Cultivation and the Elaboration Likelihood Model: A Test of the Learning and Construction and Availability Heuristic Models

An analysis of 19 care-provider interviews demonstrates four different orientations toward spirituality: exclusive spirituality, inclusive spirituality, conflicted spirituality, and spirituality as separate from care. Two prominent ethical dilemmas experienced by care providers are discussed. Care providers face an internal dilemma presented by competing discourses that suggest different ways to incorporate spirituality into care. Care providers also face an interactional dilemma as they seek to balance their own spiritual needs with the needs of care recipients.     

Characterizing organizational spirituality: An organizational communication culture approach

This study focuses and extends the academic literature on spirituality in organizations. Although spirituality has gained attention in organizational scholarship during the past decade, there has been little systematic development. Current literature on spirituality in organizations is characterized by divergent approaches to spirituality and a number of organizational foci. The present study, based on qualitative field research in a nursing home, advances understanding of spirituality in organizations by identifying three central characteristics of organizational spirituality: value alignment, personal spirituality, and relationship‐based organizing. These central characteristics, supported by the field research and current literature on spirituality in organizations, lead to issues for further research. The study concludes with an invitation for dialogue on the emergent topic of organizational spirituality.     

A Comparative Study of Sources of Health Information and Access to Preventive Care Among Low Income Chronic Drug Users

Much of health research that examines patterns of health utilization for chronic drug users fails to account for the role of media use and health information seeking. This paper suggests that the nature of drug use is associated with a decreased health orientation that is manifested in media selection and consumption. A comparative analysis was conducted to examine: (1) the differential health perceptions as a function of drug use, (2) the sources of information used, and (3) the relationship between sources of information and primary health care access among chronic users of illicit drugs and socio-demographically similar persons who are not chronic drug users. Results point to both common as well as differential patterns of health information sources. Logistic regression analysis found that medically related sources such as doctors and pamphlets are important sources associated with increased primary care. Important implications are discussed.     

Qualitative analysis of parents' information needs and psychosocial experiences when supporting children with health care needs

OBJECTIVE: To identify the information needs of parents of children with health care needs. METHODS: A series of three focus groups and one in-depth interview were held with parents (n = 10, 90% female) in Barnsley, South Yorkshire, UK. RESULTS: Findings were grouped into four themes: delivery of information; levels of support; relationship between the family and professional; and management of events. Parents expressed a preference for information to be delivered on a verbal, 'one-to-one' basis by a professional, supplemented by accessible, written reference materials. The provision of a contact telephone number for a named professional, so further information could be obtained when required, was identified as a key source of support. Participants emphasized the importance of being consulted about the care of their child, the interaction between professional and child, and also of being treated as an individual by the professional. CONCLUSIONS: Delivery of information to parents may be most effective on a verbal, 'one-to-one' basis with a professional, in conjunction with written accessible general and child-specific reference materials. The importance to parents of the provision of contact details for a named professional and specialist nurse support is also emphasized. The psychosocial experiences of parents, along with the impact of the relationship between family and professional, and requirement for good channels of communication, must be taken into account by professionals during the care of children with health care needs. These findings have important implications for professionals and service providers for the future delivery of information to parents of children with health care needs.     

Perceived Information Exchange and Health Control Expectancies as Influenced by a Patient's Medical Interview Situation

The purpose of this study was to examine how a patient's medical interview situation influences the relationship between the health locus of control and information exchange. Participants included 537 people who completed the Multidimensional Health Locus of Control Scale and the patient version of the Medical Communication Competence Scale in reference to their last health care visit. The results indicated that the situation surrounding the medical interview influenced the relationship between the health locus of control and information exchange.     

Mapping the literature of health care chaplaincy

Objective:

This study examined citation patterns and indexing coverage from 2008 to 2010 to determine (1) the core literature of health care chaplaincy and (2) the resources providing optimum coverage for the literature.

Methods:

Citations from three source journals (2008–2010 inclusive) were collected and analyzed according to the protocol created for the Mapping the Literature of Allied Health Professions Project. An analysis of indexing coverage by five databases was conducted. A secondary analysis of self-citations by source journals was also conducted.

Results:

The 3 source journals—Chaplaincy Today, the Journal of Health Care Chaplaincy, and the Journal of Pastoral Care and Counseling—ranked as the top 3 journals in Zone 1 and provided the highest number of most frequently cited articles for health care chaplaincy. Additional journals that appeared in this highly productive zone covered the disciplines of medicine, psychology, nursing, and religion, which were also represented in the Zones 2 and 3 journals. None of the databases provided complete coverage for the core journals; however, MEDLINE provided the most comprehensive coverage for journals in Zones 1 and 2, followed by Academic Search Complete, CINAHL, PsycINFO, and ATLA. Self-citations for the source journals ranged from 9% to 16%.

