Health-related needs of survivors of hypertensive disorders of pregnancy: implications for health communication interventions.

BACKGROUND: Hypertensive disorders of pregnancy (HDP) are key contributors to maternal morbidity, mortality, and future risk of cardiovascular disease. This exploratory study aimed to unearth the health-related needs of women with a reported history of HDP by inquiring about preferences for care. METHOD: Deductive, qualitative analysis was conducted of HDP survivors' retrospective 'wishes' about the care received. RESULTS: In analyzing 244 open-ended, online survey responses, we identified a taxonomy of health-related needs arising across the trajectory of HDP: clinical information, needs requiring clinical knowledge, such as information about the etiology or prognosis of HDP; medical, needs associated with HDP intervention and management; logistical, needs regarding practical information, such as how to contact a provider or obtain the correct medical device; emotional, needs involving a desire for support or validation; and communication, needs for improved explanations and recognition of HDP. CONCLUSIONS: A taxonomy of diverse health-related needs may assist clinicians in approaching HDP patients more holistically. Additionally, opportunities exist for health communication research to inform standard approaches to HDP-related communication flowing from provider to patient.

#Preeclampsiasurvivor and symbolic interactionism in women's maternal health.

A hypertensive disorder of pregnancy and leading cause of maternal mortality worldwide, preeclampsia (PE) impacts approximately one in 25 pregnancies. Biomedical researchers continue to look for concrete causes and effective treatments for PE, but the experience of PE-the personal and socially constructed meanings surrounding the condition-remains under-researched. Using a symbolic interactionism approach, we examined Instagram posts accompanying the #preeclampsiasurvivor hashtag during Preeclampsia Awareness Month. Themes emerging from interpretive analysis of 98 posts (160 images) included the role of PE in redefining a woman's relationship to her body, reifying a woman's connection to her child, and illuminating the transitive aspects of a childbearing woman's identity. Additionally, PE survivors turned to Instagram to speak to an imagined, 'generalized sisterhood' of women sharing a common set of experiences. Our study is unique in its examination of the lived experiences of PE survivors.

Health Information Behavior of Expectant and Recent Fathers.

Given the importance of paternal involvement in maternal and child health, the current investigation takes a closer look at expectant and recent (E/R) fathers' health information behavior during pregnancy, childbirth, and child care. A total of 186 E/R fathers (68 low-income) completed a survey gauging information needs, sources of information, and information-seeking behavior. Results are summarized in four statements that may help low-income E/R fathers get the information they need during a partner's pregnancy or after a child is born: (a) paternal information needs are diverse, (b) information needs change across stages of child development,

Managing End-of-Life Uncertainty: Applying Problematic Integration Theory to Spousal Communication About Death and Dying.

A significant number of Americans die in ways that do not reflect their preferences for end-of-life (EOL) care. For married individuals, the spouse often has the legal authority to make decisions at EOL. Many factors, most notably open preemptive communication about care preferences and dying wishes, determine whether such communication is viable and a partner's wishes are respected. We used a mixed method approach, involving a content analysis of spouses' reasons for seeking and avoiding conversations regarding their partners' EOL care preferences, and examined whether certain demographic factors (eg, income, gender, age) more likely contributed to the initiation of EOL conversations. We situate our findings within the broader cultural discourse about death and dying and highlight the influence of uncertainty in spousal EOL communication.

Recognizing Success in the Chaplain Profession: Connecting Perceptions With Practice.

The current investigation examines the communicative hallmarks of successful chaplaincy work as articulated by professional chaplains providing spiritual care at the end-of-life. Data grounded in qualitative interviews with 32 chaplains of various denominations and lengths of service reveals a challenge in gauging success when working with dying patients and families. Chaplains reported nonverbal hallmarks of success consist of (a) intrapersonal sense of accomplishment, (b) progress in fulfilling patient needs, and (c) meaningful connection with patients. Verbal hallmarks of success include (a) patient affirmation, (b) family affirmation, and the (c) chaplain being asked to participate in religious rites. In practice, the authors conjecture, chaplains assess professional competency in the self, patient, and family domains. Implications and future directions are discussed.

Information gathering and technology use among low-income minority men at risk for prostate cancer.

