Health Communications HNSC 2187 EXAM2 PDF

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5 6 7 Health Communications: Exam 2 No chapter 8 Chapter 5: culture and diversity issues in healthcare  In addition to language, there may be other cultural differences in belief about health/comm behaviors when individuals seek care in another country  Culture permeates many life aspects, influence perception in health.  Culture seen as dynamic, NOT STATIC, cult. Means are in flux w/ changing condition  Ignoring cultural diff. in illness conceptions and health can lead to prob btw provider/patient.  Health literacy: capacity to obtain process understand basic health info needed to make appropriate health decisions.  Many healthcare orgs now implement intercultural comm. U.S continues to become more culturally diverse through language, ethnicity, diversity  Provider challenges: if they lack important info about groups, don’t know how to comm  Health Disparities: vulnerable people have significant health literacy differences, challenged by intercultural comm barriers to assess relevant health info o Preventable health differences groups of ppl exp based on race, age, SES Cultural differences in concepts of Health and medicine  Biomedical model of health: refers to medical practices and beliefs derived from western science tradition, germ theory/biology/Biochem/ causes of illness  Ethnomedical belief system: culturally unique knowledge about health and disease. o Providers lack adequate training in this  Many cultures attribute illness to spiritual forces. Direct conflict of biomedical model  biopsychosocial model= individuals operate within a web of individual social roles  healthcare personnel need to identify each patient’s attitudes towards health options such as treatment, quality-of-life, environment  Acculturation: change of lifestyle which affect health ex: sedentary, fat food consumpt.  Informed Consent: legal right to stay fully informed about health condition, ethical  different co-cultures among US-born ppl influence health beliefs (amount of info that a patient has provided also impact decision-making)  immigration from different countries increases healthcare provider demands. Must be culturally sensitive recognizing cultural diversity in concepts of health believes  Health workers must comm effectively. culturally sensitive, respect beliefs/values  Consideration of mortality, influenced by not just culture but also religion, personal experiences o Preferences for life-sustaining treatments, less likely to use hospice care/organ donation. Longevity might be more important than quality of life.  Barriers providing culturally sensitive healthcare: providers may not have sufficient knowledge of how lifestyle change in diff culture affect immigrant health. Hospitals may not have translators/personnel that understands ethnomedical belief. o Structural barriers: material phenomena prevent healthcare access (poverty, language difference) o Health belief barriers: social constructed ideas about health and wellness that either inhibit or enable access

Alternative Medicine: 42% of U.S does it (holistic therapy) o Use of herbal remedies, acupuncture, osteopathy, yoga, massage, shock o Majority do not mention their alternative form of medicine use to their Dr. o Hesitant to talk bc dominance of mainstream biomedical approaches, health care providers concern over possible interaction effects of prescript. Meds over the counter tx for same problem o Biomedical practitioners began to form associations such as AMA, books while alternative has been described as unprofessional due to lack of standards o What is perceived as advantage/dis by patient depends on their values regarding health, illness, and quality of life. o Bc holistic approaches don’t treat disease aggressively, indiv with good prognosis may consider biomed tx with complementary holistic therapies. o Religion: organized system of beliefs, practices, rituals, symbols o Spirituality: transcendent relationship to some higher power, quest for understanding answers to ultimate questions about life Spirituality, Culture, Health  religion and spirituality are defined. Overlapping and separate concepts  Intrinsic religiosity: living accord. to one’s religion beliefs bc one truly believes in them  Extrinsic religiosity: one’s religion to meet need such as social support, tradition, status  Religious beliefs assoc. w/ social/psych mechanism enhance health. Religions encourage healthy lifestyles (avoid smoking, alcohol), med schools include curriculum.  Benefits from church, spiritually based health intervention work for hardto-reach area Social Implications of Illness:  Disease/illness effects physically and with social implications. Perception of health and illness influenced by different social factors, includ social media/religion/edu/fam  Influences on our perception effect how we comm about health and behavior.  Stigma (Mark of Shame) disgrace, taboo that is attached to ppl and their problems. o If feeling stigmatized, individuals may withdraw from ppl/attempt to conceal health conditions. o HIV/AIDS stigma focus on sexuality, gays, avoid talk on sex, limited knowledge  Couples don’t discuss condom usage, prev partners, stigma worsens o Cancer Stigma: ppl distance themselves from cancer person due to induced fears about disease and health, comm plays important rule, need to find proactive approach to boost emotional and info processes to avoid social isolation. o Alcoholism Stigma: seen as moral issue, associated as having low character. Drinking behavior perceived as abnormal, should be able to control, o Mental Illness Stigma: Portrayed as negative, out of control, negative words, makes individuals feel shunned, invisible, comm needed to tx of mental illness Changing Social Perceptions of Stigmatized Health Issues through comm:  Comm often plays vital role in determining how ppl perceive health issues, individuals with alcoholism, cancer, HIV etc attempt to alter social perception after interactions with others. Comm is important to help ppl construct new health-related identities. The term cancer survivor has largely replaced the term cancer victim. 

