Health Communication Research Vol.13, No.1

13th Annual Conference of the Japanese Association of Health Communication

Symposium 1: Reconsidering the Relationship between “Communication” and “Information”: Does “Literacy” Link the Subjects?

Takeo Nakayama1), Hiroki Sugimori2), Takahiro Kiuchi3), Kazuhiro Nakayama4), Machi Suka5)

1) Department of Health Informatics, School of Public Health, Kyoto University Graduate School of Medicine,2) Department of Preventive Medicine, Graduate School of Sport and Health Science, Daito Bunka University,3) Department of Health Communication, School of Public Health, the University of Tokyo,4) Graduate School of Nursing Science, St. Luke’s International University,5) Department of Public Health and Environmental Medicine, The Jikei University School of Medicine

Communication and information are two major subject areas in health communication; however, their relationship has rarely been discussed in the literature. Humans are diverse and highly individualized; therefore, individual interpretations, expectations, and value attachments arise around information uncertainty, which is influenced by the literacy of both the senders and receivers of information. This symposium was held as a discussion forum to connect these keywords by using the literacy perspective to reconsider the “so close and yet so far” relationship between communication and information. The three speakers at the symposium delivered the following lectures: “From Information to Communication: The Role of Literacy,” “Communication for Informed Decision Making,” and “Health Literacy as a Prerequisite for Communication: From the Perspective of Public Health Communication. A plenary discussion was held after these three lectures. This symposium provided a valuable opportunity to gain broader perspectives and insight by considering information and literacy with health communication as a starting point.

Symposium 2: Changes and Prospects for Communication Training Initiatives During COVID-19 and Beyond

Naoko Hasunuma1), Shigeru Takanaga2), Minoru Hattori1), Yuka Kikuchi3), Junko Iida4), Tetsuro Konoo5)

1) Center for Medical Education, Hiroshima University, School of Medicine,2) Graduate School of Humanities and Social Sciences, Hiroshima University,3) Hiroshima University Hospital (Medical), Department of General Internal Medicine,4) Faculty of Health and Welfare, Kawasaki University of Medical Welfare,5) Kyushu Dental University

The Model Core Curriculum for Medical Education in Japan includes communication skills, professionalism, behavioral science, anthropology, and sociology in addition to its primary focus on medical knowledge and clinical skills. During this symposium, the participants shared examples of educational practices in various fields. In the last two years, the COVID-19 pandemic has forced university education to undergo significant changes, such as switching to online courses. Lectures were moved to online learning without any problems because many medical faculty staff already used PowerPoint slides originally. The panelists reported on their online lectures, use of video materials, and innovations for sharing opinions and discussions among students in behavioral science, communication training, anthropology, and professionalism. This symposium provided meaningful opportunities to share best practices on prospects, the limitations of online lectures, and the requirements for information and IT (information technology) literacy education.


Balancing Cancer Treatments and Work: Communication between Patients with Cancer and their Supervisors and Co-workers

Keiko Sakakibara1), Mieko Homma2), Kumiko Hashimoto3), Hideko Yamauchi4)

1) Faculty of Sociology, Toyo University,2) Department of Health Sciences, Saitama Prefectural University,3) Cancer Information and Support Service, St. Luke’s International Hospital,4) Department of Breast Surgical Oncology, St. Luke’s International Hospital

Balancing work and cancer treatments is a major challenge in Japanese society. Breast cancer is the most prevalent cancer among women; hence, this study examined the communication between patients with breast cancer and their colleagues about balancing work and cancer treatments. Semi-structured interviews were conducted between May 2018 and October 2020 with 12 working women in the Tokyo metropolitan area who had breast cancer. Three themes were extracted after thematic analysis: “actively obtaining information to face cancer and treatments,” “disclosure of breast cancer diagnosis at workplace and coworkers’ reaction,” and “how to interact with colleagues at the workplace after returning to work.” The study participants actively obtained information to face their cancer, disclosed their cancer diagnosis to the people around them, received support, and built good relationships in their workplace through continuous communication after returning to work. The findings show that communication between patients and their supervisors and coworkers is essential for balancing cancer treatments with their workload. Organizations must develop a workplace culture where patients with cancer can feel comfortable sharing their diagnosis and can continue to work while undergoing treatments. This type of environment is critical for supporting patients with cancer in balancing their work with cancer treatments.

