Graduate theses: An index of graduate work in speech,XXXIII

Six themes of physicians' relational communication were hypothesized to predict patients' satisfaction and compliance, to relate to strategies used by physicians to gain compliance, and to relate to frequency of physician‐patient contact. Telephone interviews with 234 adults who had seen a primary care physician within the previous six months confirmed that perceived relational communication was strongly related to affective, cognitive, and behavioral satisfaction. More expressions of receptivity, immediacy, composure, similarity, and formality and less dominance by the physician were associated with greater patient satisfaction. Only perceived similarity related to patient‐reported compliance. Several relational message themes were associated with physicians’ use of 17 verbal compliance‐gaining strategies. More prior contact also was associated with more perceived use of immediacy and receptivity messages by the physician and with more satisfaction. Finally, satisfaction was modestly correlated with compliance.     

Nonverbal immediacy in the physician/patient relationship

This study examined the relationships between the nonverbal immediacy of physicians and their patients’ satisfaction with them as doctors and overall medical care. Consistent with the results of previous studies in the instructional and organizational communication areas, substantial associations were found in this medical context. Patients who see their physicians as more immediate report more satisfaction with the physician and are generally more satisfied with the medical care they receive. The patients also indicated experiencing less fear of their physician when the physician was more immediate.     

The Influence of Medical Orientation on Perceived Physician Credibility

This study assessed whether two medical orientations of physicians—biomedical vs biopsychosocial—influenced individuals’ perceptions of physician credibility. Participants read a vignette describing a physician communicating either a predominantly biomedical or a predominantly biopsychosocial orientation and then completed the Measure of Source Credibility in reference to the physician. Results indicate that physicians who display a biopsychosocial orientation were rated higher in perceived competence, character, and caring. Future researchers should address various effects of the medical context on physician credibility and how patients’ preferences regarding physicians’ medical orientation influence choice of and communication with physicians, patient satisfaction, and compliance.     

Perceptions of Health Care Professionals' Credibility as a Predictor of Patients' Satisfaction with their Medical Care and Physician

The purpose of this study was to examine how patients' perceptions of source credibility related to their satisfaction with the quality of medical care they received and satisfaction with their physician. Patients' perceptions of the competence and caring dimensions of source credibility were analyzed for physicians, nurses, and support staff members. Three hypotheses were proposed and supported. Results indicated that higher perceptions of competence and caring for each member of the medical team were related to more patient satisfaction. This paper discusses the importance of the doctor-patient, nurse-patient, and support staff-patient relationships in light of the findings.     

The Effect of Patient Self-Advocacy on Patient Satisfaction: Exploring Self-Compassion as a Mediator

The purpose of this study was to examine the role of self-compassion as a predictor and mediator of the relationship between patient self-advocacy and patient satisfaction in health care. A sample of 522 patients completed a questionnaire that asked for their perceptions of their own self-compassion, patient self-advocacy behaviors, including illness education, assertiveness, and mindful nonadherence, and patient satisfaction. This study found that both patient self-advocacy and self-compassion were positive predictors of patient satisfaction. More specifically, patients’ illness education and assertiveness positively influenced patients’ satisfaction with their physician. Self-compassion was also shown to be a mediator between patient self-advocacy and patient satisfaction. The implications of these findings and future directions are also discussed.     

疫情防控常态化下患者双渠道就诊满意度影响因素研究

[目的/意义]通过分析患者双渠道就诊模式下的在线评论,挖掘其满意度的影响因素,丰富患者满意度研究,从患者满意角度出发为后疫情时期患者双渠道就诊模式下在线医疗平台及关联线下医院的运营提供可行性参考建议.[方法/过程]首先基于扎根理论对患者双渠道就诊模式下的在线评论进行编码,识别患者满意度的主要影响因素及其关系,结合双因素...     

The effects of nonverbal reinforcement and interviewee‐interviewer relationship on interviewee's verbal response

Utilizing survey data from 99 nursing home residents in nursing home facilities serving Medicaid patients, this study investigated the relationship of interpersonal network involvement to perceived life satisfaction and perceived need accommodations. Each subject completed three survey instruments developed to measure (a) resident's perceived quality care, (b) residents’ satisfaction with personal need accommodation and (c) interpersonal network satisfaction. Residents’ perceptions of quality care (i.e., attitude of staff, food, and self‐selected social activities) and satisfaction with roommates are significant predictors of perceived needs being met. Further, residents are more satisfied with self‐selected relationships than with institutionally‐selected roommates.     

Teacher Influence in the Classroom: A Preliminary Investigation of Perceived Instructor Power,Credibility, and Student Satisfaction An earlier version of this paper was presented on a program of the Communication Education interest group at the annual convention of the Central States Communication Association,Milwaukee, WI,April 2002.

