'That gave me a lot of comfort, that he would ask my opinion about how we wanted to talk about this': A qualitative analysis of clinical communication experiences of ostomy patients.

OBJECTIVES: The purpose of this study was to investigate the communication challenges and successes that people with ostomies experienced during their healthcare encounters. DESIGN: We conducted semistructured interviews of people with ostomies. Interviews focused on important social situations and health communication strategies for managing these situations. We transcribed interviews and coded them to create themes. PARTICIPANTS: Participants were eligible to participate if they were above the age of 18 and have had an ostomy for at least a year. 27 people participated in the study. SETTING: The study was conducted in a university setting. RESULTS: Interviews with ostomates surfaced several themes related to ostomate needs. Participants benefited from communication that was open, thorough and had a positive outlook on ostomies. Participants found patient-clinician communication to be challenging when there was a lack of knowledge surrounding ostomy care, communication was unclear or inadequate, and when clinicians had a negative outlook on ostomies. CONCLUSIONS: Findings from this project are intended to amplify existing patient and clinician education materials and to inform the creation of a communication guide specifically for the ostomy context.

Confirmation in personal relationships.

Through our interactions in our personal relationships, we create relational climates, or how we feel regarded in our relationships. Confirmation is conceptualized as messages that accept and validate the individual but that also encourage growth. Accordingly, confirmation theory centers on how a confirming climate built across an accumulation of interactions should foster healthier psychological, behavioral, and relational outcomes. Research in various contexts such as parent-adolescent relationships and development, health communication among romantic partners, teacher-student relationships, and coach-athlete relationships supports the beneficial effects of confirmation as well as the deleterious effects of disconfirmation. In addition to reviewing the relevant literature, conclusions and future directions are discussed.

Romantic partner undermining of weight loss: Links between overweight individuals' weight management efforts and perceptions of their partner's undermining motivations and behaviors.

This study investigated romantic partners' undermining of weight management (i.e. hindrance of weight loss efforts) and how perceived motivations behind undermining were associated with weight loss progress. Data from 241 overweight individuals currently cohabiting with a romantic partner and trying to lose weight revealed two overarching undermining factors (i.e. verbal criticism/complaint, behavioral interference) and six perceived motivations (e.g. partner believed weight loss was unnecessary, partner relational fears, weight loss was an imposition on partner). Path modeling showed both undermining behaviors were negatively associated with weight management. Yet, only certain motivations (e.g. imposition on partner, weight loss was unnecessary) were linked to weight management, either directly or indirectly, through undermining. Specifically, whereas criticism/complaint mediated the associations between these motivations and weight management, interference only mediated the association between imposition and weight management. Findings are discussed in terms of the theoretical and practical value of distinguishing undermining behaviors and their underlying motivations.

The Role of Psychological and Physical Aggression In Relationship Reconciliation.

Previous research has established a link between aggression and relationship cycling (i.e., multiple breakups and renewals with the same romantic partner). Couples who have experienced breakups and renewals are up to twice as likely to have experienced psychological and physical aggression in their relationships. Partners who return to previous relationships are also more susceptible to greater violence. To explore this link further, we employed longitudinal data from 179 individuals who had recently experienced a breakup. We assessed post-dissolution closeness and self-concept clarity as mediators of the association between a history of aggression while dating and reconciliation within 6 months. We also assessed the directional nature of aggression (unidirectional or bidirectional) as a potential moderator. Logistic regressions as well as moderating mediating analyses (using Hayes' PROCESS) showed that both psychological and physical aggression were linked to reconciliation. Additionally, closeness mediated this association, but only for those who reported undirectional aggression. Specifically, aggression prior to breakups was associated with feeling closer with the ex-partner, which set the stage for reconciliation, primarily for those who reported one-sided aggression in their relationships. The findings offer insights on identifying those who are more susceptible to revictimization as well as why partners return to previously aggressive relationships. The results suggest additional research examining the causal linkages between cycling and aggression is warranted.

Romantic Partner Perspectives of the Relational Context of Weight Loss Support.

Much of the research on romantic partner support of weight loss takes the perspective of targets pursuing weight loss. This study, however, assesses the perspectives of the partners providing support, and specifically their perceptions of the relational context and their support strategy use. An MTurk sample of 283 partners of individuals trying to lose weight reported on relational context characteristics (i.e., having a team effort, opposing approaches, and imposition regarding the weight loss pursuits) and their use of encouragement, direct influence, and coercion. Analyses largely supported the hypotheses regarding the associations between the relational characteristics and strategy use. For example, higher team effort and lower opposing approaches about weight management were linked with more encouragement, and greater opposing approaches and imposition were associated with more coercion. Four relational weight loss climates based on the collective of these characteristics were also linked with strategy use. All associations were found after accounting for general relationship satisfaction as well as other control variables. Overall, the findings suggest that perceptions of the weight loss in the context of the relationship were connected to the strategies partners employed in helping targets achieve weight loss. Because strategies vary in effectiveness, understanding which relational characteristics, as well as which broader relational climates, facilitate partner strategy choice can ultimately help augment individuals' weight loss success.

