Talking About Health; Why Health Communication Matters

Do doctors get anxious about talking to patients?

April 17, 2011 GUEST BLOG POST by Autumn Ciliberto

I recently read some interesting research that addresses this question. It was conducted by Dahlin in 2007: “Burnout and Psychiatric Morbidity among Medical Students Entering Clinical Training: a Three Year Prospective Questionnaire and Interview-based Study.” This article covered the important subject matter of dealing with medical students still in their college practices, graduating with anxiety and incompetent speaking skills.

The medical students are doing 16+ hour days–doing school work and then going to practice within the hospitals. The researchers worked with first year medical students to compare their stress levels to the third year program students. They wanted to learn if trait anxiety and vulnerability was present in students before reaching the third year, and what effect this anxiety had on the medical students’ communication skills with patients.

The research revealed a high burnout rate among medical students who showed depressive symptoms and/or financial concerns in the first year. At the third year, a significant number of medical students had anxiety and/or depressive symptoms, but few were willing to seek help–perhaps worrying about the effects on their career. This may affect the communication between these future doctors and their patients. The researchers conclude that, “There is evidence that mental distress during medical school predicts later problems in physicians, which in addition to the personal suffering of the individual doctor might negatively affect patient care” (Dahlin, p.1)…

Dahlin, M.E. (2007). Burnout and Psychiatric Morbidity among Medical Students Entering Clinical Training: a Three Year Prospective Questionnaire and Interview-based Study. Biomed Central Medical Education, 7, 6.

How should we talk with children about a parent’s cancer diagnosis?

April 15, 2011 GUEST BLOG POST by Alan Mars

I have been reviewing research about talking to children about a parent’s cancer diagnosis. One such article [see citation below] relates to parents communicating with their children about the mother’s diagnosis of breast cancer. It focuses on how important it is to engage and include the fathers when communicating about the diagnosis of breast cancer to the mother’s children.

In this article, based on the research done by the authors, the reader learns that an open family communication style is important when a family is coping with the emotional distress that accompanies the genetic testing process. In other words ,all members of a family (children as well as parents, even grandparents) need to be able to feel that he/she can voice the emotions he/she is feeling because of the diagnosis of breast cancer in the mother, not just keep it bottled inside.

The authors also believe that a strong relationship between the mother and the father can help the open communication to continue. This is stated because in many cases of the study, when the father was not present on a consistent basis, it was shown that communication was lacking between the mother and the children, and this hindered the coping/recovering process of the family.

Basically, fathers are more important with the communication process of a family than they may realize… especially when that family involves a mother diagnosed with breast cancer! Let me know what you think about this research!

Demarco, Tiffani A., Beh N. Peshkin, Heiddis B. Valdimasdottir, Andrea F. Patenaude, Katherine A. Schneider and Kenneth p. Tercyak (2008). Role of Parenting Relationship Quality in Communicating about Maternal BRCA1/2 Genetic Test Results with Children. National Society of Genetic Counselors, volume 17, 283-287.

What role can coaches play in preventing concussions among athletes?

April 14, 2011 GUEST BLOG POST by Mike Emmerling

The Centers for Disease Control and Prevention, CDC, along with the support of partners and experts in the field of concussions, developed a “Tool Kit” for high school coaches giving them knowledge, attitudes, and practices related to the prevention and management of concussions. The Centers for Disease Control and Prevention did a study on their “Tool Kit” in 2005-2006 using their website for coaches whose schools owned and used the “Tool Kit” as their participants.

This study was a mixed method evaluation first by a mail survey which collected quantitative information on coaches’ use of the “Tool Kit.” Second, six focus groups were conducted with a sample of coaches who responded to the survey to gain further insight into the quantitative findings. A semi-structured moderator’s guide with open-ended questions was used to lead the particular focus groups discussion(s). The participants were made aware that the focus group discussion(s) would be audio recorded and no participants objected. Finally participants were self-selected and represented diverse geographical locations on a variety of various sports.

