Communication and Medicine <p>Since its inception in 2004,&nbsp;<em>Communication &amp; Medicine</em>&nbsp;has been consistently interrogating the `black box’ of what is routinely characterised as `the communicative turn’ in healthcare practice in clinical and public health domains. It is now firmly established as a leading forum for these critical debates.</p> en-US <p>copyright Equinox Publishing Ltd.</p> (Srikant Sarangi) (Ailsa Parkin) Fri, 15 May 2020 00:00:00 +0000 OJS 60 Dementia and identity <p>Dementia is often interpreted as a loss of identity because of the changes it causes in memory, mood and behaviour. Such a binary interpretation impacts the quality of care an individual receives and reinforces stigma surrounding the condition. In this paper, an approach informed by social constructionism considers how people with dementia on an online forum discursively construct identities in relation to dementia. Utilising the tools of corpus linguistics, the study examines six-months of forum contributions, totalling 120,000 words. A close analysis of the keywords dementia, Alz, illness and disease reveals how forum users position themselves around and despite dementia. A collective identity is constructed which asserts shared experiences and the ability to empathise, while in other instances linguistic choices distance the individual from dementia, advocating a distinct, non-dementia identity. The paper illuminates some of the ways that people with dementia negotiate the complexities of identity construction while navigating the challenges of living with chronic illness.</p> Annika Bailey Copyright (c) 2020 Equinox Publishing Ltd. Fri, 15 May 2020 00:00:00 +0000 How working women navigate communication privacy management boundaries when seeking social support during cancer treatment <p>Working women diagnosed with cancer face difficult decisions about disclosing personal information. A 2017 survey for Cancer and Careers, a non-profit organization assisting cancer patients and survivors with finding and continuing employment, found that women are more likely than men to share their diagnosis with work colleagues, and do so more often to feel supported by co-workers. However, disclosure guidelines for communication about having cancer are difficult to establish, as they may vary widely depending on the individual and the situation. Most research about health self-disclosure has focused on the initial decision to divulge that one has an illness and on the depth of that initial disclosure. The current study was designed to further describe how working women navigate disclosures not only during the initial diagnosis, but throughout treatment and into recovery to gain needed social support. Using the typology of social support and the tenets of Communication Privacy Management Theory, the goal of this study is to share individual narratives of how working women change privacy rules to procure the type of social support needed in each stage of their experience.</p> Donna M. Elkins Copyright (c) 2020 Equinox Publishing Ltd. Fri, 15 May 2020 00:00:00 +0000 Values at work <p>Tensions between nurses and physicians have been linked to differences in power, hierarchy, education, compensation and gender. Less attention has been paid to the underlying values on which these differences are predicated. Likewise, little is known about how frequently values conflicts are resolved, and the threats to patient safety unresolved conflicts pose. Our aim was to compare the values embedded in affirming and challenging narratives elicited from nurses and physicians from a large health system. We used thematic analysis and descriptive statistics to assess goodness-of-fit of observed differences in themes. Narratives were coded into eight values categories. Nurses felt affirmed by emotional investment, altruism, humanism, and being of service; for physicians, it was humanism and teamwork. Nurse challenges involved respect, altruism/kindness and emotional investment. For physicians it was also respect and, in addition, professionalism, being of service, humanism and teamwork. Some values affirming narratives, e.g., humanism, were indistinguishable, while for some values challenging narratives e.g., respect, there was virtually no overlap. Participant narratives provide important insights into work-life satisfaction and tensions arising from differences in the underlying values of close working professional groups. Unresolved values conflicts are a potential threat to quality, safety and effective relationships.</p> Richard M. Frankel, Thomas S. Inui, Orit Karnieli-Miller Copyright (c) 2020 Equinox Publishing Ltd. Fri, 15 May 2020 00:00:00 +0000 The ambiguity of preparing and being prepared for a patient consultation <p>This paper presents findings from a study on the ways in which counsellors working at national centres for rare disorders in Norway experience preparing, and being prepared for, a face-to-face patient consultation. The research involved semi-structured interviews with five experienced counsellors from different health professional backgrounds working at two separate centres. These interviews were then analysed with reference to the theoretical insights of phenomenologists. The excerpts chosen for this paper shed particular light on the process of preparing for a face-to-face patient consultation. Our findings underline the significance of preparing and being prepared while also drawing attention to the multifaceted, complex and ambiguous nature of the processes involved. Preparing for face-to-face consultations with patients is revealed to require approaches that are thoughtful, flexible and empathic. To be prepared for something one does not yet know is about being open to the unexpected and the unpredictable.</p> Wibeche Ingskog, Wenche S. Bjorbækmo Copyright (c) 2020 Equinox Publishing Ltd. Fri, 15 May 2020 00:00:00 +0000 Psychotherapeutic potential of online self-help groups <p>Previous research has found that online self-help groups related to healthcare can be therapeutic. These therapeutic effects often stem from social support conveyed by respondents; however, relevant studies appear to have overlooked the therapeutic potential of thread openers’ narratives. This article investigates thread openers’ narratives in 80 threads from four online self-help groups for anxiety and depression. The data analysis focuses on unique outcomes (UOs), referring to opportunities for therapeutic change to occur, which are conceptualized within the framework of innovative moments (IMs). The findings indicate that the presence of IMs is what makes online narratives therapeutic, but that they diminish gradually through interactions with respondents. This decline can arguably be attributed to respondents’ provision of unsolicited support, and this implies that most users do not find resolution for their problem through participating in online self-help groups.</p> Jesse W.C. Yip Copyright (c) 2020 Equinox Publishing Ltd. Fri, 15 May 2020 00:00:00 +0000