Parenting Practices, Autonomous Motivation, and Adolescent Diet Habits.

Guided by self-determination theory, the aim of this study was to examine whether adolescents' autonomous motivation for making healthy diet choices mediates the association between parenting practices regarding diet and adolescent food choices. We analyzed data from the NCI FLASHE study, a survey of demographically diverse parents and their adolescent children (N = 1,646 dyads). Path models supported self-determination theory's assertion that indirect, encouraging parenting practices fostered internal motivation; in contrast, regulation was both positively and negatively linked to motivation depending on the model. Models also yielded direct paths between parenting practices and healthy and unhealthy diet choices. Overall, regardless of what predicted motivation, adolescents' autonomous motivation was linked with their consumption of healthier foods and drinks. As such, cultivating a sense of internal motivation during these formative years may put young people on a path toward healthy patterns of self-regulation later in life.

Strategies in Context: How Perceptions of Romantic Partner Support for Weight Loss Vary by the Relational Context.

Because romantic partners can be a strong influence on individuals' weight loss efforts and progress, the current study assessed the relational context of weight loss-dynamics within the relationship that pertain to weight loss. Three relational characteristics were examined: whether the weight loss was a team effort, how much partners had opposing approaches to weight loss, and individuals' difficulty in balancing their weight loss goals within their relationship goals. Findings showed that the relational characteristics were associated with both the perceived frequency and effectiveness of partner strategies (i.e., instrumental influence, encouragement, and coercion). Team effort was associated with perceiving all three strategies as more frequent and effective; opposing approaches were negatively associated with encouragement but positively associated with coercion for both frequency and effectiveness; and balance struggle was positively associated with coercion frequency and effectiveness. Additionally, a cluster analysis of the three relational characteristics yielded four relational climates: synchronized (high team effort, low relational strains), contentious cooperatives (moderate in all three relational characteristics), autonomous (low in all relational characteristics), and lone battlers (low team effort, high relational strains). The groups varied in the strategies they perceived as effective. All of these findings emerged beyond the variance explained by general relationship satisfaction. Overall, these results better explicate relationship characteristics that can be incorporated into a larger, ecological model on health behavior change.

The Buddy Benefit: Increasing the Effectiveness of an Employee-Targeted Weight-Loss Program.

It is well known that significant others (particularly romantic partners) can influence people's weight management efforts. However, what constitutes effective support-and from which type of individual (e.g., romantic partner, family member, friend)-is unclear. Thus, framed by confirmation theory, we assessed the effectiveness and types of communication of a weight-loss "buddy" through reports of 704 individuals enrolled in a 15-week synchronous online weight-loss program. Roughly 54% of participants chose buddies; and those who did lost more weight and waist inches than those who were involved in the program without buddy support. We also found that a combination of high accepting and high challenging messages from buddies was associated with the greatest decrease in body mass index (BMI) as well as the greatest reduction in waist size. Furthermore, the support by romantic partners paralleled support by other types of buddies. Having a supportive buddy who was not a romantic partner was just as effective as turning to a romantic partner for assistance. This study underscores the important role of a buddy in supporting weight-loss program involvement and encourages individuals to consider enlisting the help of a buddy, as opposed to losing weight alone, in order to maximize weight management effectiveness.

Memorable Messages about the Misuse of Prescription Stimulants.

The misuse of prescription stimulants among college undergraduates is a prevalent and dangerous problem on college campuses across the United States. Guided by a memorable messages framework, this research sought to examine the messages that college students recall about the misuse of prescription stimulants and examine how those messages are associated with students' intention to use stimulants. We analyzed the recalled memorable messages of 129 undergraduates. Three predominant themes emerged from the analysis: academic implications, health implications, and ethical implications. Theme, source, and valence of the memorable messages were not associated with behavioral intention to engage in the misuse of prescription stimulants. These findings contribute to the scholarly and practical understanding of undergraduates' experiences with illicit behaviors, and demonstrate a need to further investigate students' sense-making in relation to risky decisions made during their college experience.

Meeting Weight Management Goals: The Role of Partner Confirmation.

Social support research suggests romantic partners could play a vital role in the success of individuals' weight management (WM) efforts, but contradictory findings from previous research have impeded our understanding of how romantic partners influence weight management goal attainment. Employing a confirmation perspective, overweight participants (body mass index [BMI] greater than 25) who were actively trying to manage their weight (N = 53) were asked to respond to daily questionnaires for a period of 2 weeks regarding their interactions with their romantic partner. Diet, exercise, and general weight management goal accomplishment were assessed. HLM was employed to assess the independent and interactive effects of partner acceptance and challenge on each of these goals. Findings suggest that perceiving high levels of both acceptance and challenge from partners was associated with more general WM and diet goal accomplishment. However, greater attainment of exercise goals was associated with only challenge. Fluctuations in partner acceptance and challenge were also examined to determine whether consistency in confirmation behaviors was associated with WM goals. Hierarchical regressions revealed that fluctuations in acceptance, but not challenge, were linked with goal attainment. Specifically, fluctuations in acceptance were helpful for those whose partners were perceived to exhibit lower levels of acceptance, but fluctuations were detrimental for those whose partners exhibited greater acceptance. Implications for communication among couples in which one partner is attempting to lose weight are discussed.

