Communication and Medicine最新文献

This article examines instructions on the handling of medicines produced by a Finnish hospital pharmacy from the perspectives of two reader concepts: the model reader and the reader-in-the-text. The former comprises virtually all the medical professionals working in diverse wards, and two group interviews with hospital pharmacists are used to explore how instruction writers orientate to this versatile readership and construct model readers. The concept of "reader-in-the-text" is then used to examine 22 instruction texts from the perspective of textual interaction. The analysis reveals that the writers construct an "official" model reader, who is anyone working in healthcare, but also that more informal, profession-specific model readers are introduced. The official model reader is reflected in the text documents as a collection of impersonal features and term explanations. What is required from the reader-in-the-text to navigate the instructions successfully is background knowledge of the organizational division of labor.

This paper explores the intersection of science and pseudoscience in online discourse about detoxification, investigating how and to what extent they coexist on the web. Drawing on previous studies of internet health scams, it examines the discursive strategies used to either validate or refute alternative detox treatments. Using a corpus-assisted discourse studies approach, the study analyses a corpus of texts (167,177 tokens) about detoxification randomly collected from the web. The results show that corrective messages debunking the detox myth make up less than 10% of the corpus. Furthermore, many keywords in the corpus, such as "toxin(s)," are subject to constant renegotiation. Advocates of alternative medicine use the term "toxin(s)" to justify detox treatments, while scientists criticize it as pseudoscientific. The study highlights how terminological ambiguity facilitates the mixing of science and pseudoscience, confusing readers. It also highlights the role of language in health-related misinformation and calls for interdisciplinary research to develop educational tools for health professionals.

Drawing on a subset of the research data from the Queer Queering and Questioning (QQQ) project, a qualitative study examining patient and provider perceptions of good-quality healthcare for people who identify themselves as 2SLGBTQI+ (Two Spirit, Lesbian, Gay, Bisexual, Trans, Queer/Questioning and/or Intersex+), this paper explores the significance of nonverbal communication in shaping healthcare experiences for 2SLGBTQI+ patients. Using data from 68 individual interviews and 11 focus groups, constructivist-grounded theory approaches, including reflexive thematic coding and continuous coding, were used to reveal the effects of unconscious nonverbal communication on patients' experiences. The analysis of the participant narratives suggests that greater attention to communication skills and critical reflexivity in health professional education and training would improve the patient experience by supporting healthcare professionals to manage unconscious responses and by providing professionals with better knowledge and resources to care for the needs of 2SLGBTQI+ patients. Attention to the clinical space and the design of physical environments to demonstrate knowledge, care, and concern for 2SLGBTQI+ patients would also enhance positive outcomes.

At present, doctor-patient communication is undergoing significant transformation due to digital technologies. The rise of the internet, social media, and digital tools that support medical purposes requires that doctors have new skills. This study presents the experiences of a new course for undergraduate medical students at the University of Pécs Medical School in Hungary. The course endeavors to demonstrate the internet's impact on the doctor-patient relationship by giving medical students the opportunity to practice communication strategies with 'Google patients' and e-patients, and use telemedicine in simulation-based training. We also explain how simulated patient consultations and feedback are incorporated into the curriculum and the methods used to prepare the students for these interactions. We explored the students' evaluations with the help of a course feedback questionnaire and written reflective essays. Based on the responses, students were satisfied with the training content and found the course innovative and relevant in the post-pandemic period. They highlighted the novel combination of theoretical teaching with simulation training and emphasized the need for practice in the field.

This article presents a study on team talk in psychosocial rehabilitation with reference to collective decision making. It focuses on problem formulation processes that occur during weekly team meetings in a Swiss organization providing psychosocial rehabilitation to chronic mental health patients. The corpus of team meetings (34 hours of recorded talk) was analyzed along three narrative dimensions: participation framework, timeline organization and forms of evaluation. The analysis was supported by ethnographic information (field notes collected during participant observation over ten months), in order to access the local conception and organization of rehabilitation work, which is repeatedly referred to and reshaped through discourse. The discursive practices identified show that team members learn to formulate problems in a way that allows them to identify and plan interventions in line with their rehabilitation model and the actual opportunities they have. Further, the role-related forms of participation highlight how different professionals contribute to the problem formulation in specific ways. In sum, the interaction turns out to be strongly centralized around the role of a meeting coordinator, who is able to enhance the participation of the other team members and to build institutional narratives on the basis of individual contributions, carrying out discursive work that can be metaphorically described as the weaving and knotting threads that make up a tapestry.

