Talking About Health; Why Health Communication Matters

How can we really understand informed consent?

April 3, 2011 GUEST BLOG POST by Aimee Hilton

You are told you have a left clavicle contusion and your face just screams “What?” You go home to research and find you simply have a bruised collarbone, i.e your shoulder is going to hurt for a little while. Doctors may forget that they spent eight plus years in education learning the medical jargon that most of their patients do not understand. So when the patient has an important decision on the line, like whether or not to participate in a clinical trial based on their illness, how do we organize the information to make an informed decision? When we can’t understand words like randomization and placebo, how can we really understand the informed consent?

A study performed by Jefford et al. (2009), looked at how well patients understood the clinical trial they recently enrolled in. 102 patients who signed up for a clinical trial concerning cancer within the last two weeks participated in the research. The most important results showed that doctors needed to ask specific questions pertaining to the patient’s understanding of the trial, instead of simply “Do you understand”. Using a method known as “the teach back method” allows the patient to understand and develop questions. As a patient, if making a decision about a clinical trial, be sure to restate the clinical trial process and informed consent to your doctor. It will make sure you understand and they know you understand.

Patients should also receive written information and a recording of the conversation discussing the clinical trial. This allows the patient to go back and look over any information they found confusing or did not comprehend. Doctors also should be sure to discuss the standard treatment and other possible treatments in the trial. Patients should be aware of all options and possibilities throughout the trial.

It may seem that clinical trial information is overwhelming. However, if the doctor presents the information in an organized process, the patient will be more likely to understand and receive enough information to understand the informed consent they need to sign. Clinical trials are very important for the advancement of science and treatments. If doctors can help patients have a better understanding of the trial, hopefully more patients will be willing to participate.

Jefford, M. Mileshkin, L. Matthews J. et al. Satisfaction with the decision to participate in cancer clinical trials is high, but understanding is a problem. (2009) Support Care Cancer, 19, 371-379.

Does peer sexual health education change the trainers’ behaviors?

April 3, 2011 GUEST BLOG POST by Kaitlyn Krauss

I get it–sex is a taboo topic. It’s something that shouldn’t be discussed in public let alone in front of people you don’t know. Yet I do this all the time. I know my dad would never tell his friends his daughter hosts “Safer Sex Parties” up at Penn State and I know my mom isn’t too happy that I demonstrate how to properly put on a condom, but it’s something I do and it’s something I love.

As a peer educator through University Health Services, I chose to become involved with the sexual health group. During my first year as a volunteer, I was elected the group leader. I believe that unsafe sex is one of the biggest problems that all college campuses face. It is important for everyone to be aware of the risks of sexual activities because STIs such as HPV, Chlamydia, Gonorrhea and Genital Herpes are common on college campuses.

The CDC reports that 1 in 4 college students have been diagnosed with an STI in their lifetime. I don’t know about you but that statistic shocks me every time I hear it. It was my love of communication, volunteering and always wanting to help others that led me to become a peer educator. Regardless that not everyone agrees with what I do, I’d like to think it’s worth it, even if I help one person or change one persons mind.

Because of my experiences as a peer educator, I review research about the benefits of peer educators in talking to people about sex. One of these articles conducted in 2007 (http://www.informaworld.com/smpp/content~db=all~content=a903650971) considered the question, “Does Peer Sexual Health Education training shift trainee’s own behavior towards health promotion and safer sex behavior?” Through a series of surveys and training programs, the study found that participants improved their STD knowledge and health-promotion counseling self-efficacy. This is something that I believe all peer educators should grasp before preaching safer-sex to hard-headed college students. Whenever I give a safer sex party, it’s new facts that often motivate people to change. By learning the facts and improving one’s training skills, peer educators become more valuable.

College students believe they are invincible and many won’t stop and think twice about something until they are hit with the consequences. STIs are serious and that is why I try to convince people to prevent them instead of deal with the problem when it arises. The study found that peer educators were a successful tool in training college students. A lot of the educators also changed their ways after going through the training. All of the health promotion competencies they learned in the study are necessary components of a peer education program that enhances the health of its clients. And that’s why I do this, to enhance the health of my clients, my peers, and my friends…

How do parents talk to children about diabetes?

