Communication and Medicine最新文献

This study examines face-work and politeness strategies during interactions between a female doctor and two male patients presenting with sexual and reproductive health issues at a public hospital in Kenya. Grounded in the conceptual frameworks of face-work and politeness, this study explores how face-saving and face-threatening acts are managed in medical encounters. It considers the cultural and gendered aspects of politeness in these interactions. The analysis of the qualitative data collected through recordings, participant observation, and a follow-up interview with the doctor has led to the following findings. The doctor uses indirect language and culturally sensitive communication to preserve the male patients' positive face, particularly around stigmatized issues such as sexually transmitted infections. The male patients employ defensive face-work to maintain their social image and masculinity. This study sheds light on the power dynamics, politeness strategies, and cultural norms that shape doctor-patient interactions in reproductive health settings, contributing to a deeper understanding of gendered communication in healthcare.

This paper is a discourse analysis based on three illness narratives, known as autopathographies/memoirs, selected from a larger study. The memoirs were written in English by patients who suffered from contested illnesses. The memoirists report that as patients, they have encountered skepticism from their doctors regarding the doctorability of their conditions. Drawing on the theory of dialogism, the theory of memoirs, narrative analysis, and evaluation in linguistics, this paper argues that these memoirists answer their doctors, among other addressees, to vindicate themselves. They covertly claim that (a) their visceral authority is right and (b) their illness narratives are credible and real rather than imaginary. The close reading technique is used to analyze the memoirists' use of devices in the orientation section of the memoirs. Direct evidentials, combined with the mirative stance and deferred realization, are observed as firsthand sources of information. More specifically, prolepsis, ventriloquism, quotative evidential, and intertextuality are observed as secondhand sources of information. Whereas the devices associated with the firsthand sources of information enhance the subjective stance of the visceral authority as inalienable, the devices associated with the secondhand sources vouch for credibility by providing an objective source of information. In constructing credibility, these memoirs contribute to normalizing contested illnesses.

This study aims to explore the nature of interprofessional collaboration between radiation therapists (RTTs) and radiation oncologists (ROs) during radiation therapy (RT), with the shared goal of treating patients with radiation. Generally, there seems to be a lack of studies describing the nature of interprofessional collaboration between RTTs and ROs. The present study adopts an exploratory descriptive qualitative research design. The setting is the private and public RT departments situated in the Tshwane municipal area, Gauteng, South Africa. A variation is noted between the Health Professions Council of South Africa (HPCSA) scope of practice for RTTs, published in 1979, and the new scope circulated for comment in 2021. Practising RTTs and ROs have been invited to take part in semi-structured interviews by using expert purposive sampling. Ten radiation therapists and seven radiation oncologists were interviewed, and data analysis included content and thematic analysis. Two main themes emerging from the data were the dual purpose of collaborative communication and grappling with the collaborative communication divide. The findings indicate team structure issues, the fact that the two disciplines mostly work in separate locations, and the status of current communication being dominated by intermediaries are perceived by the participants to hinder collaborative communication between the two professional groups.

This study aims to gain insight into participants' use of gaze in sign language-interpreted consultations in health centres for babies and toddlers in the Norwegian context. The study investigates how gaze direction and eye contact frame the interaction between participants comprising mothers who are deaf and health personnel who are hearing. The empirical material is based on five video recordings of interpreted health consultations, and multimodal interaction analysis is used to examine the participants' use of gaze in these interactions. The analysis demonstrates differences in eye contact that provide participants with access to different footings because of their language modalities and language knowledge. The mothers and the sign language interpreters take responsibility for the interaction when the health professional is unaware of the importance of a specific gaze in sign language. When taking responsibility, they shift between frontstage and backstage activity. In addition, the mothers do not have full access to the interaction, even with sign language interpreters present. The findings show that it is imperative that health personnel know how to communicate with deaf parents and how to work with sign language interpreters.

Speech language therapists (SLTs) are often challenged in their work with patients with different communication vulnerabilities. Even though SLTs are trained experts in communication, experiences from the field indicate that they often feel uncertain in interactions with multilingual patients and their families. This paper explores how language discordance between SLTs and multilingual parents influences regular institutional interaction. A discourse analysis is conducted on 33 authentic transcripts of specific discourse types between SLTs, parents, and their children within a multilingual constellation. Three emerging themes are discussed: (a) applied interactional strategies (b) involving the child in interaction and (c) addressing future parental engagement in therapy. By reconstructing discourse it is apparent that the knowledge of SLTs and parents does not always align, which influences the transfer of this knowledge, resulting in less achievement of interactional goals. When a language discordance is present, the participants have no equal access to interpretative processes in communication due to different linguistic and cultural frameworks, leading to less successful interactions and an asymmetrical relation between the participants. In successful interactions, alignment and shared decision-making are achieved through discourse by actively involving the patients and the parents, creating shared responsibility, and applying supportive communicative strategies for inclusive multilingualism.

