
3. Consumers: Patient increasingly dominant within health interactions; patients
view themselves as paying the health care providers for specific information and
expecting providers to carry out patients’ wishes
4. Partners: Patient and providers work together to solve problems and are viewed as
equals.
B. How Patients and Providers Communicate
1. Providers tend to dominate interactions with patients through questions and
directives.
2. Providers most often focus on a patient’s physical problems rather than
psychosocial problems and may limit personal disclosure, avoiding engaging
behaviors that might serve to increase closeness with patients.
3. Patients too may limit disclosure of medical concerns to providers.
C. Improving Patient-Provider Communication
1. Patient-Provider Communication Principles The table reviews primary ideas
behind seven communication principles that could make patient-provider
relationships more effective.
a. Patient Stories: Patient stories reveal important details
pertaining to a patient’s symptoms and psychological and relational issues.
b. Patient Expertise: Patients should be considered experts about their
situation.
c. Provider Expertise: Providers should use their knowledge to educate the
patient and share their expertise.
d. Physical and Psychosocial Connections: Recognition beyond the
biological into more holistic understandings can improve diagnoses and
treatment options.
Instructor Resource
Duck/McMahan, Communication in Everyday Life, 3e
SAGE, 2018
e. Emotions: Expression, recognition, and transacted meaning of emotion
can benefit interaction.
f. Reciprocity: Patients will act in accordance with provider styles (positive
or negative) and vice versa.
g. Roles and Expectations: Recognize the influence of traditional roles and
expectations while making relationships more constructive and effective.
D. Benefits of Effective Patient-Provider Relationships
1. Satisfaction: Effective patient-provider relationships can enhance feelings of
patient satisfaction.
2. Adherence to Treatments: Effective patient-provider relationships also increase
the likelihood that patients will adhere to treatments and lifestyle
recommendations established by providers.
3. Physical and Psychological Health: Effective patient-provider communication
can enhance physical and psychological outcomes by reducing stress and anxiety
related to illness and increasing the likelihood for adherence to treatments.
4. Malpractice Claims: Overall communication patterns of providers influence the
likelihood that a malpractice claim will or will not be filed.
II. Social Networks and Health
A. Social Networks and Health and Lifestyles
1. Family and friends have a profound influence on health and lifestyle decisions.
2. Health behaviors are frequently shared relational activities and can have both positive
(i.e., weight loss, exercise) and negative (i.e., smoking, drinking) outcomes.
3. Relational obligations can influence health behaviors, making some more and some
less difficult to enact.
4. Eating and Exercising With Others
a. Family members have an incredible influence on your food consumption and
your exercise habits through both their actions and the ways in which they talk about
these things.
b. Friends have a profound influence on diet and exercise decisions.
c. Behaviors and talk about food and exercise influence people’s attitudes and the
decisions that are made about diet, exercise, and ordering the super-sized meal.
d. Your friends’ eating habits and exercise routines may influence or set the
standards for your own.
5. Smoking With Others
a. Attitudes toward smoking and smoking-related behaviors are strongly
connected to social networks.
b. Smoking is frequently a shared relational activity.
c. Relationships with others through the social bonding provided by
commonly shared smoking habits have consistently been listed as one of the
perceived benefits of smoking.
d. People’s talk about their smoking also serves to minimize the perceived
risks.
Instructor Resource
Duck/McMahan, Communication in Everyday Life, 3e
SAGE, 2018
e. Social networks also influence attempts to cease smoking and can be
negative or positive.
6. Drinking With Others
a. Alcohol consumption is a lifestyle behavior associated with relationships.
b. Drinking alone has been listed as a potential sign of alcoholism.
c. Alcohol often plays a prominent role in holidays and special occasions.
d. The role of alcohol and talk about drinking alcohol in families are a
significant indicator of a person’s attitudes toward drinking and his or her
consumption of alcohol.
e. Friends also influence the use and consumption of alcohol.
(1) Drinking among college students continues to be a problem on
many campuses, resulting in physical, academic, relational, and
legal problems for many students.
(2) Pressures to drink in general are often based on relational
obligation, and those who try to avoid the consumption of alcohol
often experience relational distress as a result.
f. Beliefs may result in perceiving that alcohol consumption is necessary
in order to fit in when it may very well not be necessary.
B. Social Networks and Support
1. Action-facilitating support: Involves providing information or performing tasks
for others. a. Informational support involves providing someone with information
to increase his or her knowledge and understanding of health issues.
b. Providing someone with information increases not only his or her
understanding of the situation and ability to make informed decisions but
also his or her feelings of competence and value, issues related to
nurturing support.
c. Instrumental support involves performing tasks for someone.
d. Providing instrumental support goes beyond mere completion of tasks
and additionally entails personal and relational reinforcement.
2. Nurturing support helps people feel better about themselves and the issues they
are experiencing, and includes emotional support and esteem support.
a. Emotional support enables people to express their feelings and to have
those feelings validated by others.
b. Esteem support involves making someone feel competent and valued.
C. Secondary Goals of Social Support
1. Identity Goals of Social Support
a. Since most people want to be seen as worthwhile and decent, seeking social
support can put one’s identity at risk in certain ways.
b. Managing interactions to prevent negative face is valuable.
2. Relational Goals of Social Support
a. Expectations surrounding relationships influence specific types of support
available from certain relationships.
b. When support expectations are not met from certain relationships, negative
relational consequences (disappointment and rejection) can result.
