Department of Communication Studies Works

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Relationship between health-related quality of life, depression, and anxiety in older primary care patients and their family members
(Taylor & Francis, 2024) Fowler, Nicole R.; Perkins, Anthony J.; Park, Seho; Schroeder, Matthew W.; Boustani, Malaz A.; Head, Katharine J.; Bakas, Tamilyn; Communication Studies, School of Liberal Arts
Objectives Patient-family member dyads experience transitions through illness as an interdependent team. This study measures the association of depression, anxiety, and health-related quality of life (HRQOL) of older adult primary care patient-family member dyads. Methods Baseline data from 1,808 patient-family member dyads enrolled in a trial testing early detection of Alzheimer’s disease and related dementias in primary care. Actor-Partner Independence Model was used to analyze dyadic relationships between patients’ and family members’ depression (PHQ-9), anxiety (GAD-7), and HRQOL (SF-36 Physical Component Summary score and Mental Component Summary score). Results Family member mean (SD) age is 64.2 (13) years; 32.2% male; 84.6% White; and 64.8% being the patient’s spouse/partner. Patient mean (SD) age is 73.7 (5.7) years; 47% male; and 85.1% White. For HRQOL, there were significant actor effects for patient and family member depression alone and depression and anxiety together on their own HRQOL (p < 0.001). There were significant partner effects where family member depression combined with anxiety was associated with the patient’s physical component summary score of the SF-36 (p = 0.010), and where the family member’s anxiety alone was associated with the patient’s mental component summary score of the SF-36 (p = 0.031). Conclusion Results from this study reveal that many dyads experience covarying health status (e.g. depression, anxiety) even prior to entering a caregiving situation.
Socializing employees into a culture of health
(Emerald, 2023-06) Martin, Natalie; Brann, Maria; Goering, Elizabeth; Communication Studies, School of Liberal Arts
Purpose A culture of health within an organization offers benefits such as managing healthcare costs and supporting employees in becoming and staying healthy. This study aims to identify successful organization's strategies utilized to socialize employees into a culture of health. Design/methodology/approach In-depth interviews were conducted with 19 representatives from organizations recognized for their success in creating a culture of health. Grounded theory analysis of collected data was used to identify themes related to the goals of this study. Findings New employees are socialized into the culture of health during the recruitment process, at new employee orientation and throughout the early employment period. Existing employees are also continually socialized using a variety of on-going communication strategies. This process is consistent with Jablin's organizational assimilation model, and this study offers the opportunity to use this model to help understand organizational health. Practical implications Organizations desiring to create a culture of health can support this culture by incorporating socialization strategies into the recruitment, hiring and new employee on-boarding process. Originality/value Though strategies have been shown to be helpful in socializing new employees into organizations, limited research has explored the relationship between socialization and a culture of health. Results from this study offer insight into how organizations that have been recognized for their success in creating a culture of health socialize new and existing employees to create and maintain a culture that supports health and well-being. Also, this study applies socialization theories to health within the workplace, offering new insights both theoretically and practically.
“Our Birth Experiences are What Binds Us”: Women’s Motivations for Storytelling about Birth to Build Motherwisdom
(Taylor & Francis, 2020) Johnson, Nicole L.; Scott, Susanna F.; Brann, Maria; Communication Studies, School of Liberal Arts
Childbirth is widely considered to be a bonding experience among women. Women often feel compelled to share their story, and this research highlights communicative and reflexive aspects of storytelling as a means for meaning-making and relationship-building. This inductive thematic analysis explored 22 women’s motivations for engaging in storytelling about birth across five focus groups and two one-on-one interviews. Findings demonstrate one primary theme, building motherwisdom, a term coined here to reflect the uniqueness of the birth storytelling context. We also identified three secondary themes for motivation to engage in birth storytelling: (1) fulfilling a sense of responsibility to share one’s story to normalize a variety of birth experiences and to listen to learn about birth, (2) empowering women, and (3) seeking validation. Women receive positive therapeutic benefit from storytelling, and this may be particularly important in maintaining and improving mental health during the postpartum period. Our work informs the environments we can create to motivate mothers to share and listen to birth stories to foster this benefit.