Of the 333 eligible coaches who responded to the survey, most were male and coached at a public high school. Most of these coaches had over ten or more years’ experience. The majority of the coaches lived in suburban or rural areas with less than 1,000 students in their school. The variety of sports that these coaches coached included football (41%), boys’ basketball (13%), and girls’ soccer (11%). Concussions were highly relevant topic because 63% of coaches reported being aware of sports-related concussions among their athletes during the 2005-2006 playing season.

The end results of this study showed that the “Tool Kit” led to positive changes in high school coaches ‘knowledge, attitude(s), and behavior(s)/skills toward concussion prevention and management. Despite the fact that most of the coaches who responded had 10 or more years of coaching experience, the coaches made changes in the ways they prevent and manage concussions. Findings from this survey also suggest that many coaches face barriers to preventing and addressing concussions because there is no specific concussion policy in high school sports. This study in the end shows that coaches have a strong role and responsibility when dealing with the safety of their athletes and concussions. Coaches feel obligated to educate themselves about concussions to ensure the correct use of safety equipment and implement training techniques that minimize the potential concussion risk by allowing more people who are experts in concussions to become more involved in the sports program.

Sarmiento, K., Mitchko, J., Klein, C. and Wong, S. (2010), Evaluation of the Centers for Disease Control and Prevention’s Concussion Initiative for High School Coaches: “Heads Up: Concussion in High School Sports”. Journal of School Health, 80: 112–118.

What do we say to youth about exercise?

April 13, 2011 GUEST BLOG POST by Elliot Searer

In many previous studies, we have found out that a healthy balance of diet and exercise is the most efficient way of staying healthy. I feel more emphasis needs to be put on children and how much physical activity they receive, and if they are even coming close to the recommended 60 minutes per day. I feel that organizations, like YMCAs, should offer more opportunities for our youth to have a place to properly exercise. Questions I have are:

Do our youth have proper access to a clean, safe environment suitable for physical activity and play? Do our youth understand the importance of physical activity from a health perspective? Do our youth have access to information that answers their questions about different exercises or exercise equipment? Do children understand the importance of nutrition in order to gain the most from their physical activity? Are youth who lived in dirty, unsafe conditions permitted to exercise at facilities like YMCAs despite possibly not having the proper financial means?

In a study conducted by Bowman and Neal, particpants between 5 and 17 years of age were scheduled to attend nutrition classes only or nutrition classes and family YMCA membership. The primary outcome measure was change in BMI-for-age percentile. Four participants in the control group and one in the treatment group achieved the target reduction of 2 BMI percentile points. Within the treatment group overall, YMCA attendees had a mean increase of 0.30 BMI points compared with an increase of 0.60 BMI points in nonattendees. Questions I have about the study in particular are:

1) In what type of shape, physically, were the eligible participants in before the experiment? 2) After? 3) What type of guidance was received from YMCA workers or someone of a trainer’s capability?

Through my personal experiences as an athlete, I find it extremely surprising that better results weren’t seen. The study states that some of the participants didn’t even go to the YMCA despite having a paid membership. I would like to know what type of guidance they were getting. For example, if they were doing proper exercises to promote weight loss or if they even knew how to properly operate the equipment and machines.

I feel a lot more can be done by communities to stress getting the 60 minutes of daily physical activity. Organizations should take a stronger stance and venture out in the community, and set up activities in parks or rec sites. It wouldn’t be hard, and would be low cost. Also, the organizations may not even have to use their facilities as host sites for the gatherings. Getting our youth out in the community, learning how to properly take care of themselves through physical activity could possibly lead to more benefits. Better eating habits, spreading nutrition information to other family members, and overall healthier communities may encourage children to pursue sports or other careers based on exercise/play as opposed to sitting at home…

M. A. Bowman and A. V. Neal; Policy and Financing in Family Medicine and the Medical Home. J Am Board Fam Med, May 1, 2010; 23(3): 277 – 279.

How should we talk about tanning?

