Smith Rachel A, Hernandez Rachael, Catona Danielle
The Pennsylvania State University.
Rutgers University.
West J Commun. 2014 Jul;78(4):426-440. doi: 10.1080/10570314.2013.786120.
Initial disclosures of health conditions are critical communication moments. Existing research focuses on disclosers; integrating confidants into studies of initial disclosures is needed. Guided by the disclosure decision-making model (DD-MM; Greene, 2009), this study examined what diagnosed persons and confidants may say when faced with unexpected test results and unexpected disclosures, respectively. Participants ( = 151) recorded an audio-visual message for another person, after imagining that they or the other person had just received unexpected, positive HPV test results. The qualitative analysis revealed four themes: (1) impression management and social distance, (2) invisible symptoms and advice regarding future disclosures, (3) expressing and acknowledging emotional reactions, and (4) misunderstandings and lacking knowledge about HPV. These findings suggested that DD-MM may be a relevant framework for understanding not only when disclosers share, but what disclosers and confidants in early conversations about new diagnoses. While disclosers' and confidants' messages showed marked similarities, important differences appeared. For example, confidants focused on assuaging disclosers' fear about the consequences, whereas disclosers expressed distress related to their uncertainty about the prognosis of an HPV infection and how to prepare for next steps. The discussion highlighted implications for the DD-MM, HPV disclosures, and future interventions.
健康状况的初次披露是关键的沟通时刻。现有研究聚焦于披露者;需要将密友纳入初次披露的研究中。在披露决策模型(DD-MM;格林,2009年)的指导下,本研究考察了被诊断者和密友在分别面对意外检测结果和意外披露时可能会说些什么。参与者( = 151)在想象自己或对方刚刚收到意外的、阳性的人乳头瘤病毒(HPV)检测结果后,为另一个人录制了一条视听信息。定性分析揭示了四个主题:(1)印象管理和社会距离,(2)隐匿症状以及关于未来披露的建议,(3)表达和承认情绪反应,(4)对HPV的误解和知识欠缺。这些发现表明,DD-MM可能不仅是理解披露者何时分享的相关框架,也是理解披露者和密友在关于新诊断的早期对话中会说些什么的相关框架。虽然披露者和密友的信息有明显相似之处,但也出现了重要差异。例如,密友专注于减轻披露者对后果的恐惧,而披露者则表达了与他们对HPV感染预后的不确定性以及如何为下一步做准备相关的苦恼。讨论强调了对DD-MM、HPV披露和未来干预措施的启示。