“I’m not your mom, I’m your sister:” A Normative Approach to Understand How National Panhellenic Council Sorority Leaders Handle Honest Conversations
(Association of Fraternity/Sorority Advisors, 2024) Binion, Kelsey E.; Unruh, Maggie A.; Brann, Maria; Communication Studies, School of Liberal Arts
This study used Goldsmith’s normative rhetorical theory to explore dilemmas in honest conversations between National Panhellenic Council (NPC) sorority members. Researchers interviewed 16 leaders from one NPC sorority across 14 chapters in the United States. A phronetic iterative analytic approach revealed two communication dilemmas: I have to have this honest conversation with you, but I do not want to and I have power, but I am your equal. To manage these dilemmas, two communicative strategies were identified: intentional planning and message delivery. Findings offer guidance on navigating honest conversations to foster belonging and maintaining a supportive social network.
“I’m not sure I’ll ever forget the experience”: a narrative analysis of Chrissy Teigen’s social media describing her miscarriage
(Taylor & Francis, 2024) Binion, Kelsey E.; Brann, Maria; Communication Studies, School of Liberal Arts
In August 2020, celebrity Chrissy Teigen shared on social media that she was pregnant with her third child. The following month, Teigen used social media to document her pregnancy complications. On September 30, 2020, Teigen posted five black and white photographs via Instagram that chronicled the emotional and physical pain of a miscarriage. One month later, Teigen published an online essay describing the circumstances surrounding her miscarriage and explaining the importance of documenting her experience. By using narrative criticism, this study describes the rhetorical features, specifically the characters, settings, and medium, to explain how Teigen, using social media, sparked a national conversation about miscarriage and the need for compassion and awareness. This analysis discusses the implications of using technology in removing the shroud of silence and stigma that exists around miscarriage in American culture.
Identifying communication behaviors and assessing effectiveness among interprofessional healthcare teams: A simulation study
(Kentucky Communication Association, 2024) Binion, Kelsey E.; Brann, Maria; Communication Studies, School of Liberal Arts
To deliver high quality health care, effective communication must exist among providers and between providers and patients. However, communicating across health disciplines is challenging because learners train in professional silos. Using a two-part simulation, this study's objectives were to identify effective communication behaviors of interprofessional healthcare teams and to evaluate their success in delivering team-based care for standardized patients. During the simulation, 10 standardized patients completed an evaluation to assess 46 teams of learners (n = 222). The evaluation included a patient-rated measure of healthcare providers' empathy and communication skills as well as a comment box for feedback. Of the 92 evaluations collected, four effective communication behaviors among interprofessional healthcare teams were identified: be aware of the patient's situation, participate in the interaction equally, create a comfortable environment, and nurture and strengthen a relationship. Learners demonstrated improvement in team communication between the first and second encounters with a standardized patient, and they exhibited five of the eight communication sub-competencies that are deemed necessary for interprofessional collaborative practice. This study demonstrated that learners' communicative behaviors improved during the simulation; thus, future interprofessional simulation activities should consider exercises that require learners to practice and refine their communication and teamwork skills.
“I’m Not Comfortable With COVID, But …”: Dilemmas and Decision-Making to Mitigate Risks Among Mothers Who Gave Birth During the COVID-19 Pandemic
(Sage, 2024) Johnson, Nicole L.; Brann, Maria; Scott, Susanna F.; Bute, Jennifer J.; Communication Studies, School of Liberal Arts
Individuals have faced unprecedented uncertainty and risk surrounding the COVID-19 pandemic, and decision-making dilemmas have been complicated by quickly evolving and often contradictory recommendations for staying healthy. Using tenets of problematic integration theory and risk orders theory, we analyzed interview data from 50 mothers who gave birth during the pandemic to understand how uncertainty and risk perceptions shaped their decision-making about keeping themselves and their infants healthy in the first year after birth. Results describe how some mothers in our sample made sense of their decision-making to prioritize first-order risks to their own and their family’s physical health, and other mothers prioritized second-order risks to their relationships and identities. We also discuss the social nature of mitigating risk during the COVID-19 pandemic and the catalysts for shifting risk perceptions. Theoretical and practical implications include improving public health messaging and clinical conversations to enable individuals to effectively manage social and identity needs alongside serious threats to physical health.