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Social identity theory: framework how we talk w/ each other based on group membership. Person is not really their own self but rather multi selves part of big group. Social Discrepancy theory: 2nd framework to explain how individuals adjust their emotional states and attitudes based on conflicting beliefs about themselves. Actual Self: representing who the person actually is Vs Ideal: who the person believes that people think they should be o Disappointment and anxiety can occur when they don’t meet each other. Culturally centered health campaigns: need to understand minority groups, greater chance of influencing health outcomes, understand audience Provider diversity: patients/providers enter healthcare interactions with diff beliefs, influence on comm patters impacting outcomes, Diversity among providers in terms of occupation, edu, expertise, SES. Health literacy effective means of comm active listening tech, and checking for understanding, providing health info as many different mediums as possible

Chapter 6: Communication and Healthcare Organizations Healthcare Organizations as Systems  System: interdependent collection of components that are related to one another and combine their relative strengths to respond to internal changes and external changes o Ex: Hospital can be viewed as complex system, contains many smaller systems (interrelated units), like administration, radiology department, nursing etc  Hospitals usually embedded within larger systems that influence daily operations or provide them with resources (pharmaceutical companies with med supplies)  Functioning of healthcare systems have important implications for patient care (The way the system works in 1 org may differ from another in terms of how systemic opinions may be expressed from different perspectives, cost etc.  Many hospital administrations and other key decision-makers within healthcare systems often focus on the bottom line financially, while patient care that is tailored to the individual rather than to the system can be less important. Characteristics of Systems  According to systems theory, systems have certain traits that influence the communication behaviors of individuals within them  Complex systems (healthcare org) are more than the sum of their individual parts  Different units of a system are interdependent, and interact in ways creating outcomes otherwise not possible  Hospital can’t function if relied solely on service of providers. o Needs support from others (Pharmacies, health insurance orgs, etc) o Each unit works together, coordinate actions for hospital’s function, comm btw and within diff. elements of org is VITAL! For effective function  Systems have other features like homeostasis: ability of a system to selfregulate/achieve a sense of balance when faced with changing condition/situations o Ex: normally busy med clinic finds itself with fewer patients than avg for several months may need to advertise its services or make arrangements to have suitable # of patients for business to function