Instructor Resource
Duck/McMahan, Communication in Everyday Life, 3e
SAGE, 2018
D. Everyday Communication and the Foundations of Social Support
1. Supportive Functions of Everyday Communication (Table)—Regular everyday
communication establishes a basis for support in the future as needed.
2. There are a total of six supportive functions of everyday communication that
influence how and if support will be available when needed:
a. Information: Determines who will support and in what ways they will be
effective at giving various kinds of support.
b. Perpetuation: Sustaining social relationships in order to maintain options
for support.
c. Detection: Ability to observe and note changes in relational/personal
patterns as an indication of need for support.
d. Ventilation: Allows for ventilation of stress and worries.
e. Distraction: Trivial, routine communication can serve as temporary
distraction from stressors.
f. Regulation: Everyday talk serves as a precursor to serious talk, and
support can be sought in less serious ways when needed.
E. Communication Privacy Management
1. Sandra Petronio’s (2002) communication privacy management theory explains
how people create and manage privacy boundaries in their relationships.
2. Several facets of this theory are reviewed:
a. Self-disclosure: Deals with the revelation of private,
sensitive, and confidential information.
b. Ownership: Private information is owned and consequently can be
controlled.
c. Privacy boundaries: Borders between what is considered private or not.
d. Permeability: Depending on degree of closeness and
relational type, the degree to which some are allowed
access to information and others are denied.
e. Coordination: Cooperation among persons who share
private information to keep boundaries intact and ensure
that information revealed is not misused by the recipient.
f. Boundary turbulence: Occurs when people struggle to
coordinate privacy rules and boundaries.
III. Media, Technology, and Health
A. Entertainment Media and Health
1. Can affect perceptions of health care and expectations.
2. Positive impact includes increased awareness of medical issues and
procedures.
3. Negative impacts include inaccurate expectations and perceptions of things like
chronic versus acute illnesses, expertise of physicians and drug companies, and reasons
for illness.
4. The mortality rate of fictional hospital patients has been shown to be nine times
higher than that of real hospital patients.
B. News Media and Health
Instructor Resource
Duck/McMahan, Communication in Everyday Life, 3e
SAGE, 2018
1. Television news, newspapers, magazines, and general health programming are
also sources of information and misinformation about health.
2. Health issues are framed in particular ways that may be misleading.
3. Certain health and illness issues are more frequently addressed in news media
than in others.
4. News media frequently provide audiences with social and moral
meanings of health-related issues.
a. As with any development of meanings, those encouraged by
news media are biased toward certain perspectives.
b. An analysis of a decade’s worth of news reporting about weight
issues and obesity discovered that thinness is associated with moral
virtue and obesity is associated with poor individual choices.
c. Such reporting, it can be argued, reinforces cultural stereotypes
by overlooking both biological causes of obesity and
socioeconomic associations.
C. Advertising Medications
1. Direct-to-consumer advertisement of medications has both positive
and negative impacts on health communication.
a. May increase patient awareness of illnesses and treatment
options
b. May also lead to unneeded treatments and overmedicating
2. Advertising may increase patient awareness of an available treatment
option.
a. Drug treatments focus on physical elements of illness and tend
to overlook psychosocial and other factors contributing to the
illness as well as nonmedicinal treatments.
b. Such advertising increases the prescription of certain
medications even though other medications may be just as if not
more effective.
3. Direct-to-consumer advertising increases the likelihood that patients
will take a more active role in discussions with providers.
a. Increased awareness may encourage patients to feel more
equivalent to providers.
b. Information gleaned from a brief commercial or print
advertisement, however, is usually quite limited, and the potential
problems caused by the drug are generally not fully realized.
c. Providers must spend time reeducating patients, limiting time
available to discuss other issues and concerns about a patient’s
illness and treatment options.
D. Health Communication and the Internet
1. Searching for Information
a. Seventy-two percent of Internet users have searched for health
information online within the past year.
b. Half searched for information on behalf of someone else.
2. Support
Instructor Resource
Duck/McMahan, Communication in Everyday Life, 3e
SAGE, 2018
a. Support groups are now available online and are beneficial for
convenience and relatively easy access along with providing an
outlet for people physically unable to attend formal support group
meetings or people who choose not to attend face-to-face meetings
for personal reasons.
b. Online support groups have been found to benefit users through
multiple forms of social support.
c. Support also comes in the form of information from others.
d. The number of Internet users seeking online support will likely
increase as familiarity with and access to the Internet continue to
increase.
3. Connecting Patients and Providers
a. The Internet is increasingly used as a means of connecting patients and
providers.
(1) Some providers are connecting with their patients through
social networking sites (Mathews, 2013).
(2) Providers are able to supply patients with general medical
information and encourage healthy lifestyle choices between visits.
(3) Patients are provided with another means of contacting
providers when needed.
(4) Social networking site connections may encourage partner
identity, enabling both the patient and providers to play active
roles in health care and treatment.
(5) Although there may be advantages to these social networking
site connections, there also exist concerns about privacy and
relational boundaries.
b. The Internet is also being used for patient evaluation and treatment by
providers (Mathews, 2012).
(1) Rather than interacting in a doctor’s physical office, patients
and providers interact virtually or through webcams.
(2) Virtual and online interactions provide such benefits as
decreased costs, increased accessibility, and increased
convenience.
(3) At the same time, there are concerns about the risk of
misdiagnosis and potential deception.
(4) Online treatment is a relatively new phenomenon, but as
with other uses of the Internet, it is likely to become more common
with the passing of time.