Health Communication
Richard K. Thomas Health Communication
Richard K. Thomas rthomas5@midsouth.rr.com Library of Congress Control Number: 2005927078 ISBN-10: 0-387-26115-X e-isbn: 0-387-26116-8 ISBN-13: 978-0387-26115-7 Printed on acid-free paper. C 2006 Springer Science+Business Media, Inc. All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, Inc., 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed in the United States of America. (TB/SBA) 9 8 7 6 5 4 3 2 1 springeronline.com
Preface During the last years of the 20 th century health professionals developed a growing appreciation of the critical role that communication plays in healthcare. The communication of information among the various players in healthcare has always been taken as a given. Like many common phenomenon, however, the nuances and unspoken interaction may have serious implications for the communication process. Examples of the pivotal role of communication in healthcare are everywhere communication between doctors (and other clinicians) and patients, between health educators and their clients, between pharmaceutical companies and consumers, between parents and children. Just as important as the positive contribution that communication can make to healthcare has been the realization of the negative impact that ineffective communication can have within the healthcare arena. We only have to note the contribution of poor communication to malpractice suits, misdiagnoses, failures in patient compliance, and cross-cultural misunderstandings to see the role that communication plays. Many of the challenges facing healthcare today, in fact, reflect failures in communication. The headlines are full of stories related to medical errors, patient confidentiality, patient compliance, and other concerns related to the delivery of care. The common theme running through these headline-grabbing issues is communication. Given these circumstances, there has never been a better time to address the issue of health communication. It is a time when the importance of health communication is being recognized, when the role of health communication is expanding, and when the implications of effective (or ineffective) communication are becoming more significant. v
vi Preface There is no question that the need for stepped up efforts in the area of health communication is growing in all areas. Fortunately, the resources available for improving health communication are increasing as well. The base of knowledge that which is being communicated has increased exponentially over the past few years. Health professionals now know what to tell people in most instances. The body of research on what is effective and what is not has grown dramatically and health professionals are benefiting from advances in communication theory. The number and range of available communication techniques have greatly expanded, providing the health communicator with an unprecedented armamentarium of approaches to use. The dramatic impact of the Internet on our everyday lives has also ushered in an age of opportunity for those who seek to communicate health-related messages to both the general public and to narrowly targeted audiences. The revival of interest in traditional systems of healing has also furthered the interest in health communication. The movement toward integrated health systems that take a holistic approach to the patient emphasizes the importance of communication between healers and their clients. The critical role of therapeutic communication that formed the basis for treatment within traditional systems has been rediscovered and the health communication process is increasingly being recognized as more than a technical aspect of care but as a component of the therapy process in its own right. This renewed interest is also reflected in recent funding initiatives on the part of federal agencies. Driven by concerns over issues like access to care, disparities in treatment, and increasing patient dissatisfaction, numerous federal programs now include research on health communication among their priorities. Ultimately, this book hopes to ride the wave of optimism with regard to the role health communication can play in improving the health status of individuals and communities. This author s presentation in the early 1980s about the imminent ascendancy of health communication in the field turned out to be premature. But today the knowledge, acceptance and tools necessary for the promotion of health communication are all in place. University of Tennessee Health Science Center May 2005 Richard K. Thomas
Contents 1. Introduction to Health Communication... 1 2. The Changing Sociocultural Context... 9 3. The Changing Healthcare Context... 21 4. The History of Health Communication... 39 5. Health Communication Audiences... 47 6. Understanding Health Behavior... 65 7. Understanding Communication... 85 8. Steps in the Health Communication Process... 103 9. Traditional Approaches to Health Communication... 119 10. Contemporary Approaches to Health Communication... 133 11. Case Studies in Health Communication... 149 12. Evaluating the Impact of Health Communication... 167 13. The Future of Health Communication... 179 vii
viii Contents Bibliography... 187 Glossary... 191 Index... 211