o During cold/influenza szn, dep. Of public health may need steady supply of influenza doses to keep up with increased demand o Systemic problems can be costly to health orgs, more Healthcare-associated Infections (HAIs) (leading cause of death, determined preventable)  Systems exhibit Equifinality: many different ways a system reaches the same end state. o Health orgs use many diff strategies to achieve a desired goal. o Increased costs within org can be fixed by layoff staff, find more efficiency in providing care, focus on preventive measures to reduce cost.  Comm among members of system important for achieving homeostasis & Equifinality Types of Healthcare organizations (from small clinics/practices -> large govt agency)  Growth in these orgs due to (increase specialization, healthcare marketplace competition, managed care, changing pro/legal standards, diverse health needs) Ex: hospice centers, hospitals, PH department, med group, pharm org  Many orgs are interdependent/influenced by one another.  Health insurance org important for access to healthcare services, managing the costs of healthcare and paying providers for their services. Fed. Govt/t provide health insurance through Medicaid and Medicare  Healthcare delivered service organizations in both public and private sector  Fed. Govt provides healthcare services for veterans through the Veteran’s Administration Healthcare system, overseen by Depart. Of Health & human services include CDC, NCI  Orgs like Joint Commission on Healthcare Organizations make sure Hospitals/other facilities meet certain standards of quality healthcare on a 2 or 3-year basis. Organizational info theory and healthcare organizations  Importance of communication in meeting challenges faced by healthcare org  Healthcare org must use comm to acquire, disseminate, evaluate, and act upon info to function effectively  Comm is vital component of the interrelationships within an organization. o Administrator Provider, provider-provider, provider-patient, relationships present in hospitals, diagnostic lab, pharm companies, health insurance  Organizational Information theory: framework to assess ways in which healthcare org use info to function on a daily basis and to meet org goals o Change is constant within organizations o Confronting change successfully is necessary for the survival of org  Examples include provider specialization, managed care rise, HIV/Epidemic  Org rely on members skilled in certain areas to interpret info, find others outside of org  Must decide if info is relevant/useful (Dr poor handwriting high % of mistakes in pharm)  When confronted with an ambiguous problem o Cycle: Comm patterns engaged in by org include…  Action: nurse asks why so many children are coming with ear infection  Response: I saw problem last winter during the season  Adjustment; alerting physician, might expect more cases in future  Double Interact Loops: multiple cycles o Most org have formal rules/policies for interpreting/acting upon amb. Info

3 types of Message Flow o Downward Comm: Upper manager/administrators identify issues/messages then communicated to lower levels of the hierarchy o Upward Comm: ppl at lower levels of hierarchy) maintenance personnel) encounter info that might be useful to org and comm w/ higher level o Horizontal comm: when messages are comm among individuals who share a similar status within the org (info exchange among nurses)  Messages comm thru formal and informal org comm networks. o Formal: tied to structure of org and messages include emails, memos o Informal: more interpersonal, consist of relationships that develop within org Health Organization Culture:  Use comm for more than processing info/managing uncertainty. Central to dev. And maintenance of relationships and creation of org culture  Culture = defined as the beliefs, assumptions, attitudes, and values a group of individuals share about the world based upon common experiences  Cultural approach, indiv. Within org create meanings for everyday events that occur in org, ultimately develop a unique sense of org reality  Org members create behavior meanings, shared with others through diff. comm. o Healthcare setting values holistic approach to healthcare, addressing patient’s emotional needs while caring for physical health. o Beliefs/attitudes/beliefs of other health org can be known by their promo materials like TV commercials and pamphlets Influences on Health Org Communication:  Pharm companies are important influence on healthcare org bc are main supplier of prescription drugs. *Ethical/other issues associated with cost o Pharm companies spend big portion of marketing on promoting presc. Drugs. o Direct-to-consumer marketing also a tool used where direct-to-consumer advertising urges consumers to ask your DR about particular conditions. Health Insurance Portability and Accountability Act  1996, U.S Congressed pass HIPPA, designed to lower healthcare costs, safeguard identifiable patient data, promote e-commerce in health, law required Health org identified by HIPPA compliant by 2003 April. Patient Privacy of HIPPA:  Requires healthcare org to protect verbal, written, and electronic patient data  Health org spend billions making changes to handle patient info in order. HIPPA effect on Medical research  HIPPA researchers must obtain detailed written permission from patient to use individually identifiable patient data. More stringent policy encourages patient participant due to assurance of sensitive information. Centers of Medicare and Medicaid 1965:  Medicare: individuals 65+, ppl with permanent disability.  Medicaid: health insurance to lower income individuals and their children. Purpose of Managed Care: 

