Managing Patient-centered Communication across the Type 2 Diabetes Illness Trajectory: A Grounded Practical Theory of Interactional Sensitivity

This article uses the theoretical and methodological framework of Grounded Practical Theory (GPT) to provide a lens for analyzing and interpreting discourse as a situated form of social action in routine Type 2 diabetes visits. Drawing on a total data-set of 400 audio-recorded routine visits, we randomly selected 55 visits for qualitative analysis. In this article, we use Conversation Analysis to document communication techniques, which we in turn use as evidence to ground our claims within the GPT framework. We use two single cases of interaction to analyze communication techniques physicians use when recommending a change from oral medication to insulin. We argue treatment intensification is a key moment in health communication to reflect about patient centeredness because physicians can find themselves in an interactional dilemma: while insulin may effectively help control unstable disease, an insulin recommendation may simultaneously counter patient values and treatment preferences. Our analysis suggests that physicians use what we call interactional sensitivity to balance medical need and patient preferences when making medical decisions by tailoring their communication according to the local situation and the patient's larger illness trajectory. We propose that interactional sensitivity is a type of communication work and a quality of patient-centered communication characterized by the theoretical relationship between tailoring communication to the contingencies of the local interaction and the global illness trajectory. Overall, this article contributes to health communication scholarship by proposing a normative model for reflecting on how physicians negotiate challenging interactions with patients during routine chronic illness visits.     

Enacted Goal Attention in Family Conversations about End-of-life Health Decisions

Most extant research on end-of-life communication in families has been based on the assumption that more communication is better communication. We used a multiple goals theoretical perspective to demonstrate that the quality of communication about end-of-life decisions matters. Members of 121 older parent/adult child dyads (N = 242) engaged in an elicited conversation about end-of-life health choices and reported their assessments of the conversation. Using multilevel linear modeling, we found that outside ratings of a person's communication quality (i.e., attention to task, identity, and relational goals) as well as outside ratings of the partner's communication quality were positively associated with the person's reported conversational satisfaction and hopefulness and negatively associated with the person's hurt feelings and relational distancing.     

An Experimental Test of Medical Disclosure and Consent Documentation: Assessing Patient Comprehension,Self-Efficacy,and Uncertainty

Effectively conveying risks and hazards in medical disclosure and informed consent documentation is a crucial type of communication. However, existing protocols typically do not meet the needs of patients or practitioners. In the present study, we advance a reconceptualization of obtaining written informed consent by analyzing it as a process of uncertainty management rather than a matter of document readability and recall. Results of this randomized trial indicated that patients who reviewed a simplified consent document reported greater comprehension of medico-legal terminology and lower uncertainty about the document, although they did not evince greater self-efficacy. Health literacy was a significant moderator of the relationship between consent form version and comprehension.     

正确解读《体育与健康课程标准》--兼谈在实施体育课程改革中存在的误区

从新的教学理念、指导思想、目标体系和评价体系等方面，对《体育与健康课程标准》进行了正确的解读。同时对部分地区中学对《体育与健康课程标准》的实施情况进行了调查，指出了当前体育与健康课程改革中存在的问题和误区，并提出了对策。     

构建学分制下《体育与健康课程》体系的研究

采用文献资料法、问卷调查法、实验法、逻辑分析法,对“学分制体育与健康课程体系”进行研究,提出了构建“学分制体育与健康课程体系”的依据和思路,确立了其课程性质与目的,并对其课程设置、教学内容、教法方法、组织形式、教学管理体制、教学评价、教学效果等进行了详实的阐述。     

高校女生健美操健康功能因素模型的构建与实践研究

运用教学实验、问卷调查、数理统计和回归分析等方法,对实验所获取的实验测试指标进行定量定性分析与研究,以探求健美操健康功能对高校女生健康状况的影响程度,并构建健美操健康功能因素模。健美操健康功能因素模分别由健身功能、健心功能和美育功能构成。     

关于高校体育与健康课素质教育改革的思考

以教育部颁布的《全国普通高等学校体育与健康课教学指导纲要》为依据 ,分析了体育与健康课教学指导纲要的基本特征及新变化 ,提出了 2 1世纪高校体育教师在实施指导纲要的要求时应注意的问题 ,以提高教育行政部门及教育工作者对高校体育与健康课的正确认识 ,更好地贯彻落实“素质教育”和“健康第一”的指导思想。     

2004年江苏省大学生身体形态和机能的状况分析

采用文献资料法,实验法和数理统计法,对2004年江苏省219050名男、女大学生的身体形态和机能的发展状况分析,探讨江苏省大学生的体质健康状况发展的规律,特点及存在的问题,提出改善对策。     

我院开设中医养生学课程的探索及反馈调查

为了培养大学生终身健身思想、促进健身行为,湖南师范大学体育学院进行开设中医养生学课程的尝试.采用问卷调查反馈,资料统计及逻辑分析法研究表明:大学生健身意识强烈、观念正确,对安排养生学课程学习态度积极,对养生学的价值及其学习的必要性一致肯定;开设中医养生学课程后大学生的健身意识强化,养生健身需求和兴趣提高,思维方式优化,增加了健身的知识、手段和方法,从而形成良好行为生活习惯和促进养生健身行为;中医体质辨证养生方法使学习者能针对自己的体质高效健身,由中医特色理论方法的渗透,实现健身素质的提高,将使学习者终生受益.     

新体育(与健康)课程教学存在的问题、原因和对策

采用献资料调研、实地考察和比较分析等方法，对新一轮的体育(与健康)课程教学在广东和全国其他实验区的试验、推广过程中所暴露出的一些比较突出的问题和矛盾进行了理性思考和辨证分析，并在此基础上提出了相应的解决策略。