Narrative Sense-Making During COVID-19: Using Stories to Understand Birth in a Global Pandemic
(Taylor & Francis, 2024) Brann, Maria; Bute, Jennifer J.; Foxworthy Scott, Susanna; Johnson, Nicole L.; Communication Studies, School of Liberal Arts
Women who gave birth in the spring and summer of 2020 contended with a host of challenging factors. In addition to facing pregnancy, labor, and delivery during an emerging global pandemic, women grappled with health care restrictions that altered their birth experience. To explore how women made sense of their birth during COVID-19, we analyzed written narratives from 71 women who gave birth in the United States from March to July 2020. Based on tenets of communicated narrative sense-making, the themes that emerged from our data suggest that women framed the role of the pandemic as either completely overshadowing their birth experience or as an inconvenience. Women also wrote about threats to their agency as patients, mothers, and caregivers, as well as the evolving emotional toll of the pandemic that often prompted feelings of fear and sadness, along with self-identified anxiety and depression. We discuss these findings in light of the literature on birth stories as essential sites of narrative sense-making for women and their families.
A Case of Error Disclosure: A Communication Privacy Management Analysis
(Sage, 2013-12-01) Petronio, Sandra; Helft, Paul R.; Child, Jeffrey T.; Communication Studies, School of Liberal Arts
To better understand the process of disclosing medical errors to patients, this research offers a case analysis using Petronios's theoretical frame of Communication Privacy Management (CPM). Given the resistance clinicians often feel about error disclosure, insights into the way choices are made by the clinicians in telling patients about the mistake has the potential to address reasons for resistance. Applying the evidenced-based CPM theory, developed over the last 35 years and dedicated to studying disclosure phenomenon, to disclosing medical mistakes potentially has the ability to reshape thinking about the error disclosure process. Using a composite case representing a surgical mistake, analysis based on CPM theory is offered to gain insights into conversational routines and disclosure management choices of revealing a medical error. The results of this analysis show that an underlying assumption of health information ownership by the patient and family can be at odds with the way the clinician tends to control disclosure about the error. In addition, the case analysis illustrates that there are embedded patterns of disclosure that emerge out of conversations the clinician has with the patient and the patient's family members. These patterns unfold privacy management decisions on the part of the clinician that impact how the patient is told about the error and the way that patients interpret the meaning of the disclosure. These findings suggest the need for a better understanding of how patients manage their private health information in relationship to their expectations for the way they see the clinician caring for or controlling their health information about errors. Significance for public health: Much of the mission central to public health sits squarely on the ability to communicate effectively. This case analysis offers an in-depth assessment of how error disclosure is complicated by misunderstandings, assuming ownership and control over information, unwittingly following conversational scripts that convey misleading messages, and the difficulty in regulating privacy boundaries in the stressful circumstances that occur with error disclosures. As a consequence, the potential contribution to public health is the ability to more clearly see the significance of the disclosure process that has implications for many public health issues.
Informed Consent
(Wiley, 2023) Brann, Maria; Communication Studies, School of Liberal Arts
This entry provides an overview of informed consent in healthcare interactions. By addressing what constitutes informed consent, taking a brief look at the historical significance of informed consent, and highlighting research that focuses on the informed consent process in health communication, readers gain a better understanding of this necessary communicative act for patient-centered healthcare. The Western value of patient autonomy is noted as necessary for informed decision making, and the problems when respect for persons is overlooked by not engaging in informed consent are discussed. The act, and end result, of informed consent is a recognized right for patients during healthcare interactions.

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