One of the main, unsolved controversies that has developed throughout the COVID-19 emergency concerned the safety and multifaceted communication of its vaccine. Therefore, it represents an exemplary starting place for reflections on the linguistic and discursive strategies of medical risk and uncertainty communication enacted by authorities who must reassure and guide nonspecialists and professionals. The present study compares two institutions with differing communicative frameworks, i.e., the US Department of Defense, which follows a militaristic "natural objectivism" model implemented in the course of an emergency, and the World Health Organization (WHO), which raises ethical questions on the equity and humanitarian aspects of any vaccination delivery by means of a "cultural relativism" framework. The study makes use of two corpora consisting of various texts and documents (guides, press releases, memos, and frequently asked questions [FAQs]) from the two websites to examine their discursive and stylistic practices. The analysis begins with the multimodal risk communication presented in the two institutions' webpages on COVID-19 vaccines, complemented by a corpus stylistics and corpus-assisted discourse analysis on the aspects of storytelling, transparency, trust building, hedging, probability, and approximation. The study highlights, on the one hand, the DoD's confidence and continuous experience, but also its limited public information and, on the other hand, the WHO's transparency and trust engenderment, but also its emphasis on uncertainty. In conclusion, it argues and reflects on a possible convergence of the two approaches in providing reassuring and trustworthy health care communication in the face of uncertainty.

Disclosure of HIV status is critical for HIV prevention and control. However, although the benefits of HIV disclosure have received extensive documentation, the same cannot be said for its drawbacks. In the current study, we used a descriptive qualitative study design to highlight the implications of disclosure among 30 pregnant and postpartum women living with HIV in Uganda. We conducted a qualitative content analysis and found that healthcare professionals responded positively and supportively when HIV-positive pregnant and postpartum women disclosed their status, and that individuals who disclosed their status to their husbands but not to wider circles also experienced no mistreatment or discrimination. Contrarily, however, some husbands reacted unfavourably to their wife's HIV-positive status when a larger audience was involved in the disclosure. In particular, we discovered that co-wives and in-laws promoted stigmatization, including violence, by husbands. The interaction between these HIV-positive women and their mothers also demonstrated both positive and negative implications. This counterintuitive attitude has the consequence of reducing the uptake of antiretroviral drugs. There is therefore a need for policies and initiatives that not only encourage disclosure to health professionals, spouses and a few close relatives or friends but prevent stigmatization, violence and other forms of abuse against HIV-positive women.

This article presents a critical discourse analysis comparing linguistic representations of the public, experts, and politicians in UK newspaper reporting on COVID-19 policies. The analysis focuses on 120 articles published between 2020 and 2022, sourced from four national newspapers representing a cross-section of political leanings and formats. Quantitative and qualitative analyses of references and quotations suggest that the public is primarily represented as a collective entity, with functional references, rather than as distinct individual actors. Moreover, although the public is the most frequently mentioned among the groups considered, their engagement is mostly conveyed through emotional expressions of vulnerability, with little representation of individual voices. In contrast, politicians are depicted as individuals with far greater agency. Public health experts, meanwhile, are represented as having a marginal role in influencing policy decisions. The analysis of direct quotations carried in the media demonstrates that the stances expressed toward policies in such quotations consistently align with the ideological orientations of the newspapers across all three social groups. In newspapers with distinct left- or right-leaning perspectives, direct quotes tend to show greater levels of policy disagreement than in less ideologically polarised publications. Given that news discourse has been found to strongly influence public perceptions of public health policies, we suggest that the public might be better served by newspaper coverage of health crises that counters the trend of prioritising political biases over evidence-based conclusions. Moreover, featuring the perspectives of the public more prominently in such coverage might enhance positive policy engagement from some sections of the public.

In the last decade, a number of studies from medical sciences have analyzed data from the reviewing platform Yelp to explore patient satisfaction. Many of these have adopted a thematic analytic approach and have consistently found that patients tend to discuss nonclinical issues far more frequently than they do clinical issues. Specifically, patient narratives frequently mention interpersonal interactions and communications with physicians and staff. Our study builds on this scholarship by providing a more fine-grained discourse analysis of Yelp reviews in order to better understand the ways in which patients refer to their encounters and interactions with doctors, nurses, and staff members in a set of hospital reviews. Our analysis of 100 positive and negative reviews of 10 hospitals found that reviews were often written by family members on behalf of patients rather than by the patients themselves. In addition, reviewers were far more likely to name specific individuals in positive reviews; conversely, negative reviews featured more impersonal constructions. The study also found that different types of linguistic resources (i.e., adjectives versus verbs) were used by reviewers for positively evaluating physicians and nurses, respectively, and that negative reviews of physicians, nurses, and staff discussed a range of different communicative behaviors. Finally, our findings suggest that some complaints about hospital employees may, in fact, point to larger, organization-level problems.

To examine change in psychotherapeutic conversations, Conversation Analysis (CA) can be a powerful tool. The present study goes beyond previous studies for conducting a longitudinal analysis of psychotherapy by focusing on both conversational partners equally-the therapist and her interventions and the patient and her responses. Video recordings of sessions involving an entire outpatient psychodynamic psychotherapy in the German language serve as database. The analysis demonstrates evidence of change in the actions of both participants. The therapist, for example, changes her choice of words over the course of the therapy, indicating in later sessions that she relies on previous interventions and assumes that the patient has gained knowledge. In the first half of the therapy, the patient offers usually dispreferred responses. Toward the end of the therapy, she offers less dispreferred responses but still does not cooperate completely. This study shows how changes in both the therapist's interventions and the patient's responses can be recognized over the course of psychotherapy sessions, even if these changes are rather small.