Effectively communicating support to widows: advice from those who have lost their husband

Guided by theories of communicative disenfranchisement (TCD) and memorable messages (ToMM), this study analyzes 60 open-ended survey responses detailing experiences of grief following the onset of invisible, physical illness (e.g. chronic overlapping pain conditions, autoimmune rheumatic diseases). Employing reflexive thematic analysis, we identify (1) illness-related losses that are disenfranchised by discourses surrounding grief and (2) opportunities to enfranchise these losses via memorable messages. Situated at two points in time, before and after the onset of illness, we identify disenfranchised losses as what once was (e.g. physical [in]dependence, relational connection, images of self, and trust in institutions) and what will never be (e.g. family planning and career dreams). Next, we identify opportunities to disrupt this disenfranchisement through memorable messages of presence (e.g. nonverbal acknowledgment and verbal expressions of belief) and finding the fit (e.g. physical restructuring and community connection). In doing so, we extend theoretical understanding of both memorable messages, in the form that they can take (of experience) and as points of (dis)enfranchisement, and communicative (dis)enfranchisement. This study contributes to a growing body of health communication research on disenfranchising experiences in chronic illness by highlighting a resulting experience of illness not often talked about – illness-related loss and its grief process. Theoretical and practical implications, as well as limitations and future directions, are discussed.

End-of-Life Decision Making, Organ Donation, and Critical Care Nurses

Many women in intimate relationships with violent partners often report facing stigma related to intimate partner violence (IPV), which typically includes blame, shame, discrimination, loss of status, dismissal, or isolation. Researchers studying IPV and stigma have yet to examine the content of stigmatizing messages from informal support networks, which may resonate with women for an extended period—memorable messages—and contribute to the persistence of their adverse outcomes. To address this gap, this qualitative study explored the content of memorable stigmatizing messages in the accounts of twenty-eight women affected by IPV living in the United States. Conducting a reflexive thematic analysis of their accounts, we identified five themes: “regardless of what happened,” “you should be okay,” “you need to leave,” “there is something wrong with you,” and “you are lying.” Our analysis of the “regardless of what happened” messages highlights the ideologies they reinforce and the anticipatory exclusion function of memorable messages. The messages under other themes reinforce various misconceptions about IPV and the women who experience it. We offer recommendations for health practitioners on how to help women counteract the lasting impact of stigmatizing memorable messages related to IPV, along with the ideologies and misconceptions these messages perpetuate.

We will get through this together. Trustworthy memorable messages in formal caregiving for breast cancer patients.

The patient-doctor relationship, including communication, is recognised as a critical aspect of the patient experience. Memorable messages are a part of communication between patient and doctor. However, little is known which memorable messages reduce patients' trust in doctors or lead to distrust. To reconstruct memorable messages which breast cancer patients recalled while receiving care from their clinicians leads patients to distrust doctors. In-depth interviews were conducted with 24 breast cancer patients, in Poland and Croatia. Participants ranged in age from 34 to 76years. Reflexive thematic analysis was used. Breast cancer patients recalled many memorable messages that reduce trust in oncology care. The overarching theme of untrustworthy memorable messages was developed, and it embraces three themes: seemingly caring memorable messages, careless memorable messages, missing expected memorable messages. They come in verbal, nonverbal and absent forms. Patient's responses to them include drawing attention directly to inappropriate communication, changing the doctor, learning to be better prepared for medical encounters, or passive adaptation. These results enrich the studies on memorable messages, enhancing the understanding of communication behaviors in triggering distrust toward doctors. Although patients are aware that doctors are overworked, they expect care, attention, individual approach, understanding, and empathy. However, doctors sometimes give untrustworthy memorable messages - especially messages perceived as dismissive, harmful, inadequate, or absent although expected - throughout the cancer trajectory. Thus, greater attention should be given to eliminating untrustworthy memorable messages, improving the understanding of trust dynamics in oncology, psycho-oncology and health education.

As obesity is an increasingly vital health issue in the United States, this study aims to understand the memorable messages about diet and exercise received from parents throughout adolescence. Previous research suggests that parental messages continue to influence children's beliefs, behaviors, and development long after they have left home. This study utilizes a qualitative research design to explore health-related memorable messages shared in 12 focus groups including 77 women ages 20–57. A myriad of memorable messages and modeled behaviors was reported representing three parenting styles: parental critic, parental professor, and parental protector. Results suggest that memorable messages are associated with parenting styles and family environment may influence message interpretation. Theoretical and practical implications for scholars and health educators are discussed along with directions for future research.