Conclusions:

Health care chaplaincy draws from a diverse body of inter-professional literature. Libraries wishing to provide access to journal literature to support health care chaplaincy at their institutions will be best able to do this by subscribing to databases and journals that cover medical, psychological, nursing, and religion- or spirituality-focused disciplines.

Highlights

• Health care chaplaincy is a broadly inter-professional field that draws from and contributes to medical, nursing, psychological, and religion or spirituality literature.
• Two of the three source journals were sponsored by professional chaplaincy organizations.
• Journals and books were cited with almost equal frequency.

Implications

• For full coverage of the health care chaplaincy literature, librarians should consider searching in databases beyond MEDLINE, for example, CINAHL and Academic Search Complete, to assure comprehensive coverage.
• Health care chaplaincy researchers and educators considering publication will find the study useful for identifying relevant journals from related disciplines.

     

Strategies for Living Long and Healthy Lives: Perspectives of Older African/Caribbean-American Women

The influence of health and socioeconomic status on perceptions of aging and adaptation strategies of older African/Caribbean-American women was examined. Responses of 38 women (average age=77.3 years) to: “What do you like and dislike about growing old?” and “To what would you attribute your long life?” were analyzed. Respondents were classified as: financially independent/healthy, financially dependent/healthy, financially independent/not healthy and financially dependent/not healthy. Narratives revealed declining health and restricted financial resources limited perceptions of opportunities for well-being. Despite differences in health and financial status, groups had some common strategies: avoiding risk behaviors, holding moral beliefs, optimism, altruism and spirituality. It was concluded that health and socioeconomic status had some influence on perceptions of aging and adaptation strategies.     

Stigma in the line of face: Self‐disclosure of patients' HIV status to health care providers

Patients who are HIV+ are often faced with the choice of whether or not they should tell their health care providers that they are HIV+. Although appropriate health care and safety require the communication of such information, the stigmatization associated with HIV puts at risk the patients’ pride, dignity, and ultimately the quality of their health. Using Goffman's (1963, 1967) notions of face and stigma, the present study described the major influential factors prompting the act of disclosure of HIV, the act itself, and the effect that act appears to have had on the patient/provider relationship. Phase I of the study gathered pilot data through in‐depth interviews, leading to a quantitative questionnaire used in Phase II. A sample was obtained through AIDS organizations around the U.S. and via electronic mail addresses for AIDS/HIV electronic discussion groups. The interviews and surveys asked respondents to recall a time when they had to make the decision to disclose or not disclose their HIV+ status to a care provider. The results indicated that patients typically did disclose their HIV+ status despite their strong feelings of stigmatization. Three key factors were related to their decisions: 1) perceived necessity of disclosure; 2) subjective feelings of comfort about the disclosure; and 3) perceptions of stigmatization. Patient satisfaction levels were also related to these factors. Implications for face maintenance and health care management as well as the determinants of subjective comfort are discussed.     

Medicine and health care: implications for health sciences library practice

The American health care system is experiencing a period of unprecedented change. This paper identifies and discusses the major changes in patient care, research, control of the health care system, and medical education, and their implications for health sciences librarians. These changes have resulted in new demands for effective information delivery and a broader health sciences library clientele. There are both challenges and opportunities for health sciences librarians as they respond to information pressures of the current health care environment and anticipate future needs.     

Controversial issues: female genital mutilation

As immigrant women from African countries enter the U.S., Canada, Australia, and Western Europe, western health care providers are beginning to see patients affected by the cultural practice of Female Genital Mutilation (FGM). Unfamiliar with the practice, either medically or culturally, these providers are turning to medical librarians for information. Complicating the issue are the strong negative feelings most western health care workers have about FGM, which appears to them to be both barbaric and cruel. These feelings may conflict strongly with those of their immigrant patients, who regard the practice as normal and desirable. Both medical and cultural information are needed for the professional to provide treatment of medical conditions, while also establishing a good relationship with the FGM affected patient. This article identifies and describes the most important refereed journal article databases, available now over the Internet, providing both medical and cultural information on FGM, and the most useful Web sites for health professionals, librarians, and interested laypersons who need information about this difficult multicultural issue.     

Business information sources for health sciences librarians.

As the health care industry becomes more business oriented, health sciences librarians will encounter more patrons seeking business information. Administrators and managers of health care facilities are primarily in need of business information. This paper discusses those resources with which health sciences librarians must be familiar to successfully meet the challenges of these new demands. It identifies traditional and online sources, and emphasizes business sources geared to the health care industry. The business managers of the health care facility represent a new patron market for the health sciences librarian.     

Health Care Providers' Confidentiality Practices and Perceptions: Expanding a Typology of Confidentiality Breaches in Health Care Communication

Confidentiality breaches of health information can affect every person who seeks medical care. To better understand this phenomenon, breaches of confidentiality by employees in a health care organization were examined and compared to the perceived confidentiality maintenance actions of the organization's health care providers. The study, using observation and interviews of a health promotion department, supported Brann and Mattson's (2004) typology of confidentiality breaches, provided evidence for another type of communicative breach, and revealed inconsistencies between health care providers' actions and their perceptions of those actions. Future research should address the prevalence of such discrepancies in other health contexts and its impact on patient care.     

