Giving patients a voice in medical consultations and encouraging patient-centered communication are essential to improving the effectiveness and appropriateness of medical treatments. However, this is often difficult to achieve when patients are children, as paediatricians prefer to interact with parents and need parental consent. Drawing on a corpus of 12 authentic interactions recorded in an Italian diabetes outpatient clinic, this paper investigates the ways in which migrant children exercise agency and how this can be supported by paediatric diabetologists and sometimes by their parents. Adopting a discourse analysis approach, the paper identifies two ways in which children assert their agency by displaying epistemic authority, namely (1) by taking initiatives to trigger talk, and (2) by accepting the floor from other participants. Children's initiatives are produced that provide information, ask questions and sometimes contradict adults' utterances. Paediatricians usually support children's exercise of agency in such cases. Children's agency can also be promoted when children do not take the floor spontaneously but are encouraged to speak by pediatricians, who invite them to elaborate on their answers by using minimal positive feedback, by asking questions and by formulating and encouraging children's answers. The findings also show how parents' competition to take or hold the floor can hamper children's agency.
{"title":"Migrant children's epistemic authority in paediatric consultations.","authors":"Federica Ceccoli, Claudio Baraldi","doi":"10.3138/cam-19.3-0001","DOIUrl":"10.3138/cam-19.3-0001","url":null,"abstract":"<p><p>Giving patients a voice in medical consultations and encouraging patient-centered communication are essential to improving the effectiveness and appropriateness of medical treatments. However, this is often difficult to achieve when patients are children, as paediatricians prefer to interact with parents and need parental consent. Drawing on a corpus of 12 authentic interactions recorded in an Italian diabetes outpatient clinic, this paper investigates the ways in which migrant children exercise agency and how this can be supported by paediatric diabetologists and sometimes by their parents. Adopting a discourse analysis approach, the paper identifies two ways in which children assert their agency by displaying epistemic authority, namely (1) by taking initiatives to trigger talk, and (2) by accepting the floor from other participants. Children's initiatives are produced that provide information, ask questions and sometimes contradict adults' utterances. Paediatricians usually support children's exercise of agency in such cases. Children's agency can also be promoted when children do not take the floor spontaneously but are encouraged to speak by pediatricians, who invite them to elaborate on their answers by using minimal positive feedback, by asking questions and by formulating and encouraging children's answers. The findings also show how parents' competition to take or hold the floor can hamper children's agency.</p>","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":"19 3","pages":"207-220"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elisabet Cedersund, Anna Olaison, Susanne Kvarnström
Team meetings are central to social workers' decision-making practices. These meetings often function as a forum for collegial consultations, when applications are processed and recommendations on decisions are discussed. In this paper, we present findings from a case study on team talk and decision-making practices in gerontological social work. The data come from a body of material gathered within the framework of a larger project covering the process of assessing elder care for older persons in three Swedish municipalities. The case concerns an application, due to homelessness, from a couple for an apartment in special housing. The team meeting was analysed using a data-driven perspective within a micro-analytical approach to talk, focusing in detail on how conflicting perspectives in the assessment of the couple's needs are dealt with, and how tensions between divergent views and opinions are handled in relation to institutional and professional conversational frames. The findings show how the care managers (in Sweden the professional title for social workers working in elder care) negotiated the boundaries of responsibility and power within both the institutional and professional frames, revealing that the institutional frame dominated when it came to making decisions. The findings have implications for practice, as they give insight into the interactional dynamics involved in social workers' assessments when navigating different conversational frames within their decision-making practices.