April 12, 2011 GUEST BLOG POST by Danielle Torrisi

Take a look around any college campus, and you’ll notice at least a handful of tanning salons. Pick up their college’s newspaper and you’ll find ads for tanning salons with gorgeous, tanned women pictured with the slogan “Beautiful Tan Today. Young looking skin tomorrow” and promotional discounts that is sure to catch the eye of any student. The tanning industry portrays tanning as harmless and risk-free. However, research has shown that the incidence of melanoma has continued to rapidly increase since the 1970’s.

A recent study at a southern university surveyed 492 students and results showed that a majority of the participants knew sun exposure increases the risk for skin cancer, but only 29% correctly identified behaviors that reduce this risk.

Less than 46% of the participants were able to identify signs of melanoma, and less than 10% were able to identify the primary area of the body for melanoma. Approximately half of the participants strongly believed that a tan improves one’s appearance, and only half thought that sun safe behaviors are necessary. It is very troubling to learn that they think their appearance outweighs their health.

College students need to be informed about the dangers of using tanning beds in hopes of changing attitudes and behaviors. It all starts with the media and advertisements need to show a more natural appearing skin. “As long as marketers portray being tan as healthy, attractive and sexy, young women will continue to believe that a tan is desirable, regardless of the risks” (Spradlin et al).

It needs to be understood that there is no such thing as a healthy tan. “In fact, UVA rays which are used in tanning beds can go all the way through the skin’s protective epidermis to the dermis, where blood vessels and nerves are found. Because of this, UVA rays may damage a person’s immune system, making it harder to fight off diseases and leading to illnesses like melanoma, the most serious (and deadly) type of skin cancer” (Tanning). This needs to be reinforced in student’s minds in order to see a behavior and attitude change.

To view this article go to: Citation: Spradlin, Kimberly, Martha Bass, William Hyman, and Rosanne Keathley. (2010). Skin Cancer: Knowledge, Behaviors, and Attitudes of College Students. Southern Medical Journal. 103, 999-1003.

How should we talk about food?

April 11, 2011 GUEST BLOG POST by Shaan Saini

It is important to effectively discuss food habits with those who are closest to you in order to motivate healthy behavior as well as gain more information from each other. In a recent article, the effect of spousal support on food-related behavior and diabetes was studied. Couples in which both partners had diabetes seemed to have more knowledge about what they should be eating, mainly because both had similar goals of regulating blood sugar levels. Furthermore, it was found that those who are married seemed to have more food control over those who are not, illustrating the positive effect of support from loved ones on diet.

Beverly, E. A.; Miller, C. K.; Wray, L. A. (2008). Spousal support and food-related behavior change in middle-aged and older adults living with type 2 diabetes. Health Education & Behavior, vol. 35 no. 5, 707-720

How do parents talk to adolescents about alcohol?

April 7, 2011 GUEST BLOG POST by Ahjine Garmony

I am interested in research about how parents communicate with adolescent children about alcohol use. Ennett and colleagues conducted a study that gives some insights about this issue. It showed that a high percentage of parents talk about negative consequences for the use of alcohol. By communicating to adolescents about alcohol, they know how alcohol can affect them negatively and are more likely to refrain from drinking.

The study also looked at how parents communicate about the effects of alcohol. In the study they referred to “hard” communication as more direct and actually telling the adolescent NOT to use the alcohol. For softer communication, the parent would talk about the potential harm and circumstances if they were to use alcohol but not necessarily tell them directly to not use it. It was found that parents tended to use softer communication about potential harm and circumstances in which alcohol use may be promoted. The softer approach may help youth to be better informed and make their own decisions about not using it…

Ennett, Susan T., Karl E. Bauman, Vangie A. Foshee, Michael Pemberton, and Katherine A. Hicks. “Parent-Child Communication About Adolescent Tobacco and Alcohol Use: What Do Parents Say and Does It Affect Youth Behavior?” Journal of Marriage and Family 63.1 (2001): 48-62.

Why are nutrition education programs an important part of medical education?

