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Access Type
WSU Access
Date of Award
January 2023
Degree Type
Dissertation
Degree Name
Ph.D.
Department
Communication
First Advisor
Julie Novak
Abstract
In 2018, there was an estimate of 16.3 million Americans living with cancer (National Cancer Institute, 2022). In addition to the initial diagnosis stage, researchers have examined several integral communication processes that take place during care conversations among cancer patients and their providers regarding cancer management. However, the literature on how patients and providers communicate about health and management of cancer during the terminal stage, outside of initial diagnoses and end-of-life stages, is sparse. This study examines communicative constructions in the medical encounter between providers and patients whose cancer is noncurative. More specifically, this study examines how patients, in coordination with their providers, construct what health means which informs strategies to manage their health so they can manage their care to live “healthfully” while living/dying from cancer.This is a secondary data analysis of transcripts from video recorded patient-provider encounters. A qualitative thematic analysis utilizing the coordinated management of meaning as a framework was implemented to examine encounters between patients living with terminal prostate cancer and their oncologists (n = 37). Data were analyzed using an iterative approach and Atlast.ti software. Findings reveal that understanding how patients and providers discuss health at the terminal stage of illness cannot be disentangled from understanding how healthcare is communicatively coordinated and managed. Specifically, findings demonstrate how patients and providers communicatively construct health and healthcare, how their understandings of health and resulting actions are shaped and constrained by systems and resources, and how this implicates the encounter and life with cancer. Implications are discussed related to the coordinated management of meaning, practice implications for patients and providers and the importance of capturing both patient and provider perspectives during encounters.
Recommended Citation
Simon, Lacey, "How Patients With Terminal Cancer Communicatively Coordinate And Manage The Meaning Of Health And Healthcare With Their Providers" (2023). Wayne State University Dissertations. 3866.
https://digitalcommons.wayne.edu/oa_dissertations/3866