The script of parenting shifts when parents learn of their child’s Down syndrome diagnosis. To build a theory of the diagnostic experience and early family sense-making process, we interviewed 33 parents and nine grandparents living in the United States who learned prenatally or neonatally of their child’s diagnosis. The core category of rescuing hope for the future encompassed the social process of sense-making over time as parents managed their sorrow, shock, and grief and amassed meaningful messages that anchored them as they looked toward the future. Application of the theory to practice underscores the import of early professional support offered to parents at key points in the sense-making process: Early as they disclose the news of the diagnosis to family and friends, and later close friends and kin assimilate meaningful messages about what the diagnosis means as they recalibrate expectations for a hopeful future.

codes of ethics, organizational discourse, Sarbanes-Oxley, structuration theory,

Hospital discharge processes are complex and confusing, and can detrimentally affect patients, families, and providers. This qualitative study investigated pediatric hospital discharge experiences from the perspectives of parents of children with acute and chronic health conditions, primary care providers, and hospitalists. Focus groups and interviews with parents, primary care providers, and hospitalists were used to explore discharge experiences and ideas for improvement offered by participants. Using an iterative approach to analyze data resulted in five major themes for discharge experiences: (a) discharge problems, (b) teamwork, (c) ideal discharge, (d) care chasm, and (e) discharge paradox. The first three themes concern practical issues, whereas the last two themes reflect negative emotional experiences as well as practical problems encountered in the discharge process. Improvements in communication were viewed as a primary strategy for improving the discharge process for better outcomes for patients, their families, and providers.

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Raising a child with disabilities involves balancing a number of challenges, including seeking and gaining support. A synthesis of past research on support for families is needed to map directions for future research. This article reviews the past 10 years of empirical research on formal and informal support for families of children with disabilities. The review includes quantitative and qualitative studies representing several disciplines. Nine focus areas are identified: well-being, resources and socioeconomic factors, culture and minorities, intervention, extended families, siblings, professional support relationships, religion, and policy. Research is synthesized within each of the focus areas and suggestions are provided for future communication research. Dominant theories in existing studies are reviewed with directions for future theory-driven communication research.

This article presents a theoretical framework for investigating the communicative construction of policy knowledge. Research regarding public policy and organizational knowledge demonstrates the importance of these areas for organizational communication scholars. In light of this research, structurating activity theory is offered as an integration of structuration theory and cultural-historical activity theory (CHAT). Four theoretical constructs are discussed: (a) structuration through activity, (b) mediation of social activity, (c) contradictions as generative mechanisms, and (d) intersections of activity systems. Six propositions offer the explanatory significance of each construct, and then the theory is applied to a case study of the construction of special education policy knowledge. Additional applications of structurating activity theory are proposed and suggestions for future research directions are offered.

We use structurating activity theory, an integration of structuration and culturalhistorical activity theories, to examine how individuals construct policy knowledge. The study was conducted over 5 months with participants from related activity systems who interacted regarding special education policy. Qualitative analysis focused on how participants drew on system-specific and structural rules and resources to construct policy knowledge within and between activity systems. Results reveal how participants developed policy knowledge that was mediated by system elements of divisions of labor, communities, rules, subjects, and both material and symbolic mediating resources. The mediated knowledge construction process also reproduced broad structural features. Results interpreted through structurating activity theory extend current understandings of policy and knowledge processes and offer directions for future research.

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