April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Non-Disclosure Decisions as Communication Work in Young Adults and Supporters Coping With Cancer
Communication work involves messages exchanged by illness sufferers and close supporters when keeping loved ones informed about a serious illness. While it involves preparation and strategic message design—and it is often perceived as demanding and effortful—most communicators feel that they have a duty or obligation to perform communication work effectively. However, cancer survivors sometimes choose not to talk about their cancer with others. To our knowledge, no studies have examined disclosure avoidance decisions/behaviors alone as specific types of communication work. Thus, this study focuses on ways in which young adult (YA; 18-39 years old) cancer patients and their closest supporters (i.e., partners, parents, siblings) describe non-disclosure as communication work following a cancer diagnosis.
The first author conducted individual semi-structured interviews with 21 YA patient-close supporter dyads, 1 triad, 9 individual YA patients, and 8 individual supporters (N=62). Participants described times they purposely did not tell someone about their cancer experience when they had the opportunity. Both authors met regularly to conduct constant comparative analysis and to explore connections between communication work and participants’ descriptions of their non-disclosure experiences.
Participants described non-disclosure decisions as communication work by explaining that a) they often felt they had a duty not to disclose, b) non-disclosure decisions were sometimes burdensome, and c) they used non-disclosure strategically. First, participants felt they had a duty to themselves not to disclose their cancer experience to remain consistent with their tendency to cope privately with negative emotions, to protect themselves from experiencing their own/others’ emotions, to maintain control over valued identities, and to avoid the possibility that the information could affect their careers/finances. They felt obligated to protect others from the discomfort of their cancer-related information, particularly if they felt the person was already experiencing significant unrelated burden, or if that person had previously made a rude/ insensitive comment related to their appearance/recent absences. Second, participants found non-disclosure decisions to be burdensome, particularly when they conflicted with existing relational/identity goals. Participants were unsure who they should avoid telling, how they would continue to hide information over long periods of time, when they should eventually disclose the information, and whether the risk of others’ negative reactions outweighed the potential for positive connections. Finally, participants revealed relational (e.g., evaluating situational relevance and others’ potential level of interest) and temporal (e.g., waiting until enough information was collected before disclosing) strategies for making non-disclosure decisions.
These findings extend communication work and indicate that non-disclosure can be strategic and more complicated than simply “deciding not to tell.” There is work/labor associated with non-disclosure, and perhaps we need to “train” YA patients and supporters on how to make disclosure decisions and manage this work. Because some participants mentioned using social media to disclose to larger groups, research could investigate how YAs make disclosure decisions and manage communication work using technology. Research could also examine how YAs and their closest supporters divided and shared non-disclosure decisions/behaviors following a cancer diagnosis, and how this collaborative component of communication work overlaps with communication privacy management theory.
The first author conducted individual semi-structured interviews with 21 YA patient-close supporter dyads, 1 triad, 9 individual YA patients, and 8 individual supporters (N=62). Participants described times they purposely did not tell someone about their cancer experience when they had the opportunity. Both authors met regularly to conduct constant comparative analysis and to explore connections between communication work and participants’ descriptions of their non-disclosure experiences.
Participants described non-disclosure decisions as communication work by explaining that a) they often felt they had a duty not to disclose, b) non-disclosure decisions were sometimes burdensome, and c) they used non-disclosure strategically. First, participants felt they had a duty to themselves not to disclose their cancer experience to remain consistent with their tendency to cope privately with negative emotions, to protect themselves from experiencing their own/others’ emotions, to maintain control over valued identities, and to avoid the possibility that the information could affect their careers/finances. They felt obligated to protect others from the discomfort of their cancer-related information, particularly if they felt the person was already experiencing significant unrelated burden, or if that person had previously made a rude/ insensitive comment related to their appearance/recent absences. Second, participants found non-disclosure decisions to be burdensome, particularly when they conflicted with existing relational/identity goals. Participants were unsure who they should avoid telling, how they would continue to hide information over long periods of time, when they should eventually disclose the information, and whether the risk of others’ negative reactions outweighed the potential for positive connections. Finally, participants revealed relational (e.g., evaluating situational relevance and others’ potential level of interest) and temporal (e.g., waiting until enough information was collected before disclosing) strategies for making non-disclosure decisions.
These findings extend communication work and indicate that non-disclosure can be strategic and more complicated than simply “deciding not to tell.” There is work/labor associated with non-disclosure, and perhaps we need to “train” YA patients and supporters on how to make disclosure decisions and manage this work. Because some participants mentioned using social media to disclose to larger groups, research could investigate how YAs make disclosure decisions and manage communication work using technology. Research could also examine how YAs and their closest supporters divided and shared non-disclosure decisions/behaviors following a cancer diagnosis, and how this collaborative component of communication work overlaps with communication privacy management theory.