March 31, 2011 GUEST BLOG POST by Ryan Clark

Recently, I checked into research about how parents talk to their children with adolescent diabetes. I found this to be very interesting because adolescent diabetes is on the rise due to childhood obesity and unhealthy eating habits. According to an article in the Journal of Pediatric Health, there are 5 themes that are revealed in communication between parents and adolescence about diabetes. These themes are fear, frustration, trusting, normalizing, and discounting.

Fear was defined as the participant’s expression of their dread of an unpleasant, undesired or regrettable outcome. Frustration was defined as an expression of annoyance or anger that tended to recur around issues of the adolescent’s assumption of responsibility for self-care. Trusting was defined as the parent or child being able to count on the other to meet particular behavioral expectations for diabetes management behaviors. Normalizing statements were those that indicated that the family was trying to view and treat the adolescent’s disease as a normal part of life. Discounting was represented by statements and interchanges that revealed a lack of respect for the adolescent’s opinions or efforts and a failure to include the adolescent in discussions about the issues.

These themes are very important to think about while communicating with a child not only about diabetes but health care in general. Often, kids are scared and confused with what is going on with the state of their health. Clarification to your child on what exactly is happening to them and how you, as a family, will get through this together is vital. The child should trust that you are there with them throughout the process and being well-rehearsed in any information about your child’s health will certainly help. Creating a certain comfort level for one’s child while going through any medical situation will make the process much smoother. An understanding of what has been talked about in this journal article may help you better prepare. You can find the article at:

Dashiff, C., Ivey, J., Wright, A. (2009) Finding the Balance: Adolescents with Type 1 Diabetes and Their Parents. Journal of Pediatric Health Care. 23, 10-18.

Can you set the table please?

March 30, 2011 GUEST BLOG POST by Melissa VanAlstyne

“I have work to catch up on”, “I’m not hungry”, “I’m going out”, we have all heard these excuses when it comes to sitting down to a family meal and often it seems easier to just forgo it all together. However, research is proving just how big of an impact family meals do have. Not only is sitting down to a family meal a good way to keep the family connected but it also has a number of health benefits as well, one of which is promoting healthy eating habits among adolescents.

According to a journal article in the Journal of Adolescent Health [full citation below] having a family meal can help to detect early signs of disordered eating as well as help prevent disordered eating from ever beginning. Having a family meal allows adolescents to see their parents engaging in healthy eating habits and therefore model their own eating habits after them. In addition, eating together allows parents to monitor their children’s diet which allows them to detect signs of disordered eating earlier.

While simply prioritizing sitting and eating together is good in and of itself, family meals should be times that parents and children value and find enjoyable. This means keeping discussion at the meal free from conflict around food or other issues, thus making the meal something the family looks forward to each day.

While life is undoubtedly extremely stressful and busy and finding time to sit down and eat together may seem a daunting task, the benefits of making sure to prioritize this family time cannot be overstressed. Adolescents who report more frequent and enjoyable family meals have been repeatedly found to be at a decreased risk for engaging in unhealthy weight control behaviors. So find a time that works for your family, sit down, pass the chicken and enjoy!

Fulkerson, J. Neumark-Sztainer,D. Story, M. Wall, M.(2004).Are Family Meal Patterns Associated with Disordered Eating Behaviors Among Adolescents? Journal of Adolescent Health,35. 350-359

How can parents approach talking with children about sex?

March 28, 2011 GUEST POST by Kori Federici

Regarding the issue of parents communicating to their children about sex, researchers have found that:

An already positive relationship with the offspring would result in an easier ability to discuss this taboo topic.
Negative relationships between the parent and offspring may make the communication of sex more difficult.
Parental knowledge of a child being in a romantic relationship made the communication easier as well.
Sons are questioned less about sex than are daughters.

The study followed families and their children through the ages of 12-18. The parents were asked questions about whether their child (or if they thought) was or had been in a romantic relationship before and if the parent had any concerns.

It is interesting to note that daughters were more often questioned. Does this suggest that daughters are trusted less than the sons? Or, are parents more worried about the health and well-being of daughters who might become pregnant? The sons of the parents were said to feel more independent when it came to parents intervening in their relationships. Also, mothers were more supportive than fathers, but the fathers were more restrictive than the mothers.

These factors often play a primary role in a parent’s decision on how and when to have the “talk” with their child. Should females receive the sex talk earlier than males? Should parents wait until their children start dating to discuss sex? How involved should I be with my child’s sex life? These are some questions to ask yourself if you are a parent struggling to decide what time is the best time to communicate with your child about sex.

