Читать книгу Medical Communication: From Theoretical Model To Practical Exploration - Tao Wang - Страница 12

Before the concept of “health communication” was formally introduced, there was an alternative concept in the West, namely “therapeutic communication”. Therapeutic communication is closely related to medicine. Until the mid-1970s, health communication, which is a more comprehensive and more abundant concept, has been promoted instead of this restricted one.

Scholars give their own definition of health communication from different angles. Originally proposed by L.D. Jackson in 1992, he believes that “health communication is to use the mass media as a channel to transmit health-related information to prevent disease and promote health. In the process, the mass media is in the medical field. The results have been transformed into public health knowledge prediction and dissemination, and the correct construction of social landscapes to help the audience to establish prevention concepts plays an important role.” Then, American scholar E.M. Rogers proposed a definition that “Health communication is a specialty field of communication study that includes the media agenda-setting process for health issues, media advocacy for health, scientific communication among biomedical scientists, doctor–patient communication, and particularly, the design and evaluation of preventive health communication campaigns. The main dependent variables of study in health communication research are usually of unquestioned good: HIV/AIDS prevention, substance abuse prevention and early treatment, improved doctor–patient communication, the effectiveness of media advocacy for health lifestyles, avoidance of unwanted pregnancy, smoking cessation, early detection of cancer, and the prevention of drunk-driving accidents.” He gave a brief explanation of health communication in 1996. “Health communication is any type of human communication whose content is concerned with health” (Rogers, 1996, p. 156). Xu Meiling, a scholar from Taiwan, also discussed the definition of health communication. She considered that “Health communication is the process of people seeking, processing and sharing medical information. It is concerned not only with the process of individuals seeking medical information or the communication between doctors and patients, but also with the flow and processing of information throughout the medical system.” The focus of her definition is on the medical field, including the subject, object, and media of health communication. Second, it is multilevel, with individual behavior, as well as systematic behavior.

Health communication is an act of spreading health-related content by four different delivery levels. They are self-individual communication, interpersonal communication, organizational communication, and mass communication. For example, the physical and mental health of individuals is at the level of self-individual, while the relationship between doctor and patient’s family is at the interpersonal level, and the relationship between hospital and patient, the on-the-job training of medical staff is at the organizational level and media issue setting. The relationship between media and audience is at the mass level. These four levels do not clearly transmit the subject; they just contain all the health-related content. For this reason, health communication does not emphasize the professionalism of the source of communication to ensure the scientific nature of the content.

From the perspective of scientific communication, medical communication attempts to reduce the unequal information between the two in medical knowledge by building bridges between experts and the public, and to create a scientific culture of society. In this process, it is very clear that the communicator of communication is a professional medical staff. At the same time, it emphasizes the professionalism and scientific nature of the content. Health communication and medical communication are similar in the topic of communication, but there is a fundamental difference. Some examples from the four levels will help us to illustrate the difference between medical communication and health communication.

First, let us see an example at the level of self-individual communication. There was a middle-aged person who was overweight. In order to be healthy, he began to eat only one meal a day. His weight was reduced after two months. He thought this was a very good, effective, and harmless way of losing weight, so he continued. This is the self-individual communication in health communication. For each specific individual, the content of the communication is difficult to control. Those who lack medical common sense will take for granted that some unhelpful and even harmful ways are good for health. Such defects in health communication are difficult to avoid. While in medical communication, if the middle-aged person needs to lose weight, a doctor will complete a health evaluation to confirm whether he is overweight and whether he needs to lose weight at first. Then the doctor will tell him how to scientifically and gradually lose weight, how to lose weight to bring the greatest benefits, and how to avoid the harm of excessive weight loss. It can avoid ambiguity of communication content and the harm to people.

The self-individual communication level in medical communication is the scientific self-propagation under the guidance of professional medical personnel. It can be considered as medical communication if the same person lost his weight guided, approved, and supervised by medical staff.

Second, take an example at the level of interpersonal communication. A diabetic who controlled his blood sugar well by eating only one meal a day and running for two hours a day felt that his blood sugar management experience was very effective. Thus, he shared his experience with his family and other friends with diabetes. This belongs to the human-to-human communication of health, not medical communication. The communicator of medical communication is medical professionals, not patients themselves. The difference is that medical communication should be scientific and draws a universal conclusion, not just a person’s own experience and thought. The content of the patient’s communication is related to health, so it is in the category of health communication. But in medical communication, this patient is not a professional medical staff and his experience in controlling blood sugar is not accurate and reliable. There are no scientific basis and argument to assert it will play a corresponding role for other patients. So, it clearly does not belong to medical communication. In the field of medical communication, naturally there will also be the possibility of interpersonal communication; as the saying goes, in the process of communication, there is no one to supervise or be responsible for the review of the content of the dissemination. There are too many levels of interpersonal communication, thus there is likely to be a change in the content of the dissemination. It is not possible to guarantee the accuracy and reliability of the dissemination. For example, at the first level of interpersonal communication, the public is informed that the daily amount of salt should be less than 6 g, and to the second level or the third level, or even more, this number may become 16, or become 60, which is very irresponsible. Therefore, there is a phenomenon of human-to-human communication in the field of medical communication, but the interpersonal communication without regulation and organization is not recommended.

Third, take an example at the organizational level. Imagine that a community organized a health lecture, of which the topic was diabetes prevention and health knowledge. If the main speaker is a medical professional, then he can communicate from the mechanism of diabetes, symptoms, harm, and other aspects with vivid elaboration, thus it belongs to the field of medical communication. And if the presenter is only a patient, a teacher, or any other nonprofessional medical personnel, even if the content is the same, the effect is different, because he has not been professionally trained. Then this dissemination can only belong to the field of health communication or organizational communication, not real medical communication, because nonprofessional communicators cannot master the accuracy and knowledge of the content of the communication.

Finally, let’s talk about the mass level. At present, a wide variety of media, including new media and self-media, concern about medical and health content. The public generally concern more about themselves and the health of their families than the world political situation. If these media in the dissemination of health content do not have the support of medical professionals, it is best only at the field of health communication or mass communication, not the real sense of medical communication. Medical communication can be in various media, including new media, self-media, but must be carried out and promoted by medical professionals. The content of communication also should be controlled and screened by these medical professionals. The lack of control is easy to cause a variety of miscommunicated content. There are some new media that carry out activities for profit in the name of health; this not only is not beneficial to health, but also has the potential to cause harm to the population, which is one of the reasons why we urgently need to establish the concept of medical communication and the field of medical communication.

In addition to the difference in the subject of communication, the second fundamental difference between medical communication and health communication is the content of the communication. As the communicator of medical communication is medical professionals, the content that is written or identified by medical staff will be scientific and objective. This professional advantage ensures the reliability of the source of medical communication, which is unmatched by traditional health communication scholars. At the same time, medicine has different professions and categories. Therefore, what medical communication scholars spread should be their medical expertise with full professional knowledge, not just general medical knowledge. For instance, a cardiovascular doctor should communicate in the field of cardiovascular medicine, not spread their unfamiliar knowledge in obstetrics and gynecology. Pediatricians should disseminate knowledge in pediatrics. The clinical knowledge and norms of adults are partly different from children, so pediatricians are not suitable for the general dissemination of adult medical knowledge. Therefore, the content of medical communication can be summarized as professional knowledge certified by professionals.

Health communication is a branch of communication, whereas medical communication is a branch of medicine.