In the 1960s, feminists voiced their outrage about the health care system in the United States which routinely discriminated against women and, in so doing, literally jeopardized their health and well-being. Over a decade later, women's health advocates still stressed the need for reform of this male-dominated institution because of the on-going threat to the health of American women. In the 1990s, nearly 40 years after women began their fight for quality and equitable treatment from the medical profession, women unfortunately continue to confront problems on numerous levels including discrimination in medical research and in the availability of insurance and health care providers. Most alarming, however, is the fact that women today--like women in the '60s and before--lack information, understanding, and adequate diagnoses and treatment from their health caregivers.
This book extends from a program of research on women's health issues by the authors. More than 150 audio-taped, naturally occurring interactions between health caregivers and their female patients from three different health care settings--as well as ethnographic field notes in three additional settings which provide health care to women-- constitute the data for this investigation. They explore the consequentiality of relational issues during women's health care encounters and examine how health care participants save face, enact roles, co-construct their encounters, and accomplish the objective of education and medical care.
Unlike earlier works, this study utilizes an extensive data collection derived directly from hundreds of interactions between health care providers and their patients, as opposed to surveys or case studies of singular practitioners. The authors examine the data in light of insights from a variety of theoretical perspectives and are committed to exploring the implication that medical encounters are collaboratively managed by both patients and caregivers. Given these theoretical and empirical contributions, the authors believe this book will advance present understanding in the areas of health and relational communication, women's health care, gender issues in communication, conversation analysis, discourse processes, and institutional talk.

This exceptional work explores the complexities of communication at one of the most critical stages of the life experience--during advanced, serious illness and at the end of life. Challenging the predominantly biomedical model that informs much communication between seriously ill and/or dying patients and their physicians, caregivers, and families, Sandra L. Ragan, Elaine M. Wittenberg-Lyles, Joy Goldsmith, and Sandra Sanchez-Reilly pose palliative care--medical care designed to comfort rather than to cure patients--as an antidote to the experience of most Americans at the most vulnerable juncture of their lives. With an author team comprised of three health communication scholars and one physician certified in geriatrics and palliative medicine, this volume integrates the medical literature on palliative care with that of health communication researchers who advocate a biopsychosocial approach to health care. Applying communication theories and insights to illuminate problems and to explain their complexities, the authors advocate a patient-centered approach to care that recognizes and seeks to lessen patients' suffering and the many types of pain they may experience (physical, psychological, social, and spiritual) during life-threatening illness.

In the 1960s, feminists voiced their outrage about the health care system in the United States which routinely discriminated against women and, in so doing, literally jeopardized their health and well-being. Over a decade later, women's health advocates still stressed the need for reform of this male-dominated institution because of the on-going threat to the health of American women. In the 1990s, nearly 40 years after women began their fight for quality and equitable treatment from the medical profession, women unfortunately continue to confront problems on numerous levels including discrimination in medical research and in the availability of insurance and health care providers. Most alarming, however, is the fact that women today--like women in the '60s and before--lack information, understanding, and adequate diagnoses and treatment from their health caregivers.
This book extends from a program of research on women's health issues by the authors. More than 150 audio-taped, naturally occurring interactions between health caregivers and their female patients from three different health care settings--as well as ethnographic field notes in three additional settings which provide health care to women-- constitute the data for this investigation. They explore the consequentiality of relational issues during women's health care encounters and examine how health care participants save face, enact roles, co-construct their encounters, and accomplish the objective of education and medical care.
Unlike earlier works, this study utilizes an extensive data collection derived directly from hundreds of interactions between health care providers and their patients, as opposed to surveys or case studies of singular practitioners. The authors examine the data in light of insights from a variety of theoretical perspectives and are committed to exploring the implication that medical encounters are collaboratively managed by both patients and caregivers. Given these theoretical and empirical contributions, the authors believe this book will advance present understanding in the areas of health and relational communication, women's health care, gender issues in communication, conversation analysis, discourse processes, and institutional talk.