April 6, 2011 GUEST BLOG POST by L. Ashley Lynch

Today, I will discuss some research that relates to communication about whole grains. One of the main concepts of research done by K. B. Michels and his colleagues was how to effectively use nutrition education programs. Their research discussed the use of places such as the workplace, communities, and schools, to reach audiences with this information. Access to nutrition education programs includes being able to afford and have transportation and time to participate. It is an important step in having the ability to make changes in diet that reflect nutrition program goals.

The incentives of the program in Michels’ study include that the education is cost effective and can lead to prevention of health risks based on incorporating whole grains into our diet. Overall, nutrition education is a great chance for people to better understand information about foods instead of relying on looking at food packages and trying to figure it out on the spot. It is often easier going into a situation with the tools and information necessary to make an informed decision than it is to take time on the spot to become educated in hopes of making an informed choice.

Michels’ research touched on incorporating healthy choices in cafeterias to encourage healthy habits. The research focused on medical education students. If doctors are educated about healthy food choices, hopefully, it gets passed on and becomes more than a trend in American society.

For more information, the article may be located at: Michels, KB, BR Bloom, P Riccardi, BA Rosner, and WC Willett. “A study of the importance of education and cost incentives on individual food choices at the Harvard School of Public Health cafeteria. Journal of the American College of Nutrition, 27, 6-11.

How do you communicate to children about cancer?

April 5, 2011 GUEST BLOG POST by Joey Debernardis

Since cancer has such a huge impact on many people’s lives, I thought it would be a very important topic to talk about. More specifically, the study below considered how to talk to children about cancer. This specific study was done at ‘Three Principal Cancer Treatment’ in the United Kingdom.

The study was based of 38 participants at different levels of their cancer journey. The groups broke down as follows: young children (4-5 years), older children (6-12years), and young people (13-19 years).

Some of the results that were found were quite interesting. As a young child, the cancer patients were not able to voice their preferences. They just did not have the ability to do so. Children also worried about the permanence of symptoms. Older children were unhappy about their parents leading communications with the health professionals.

The children aged 4-12 years reside in the background of information sharing with health professionals until they gain autonomy as the young people (roughly 13 years). They then moved in a foreground, and their parents transition into a supportive background role. In this way, younger children begin to realize their abilities to voice their preferences. Parents and the professionals, in turn, can learn to develop their supportive background roles…

Gibson. F. (2010). Children and young people’s experiences of cancer care: a qualitative research study using participatory methods. Pubmed. http://www.ncbi.nlm.nih.gov/pubmed/20430388

Who do athletes talk to about nutrition?

April 5, 2011 GUEST BLOG POST by Robert Jacobs

When people watch sporting events, particularly the athletes within these sporting events, they might only see the physical skills that that athlete portrays on the field of play. They might think about how that athlete prepares for competition with regards to practice or what they do in the weight room. What this observer may not think about is what these athletes are consuming as far as food goes.

The diet of an athlete is very important to how the athlete performs within their sport. Some research considers how much athletes really know about a proper diet and how to communicate to these athletes about these diets.

In one of these articles, different levels of athletes were questioned about their diets and the supplementation. The common trend seemed to be that the older the athlete was the more then knew. Although the older athlete knew more than the younger, the majority still did not know enough about their diets to effectively fuel their bodies.

These athletes were questioned about who they have previously discussed their diets with and how they have learned about proper dieting. Answers to this question varied. Some athletes stated that they just discuss their diets with fellow teammates and friends, others say they have talked to their coaches and parents, and some say they read magazines and try to learn that eat. Not one athlete had said that they have discussed proper dieting with a doctor, nutritionist, or a trainer.

The problem with athletes learning about proper dieting is that there are not enough available professionals to talk to freely. In order for an athlete to learn about how to properly put a diet together, they must discuss this with someone who knows what they are talking about. In order to solve this problem, the communication barriers between athlete and nutritionist must be addressed.

If you would like to learn more about these communication barriers, go to the following article: Woolisky, Ira, and Judy Driskell. “Nutrition Knowledge of Athletes.” Nutritional Applications in Exercise and Sport (2001): 255- 260. Web. 22 Mar 2011.