{"title":"Tensions between institutional and professional frames in team talk in gerontological social work.","authors":"Elisabet Cedersund, Anna Olaison, Susanne Kvarnström","doi":"10.3138/cam.25959","DOIUrl":"10.3138/cam.25959","url":null,"abstract":"<p><p>Team meetings are central to social workers' decision-making practices. These meetings often function as a forum for collegial consultations, when applications are processed and recommendations on decisions are discussed. In this paper, we present findings from a case study on team talk and decision-making practices in gerontological social work. The data come from a body of material gathered within the framework of a larger project covering the process of assessing elder care for older persons in three Swedish municipalities. The case concerns an application, due to homelessness, from a couple for an apartment in special housing. The team meeting was analysed using a data-driven perspective within a micro-analytical approach to talk, focusing in detail on how conflicting perspectives in the assessment of the couple's needs are dealt with, and how tensions between divergent views and opinions are handled in relation to institutional and professional conversational frames. The findings show how the care managers (in Sweden the professional title for social workers working in elder care) negotiated the boundaries of responsibility and power within both the institutional and professional frames, revealing that the institutional frame dominated when it came to making decisions. The findings have implications for practice, as they give insight into the interactional dynamics involved in social workers' assessments when navigating different conversational frames within their decision-making practices.</p>","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":"19 3","pages":"221-240"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"‘But this is a wizardry something that has to be removed first’","authors":"Daniel Oluwafemi Ajayi","doi":"10.1558/cam.24273","DOIUrl":"https://doi.org/10.1558/cam.24273","url":null,"abstract":"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.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":"20 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141815603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Team talk and the evaluation of medical guidance documentation","authors":"K. N. Jenkings","doi":"10.1558/cam.25960","DOIUrl":"https://doi.org/10.1558/cam.25960","url":null,"abstract":"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.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":"52 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141654801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel G. A. Thompson, J. J. Nutor, Pascal Agbadi, E. Agbaglo, Geoffrey Anguyo
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.
公开艾滋病毒感染状况对于预防和控制艾滋病毒至关重要。然而，尽管披露艾滋病病毒感染情况的益处已经得到了广泛的记录，但其弊端却不尽相同。在本研究中，我们采用了描述性定性研究设计，以突出披露对乌干达 30 名感染 HIV 的孕妇和产后妇女的影响。我们对内容进行了定性分析，发现当 HIV 阳性的孕妇和产后妇女公开自己的身份时，医护人员会给予积极的回应和支持。然而，与此相反，当有更多的人参与披露时，一些丈夫对其妻子的艾滋病毒呈阳性反应并不积极。特别是，我们发现共同的妻子和姻亲助长了丈夫的污名化，包括暴力。这些艾滋病毒呈阳性的妇女与其母亲之间的互动也显示出积极和消极的影响。这种反直觉的态度会降低抗逆转录病毒药物的使用率。因此，有必要制定政策和举措，不仅鼓励向保健专业人员、配偶和少数近亲或朋友披露情况，而且要防止对艾滋病毒呈阳性妇女的侮辱、暴力和其他形式的虐待。
{"title":"Implications of HIV status disclosure","authors":"Rachel G. A. Thompson, J. J. Nutor, Pascal Agbadi, E. Agbaglo, Geoffrey Anguyo","doi":"10.1558/cam.24959","DOIUrl":"https://doi.org/10.1558/cam.24959","url":null,"abstract":"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.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141652712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elisabet Cedersund, Anna Olaison, Susanne Kvarnström
Team meetings are central to social workers’ decision-making practices. These meetings often function as a forum for collegial consultations, when applications are processed and recommendations on decisions are discussed. In this paper, we present findings from a case study on team talk and decision-making practices in gerontological social work. The data come from a body of material gathered within the framework of a larger project covering the process of assessing elder care for older persons in three Swedish municipalities. The case concerns an application, due to homelessness, from a couple for an apartment in special housing. The team meeting was analysed using a data-driven perspective within a micro-analytical approach to talk, focusing in detail on how conflicting perspectives in the assessment of the couple’s needs are dealt with, and how tensions between divergent views and opinions are handled in relation to institutional and professional conversational frames. The findings show how the care managers (in Sweden the professional title for social workers working in elder care) negotiated the boundaries of responsibility and power within both the institutional and professional frames, revealing that the institutional frame dominated when it came to making decisions. The findings have implications for practice, as they give insight into the interactional dynamics involved in social workers’ assessments when navigating different conversational frames within their decision-making practices.