Challenges and Considerations in Translating Health Information for Deaf People: Development of a Cancer Informational Video in Japanese Sign Language

Ai Minakawa1),Yufuko Takashima2),Chikako Yamaki3),Eiji Taira4),Kota Takayama5)

1) Center for Deaf Health Equity, Gallaudet University,2) Research Institute of National Rehabilitation Center for People with Disabilities,3) Institute for Cancer Control, National Cancer Center,4) Sign Language Research Center, Kansei Gakuin University,5) Department of Social Work, Gallaudet University

In Japan the vast majority of health information is available in spoken and written Japanese. As a consequence, deaf people who use sign language experience multiple barriers in accessing and understanding complex health information, which hinders their shared decision-making with health-care professionals. A project team translated a booklet about colorectal cancer published by the National Cancer Center Japan into Japanese Sign Language (JSL) to develop an informational video. Using a thematic analysis of the discussions during the filming of the video, this study provides suggestions for future accessible informational videos to expand health information resources available for deaf people. One hundred and four sources were coded into two categories. The first category, “conceptually and linguistically accurate translation skills” emerged from two subcategories: “improvements in making accurate translations” and “use of and adjustments to visual depiction methods.” The second category, “health communication skills meeting the needs of deaf people” emerged from two other subcategories: “development of medical terminology in JSL” and “supplementary information to facilitate comprehension by deaf people.” These findings suggest a need for skilled adaptations of health knowledge in a linguistically and culturally appropriate manner in addition to translation skills for the specific linguistic context between JSL and the Japanese language.

Patients’ Feelings and Doctors’ Concerns about Cancer Immunotherapy: A Qualitative Study

Masayo Hayakawa1),Otome Watanabe1),Tatsunori Shimoi2),Tsunakuni Ikka3),Tomoko Takayama1),Fumihiko Wakao1)

1) Institute for Cancer Control, National Cancer Center Japan,2) Department of Medical Oncology, National Cancer Center Japan,3) Division of Bioethics & Healthcare Law, Institute for Cancer Control, National Cancer Center Japan

Introduction: Cancer immunotherapy not covered by insurance provided by private practice clinics is often not a beneficial medical treatment for many patients with cancer because of the negligible scientific evidence. The harm caused by these clinics is a major concern, in addition to their high treatment costs. We interviewed both patients with cancer and their doctors to explore the patients’ feelings and their doctors’ concerns in the process from seeking information to treatment, in addition to effective approaches for preventing harm. Method: We conducted a semi-structured interview with six doctors and five patients and their respective family members regarding cancer immunotherapy. Results: The study findings show that both patients and family members sought information about cancer immunotherapy because of their “anxiety” and “wanting to find something they could do.” They relied on doctors at their private practice clinic because it was difficult to communicate with doctors providing standard therapy in designated cancer hospitals. According to the patients, doctors providing standard therapy did not deny providing cancer immunotherapy not covered by insurance provided by private practice clinics; therefore, we considered this scenario as the cause of miscommunication. Discussion: To prevent the physical, mental, and economical negative impacts of cancer immunotherapy, we recommend the implementation of a multifaceted approach, including health literacy, patient-centered communication, and a consultation system.

Feasibility and Effectiveness of Online Lecture-based Medical Communication Skills Training Using a Counseling Video

ICHIKURA Kanako1),MORIYA Rika2),CHIBA Hiroki2), INOUE Akiomi3)4),WATANABE Kazuhiro4),ARAI Yumi5), SHIMAZU Akihito6),FUKASE Yuko1),MURASE Hanako1), TAGAYA Hirokuni1),TSUTSUMI Akizumi4)

1) Department of Health Science, Kitasato University School of Allied Health Sciences,2) Department of Medical Education, Kitasato University School of Medicine,3) Institutional Research Center, University of Occupational and Environmental Health, Japan,4) Department of Public Health, Kitasato University School of Medicine,5) Department of Patient Safety and Hospital Administration, Kitasato University Hospital,6) Faculty of Policy Management, Keio University