This study addresses students of color (SOC) perceptions of memorable messages (MMs) related to their academic ability. A survey of 165 undergraduate students who identified as people of color vividly recalled both positively and negatively valenced messages. Our analysis identified four distinct positive themes embedded within the MMs: praise, encouragement, advice, and support, and four negative themes: criticism, discouragement, reprimand, and accusation. The study also showed that many SOC used positive MMs as microaffirmations to combat threats to their identity, and perceived negative MMs as racial microaggressions that trigger a lack of confidence and/or doubt in their academic ability. We conclude with a set of practical recommendations for constructing equity-minded communication in instructional settings that promotes SOC success.

Miscarriage occurs in roughly one in five pregnancies in the United States. Although it is largely considered a “women’s issue,” non-miscarrying spouses also endure the mental and relational health effects of the loss. Drawing on communicated narrative sense-making (CNSM) theory, we interviewed heterosexual, cisgender, mostly white, married men (n = 45) to solicit their stories of their spouse’s miscarriage. Six types of memorable messages (i.e., messages that affect the values, behaviors and/or beliefs of the receiver) from social network members emerged – have faith, brush it off, this (pain) is your fault, silence, I’m so sorry, and this happens a lot. These messages illuminate the importance of context in memorable message meaning-making; highlight the complexity of “message gaps” in narratively processing difficulty; and uncover ethical issues with attending to men’s experiences with miscarriage. We explore how these findings inform memorable messages theorizing and research.

This study investigated the memorable messages about mental health that international students (N = 199) received from various sources since arriving on campus in the U.S. Utilizing the memorable messages framework, we examined the types of messages (normalizing, strategizing, minimizing) they received and their association with message satisfaction, mental health stigma, and attitude toward help-seeking. The most frequently recalled messages were normalizing messages (49.2%), followed by strategizing messages (31.7%), and minimizing messages (9.5%). Participants who recalled normalizing and strategizing messages reported higher satisfaction and a more favorable attitude toward help-seeking compared to those who recalled minimizing messages. These findings offer theoretical implications for memorable messages and immigrant populations, as well as practical implications for campaign messaging and design. These results can guide university officials in tailoring their efforts to meet the mental health needs of this vulnerable population.

Black women living in the United States typically have poorer diet quality and exercise lessfrequently when compared to other groups. However, research has noted that interpersonalcommunication could be leveraged to encourage this group to engage in these health promotingbehaviors. As such, the current study examined the relation between motivation, receipt of ahealth-related memorable message, and recent diet and exercise behavior among Black women. A cross-sectional study was conducted by administering a survey to self-identified Black women in the Midwestern United States. The survey consisted of the Behavioral Regulations in Exercise Questionnaire-2 to derive relative autonomy index(RAI) which assesses motivation to exercise. In addition, the survey contained a modified version of the Summary of Diabetes Self-Care Activities Scale to gather recent diet and exercise behavior, and a section to determine receipt of a memorable message. Separate multiple linear regression models were developed to determine the impact of relative autonomy index and memorable messages on 1) days eating healthy and 2)days of exercise. The study sample consisted of 116 Black women.Days of eating healthy were positively associated with overall motivation.Both RAI score (β = 0.16) and receipt of a memorable message (β= 1.38) were predictive of a higher number of days eating healthy. Multivariate analysis revealed RAI score (β = 0.16) and receipt of a memorable message (β= 1.27) were predictive of a higher number of days exercising. Motivation is a key factor to influence greater engagement in healthy eating and exercise among Black women. Additional research is needed regarding the types of messages that may influence healthy behaviors to the greatest degree.

Objective: The main goal of this study is to explore how women in Karachi, Pakistan, perceive relational barriers as they attempt to define and communicate their invisible autoimmune illness with family, friends and health care providers; utilizing Communicated Sense Making (CSM) and Memorable Messages (MMs) to provide insight into these perceived barriers. Methods: Through a qualitative approach, Illness Narratives of women in Karachi, Pakistan were taken. By employing Communicated Sense Making (CSM) and Memorable Messages (MMs) to assess the barriers that existed for participants in articulating their illnesses to others; seven out of twenty respondents were selected through purposive sampling as case studies. Results: The findings supported the notion that although some initial support was evident, it declined over time leaving many of the participants feeling socially isolated and rejected. In addition, it was found that when the participant's invisible suffering failed to be made visible as a result of futile attempts at sense making, it resulted in increased psychological distress. Conclusion: Due to the erratic and often invisible nature of their symptoms, autoimmune diseases create significant relational burdens for those who have them. As they struggle to receive recognition for their suffering as humans, and not simply as patients or sick people. While effective communication and intentional support can be seen as mere addons to medical care, they are critical in lessening the psychosocial trauma experienced by those living with a chronic and invisible illness.