The purpose of this study was to examine the relationships between perceived teacher power, teacher credibility, and student satisfaction. Respondents were 67 undergraduate students (30 males and 37 females) enrolled in Communication classes at a southwestern university. Students’ perceptions of their teachers’ expert, referent and reward power use were found to be positively related to their perceptions of their teachers’ competence, caring, and trustworthiness. Teacher power use contributed to the prediction of a significant amount of variance in teacher credibility. Additionally, student satisfaction was positively and significantly related to both teacher referent power and expert power. Surprisingly, students’ perceptions of coercive power were not significantly and negatively related to student satisfaction. Implications, limitations and suggestions for future research are discussed.     

Measuring patients' communication apprehension about interacting with physicians: Instrument development

The purpose of these studies was to develop an instrument to measure patients' perceived communication apprehension in patient/physician interactions. In the first stydy, a five item Patients' Report of Communication Apprehension with Physicians (PRCAP) was developed. The scale appears to be a reliable, unidimensional scale which shows a moderate positive correlation with the Personal Report of Communication Apprehension (PRCA), a moderate negative correlation with willingness to communicate (WTC), and a moderate negative correlation with self‐perceived communication competence (SPCC). In the second study, designed to assess the predictive validity of the PRCAP, those who scored one standard deviation above the mean on the PRCAP reported being less satisfied with their interactions with physicians than those who scored one standard deviation below the mean on the PRCAP. It appears the PRCAP is a reliable and valid instrument that can be employed to pursue issues involving the role of CA in patient/physician interactions.     

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.     

Pediatric nurses’ communication of role expectations to parents of hospitalized children

This study examines the role performance of pediatric nurses and parents in relation to hospitalized children. The ambiguity associated with role behaviors for both groups is considered in terms of rules that might be formally adopted to define nurses’ and parents’ roles. Pediatric nurses were interviewed to identify behaviors appropriately performed by parents for their hospitalized children, and formal rules were drafted. These rules were communicated by nurses in writing, orally, or both and were compared to no formal communication for impact on nurses’ job satisfaction, parents’ satisfaction with nursing care, and both nurses’ and parents’ role ambiguity. The formal rules were found to enhance both nurses’ job satisfaction and parents’ satisfaction with the technical‐professional competence component of nursing care. Moreover, both nurses and parents perceived a reduction in role ambiguity as measured by the information that nurses give and the communication of expectations.     

Investigating the relationship between superior‐subordinate relationship quality and employee dissent

The purpose of this study was to examine how subordinates’ perceptions of superior‐subordinate relationship quality (LMX) related to their strategies for expressing dissent. Employees from various organizations completed self‐report survey instruments. Results indicated that subordinates who perceived having high‐quality relationships with their supervisors reported using significantly more articulated dissent than subordinates who perceived having low‐quality relationships with their supervisors. Conversely, subordinates who perceived having low‐quality relationships with their supervisors reported using significantly more latent dissent than subordinates who perceived having high‐quality relationships with their supervisors.     

Information Quality,Uncertainty, and Quality of Care in Long-Distance Caregiving

Approximately 13% of Americans who provide care for an ailing family member do so from a distance, making long-distance caregiving a relevant health communication topic to study. A self-report online survey examined the quality of information provided by care recipient to distant caregiver, uncertainty about care recipient health, and perceived quality of care from the distant caregivers' perspective. Information quality, uncertainty, and perceived quality of care were significantly related as predicted. How these findings offer new insight into the complex nature of distant caregiving communication is discussed.     

Organizational newcomers: Temporary and regular employees,same‐sex and mixed‐sex superior‐subordinate dyads,supervisor influence techniques,subordinates communication satisfaction,and leader‐member exchange

This study examined the relationship between newly hired employees’ characteristics (i.e., temporary vs. regular employee, superior‐subordinate gender‐dyad combinations), supervisors initial tactics of influence, subordinate communication satisfaction, and quality of leader‐member exchange. Results from 148 (71 temporary) new hires indicated (a) employee characteristics were not significantly related to the leader‐member exchange, (b) supervisors initial use of prosocial influence tactics were significantly and positively related to the quality of leader‐member exchange, and (c) subordinates’ satisfaction with communication was significantly and positively related to the quality of leader‐member exchange.     

