Problematic integration theory: Difference between revisions

Revision as of 08:54, 16 February 2023

Revision as of 13:19, 3 January 2024

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Communication is both a source of, a medium, and a method for resolving conflict.<ref>Babrow, Austin S.; “Communication and Problematic Integration: Milan Kundera’s “Lost Letters” in The Book of Laughter and Forgetting”, ''Communication Monographs'', 1995, Vol. 62, pp. 286.</ref> Communication is a source of problematic integration in that knowledge and evaluative orientations are the result of communication, probabilistic and evaluative orientations are based on and developed through message and [[meaning-making]] (forms of communication), and communication is itself "an object of thought" and is therefore an object "of probabilistic and evaluative orientations."<ref>Babrow, Austin S.; “Communication and Problematic Integration: Milan Kundera’s “Lost Letters” in The Book of Laughter and Forgetting”, ''Communication Monographs'', 1995, Vol. 62, pp. 286-7.</ref> It is also possible that a person experiencing problematic integration will seek new information or new sources of information to bolster or reinforce a desired probabilistic or evaluative orientation. This could also be seen engaging in as a form of [[cognitive dissonance]]. Communication is seen as a medium of problematic integration because communication inherently involves or is based on probabilistic and evaluative orientations, or communication is about probability and value. Communication is influenced by and formed from [[culture]]; thus, communication is a medium of PI, as and the formation of probabilistic and evaluative orientations derives from cultural frameworks. Lastly, communication is a resource for PI as we try to resolve and manage conflict caused by problematic integration through communication (internal, interpersonal, etc.).<ref>Babrow, Austin S.; “Communication and Problematic Integration: Milan Kundera’s “Lost Letters” in The Book of Laughter and Forgetting”, ''Communication Monographs'', 1995, Vol. 62, pp. 286.</ref>

Because communication may be a source, medium, and/or method for resolving problematic integration, it is possible for conflict to manifest as "extended chains" of problematic integration. Such extended chains occur through forms, foci, and layers of experience.<ref>Bradac, James J.; “Theory Comparison: Uncertainty Reduction, Problematic Integration, Uncertainty Management, and Other Curious Constructs”, ''Journal of Communication'', September 2001, Vol. 51, No. 3, pp. 461-2.</ref> By extended chains, it is meant that experiences of problematic integration and efforts to resolve problematic integration may lead to development of a new form of PI. As conflict between probability and value develops around a focal point (or topic), it can lead to conflict regarding a new topic (e.g., stress and anxiety about earning an end-of-year bonus at work can lead to new worries about [[Personalpersonal finance|personal finances]]s, sense of self-worth, and/or one's status and [[career]] prospects at work). Problematic integration becomes shared (or chained) through layers of experience when people discuss and relate their struggles with others. In this process of communicating our conflicts, others may share in our problematic integration through empathy and sympathy.<ref>Babrow, Austin S.; “Communication and Problematic Integration: Milan Kundera’s “Lost Letters” in The Book of Laughter and Forgetting”, ''Communication Monographs'', 1995, Vol. 62, pp. 287</ref> Babrow proposed that communication becomes more important to resolve problematic integration as the conflict or integration becomes more difficult.<ref>Bradac, James J.; “Theory Comparison: Uncertainty Reduction, Problematic Integration, Uncertainty Management, and Other Curious Constructs”, ''Journal of Communication'', September 2001, Vol. 51, No. 3, pp. 463.</ref>

===Critique and analysis===

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PI has been used within the realm of [[Health Communication]] studies in order to assess methods of educating, and communicating with, patients facing a variety chronic or life-threatening conditions. In 2003, Babrow received the prestigious Woolbert Award for scholarship of exceptional originality and influence from the National Communication Association [http://www.natcom.org/nca/Template2.asp?sid=9] for his work with PI.

Maria G. Checton’sChecton's findings indicate that a patient and their partner mutually influence each other in the management of [[Chronic condition|chronic illness]], and that communication and [[Sympathy|emotional support]] are vital components of successful management. Furthermore, participants identified the need for [[Health professional|medical professionals]] to acknowledge the partner's role and provide support to both the patient and their partner. This highlights the importance of integrating the patient and their partner in the management of chronic illness, which is what problematic integration theory aims to do.<ref>{{Cite journal |last=Checton |first=Maria G. |title=Patients' and partners' perspectives of chronic illness and its management. |url=https://psycnet.apa.org/doiLanding?doi=10.1037%2Fa0028598 |journal=American Psychological Association |year=2012 |volume=30 |issue=2 |pages=114–129|doi=10.1037/a0028598 |pmid=22709325 }}</ref>

