Taking Control: The Efficacy and Durability of a Peer-Led Uncertainty Management Intervention for People Recently Diagnosed With HIV.

HIV creates substantial uncertainty for people infected with the virus, which subsequently affects a host of psychosocial outcomes critical to successful management of the disease. This study assessed the efficacy and durability of a theoretically driven, one-on-one peer support intervention designed to facilitate uncertainty management and enhance psychosocial functioning for patients newly diagnosed with HIV. Using a pretest-posttest control group design, 98 participants received information and training in specific communication strategies (e.g., disclosing to friends and family, eliciting social support, talking to health care providers, using the Internet to gather information, and building social networks through AIDS service organizations). Participants in the experimental group attended six 1-hour sessions, whereas control participants received standard of care for 12 months (after which they received the intervention). Over time, participants in the intervention fared significantly better regarding (a) illness uncertainty, (b) depression, and (c) satisfaction with social support than did those in the control group. Given the utility and cost-effectiveness of this intervention and the uncertainty of a multitude of medical diagnoses and disease experiences, further work is indicated to determine how this program could be expanded to other illnesses and to address related factors, such as treatment adherence and clinical outcomes.

Communication nonaccommodation in family conversations about end-of-life health decisions.

Furthering our understanding of how communication can improve end-of-life decision making requires a shift in focus from whether people talk to how people talk about end-of-life health decisions. This study used communication accommodation theory to examine the extent to which communication nonaccommodation distinguished more from less successful end-of-life conversations among family members. We analyzed elicited conversations about end-of-life health decisions from 121 older parent/adult child dyads using outside ratings of communication over- and underaccommodation and self-reported conversational outcomes. Results of multilevel linear modeling revealed that outside ratings of underaccommodation predicted self-reported and partner-reported uncertainty, and ratings of overaccommodation predicted self-reported decision-making efficacy and change in concordance accuracy. We discuss the methodological, theoretical, and practical implications of these findings.

Caring for a parent with lung cancer: caregivers' perspectives on the role of communication.

We investigated communication and care in the context of lung cancer through qualitative interviews with 35 adult children. Participants described two core influences on communication: situational and relational influences. Participants also suggested that the ways in which support was communicated impacted how they managed challenges and how they were able to cope with the loss of their parent. This research adds to the literature on caregiving and communicating social support by exploring the experiences of families coping with lung cancer. We suggest theoretical and practical implications for the ways family members might communicate about illness.

Do message features influence reactions to HIV disclosures? a multiple-goals perspective.

People who are HIV-positive must make decisions about disclosing their status to others but do so in the context of stigma and social isolation reported by many with the disease. Disclosing an HIV-positive diagnosis is necessary to seek social support, to manage health care, and to negotiate sexual encounters, but fear of how others will respond is a strong barrier to revealing that information. This investigation focuses on various ways that HIV can be disclosed. Using a multiple-goals perspective, 24 disclosure messages (representing 6 different types) were created. Participants (N = 548) were asked to imagine one of their siblings revealing an HIV-positive diagnosis, using 1 of the 24 messages. Participants' reactions to the disclosures differed substantially across the various message types. The discussion focuses on theoretical explanations for the variations in responses and the utility of these findings for practical interventions concerning HIV disclosures.

Breast cancer patients' topic avoidance and psychological distress: the mediating role of coping.

Avoiding communication about cancer is common and is likely to have negative psychological health consequences for patients, yet the connection between topic avoidance and psychological well-being is not well understood. This study of women with breast cancer examined coping behaviors as mediating mechanisms through which their cancer-related topic avoidance might affect their psychological distress. Consistent with predictions, greater levels of patient topic avoidance were associated with higher levels of depression and anxiety. Results indicated that topic avoidance may decrease patients' use of emotional support and increase patients' self-blame, each of which may lead to higher levels of psychological distress.