Theories of Communication and Uncertainty as a Foundation for Future Research on Nursing Practice

As we enter the age of “precision medicine,” we will need “a greater tolerance of uncertainty and greater facility for calculating and interpreting probabilities than” (Hunter, 2016, p. 711) ever before. Nursing scholarship has produced the most widely known theory of uncertainty in illness (Mishel, 1988, 1990), but it emphasizes the psychological state of and deemphasizes communication. Communication scholars have attempted to overcome this deficit, but two of the most prominent of these perspectives, uncertainty management theory (Brashers, 2001) and the theory of motivated information management (Afifi & Morse, 2004), emphasize processes related to information seeking or avoidance in the service of uncertainty reduction, creation, or maintenance; in so doing, they tend to neglect important variations in the meanings of uncertainty. The article reviews these theories and also problematic integration theory, which centers the task of differentiating forms of uncertainty and other problematic meanings and the importance of form-specific adaptation of communication. The paper concludes with an agenda for collaborations between nursing and communication researchers aimed at advancing theory and practice

Social Construction of Health Risk: Rhetorical Elements in Colombian and U.S. News Coverage of Coca Eradication

This paper examines rhetorical elements related to the social construction of health risk. More specifically, we analyze how prominent Colombian and U.S. newspapers construct the health risks associated with the use of glyphosate in the “war on drugs” in Colombia. Glyphosate, an herbicide that works as a plant growth regulator, is used heavily via aerial spraying to eradicate Colombian coca cultivation: use mandated by Plan Colombia. These practices have generated wide ranging cultural and sociopolitical disputes among environmental, health, communal, and political organizations. While our focus is on the controversy related to health issues, our analyses necessarily touch on various environmental, community, and political issues

Social Construction of Health Risk: Rhetorical Elements in Colombian and U.S. News Coverage of Coca Eradication

This paper examines rhetorical elements related to the social construction of health risk. More specifically, we analyze how prominent Colombian and U.S. newspapers construct the health risks associated with the use of glyphosate in the “war on drugs” in Colombia. Glyphosate, an herbicide that works as a plant growth regulator, is used heavily via aerial spraying to eradicate Colombian coca cultivation: use mandated by Plan Colombia. These practices have generated wide ranging cultural and sociopolitical disputes among environmental, health, communal, and political organizations. While our focus is on the controversy related to health issues, our analyses necessarily touch on various environmental, community, and political issues

Prognostic communication in cancer : a critical interpretive synthesis of the literature.

Purpose - For patients with cancer, providing appropriate information about prognosis or chances of recurrent disease remains a difficult area of practice. Much research has suggested that patients want to be given all available information, although the realities of attempting to do this are complex and may be perceived by some as uncaring. A review of recent literature was undertaken to explore the process of disclosure, patient experience and preferences for information regarding prognosis or risk of recurrence. Methods - A systematic approach was taken to searching electronic databases for relevant literature from 2004 to June 2014. Primary research from a range of methodological approaches was included and critical interpretive synthesis was employed to explore themes and identify gaps in the evidence. Results - Twenty papers were identified as appropriate. They were diverse in objectives and patient groups. Themes identified included: the nature of prognostic information, patient need for prognostic information, patient need to maintain hope, balancing hope and realism, patient factors, disease factors and clinician factors. A thematic framework was developed. Conclusions - Patients often struggle to fully understand complex prognostic information. They value help in making sense of this information and generally want information that supports hope. Working with patients to understand and manage the uncertainty of their situation may be particularly valuable. Further research is needed to fully understand the process of prognostic information giving and what information patients want regarding recurrence risk. Research should be aimed at identifying strategies helpful to patients in managing uncertainty inherent in their situation.</p