{"title":"Tensions between institutional and professional frames in team talk in gerontological social work","authors":"Elisabet Cedersund, Anna Olaison, Susanne Kvarnström","doi":"10.1558/cam.25959","DOIUrl":"https://doi.org/10.1558/cam.25959","url":null,"abstract":"Team meetings are central to social workers’ decision-making practices. These meetings often function as a forum for collegial consultations, when applications are processed and recommendations on decisions are discussed. In this paper, we present findings from a case study on team talk and decision-making practices in gerontological social work. The data come from a body of material gathered within the framework of a larger project covering the process of assessing elder care for older persons in three Swedish municipalities. The case concerns an application, due to homelessness, from a couple for an apartment in special housing. The team meeting was analysed using a data-driven perspective within a micro-analytical approach to talk, focusing in detail on how conflicting perspectives in the assessment of the couple’s needs are dealt with, and how tensions between divergent views and opinions are handled in relation to institutional and professional conversational frames. The findings show how the care managers (in Sweden the professional title for social workers working in elder care) negotiated the boundaries of responsibility and power within both the institutional and professional frames, revealing that the institutional frame dominated when it came to making decisions. The findings have implications for practice, as they give insight into the interactional dynamics involved in social workers’ assessments when navigating different conversational frames within their decision-making practices.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":"82 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This interview represents an opportunity to take stock of the positioning of our discipline – broadly characterised as discourse / rhetoric / communication studies – in the context of healthcare education and practice, while at the same time exploring intersections between communication/discourse/rhetoric and ethics, through the discussion of what is articulated as the framework of ‘communication ethics’. More specifically, the notions of relationality and responsibility are alluded to as being the core of communication ethics – an effort to extend the notion of ‘communication expertise’, as outlined in previous research, as a necessary point of departure from the communication skills view which currently dominates healthcare education and practice. The interview was first published as ‘Communication skills, expertise and ethics in healthcare education and practice’, as part of a Special Issue titled ‘Rhetoric and Health’, Rivista Italiana di Filosofia del Linguaggio (RIFL) 15 (1): 106–122, https://doi.org/10.4396/2021060INT2
这次访谈提供了一个机会，让我们可以在医疗保健教育和实践的背景下，对我们的学科--广义上的话语/修辞/传播研究--的定位进行评估，同时通过对 "传播伦理 "框架的讨论，探索传播/话语/修辞与伦理之间的交叉点。更具体地说，"关系性 "和 "责任 "的概念被暗指为 "传播伦理 "的核心--正如以前的研究中所概述的那样，这是扩展 "传播专业知识 "概念的一种努力，是目前主导医疗保健教育和实践的传播技能观点的必要出发点。该访谈首次以 "医疗保健教育和实践中的传播技能、专业知识和伦理 "为题发表，作为题为 "修辞与健康 "的特刊的一部分，Rivista Italiana di Filosofia del Linguaggio (RIFL) 15 (1)：106–122, https://doi.org/10.4396/2021060INT2
{"title":"Communication skills, expertise and ethics in healthcare education and practice","authors":"Srikant Sarangi, Maria Grazia Rossi","doi":"10.1558/cam.24729","DOIUrl":"https://doi.org/10.1558/cam.24729","url":null,"abstract":"This interview represents an opportunity to take stock of the positioning of our discipline – broadly characterised as discourse / rhetoric / communication studies – in the context of healthcare education and practice, while at the same time exploring intersections between communication/discourse/rhetoric and ethics, through the discussion of what is articulated as the framework of ‘communication ethics’. More specifically, the notions of relationality and responsibility are alluded to as being the core of communication ethics – an effort to extend the notion of ‘communication expertise’, as outlined in previous research, as a necessary point of departure from the communication skills view which currently dominates healthcare education and practice.