Caring for the Family Caregiver examines the high cost and poorly addressed exigencies of the family caregiver in chronic illness, including health literacy, palliative care, and health outcomes, through the prism of communication. This book uses an interdisciplinary approach to identify the impact of communication and its burdens on the caregiver and presents four caregiver profiles: the Manager, Carrier, Partner, and Lone caregiver, each emerging from a family system with different patterns of conversational sharing and expectations of conformity. By synthesizing current data assessing the experiences of caregivers, as well as integrating the narrative experiences of a range of caregivers living through a variety of illnesses and their specific demands, the authors deliver an unflinching gaze at the journey of the caregiver. With an author team comprised of three health communication researchers and a nurse and health literacy expert, this volume integrates literature addressing caregiver needs and burdens, communication theory and practice, palliative care and health literacy research, and the real stories of caregivers. Caring for the Family Caregiver presents the groundbreaking concept of the Caregiver Types and an innovative set of support resources to facilitate improved pathways to better care for the caregiver, making it an essential resource for providers, students, clinicians, policy makers and family caregivers alike.

This exceptional work explores the complexities of communication at one of the most critical stages of the life experience--during advanced, serious illness and at the end of life. Challenging the predominantly biomedical model that informs much communication between seriously ill and/or dying patients and their physicians, caregivers, and families, Sandra L. Ragan, Elaine M. Wittenberg-Lyles, Joy Goldsmith, and Sandra Sanchez-Reilly pose palliative care--medical care designed to comfort rather than to cure patients--as an antidote to the experience of most Americans at the most vulnerable juncture of their lives. With an author team comprised of three health communication scholars and one physician certified in geriatrics and palliative medicine, this volume integrates the medical literature on palliative care with that of health communication researchers who advocate a biopsychosocial approach to health care. Applying communication theories and insights to illuminate problems and to explain their complexities, the authors advocate a patient-centered approach to care that recognizes and seeks to lessen patients' suffering and the many types of pain they may experience (physical, psychological, social, and spiritual) during life-threatening illness.

Communication in Palliative Nursing presents the COMFORT Model, a theoretically-grounded and empirically-based model of palliative care communication. Built on over a decade of communication research with patients, families, and interdisciplinary providers, and reworked based on feedback from hundreds of nurses nationwide, the chapters outline a revised COMFORT curriculum: Connect, Options, Making Meaning, Family caregivers, Openings, Relating, and Team communication. Based on a narrative approach to communication, which addresses communication skill development, this volume teaches nurses to consider a universal model of communication that aligns with the holistic nature of palliative care. This work moves beyond the traditional and singular view of the nurse as patient and family educator, to embrace highly complex communication challenges present in palliative care-namely, providing care and comfort through communication at a time when patients, families, and nurses themselves are suffering. In light of the vast changes in the palliative care landscape and the increasingly pivotal role of nurses in advancing those changes, this second edition provides an evidence-based approach to the practice of palliative nursing. Communication in Palliative Nursing integrates communication theory and health literacy constructs throughout, and provides clinical tools and teaching resources to help nurses enhance their own communication and create comfort for themselves, as well as for patients and their families.

The Textbook of Palliative Care Communication is the authoritative text on communication in palliative care, providing a compilation of international and interdisciplinary perspectives. This volume was uniquely developed by an interdisciplinary editorial team to address an array of providers including physicians, nurses, social workers, and chaplains, and it unites clinicians with academic researchers interested in the study of communication. By featuring practical conversation and curriculum tools stemming from research, this text integrates scholarship and inquiry into translatable content that others can use to improve their practice, teach skills to others, and engage in patient-centered communication. The volume begins by defining communication, explicating debatable issues in research, and highlighting specific approaches to studying communication in a palliative care context. Chapters focus on health literacy and cultural communication, patient and family communication, barriers and approaches to discussing palliative care with specific patient populations, pain, life support, advance care planning, and quality of life topics such as sexuality, spirituality, hope, and grief. Team communication in various care settings is outlined, and current research and education for healthcare professionals are summarized. Unique to this volume are chapters on conducting communication research, both qualitatively and quantitatively, to promote further research in palliative care.