For a full view of this article go to…..

Citation: Kan, M. L., McHale, S. M., & Crouter, A. C. (2008). Parental involvement in adolescent romantic relationships: Patterns and correlates. Journal of Youth and Adolescence, 37(2), 168. Retrieved from http://search.proquest.com/docview/204638246?accountid=13158

How do nurses cope with the emotions of caring for terminal patients?

March 26, 2010 GUEST POST by Jason Bankert

It is the common belief that nurses are the care givers and thus are more compassionate than physicians who are often perceived as hard and emotionless. The Intensive Care Unit (ICU) can be emotionally draining as many patients are in critical condition or are terminal. The care of terminally ill patients is called end of life care or EOLC. How do health care professionals, such as physicians and nurses cope with the emotional burden of terminal illness in the ICU and how do there perception, treatment and communication involving terminal ill patients differ? These different perspectives impact physician-nurse collaboration as well as their satisfaction with the quality of EOLC (Hamric and Blackhall 2007).

In a recent study conducted in the ICUs of a rural hospital in Southwestern Virginia and an urban hospital in Eastern Virginia, investigators examined these questions to provide an insight on how these different perspectives on EOLC ultimately impacts patient care and what interventions can be taken to reduce moral distress and improve physician-nurse collaboration (Hamric and Blackhall 2007). The study, based on survey responses, showed that RNs experience more moral distress during EOLC than do physicians, even though both groups identify the situation as morally distressful (such as aggressive treatment as requested from a family member when both groups feel the treatment is unnecessary (Hamric and Blackhall 2007). As a result, these nurses are less content with their environment or the perception of the quality of care given to the terminal patient. This higher emotional burden on nurses may be the result of their job. It is the nurses who provide the majority of the bedside care during EOLC and are in contact with the patient more often than physicians. Also, nurses lack finally authority over the treatment options implemented by physicians. Even though nurses may disagree with the way physicians communicate prognosis and diagnosis, they feel that they have no say in the final decisions regarding patient treatment during EOLC.

The emotional environment is more important for nurses who are in contact with the patient more often than physicians, providing most of the daily beside care tasks (Hamric and Blackhall 2007). Therefore, it is necessary to improve this environment to ultimately improve the overall quality of patient care. The best care in the ICU occurs when nurses are active participants in diagnosis and treatment decisions and are active in communicating with patients and families alongside physicians (Hamric and Blackhall 2007). In order to provide a environment where nurses can be proactive in the patient care, special attention and policy needs to be implemented to increase physician awareness of the extra emotional burden experienced by nurses and respect their input in regards to EOLC. Equally important is the improvement of physician-nurse collaboration. This may be accomplished by promoting open communication about the different perspectives of EOLC through team meetings, individual meetings with chief staff members and conferences involving staff and specialists from other institutions.

Hamric, A. B., L.J. Blackhall. (2007). Nurse-physician perspectives on the care of dying patients in intensive care units: collaboration, moral distress, and ethical climate. Critical Care Medicine, 35, 422-429. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/17205001

“Supercalifragulisticexpialadoctious- I think that’s what my doctor said?”

March 26, 2011 GUEST POST by Bethany Brodie

At the age of 16 ½, I could have told you what LOL meant, the most popular fashion trends, and the latest gossip around the halls, but when told “You tore your ACL and suffer from slight ligamentum laxity, so we’re going to use your patellar tendon to repair the damage”, I was far from in-the-know. Now, after 4 years of studying Biobehavioral Health and 2.5 years as a teaching assistant in Mammalian Anatomy, I clearly understand what my doctor was saying, but, I can testify to the fact that my questions lingered until it was much easier to forget about them than deal with my confusion before surgery.

As an inherent part of the medical field, technical jargon exists to identify and specifically classify different diseases and their associated terms, but unfortunately, most of us lack the necessary education to understand most or even some of their meanings. It is in the doctor’s office, though, that these two paths cross and often fail to be reconciled before moving forward with treatment.

Recent research by Castro et al. (2007), explains how type II diabetic patients encountered, on average, 4 unclarified medical terms per visit as presented to them by their doctors. After further investigation, researchers also found that patients reported understanding the words, but when asked to define them, less than 40% could actually reiterate the meanings of the most commonly used terms. Though doctors and nurses face daily time constraints, it is important for them to remember that the best possible health outcome for the patient is goal, and a necessary step in that process is patient understanding.