The relationship between perceived instructor communicator style,argumentativeness, and verbal aggressiveness

The purpose of this study was to examine the interrelationships among perceived instructor communicator style, perceived instructor trait argumentativeness, and perceived instructor trait verbal aggressiveness in the college classroom. Participants were 236 undergraduate students enrolled in a variety of communication courses at a large Eastern university. Results indicated that (a) perceived instructor trait argumentativeness was positively related to the perceived instructor communicator style attributes of impression leaving, contentious, open, dramatic, dominant, precise, relaxed, attentive, and animated; (b) perceived instructor trait verbal aggressiveness was positively related to the perceived instructor communicator style attributes of contentious and precise, and negatively related to the perceived communicator style attributes of impression leaving, relaxed, friendly, attentive, and animated; and (c) perceived instructor use of verbally aggressive messages was related in some way to the perceived instructor communicator style attributes of contentious, impression leaving, friendly, attentive, animated, relaxed, dramatic, and precise.     

Can government’s presence on social media stimulate citizens’ online political participation? Investigating the influence of transparency,trust, and responsiveness

This paper empirically investigates the association of quality information provided by a government agency on social media and citizen’s online political participation. It further answers the why and how questions regarding the existence of this relationship by examining the mediating influence of transparency, trust, and responsiveness. The data was collected from 388 followers of the social media platforms of a government agency i.e. Punjab Food Authority and the findings of the analysis were obtained using structural equation modeling technique. The results reveal that the agency’s provision of quality information on social media was significantly related to perceived transparency, trust in agency, perceived responsiveness, and citizens’ online political participation. Moreover, the results show that perceived transparency mediates the relationship between agency’s provision of quality information on social media and citizens’ trust in agency. Additionally, trust in agency was an insignificant predictor and perceived responsiveness was a negative predictor of citizens online political participation, Also, trust in agency and perceived responsiveness suppressed the relationship between agency’s provision of quality information on social media and citizens’ online political participation. This study aims to bring awareness and contribution to the body of knowledge about the governmental use of social media and its resulting benefits since in developing countries like Pakistan the research in this area is sparse. Further, it provides strategic and practical suggestions to agencies regarding advantages of utilizing social media in their communication with citizens.     

A test of a cultural model of patients' motivation for verbal communication in patient‐doctor interactions

In theory, two‐way communication between patient and physician is desirable. However, there is a dearth of research that has explored the effects of patients’ culture and cultural orientations on patients’ ability to actively participate in the medical encounter. The purpose of this paper was to test the effects of patients’ culture and cultural orientations on assertiveness and communication apprehension during medical interviews. According to the proposed model, culture and self‐construals are causal antecedents to patients’ beliefs about verbal communicativeness. Our model suggests that cultural values (self‐construals) are determined in part by culture. In regards to the mediation process, the model proposes that the greater the patient's construal‐of‐self as independent, the more positive her/his beliefs regarding patient participation, which, in turn, leads to a higher degree of motivations to communicate verbally with a physician. Our model also suggests that the greater the patient's construal‐of‐self as interdependent, the more negative her/his beliefs regarding patient participation, which, in turn, leads to a higher degree of communication avoidance and apprehension during medical interview. The data were partially consistent with the theoretical predictions made. The implications of the model for theory and practice are discussed.     

The medical information needs of internists and pediatricians at an academic medical center

Medical information needs were examined in a survey of sixty-seven physicians selected from the faculty and housestaff at Johns Hopkins Hospital. A standardized questionnaire was administered personally by a medical informatics physician to collect data on information needs, attitudes, and previous experience with computers. The types of information most frequently required by both faculty and housestaff were treatment recommendations and differential diagnosis. The sources of reference information most commonly used were textbooks and colleagues. The information needs of housestaff differed significantly in several categories from those of faculty physicians. Housestaff more frequently needed information for patient care (P less than 0.05), and preferred the use of textbooks (P less than 0.01) and handbooks (P less than 0.001) as information sources. Faculty more frequently needed information for activities unrelated to patient care (P less than 0.01) and placed greater importance on basic science information (P less than 0.01). When asked to suggest references for online access, the respondents named 143 journals and textbooks, with journals overwhelmingly preferred over textbooks. Only one reference, the New England Journal of Medicine, was requested by a majority of the respondents. The importance of a broad understanding of physician information needs through improved data-collection techniques is discussed as a means of increasing the use of medical information systems.     

Aggressive communication in the coach‐athlete relationship

This study concerned how coaches’ efforts to solicit better performance from athletes related to male athletes’ perceptions of their coaches’ communication and to athletes’ self‐reports of satisfaction and performance. Data were collected from 192 former male high‐school athletes. Results indicated that when male athletes perceived that their coaches used more aggressive tactics athletes evaluated their coaches communication unfavorably and that when male athletes evaluated their coaches’ communication unfavorably they reported less satisfaction with their coaches, less team success in terms of win‐loss percentage, and less sportsmanship.