Managed care and the paradox of patient confidentiality: A case study analysis from a communication boundary management perspective

Managed care organizations have become one of the dominant forms of health care delivery in the United States. Paradoxically, this system, designed to provide better, less expensive care for patients and increased efficiency for health care providers may be compromising patients’ privacy by making patients’ records available to a wider range of internal and external parties. By allowing many individuals access to patients’ health records, the confidentiality of patients’ private information in the managed care environment is at risk. Using an extension of the communication boundary management perspective (Petronio, 1991, 2000) within a case study approach, a breach of patient confidentiality in a managed care environment is examined. From this analysis, practical recommendations are offered to patients, health care providers, and managed care organizations for managing the paradox of patient confidentiality.     

Living Our Mission: A Study of University Mission Building

At the same time that organizational communication and management scholars are focusing attention on trends of spirituality in the workplace, faith-based organizations are taking up the question of how they might maintain a distinct spiritual identity. For these institutions, communicating mission becomes the defining feature of institutional identity. Explicitly religious organizations provide a venue for understanding the implications of incorporating spirituality in organizational discourse. This empirical study explores a mission-building conference and examines the ways in which communicating a spiritual mission simultaneously enriches and constrains both the individual members and the organizations as a whole.     

Exploring digital health care: eHealth,mHealth, and librarian opportunities

Technology advances in eHealth and mHealth are changing the way that health care consumers and providers communicate, receive and deliver care, and access health information. As electronic health records and smartphones have become ubiquitous in the United States, opportunities and applications for the integration of eHealth and mHealth have increased. In addition to technology advances, the changing health care model is simultaneously adapting to and driving initiatives in digital health care. With these digital initiatives have come challenges, including data overload, security and privacy concerns, deficits in technological and health literacy skills, and sorting through the vast number of choices of digital applications. Navigating this changing landscape can be overwhelming and time consuming for both health care providers and consumers. Librarians are uniquely positioned to assist providers and consumers to break down barriers within the digital health care landscape through data management initiatives, technology and health literacy instruction, and finding and evaluating health information and digital health technologies.     

Community Health Map: A geospatial and multivariate data visualization tool for public health datasets

Trillions of dollars are spent each year on health care. The U.S. Department of Health and Human Services keeps track of a variety of health care indicators across the country, resulting in a large geospatially multivariate data set. Current visualization tools for such data sets make it difficult to make multivariate comparisons and show the geographic distribution of the selected variables at the same time. Community Health Map is a web application that enables users to visualize health care data in multivariate space as well as geospatially. It is designed to aid exploration of this huge data repository and deliver deep insights for policy makers, journalists, consumer groups, and academic researchers. Users can visualize the geospatial distribution of a given variable on an interactive map, and compare two or more variables using charts and tables. By employing dynamic query filters, visualizations can be narrowed down to specific ranges and regions. Our presentation to policy makers and pilot usability evaluation suggest that the Community Health Map provides a comprehensible and powerful interface for policy makers to visualize health care quality, public health outcomes, and access to care in an effort to help them to make informed decisions about improving health care.     

The demand for and use of outcomes information

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Older adults' health information behavior in everyday life settings

Health information seeking is an important part of older adults' everyday lives as they cope with their health conditions. Semi-structured interviews conducted with 21 older adults in the United States were analyzed using Savolainen's everyday life information seeking (ELIS) model, especially its key concepts such as way of life and mastery of life. The interview data revealed that except for health care providers, a spouse or partner was mentioned as a credible interpersonal source of health information among older adults in a marital or romantic relationship. Characteristics of older adults' health information behavior in the ELIS context were identified based on types of way of life and mastery of life. For example, those who had more varied types of hobbies, including cognitive, affective, and social hobbies, were exposed to diverse people as they performed their daily routine, potentially resulting in different sources of useful health information. In couple relationships, those with an optimistic as opposed to pessimistic attitude toward a problem-solving situation played the information provider role rather than information receiver role.     

Information Needs Assessment for K-12 School Nurses in Rural Eastern Washington State

School nurses are an often-overlooked population of health care professionals who have great importance in rural communities where access to health care is limited. In order to better serve school nurses in rural eastern Washington, an assessment was conducted to determine their information needs, behaviors, and perceptions. Results indicated this population of school nurses searches for multiple types of health information on a daily basis and navigates obstacles to information access using a variety of resources. While largely confident in their searching ability, they are open to learning more about how to find reliable health information to support their daily responsibilities. These results will guide the development of a workshop for school nurses about using reliable health information resources to improve health care in their rural communities.