There are many steps that medical professionals can take to ensure comprehension without compromising their busy schedules. For example, they can use a medical term in a sentence that applies specifically to the patient’s condition, and then follow that sentence with a brief definition in Layman’s terms. Later, they can also have the patient teach- back what he or she learned during the visit, and ask a staff member to follow- up with a phone call to address any remaining concerns.

By adopting these practices, physicians and nurses are also demonstrating their care and concern while also empowering the patient to take control of his or her condition. Equipped with the knowledge and resources to act, patients are probably more likely to adhere to medical advice. In the end, they cooperate with their doctor, improve their health, and ultimately reduce the medical cost associated with miscommunication and lack of understanding. A positive outcome for all!

How does the media create compassion fatigue?

March 22, 2011

When we are traumatized by someone else’s trauma, we may experience compassion fatigue. While I discussed this in an earlier post in terms of vacations and leisure http://whyhealthcommunication.com/whc_blog/wp-admin/post.php?post=628], it is worth talking about in terms of so many images and messages relating to Japan’s earthquake[s], tsunami[s], and nuclear power threats… I daresay that anyone who has watched the news over the past week is experiencing compassion fatigue. How could we not be? The images are heartbreaking, frightening, and constant…

Susan Mieller, author of the book–Compassion Fatigue–[interview about the book at http://web.mit.edu/cms/reconstructions/interpretations /compassion.html] emphasizes the role of media in creating this condition. We have to focus on what we can do and not what we cannot do. We cannot go backwards and second guess decisions about how nuclear power plants in Japan have been maintained. We can do what we can do to help the Japanese people…even if it means watching ‘American Idol’ for a bit of distraction and downloading some music. We can try to understand the role of nuclear power in providing energy in the U.S. and seek direct answers about how the existing plants have been maintained…

Why is belly fat bad for your health?

March 17, 2011

I guess we would have to be living under a rock not to have heard health messages about belly fat. What I remember hearing the most is something like, “Belly fat is bad for you.” or “You want to concentrate on that belly fat.” And what I really got out of the messages had to do more with how we look–that belly fat is not attractive–than how it relates to health. I had seen a number of programs addressing how to get rid of belly fat [ http://www.meandjorge.com/] but never really made a connection with why in terms of health. Until the other day…

I can’t even say what program was on as I was making a meal but I heard them say that belly fat is especially harmful for our health because it is fat that works it way between and around our organs. That it literally does harm by wrapping our kidneys, liver, and intestines in fat… that was a rather horrifying image. The program went on to say that one cannot have belly fat liposuctioned away…because it is wrapping and twisting its way through our insides. The fat that can be liposuctioned away is just beneath the skin… [see this for a discussion, http://blog.healia.com/00488/belly-fat-damages-blood-vessels-could-cause-cardiovascular-problems]

To me, this is an example of one of those messages that needs to be clearer. I especially think that men are being shown as at risk for having belly fat…but the emphasis is too often placed on how the men look and not on what is really happening inside their bodies when the pounds add up around their middles…

How does talk about ‘play, leisure, and vacations’ relate to compassion fatigue ?

Al Gini wrote the book, ‘The importance of being lazy: In praise of play, leisure, and vacations’… I keep a copy of this in plain sight in my family room. I find that visitors are often drawn to pick it up. Why? I suppose because we don’t talk enough about the this side of life. One review of the book, http://www.spiritualityandpractice.com/books/books.php?id=5960, considers differences among nations in the emphasis given to talking about leisure. I thought about this as I was reading the results of some recent research that addresses compassion fatigue among nurses.

Compassion fatigue is the experience of too much of the emotion–compassion–causing anger and helplessness. Compassion fatigue is a condition observed among some types of jobs and professions more often than others. Nurses often experience this as a response to situations where they know that no matter what they do, the outcome for a patient is not going to be a good one. Not surprisingly, compassion fatigue relates to burnout and job dissatisfaction. But research has consistently shown that giving nurses a chance to talk about their experiences helps lessen the fatigue of feeling compassionate for those they care for… And, putting more emphasis on life outside of the workplace and nursing, learning to play and make mini-vacations out of an afternoon reduces the stress felt from caring for others…