Aim: This study evaluated the impact of online lecture-based communication skills training on students’ comprehension and confidence in communication. The students were enrolled in study programs to obtain licenses to become a clinical psychologist, physical therapist, occupational therapist, speech therapist, or orthoptist.Methods: The students watched a 30-minute e-learning program and undertook practical communication training using a 90-minute counseling video, which was developed to make students think about the counselors’ responses to their clients’ problems. A self-completed questionnaire tested the students’ understanding using the Listening Skills Scale and a visual analog scale for comprehension and confidence related to communication. The questionnaire scores were measured before e-learning, after e-learning, and after the lecture, and then compared.Results: Among the 139 students, there was no significant difference in their Listening Skills Scale scores across the three time points. However, the scores for comprehension of communication with patients, confidence in communication with patients, and confidence in clinical training or clinical practice increased significantly from before e-learning to after the lecture.Conclusion: Our findings suggest that online lecture-based medical communication skills training using counseling videos contributes to improving students’ comprehension and confidence in medical communication and clinical practice.

Quantitative Content Analysis of Questions Posted on a Q&A Site Regarding Employment for Cancer Patients

Yusuke Fujita1),Miho Iwakuma2),Nobuaki Hoshino1),Koya Hida1),Kazutaka Obama1)

1) Department of Surgery, Kyoto University Graduate School of Medicine,2) Department of Medical Communication, Kyoto University School of Public Health

With increases in cancer survival rates, employment has become a topic of discussion among cancer patients. We conducted a quantitative text analysis of questions posted on a social Q&A website to explore these patients’ information needs, specifically regarding employment. We extracted 150 questions related to patients’ employment. The most frequently used word was “surgery,” followed by “hospitalization,” “anticancer drugs,” “company,” and “return to work.” The following groups were delineated in the co-occurrence network: “periods of hospitalization or outpatient surgery,” “changes in physical strength and feelings due to side effects of anticancer drugs and the possibility of recurrence,” “communication about illness at work,” “consultation with the company about insurance, sickness benefits when taking leave, or resigning,” and “emotional and financial burden on family members.” In the correspondence analyses, the terms “anticancer drug” and “physical strength” tended to be used by those patients with metastasis or recurrence, while “surgery” and “progress” were used by those patients without metastasis or recurrence. Our findings suggest that cancer patients have diverse questions and concerns about employment, many of which may depend on their medical condition.

An Analysis of Japanese Utterances of International Students in Medical Interviews: What were the Problems in Japanese of International Students who Received “Requests for Repetition” from Simulated Patients?

Nagisa SHINAGAWA1),Tomoaki INADA2)

1) Graduate School of Medicine, International University of Health and Welfare,2) International Center, Jumonji University

The study categorized and analyzed the utterances of international students during medical interviews in Japanese and identified factors that induced requests for repetition from simulated patients in terms of language. It is known that international students are more likely to receive repetition requests from simulated patients in medical interviews than Japanese students, but it has not been clarified what problem is in their Japanese that causes the repetition requests. In March 2020, we conducted a medical interview with simulated patients among 40 international medical students from the first to third year of the International University of Health and Welfare. The utterances of international students were classified on the basis of an existing study of linguistic anomalies and errors by learners of Japanese. The following perspectives were used as classification items: Errors of pronunciation, word choice, at the levels of sentence structure (grammar), and discourse. The results indicated five utterances with errors of word choice, and 12 utterances each for errors of pronunciation, errors of sentence structure (grammar), and errors of discourse. In terms of year level, all types of errors were observed regardless of their grade except errors in word choice. This study indicates it is necessary for international students to continue Japanese communication training for medical interviews throughout undergraduate medical education.

Development of Explanatory Documents for Pet Owners at a Veterinary Clinic over 18 Years

Yoshio Miyazaki

Miyazaki Animal Hospital

The author has run a veterinary clinic for dogs and cats since July 2003. To make his medical explanations easier to understand for pet owners, he provides explanatory documents for their pets’ daily medical care. Since June 2011, he has published journal articles on how to use the best methods to make these explanatory documents more readable; however, these methods have changed over time during daily practice and dissertation writing. This paper summarizes the changes in his approaches, ideas, and devices mentioned in these documents over the last 18 years, such as: (1) the reading difficulty dropped from junior high school level to elementary school level; (2) conciseness was emphasized over providing too much information; (3) and ensuring that the explanatory documents captured the pet owners’ attention was as important as making them easily readable. These changes emerged while preparing the documents and observing the pet owners’ reactions in addition to the related research and dissertation writing. Improving explanatory documents for pet owners requires repetition in both daily practice and research considerations.

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