Health communication researchers, public health workers, and health professionals must learn more about the health information-gathering behavior of low-income minority men at risk for prostate cancer in order to share information effectively with the population. In collaboration with the Milwaukee Health Department Men's Health Referral Network, a total of 90 low-income adult men were recruited to complete a survey gauging information sources, seeking behavior, use of technology, as well as prostate cancer awareness and screening behavior. Results indicated participants primarily relied on health professionals, family, and friends for information about general issues of health as well as prostate cancer. The Internet was the least relied on source of information. A hierarchical regression indicated interpersonal information sources such as family or friends to be the only significant predictor enhancing prostate cancer awareness, controlling for other sources of information. Prostate screening behaviors were predicted by reliance on not only medical professionals but also the Internet. Practical implications of the study are discussed.

Information needs, seeking behaviors, and support among low-income expectant women.

Previous studies have consistently found associations between low income and infant health outcomes. Moreover, although health information-seeking is a maternal behavior related to improved health outcomes, little is known about the health information-seeking behaviors and information needs of low-income pregnant women. The purpose of the current investigation was to examine the information needs, information-seeking behaviors, and perceived informational support of low-income pregnant women. Accordingly, the study recruited 63 expectant women enrolled in a subsidized prenatal care program in Milwaukee, Wisconsin, during two time periods: March-May 2011 and October-December 2011. Results indicated that participants relied heavily upon interpersonal sources of information, especially family and the father of the baby; rarely used the Internet for health-related information; and desired information beyond infant and maternal health, such as finding jobs and accessing community/government resources. Participants who used family members as primary sources of information also had significantly increased levels of perceived informational support and reduced uncertainty about pregnancy. Our findings have implications for the dissemination of pregnancy-related health information among low-income expectant women.

Translating spiritual care in the chaplain profession.

Chaplains provide a much-needed service to patients and families requiring spiritual care in the healthcare setting. Despite evidence documenting improvements quality of life for patients using spiritual services, chaplains experience challenges in translating the benefits they provide into concepts understood by patients, team members, and administrators. A qualitative study using interviews with 19 chaplains found that translation problems occur in three main areas: (a) justifying the role to patients and families, (b) determinations of what constitutes a "productive" employee, and (c) effective collaboration with other members of the health care team. This study outlines several strategies used by chaplains to ease the process of translation, as well as some directions for future research.

A two-way text-messaging system answering health questions for low-income pregnant women.

OBJECTIVE: The purpose of the study was to gauge the effectiveness of a low-cost, automated, two-way text-messaging system to distribute pregnancy and health-related information to low-income expectant women. METHODS: In total, 20 participants were recruited for a one-month intervention involving the use of cell phones to text pregnancy-related questions to the system. Participants received either a direct answer or encouragement to seek answers from health care providers. Pre- and post-tests as well as a focus group at the end of the intervention were conducted. RESULTS: Participants uniformly found the system easy to use and accessible. Using the system increased levels of perceived pregnancy-related knowledge and facilitated patient-provider communication. Moreover, participants reported significant reductions in stress and depression and improved mental health after using the system. The system responded to most known questions quickly and accurately, and also encountered many new topics and linguistic expressions. CONCLUSION: Overall, the data indicated that the text messaging system offered psychological benefits and promoted health communication by providing health information and encouraging patient-provider communication. PRACTICE IMPLICATIONS: An automated, two-way text messaging system is an efficient, cost-effective, and acceptable method for providing health information to low-income pregnant women.

The chaplain profession from the employer perspective: an analysis of hospice chaplain job advertisements.

Hospitals and hospice organizations who are hiring chaplains to provide spiritual care for terminally ill patients post online job advertisements with specific qualifications and communication skills that applicants should possess. An examination of job advertisements can uncover trends in credentials and responsibilities expected of hospice chaplains. Results of a framework analysis of 71 hospice chaplain job advertisements indicated that 44% of chaplain job advertisements did not require chaplain applicants to have completed clinical pastoral education (CPE) and 41% did not required ordination and/or endorsement from a recognized denomination. Only 37% of hiring organizations required or preferred professional certification. Furthermore, patient support (70%), ambassadorship (54%), team collaboration (52%), and interfaith proficiency (46%) were the communication skills that advertisements tended to emphasize. This article focuses on how the study findings reflect ongoing challenges for the chaplain occupational group on its path to professionalization.