Jennifer E. Ohs uses Problematic integration theory to understand how [[Family|family members]] come to a shared understanding of an [[End-of-life care|end-of-life decision]], how they experience challenges in the process, and how they respond to those challenges. Communication, [[negotiation]], and [[understanding]] between family members may require outside help such as professional counseling or spiritual guidance to facilitate the process. Successful integration of perspectives is essential for families to reach a decision about end-of-life care.<ref>{{Cite journal |last=Ohs |first=Jennifer E. |title=Problematic Integration and Family Communication about Decisions at the End of Life |url=https://www.tandfonline.com/doi/full/10.1080/15267431.2017.1348947 |journal=Journal of Family Communication |year=2017 |volume=17 |issue=4 |pages=356–371 |doi=10.1080/15267431.2017.1348947 |s2cid=148645921 |via=Taylor & Francis Online}}</ref>

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The complexity of PI and the multiplicity of its manifestations makes it difficult to operationalize, measure, and apply. However, this breadth of scope also indicates that it may have extremely wide-ranging applications and opportunities for research.<ref>Bradac, James J.; “Theory Comparison: Uncertainty Reduction, Problematic Integration, Uncertainty Management, and Other Curious Constructs”, ''Journal of Communication'', September 2001, Vol. 51, No. 3, pp. 466.</ref> Because the concepts within PI are based on cultural definitions, PI is seen as being overly responsive to external conceptual influences; thus, making it potentially falsifiable.<ref>Bradac, James J.; “Theory Comparison: Uncertainty Reduction, Problematic Integration, Uncertainty Management, and Other Curious Constructs”, ''Journal of Communication'', September 2001, Vol. 51, No. 3, pp. 468.</ref>

PI has been used extensively in analysis of the health care system, particularly in regard to communication between health care providers and patients. The health-care system inherently involves communication between health-care providers (e.g., doctors, nurses, various therapists, dietitians, social workers, counselors, etc.), patients, and members of the patient's social and support network (e.g., family members, friends, members of support groups, etc.). Because understanding and communicating diagnoses, prognoses, treatment plans, expectations, and more can be complicated and because this communication relies on the communication skills of the various people involved, health-care situations offer ample opportunity to examine problematic integration. Research in this area has revealed that information is used to decrease and increase uncertainty, depending on the situation. In some cases, patients may seek information to reduce stressful uncertainty. However, in other cases, the care team and the patient may need to increase uncertainty in order to increase optimism and allow for re-evaluation of a given situation.<ref>Brashers, Dale E., Daena J. Goldsmith, and Elaine Hsieh; “Information Seeking and Avoiding in Health Contexts”, ''Human Communication Research'', 2002, Vol. 28, No. 2, pp. 261-2.</ref> PI has been used to study communication involving various medical issues, including breast cancer,<ref>Dennis, Michael Robert, Adrianne Kunkel, and Joann Keyton; “Problematic Integration Theory, Appraisal Theory, and the Bosom Buddies Breast Cancer Support Group”, Journal of Applied Communication Research, Ed. 36, pp. 415-436.</ref><ref>Ford, Leigh A., Austin S. Babrow, and Cynthia Stohl; “Social Support Messages and the Management of Uncertainty in the Experience of Breast Cancer: An Application of Problematic Integration Theory”, Communication Monographs, 1996, Vol. 63, pp. 189-207.</ref> the treatment of diabetes in the elderly, end-of-life issues, and pregnancy.<ref>Matthias, Marianne Sassi and Austin S. Babrow; “Problematic Integration of Uncertainty and Desire in Pregnancy”, Qualitative Health Research, 2007, Vol. 17, pp. 786-798.</ref><ref>Matthias, Marianne Sassi; “Problematic Integration in Pregnancy and Childbirth: Contrasting Approaches to Uncertainty and Desire in Obstetric and Midwifery Care”, Health Communication, 2009, Vol. 24, No. 1, pp. 60-70.</ref>

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== References ==

Babrow, Austin S. (1992). Communication and problematic integration: Understanding and diverging probability and value, ambiguity, ambivalence, and impossibility. ''Communication Theory'', 2(2), 95-13095–130.

Berger, C. R. (1986). Uncertain outcome values in predicted relationships: Uncertainty reduction theory then and now. ''Human Communication Research'', 13, 34-3834–38.

Berger, C. R. (1987). Communicating under uncertainty. In M. E. Roloff & G. R. Miller (Eds.), ''Interpersonal processes: New directions in communication research''. Beverly Hills, CA: Sage.

Berger, C. R., & Calabrese, R. J. (1975). Some explorations in initial interaction and beyond: Toward a developmental theory of interpersonal communication. ''Human Communication Research'', 1, 99-11299–112.

Einhorn, H. J., & Hogarth, R. M. (1987). Decision making under ambiguity. In R. M. Hogarth & M. W. Reder (Eds.), ''Rational choice: The contrast between economics and psychology'' (pp.&nbsp;41–66). Chicago, IL: University of Chicago Press.

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Festinger, L. (1957). ''A theory of cognitive dissonance''. Stanford, CA: Stanford University Press.

Hines, S.C., Babrow, A.S., Badzek, L., & Moss, A. (2001). From coping with life to coping with death: Problematic integration for the seriously ill elderly. ''Health Communication'', 13(3), 327-342327–342.

Lerner, M. J. (1980). ''The belief in a just world: A fundamental delusion''. New York: Plenum.