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.

The practice of puxa-puxa among Mozambican women: a systematic inventory of motives

Puxa-puxa is the elongation of the labia minora of the genital organs. It is one of the most widespread genital practices among women in Mozambique, and the practice seems to be specific to this country. The motives underlying this practice and its abandonment were examined in a theory-driven way. A total of 616 women currently living in the provinces of Maputo, Zambezia, and Nampula, aged 18 to 62, were presented with one of two questionnaires that contained items about possible motives for practicing puxa-puxa or possible motives for not practicing it. Seven separable motives for practicing puxa-puxa were found, and the most highly rated were "Having a satisfying sexual life"; "Satisfying my sexual partner"; and "Gaining self-control." Five separable motives for not practicing puxa-puxa were found, and the most highly rated were "Disliking a painful practice"; "Affirming one's value as a person"; and "Avoiding contamination." The main findings of the study are that the practice of puxa-puxa is associated with deep psychological motives common to most women in most cultures, namely having a satisfying sexual life with a reliable partner, creating the conditions for having children, and being able to care for them. The abandonment of this practice is largely the result of personal decisions, which are not taken under constraint and which are not exclusively taken from fear of illness.

Skin Bleaching Among Togolese: A Preliminary Inventory of Motives

The motives underlying the practice of regular skin bleaching among Togolese people were examined, using Apter’s metamotivational theory as the framework. Factor analysis using scree test and a varimax rotation showed eight independent types of basic motives that are characteristic of this theory. Four motives appeared as clearly dominant. Participants practiced skin bleaching on a regular basis mainly (a) to appear important, (b) to look attractive, (c) because they enjoyed their light-colored skin, and (d) because skin bleaching was fashionable. They did not practice skin bleaching as a demonstration of opposition to African culture or to their relatives or as a demonstration of compliance with others’ wishes. They also sometimes practiced skin bleaching as a means of securing a job. Implications in terms of health policy are discussed.