Communication in medicine

The purpose of this study was 1) to examine the significance of a patient’s active
or passive role in terms of his/her health management; 2) to determine if a relationship
exists between one’s active and passive scores and his/her self-directed learning
readiness, and 3) to identify if his/her view of one’s self as a patient (when diagnosed
with a chronic disease) impacted his/her own personal health management.
Utilizing the quantitative analysis of The Self-Directed Learning Readiness Scale
and the Vanderbilt Pain Management Inventory, 81 individuals’ descriptive statistics
were analyzed. Self-directed learning was found to positively influence an individual’s
ability to be an active patient. The moderated demographic characteristics of age,
ethnicity, education level, and gender did not have a direct relationship between selfdirected
learning readiness and active/passive coping groups. Further, it was established that the majority of the participants within the study,
83.75%, considered themselves an active patient managing their lupus diagnosis.
However, 16.25% of the participants did not believe that they were actively managing
their illness.
Self-directed learning characteristics were examined through the responses to an
open-ended question. The two most prevalent themes pertained to active coping and
control. Characteristics of self-directed learning readiness appeared predominant amongst
the responses, particularly goal-orientation and accepting responsibility for learning.
Minimal themes regarding planning and enjoying learning were provided within the data.
These characteristics were identified throughout the study in hopes of further
research and program implementations that will help to develop leadership abilities and
activity levels of self-health management in chronically ill patients. This will enable
lupus patients to have a more positive outcome, it will help them successfully manage
their own health, and it will improve their overall quality of life.

The purpose of this study was to describe the sources of infant care informational
support systems that mothers residing in the Western North Carolina Appalachian region use and prefer in the postpartum period. In addition, the study explored the associations of the sources for informational social support on infant care with personal factors (age, socioeconomic status, parity, race, ethnicity, residence, marital status, education, access to Internet, access to cellular phone, prior attendance in childbirth classes, and other adult infant care assistance in the home) of the mothers.

The purpose of this hermeneutic phenomenological study was to understand the essence of the lived experience of women after having an abnormal prenatal ultrasound. One hundred years ago, health disciplines had limited therapies for prenatal and neonatal disorders. During this period, the eugenics movement influenced leaders to involuntarily sterilize individuals who were sought to be "unfit" to prevent disorders in offspring. ... One of these contemporary reproductive genetic technologies is the use of ultrasound and serum bio-medical markers for detection of congenital, chromosome, and genetic disorders. When ultrasounds reveal abnormal findings, the perceived perfect pregnancy vanishes and gives way to feelings of shock, disbelief, fear, guilt, loss, and threats to self and their unborn baby. Twelve women who had an abnormal ultrasound were interviewed within the context of their cultural values and beliefs. The method of van Manen's hermeneutic phenomenology illuminated the meaning for these women in their life worlds. ... They endured this experience through their own coping mechanisms, but often felt uncertainty and emotional turmoil until the birth. The women also sought comfort through their cultural values, beliefs, and traditions. In coping with the risks found on this abnormal ultrasound, women often selected silence or blocking perceived threats. With these coping methods, they were alone in their suffering. ... Health providers, in not recognizing these women's misunderstandings and emotional fears, abandoned them in their psychosocial and cultural needs. The significance reveals that nurses and health providers need to infuse human caring ways of being, knowing, and doing within advanced technological environments.

Use of the Internet can increase patients' understanding about their medical conditions and offers opportunities to strengthen the patient-physician relationship, increase patient satisfaction, and improve health outcomes. However, physicians vary widely in the extent to which they accept patient online medical information seeking and make it part of the patient-physician relationship. This paper explores factors impacting the extent to which physicians advocate (encourage, speak in favor, or are supportive of) patient internet use. Specifically, using social cognitive theory as a theoretical base, this study develops a model of the determinants of physician advocation of patient use of the internet for information about medical conditions and treatments. Survey data collected from a random sample of 179 physicians licensed to practice medicine in Florida is used to test the proposed model. Proxy efficacy for patient internet use, social efficacy for enlisting patient internet use, performance outcomes expectations, and personal outcome expectations are shown to be significant determinants of physician professional advocation of patient internet use. In addition to its direct impact, proxy efficacy is shown to influence intention to advocate patient internet use indirectly thru social efficacy and outcome expectations, demonstrating the key role of this construct in the proxy agency model. Self-efficacy, in contrast, is not found to be a significant factor. Overall, the results support the proposed model of technology use.