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Effectively coordinate and oversee deliver of care that excessive/unnecessary care is eliminated reducing cost Help providers gain access to consumers by offering consumers health plans, advertising the plans, working with employees. Managed care creates binding contracts. 3 types of managed care (hybrid exists as well) o Traditional Health insurance: most plans pay for services in terms of severe need, like operations or accidents. Carry deductible, consumers pay prem, not ideal when less costly health services are needed like checkups o Health maintenance organizations: (HMOs) early type of managed care org allows consumers to access hospital or small network, prepay set amount, patients assigned primary care person, not covered for use outside of plan o Preferred provider organizations: less unified, wider range at varying cost, no primary care physician, can choose from list. Physicians employed in managed care report greater job dissatisfaction, high patient load, low autonomy, provider-patient strain Healthcare org can be stressful, lead to burnout, comm can be stressful for providers esp. about emotional topics, delivering bad news Big factor that stresses healthcare provider is Role Conflict and Role Ambiguity o Role Conflict: individual engaging in 2 or more incompatible roles simultaneously o Role Ambiguity: Lack of clarity regarding def. and expectation of particular role Stress can result from emotional labor- displaying socially appropriate emotions Must content with work-life conflict (multi demands outside the workplace) Stress and conflict often interrelated with multi demands, conflict tends to produce more stress and add more conflict. Stress can lead to fear, uncertainty, depression, guilt, o Support networks can protect employees, good comm, support

Chapter 7: New Technologies and Health Communication:  New communication techniques have permeated virtually every area of the healthcare delivery system in recent years o Ex: Provider-provider and provider-patient email exchanges, electronic records, lab results, results via internet, text, mobile phone apps, Doctor on Demand, prescriptions  Growth of new comm tech led to major changes in health comm (Convergence of internet, wireless computer tech, global satellite positioning  Healthcare org hope these tech apps will reduce cost associated with traditional comm. o Increase efficiency and convenience  New tech also used in health prevention and education to disseminate and access health info while improving relationships  New tech has ability to impact health comm both + and -, important to understand advantages and disadvantages Health Information on the Internet:

Increasing # of people using internet to search health info. Study from 2006 indicate 56% of US adults sough info about personal health concerns through health-related websites.  Connections and interrelationships of healthcare systems, globalization of media systems, convergence of media tech, smartphone apps, text message, internet are an info gathering tool transforming decision making for healthcare seekers  Info about various aspects of disease prevention, illness, tx, control but ppl question the quality of health info that is currently online  Concerns about differential access to internet, among traditionally underserved Health Information Access:  Access to health info convenient for both providers and consumers  Understanding health info influences health in a variety of ways (Ex: Screening and correctly using health info has big influence on health-related lifestyle factors, early detection, diagnosis, disease coping, symptom management, medical decisions etc)  Websites (govt organizations, Ex: NIH, CDC, online medical journals, pose questions, information from healthcare specialists, accessible- acquired anonymously, helpful when one has sensitive issues)  Patients may bring info to discuss with physicians during office visits, info from internet  There may be more conservation about info acquired from the internet during med interviews.  More recent trends in use of online health info include increases in info amount ppl seek about diet, exercise, info from other experiences, online rating of Doctors  Search engines may lack efficient way to access specific health-related websites, key word search may show different audience, have diff info quality, and specificity info about disease.  Access to info does not necessarily mean ppl will use it, understand it or change their attitudes bc of it.  Advent of mobile internet, where health info accessed through smartphones, and applications can be downloaded that monitor behaviors such as accelerometers to monitor physical activity. Health Information on the Internet Credibility  Often difficult to assess the credibility of health info found on the internet  Government, university and research org-sponsored websites typically provide the most credible info, some websites created by interest groups & individuals can also contain credible info o Ex: a cancer’s survivor or caregiver for someone with Alzheimer’s disease may have credible info to offer others bc of the 1ST hand experience with the disease  Consumers often differ in terms of what they perceive to be credible info Ex: some may find scientific studies...