Influences of Mental Illness Stigma on Perceptions of and Responses to Requests for Favors.

This article examines mental illness stigma effects on a request for a favor from a mentally ill individual. Four hundred and fourteen participants interacted with a hypothetical target on Facebook who was believed to have schizophrenia, depression, or a tooth cavity (i.e., the control group). Participants were asked to rate the favor request in terms of face threat, in addition to writing a response, which was then coded using message design logics. Results indicated that a request by a schizophrenic target threatened participants' positive face more significantly than that of a target with depression or without any mental illness. Participants' responses to the schizophrenic target were more likely to be conventional messages, whereas responses to the depressed target were more likely to be rhetorical messages. Theoretical and practical contributions are considered.

Mother-teen communication about weight management.

Although research shows family members can influence each other's diet and exercise behaviors, the specific strategies that most effectively motivate individuals to enact healthy behaviors have not been revealed. Toward this goal, this study employed confirmation theory to assess how the quality of weight management (WM) communication between 107 mother-teen dyads was related to their diet and exercise behaviors as well as their subjective perceptions of the productivity of WM conversations. Confirmation theory proposes two components of confirmation: acceptance and challenge. Analyses revealed that accepting and challenging communication were both positively related to the perceived productivity of WM conversations. However, more complex associations emerged for diet and exercise. Acceptance was more helpful in motivating better eating habits for mothers with low health motivation and teens with high health motivation. For exercise, challenge was helpful in motivating teens with higher sensitivity about communicating about weight issues; however, counter to predictions, challenge was negatively related to exercise for teens with low health motivation and low sensitivity. These interactions, however, explained less variance than analyses for perceived effectiveness and satisfaction.

Weighty dynamics: exploring couples' perceptions of post-weight-loss interaction.

Although romantic couples can use communication to help one another lose weight and maintain weight loss, the effect of weight loss on partner interaction is less understood. However, an examination of the interpersonal context in which partners manage their weight is important to help partners negotiate their weight, their relationship, and the U.S. obesity epidemic. Guided by systems theory, this study explored partners' perceptions of post-weight-loss interaction in relationships in which one partner lost weight and the other did not. Through qualitative questionnaires of 42 adults (21 romantic couples), the dyadic investigation revealed that while losing weight resulted in positive interaction for many partners (e.g., engaging in a shared healthy lifestyle), shedding weight also yielded some negative consequences (e.g., non-weight-loss partner criticism). The extent to which partners embraced new weight management rules and patterns largely influenced post-weight-loss communication and behavior.

On-again/off-again dating relationships: what keeps partners coming back?

Building on research comparing on-again/off-again (on-off) relationships to other dating relationships, the current study focused on a unique feature of these relationships-renewals. A sample of 274 participants who had experienced an on-off relationship completed a survey about why they renewed their relationships, characteristics of their breakups and renewals, and what stressors and benefits they experienced. These characteristics were used to predict the occurrence of renewals, separately as well as in multivariate analyses. In addition to lingering feelings being a predominant reason for renewals, findings suggested uncertainty about what the preceding breakup indicated, not having dated others after breakups, and feeling the on-off nature improved the relationship were all related to an increased chance of renewals. Mutual initiations of breakups, as well as reporting uncertainty about the general nature of the relationship, were also related to a decreased chance of renewals.

Reinforcement and punishment of substance abuse during ongoing interactions: a conversational test of inconsistent nurturing as control theory.

This study is the first to examine inconsistent nurturing as control (INC) theory during ongoing interpersonal influence episodes between substance-abusive individuals and their romantic partners. This study sought to determine how nonverbal (i.e., kinesic and vocalic) and verbal reinforcement and punishment of substance-abusive behavior during actual interactions influenced substance-abusive individuals' recidivism and perceptions of non-using partners' persuasive effectiveness. The findings reveal that consistent verbal punishment of substance abuse (e.g., threats, nagging) predicted lower relapse, while verbal reinforcement (e.g., telling the partner they are more fun when they use) predicted higher relapse. With regard to nonverbal communication, vocalic punishment and vocalic reinforcement predicted relapse and persuasive effectiveness. Results suggest the combination of behaviors resemble intermittent reinforcement and punishment and should actually strengthen the substance-abusive behavior the partner is trying to curtail.

Intergenerational communication beliefs across the lifespan: comparative data from Ghana and South Africa.

This paper examines (for the first time) young adult American, Ghanaian, and Black South Africans' perceptions of communication and aging. Irrespective of cultural background, as age of target increased, so did trait attributions of benevolence, norms of politeness and deference, and communicative respect and avoidance; however, attributions of personal vitality and communication satisfaction decreased linearly. Young adults' reported avoidant communication with older people negatively predicted their conversational satisfaction and enjoyment of it. In addition, communicative respect was more strongly predictive of Africans' satisfaction while certain age stereotypes had contrastive effects for the Ghanaian and South Africans' enjoyment of intergenerational communication.