Emerging adults are the age group in the U.S. most likely to become pregnant, have a child, receive abortions, and be most supportive of legal abortion. To gain insight into these seemingly contradictory facts and attitudes, this study examines emerging adults’ memorable messages about abortion and pregnancy to understand the beliefs, norms, values, and expectations circulating for younger adults. Ninety-two emerging adult college students provided memorable messages about both abortion and pregnancy. Utilizing thematic co-occurrence analysis, messages about pregnancy and abortion were characterized by three themes: political ideologies of sex, healthcare experience, and life-changing. Emerging adults described the messages as making them feel knowledgeable, empowered, and scared. Two theoretical relationships were identified: (1) pregnancy is connected to the political ideologies of sex with reactions of feeling empowered and scared and (2) abortion is connected to the politics of sex and the reactions of feeling knowledgeable and scared. Theoretical implications for the theory of memorable messages and practical applications for emerging adults are discussed.

In this study, the authors measured grief processing and deliberate grief avoidance and examined their relationship to adjustment at 4 and 18 months of bereavement for 2 types of losses (spouse, child) in 2 cultures (People's Republic of China, United States). Three hypotheses were compared: the traditional grief work assumption, a conditional grief work hypothesis, and a view of grief processing as a form of rumination absent among resilient individuals. Although cultural differences in grief processing and avoidance were observed, the factor structure of these measures proved invariant across cultures. Consistent with the grief work as rumination hypothesis, both grief processing and deliberate grief avoidance predicted poor long-term adjustment for U.S. participants. Furthermore, initial grief processing predicted later grief processing in both cultures. However, among the participants in the People's Republic of China, neither grief processing nor deliberate avoidance evidenced clear psychological consequences.

Asexual people (i.e., individuals with low or no sexual attraction) experience a unique identity development process as they come to understand themselves within an allonormative society, where sexual attraction is assumed. The messages that asexual individuals receive about sex and sexuality are an important part of this identity development process. However, the messages that they encounter are often a discursive manifestation of dominant allonormative discourses, resulting in a challenging sense-making process for asexual individuals. Guided by the theory of memorable messages (ToMM), the present study analyzed the memorable messages that asexual people (n = 85) recall receiving about asexuality, their impact on identity, beliefs, and behaviors, and opportunities for disruption of harmful messages. Employing critical thematic analysis, we identified three themes (and corresponding sub-themes) that reflected the competition between allonormative and asexual discourses: (in)visibility (i.e., absence of messages vs. asserting existence), (in)validation (i.e., exclusion from the LGBTQ+ community vs. finding community), and (in)humanity (i.e., labeling as abnormal vs. not being broken). We also identified instances where memorable messages of asexuality served to disrupt allonormative discourses, and ways in which memorable messages impacted identity development. The findings contribute to literature on asexual identity development, memorable messages, and discursive disruption, and speak to the important role of memorable messages in shaping asexual people’s understanding of themselves and their relationships.

Past research with Latina/o/x adolescent samples has found that language brokering can be a positive experience, but at times, stressful. Although many factors can contribute to these different brokering experiences, the ways in which Spanish-speaking family members and non-Spanish speakers support (or do not support) Latina/o/x adolescent children during their brokering exchanges can be a contributing factor. To better understand how Spanish-speaking family members and non-Spanish speakers can support young brokers, we interviewed 31 Latina/o/x early adolescent brokers. Our thematic analysis revealed that when brokers reported on family, the most prevalent type of supportive communication received was informational supportive communication. Brokers also reported that their family engaged in unsupportive emotional communication, but when family provided supportive communication, brokers felt efficacious and proud for helping their family. In addition, most brokers reported receiving informational supportive communication from non-Spanish speakers. Nevertheless, some brokers also reported that non-Spanish speakers provided limited informational supportive communication (i.e., absence of supportive communication). Our findings reveal what supportive and unsupportive communication might look like for brokers and how supportive communication can contribute to positive experiences for brokers.