Sickness does not involve just the human body but also has a psychological dimension, and a number of studies have identified the positive psychological potential of self-help books in relation to illness. This paper examines metaphorical mappings employed in describing cancer patients in self-help books, undertaking a comparison of an American and a Nigerian work and identifying new categorisations and highlighting their therapeutic potential. It seeks to answer the following questions: what new metaphorical categories can be identified in Nigerian and American self-help books?; what therapeutic potential do they have?; and what similarities/differences can be identified in these self-help books? The sample size is 102 self-help stories, of which 24 instances were considered relevant for close analysis. This study adopts the Conceptual Metaphor Theory (CMT) approach and employs the Metaphor Identification Procedure (MIP) and methodologies concerned with the comparison and categorisation of metaphoric membership. The findings focus on four metaphorical categories: military, journey, personification and sports. The difference between the Nigerian and American self-help books lies in the contextualised manner of metaphorical presentation. In particular, the findings highlight sports metaphors in the American books as possessing more therapeutic tendencies due to the presence of humour, trivialisation, self-deprecation and satire. This category reflects that humour can ease stress and anxiety/panic and aid relaxation.

In Nigeria, diagnoses of schizophrenia and descriptions of its symptoms and experiences are shaped by numerous biomedical and sociocultural perspectives. However, although many studies have focused on the social realities and public attitudes towards the disorder, the interactional means of how its diagnoses and experiences are constituted in psychiatric interviews have not hitherto received close attention from linguists in Nigeria. This paper thus examines a corpus of 56 audio recorded interviews in mental health clinics in southwestern Nigeria, using insights from Arundale's concept of communicating and relating and Stalnaker's notion of common ground. It observes that diagnoses of the disorder do not subscribe to any rigid diagnostic pathways, but evolve from the relational, provisional and operative interpretation of the design of its experiences and other shared contextual situations that collectively instantiate the knowledge of mental illness in Nigeria.

This article looks at team talk in a validation committee meeting assessment of a guidance document text item. The item assessment was not evidence-based in terms of Evidence Based Medicine (EBM) criteria; instead, the item was assessed via the committee members present drawing on their clinical practitioner members' knowledge and professional experience. Analysis of the meeting reveals such apparently 'mere opinion' to be a systematic evaluation of professional knowledge and personal experiences, in ways 'compatible' with thought experiments. Thought experiments are argued to be a members' resource as well as an analyst's one, although their detailed occasionedness is not reducible to a constructivist formalisation. The article's approach is informed by ethnomethodology and conversation analysis, and while the use of thought experiments as a heuristic device in the analysis is controversial, a warrant for this is attempted. The research was undertaken to locate ways of understanding and supporting team members' work of robust and useful guidance content production. 'Validating' guidance is shown in-and-as the emergent collaborative work of the committee members themselves.

Medical humour within the medical community is a diverse and contextualised phenomenon that includes 'difficult' material that is cognitively challenging to non-insiders. This paper addresses the under-researched topic of medical students' humour and its link to medical identity formation, by exploring how the humour preferences of medical students from different cohorts regarding medical memes reflects changes in their medical identity at different stages of their studies. A total of 216 medical students rated 50 medically related memes of different difficulty levels targeting doctors, patients, students and other medical issues. The results reveal that when comparing cohorts earlier in their studies vs. later on, doctor- and student-targeted memes become less and less popular while the popularity of memes about patients and other medical issues remain stable. Overall, students find memes about doctors the least funny. Simple memes also were funnier for students early in their studies compared with those approaching graduation. Our findings indicate that students most strongly identify with student and doctor memes, as these concern their current and future selves most strongly. The fact that medical identity plays a significant role in medical humour preferences may indicate that students find insider humour emotionally bonding. Our study also shows the emotional influence of humour processing (represented by targets) can have a greater impact on students' humour preferences than the cognitive aspect (represented by difficulty levels).