April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: The Parental Presence/Absence Dialectic in Emerging Adults’ Doorknob Disclosure Experiences
Rationale: Doorknob disclosures occur when patients wait until the end of an appointment, often when the provider is leaving the exam room, to (1) disclose their real reason for the visit, (2) disclose important health information needed for their care, or (3) ask important questions relevant to their care. Research about doorknob disclosures is limited; previous research suggests there are varying reasons for why patients engage in doorknob disclosures. In particular, emerging adults may experience unique reasons for doorknob disclosures.
Method: Twenty-one college students recounted their doorknob disclosure experiences. The semi-structured interview protocol asked participants to explain the doorknob disclosure event, their feelings about the experience, and recommendations for patients and providers. The transcribed interviews resulted in 113 pages of single-spaced data. During the iterative analysis process, the dialectic of parental presence and absence emerged as a salient part of emerging adults’ doorknob disclosure process.
Results: For emerging adults, a parental presence/absence dialectic directly contributed to their doorknob disclosures. The physical and emotional presence of parents made it difficult for emerging adults to communicate with their providers. Participants said parents who attended appointments often dominated conversations and because of this, providers often spoke with parents instead. Their exclusion from the care agenda made it difficult to interject, forcing them to ask questions as the visit ended. Second, emerging adults said they were often embarrassed about talking about health issues, especially sexual health issues, in front of their parents, which led to doorknob disclosures. Providers contributed to this dynamic as well, as they often waited until the end of the appointment to ask parents to leave.
The absence of parents also contributed to emerging adults’ doorknob disclosures. This primarily manifested in emerging adults’ hesitancy or uncertainty in asking questions or bringing up important topics because they are used to their parents driving the provider-patient conversation. Emerging adults reported not knowing how to talk to providers or ask questions because they had never had to before. Their inability to advocate on their own behalf often contributed to doorknob disclosures. Second, emerging adults, especially those from small towns, were concerned that their providers would disclose their questions or requests to parents, making them unsure about broaching important conversations.
Implications: The presence-absence dialectic highlights the importance of helping emerging adults transition from a triadic to a dyadic healthcare experience and empower them to ask questions and self-advocate. Specifically, addressing autonomy struggles among emerging adults is needed to build trust with providers and aid in their transition as agents of their health. Theoretically, the need for empowerment in the presence-absence dialectic connects to emerging adults’ struggle with the autonomy-connectedness dialectic as they move into a new phase of their lives. Providers empowering emerging adults to take an active healthcare role can boost the willingness of emerging adults to disclose health topics and foster autonomy. Examining this communication and empowerment of emerging adults on long-term health outcomes also contributes towards improved healthcare decision making.
Method: Twenty-one college students recounted their doorknob disclosure experiences. The semi-structured interview protocol asked participants to explain the doorknob disclosure event, their feelings about the experience, and recommendations for patients and providers. The transcribed interviews resulted in 113 pages of single-spaced data. During the iterative analysis process, the dialectic of parental presence and absence emerged as a salient part of emerging adults’ doorknob disclosure process.
Results: For emerging adults, a parental presence/absence dialectic directly contributed to their doorknob disclosures. The physical and emotional presence of parents made it difficult for emerging adults to communicate with their providers. Participants said parents who attended appointments often dominated conversations and because of this, providers often spoke with parents instead. Their exclusion from the care agenda made it difficult to interject, forcing them to ask questions as the visit ended. Second, emerging adults said they were often embarrassed about talking about health issues, especially sexual health issues, in front of their parents, which led to doorknob disclosures. Providers contributed to this dynamic as well, as they often waited until the end of the appointment to ask parents to leave.
The absence of parents also contributed to emerging adults’ doorknob disclosures. This primarily manifested in emerging adults’ hesitancy or uncertainty in asking questions or bringing up important topics because they are used to their parents driving the provider-patient conversation. Emerging adults reported not knowing how to talk to providers or ask questions because they had never had to before. Their inability to advocate on their own behalf often contributed to doorknob disclosures. Second, emerging adults, especially those from small towns, were concerned that their providers would disclose their questions or requests to parents, making them unsure about broaching important conversations.
Implications: The presence-absence dialectic highlights the importance of helping emerging adults transition from a triadic to a dyadic healthcare experience and empower them to ask questions and self-advocate. Specifically, addressing autonomy struggles among emerging adults is needed to build trust with providers and aid in their transition as agents of their health. Theoretically, the need for empowerment in the presence-absence dialectic connects to emerging adults’ struggle with the autonomy-connectedness dialectic as they move into a new phase of their lives. Providers empowering emerging adults to take an active healthcare role can boost the willingness of emerging adults to disclose health topics and foster autonomy. Examining this communication and empowerment of emerging adults on long-term health outcomes also contributes towards improved healthcare decision making.