\u0000The interview was first published as ‘Communication skills, expertise and ethics in healthcare education and practice’, as part of a Special Issue titled ‘Rhetoric and Health’, Rivista Italiana di Filosofia del Linguaggio (RIFL) 15 (1): 106–122, https://doi.org/10.4396/2021060INT2","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":"406 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141028138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Doctor -couple interactions in the context of assisted reproductive medicine frequently include occurrences of laughter, especially patient-initiated. These have been examined in previous studies from a quantitative perspective and in relation to specific topics, but not as regards the functions that laughter realises throughout the interactions. Our study aims to address this underinvestigated issue by providing an analysis of a small sample of consultations (n = 10) about assisted reproductive technology (ART) treatments. The analysis is set within a discourse-interactional perspective on clinical interactions, which focuses on consultations as advice-seeking activities in which advice-giving is the main discourse type. The consultations have been analysed through structural mapping, which has revealed five main phases: opening, information sharing, problem identification, discussion of the options and closing. Laughter tokens have been identified and their functions are described from the point of view of an incongruity-based framework. The interactional functions of laughter described in this framework, e.g., 'marking incongruity', 'softening trouble-telling', 'showing sympathy', 'marking irony' etc., have then been mapped onto the different phases of the consultations, yielding a fine-grained description of when laughter occurs and what participants are using it for. Our study expands on previous analyses of laughter in ART consultations, offering a novel methodological approach that could be applied to larger corpora.
{"title":"Interactional functions of laughter in assisted reproductive medicine consultations.","authors":"Sarah Bigi, Amanda Tedone, Elena Vegni","doi":"10.1558/cam.25300","DOIUrl":"10.1558/cam.25300","url":null,"abstract":"<p><p>Doctor -couple interactions in the context of assisted reproductive medicine frequently include occurrences of laughter, especially patient-initiated. These have been examined in previous studies from a quantitative perspective and in relation to specific topics, but not as regards the functions that laughter realises throughout the interactions. Our study aims to address this underinvestigated issue by providing an analysis of a small sample of consultations (n = 10) about assisted reproductive technology (ART) treatments. The analysis is set within a discourse-interactional perspective on clinical interactions, which focuses on consultations as advice-seeking activities in which advice-giving is the main discourse type. The consultations have been analysed through structural mapping, which has revealed five main phases: opening, information sharing, problem identification, discussion of the options and closing. Laughter tokens have been identified and their functions are described from the point of view of an incongruity-based framework. The interactional functions of laughter described in this framework, e.g., 'marking incongruity', 'softening trouble-telling', 'showing sympathy', 'marking irony' etc., have then been mapped onto the different phases of the consultations, yielding a fine-grained description of when laughter occurs and what participants are using it for. Our study expands on previous analyses of laughter in ART consultations, offering a novel methodological approach that could be applied to larger corpora.</p>","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":"19 2","pages":"99-111"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Srikant Sarangi offers probing remarks about communication ethics and the relational aspects of the patient–clinician encounter. I am particularly intrigued by the attention he draws to persuasion and its legitimate role in the moral dynamic of decision making between patients and clinicians in healthcare.
{"title":"Persuasion in healthcare needs virtue, narrative and a relational concept of autonomy","authors":"L. Kaldjian","doi":"10.1558/cam.26268","DOIUrl":"https://doi.org/10.1558/cam.26268","url":null,"abstract":"Srikant Sarangi offers probing remarks about communication ethics and the relational aspects of the patient–clinician encounter. I am particularly intrigued by the attention he draws to persuasion and its legitimate role in the moral dynamic of decision making between patients and clinicians in healthcare.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140728243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Formulating problems in psycho-social rehabilitation","authors":"Chiara Piccini, Antonella Carassa","doi":"10.1558/cam.25958","DOIUrl":"https://doi.org/10.1558/cam.25958","url":null,"abstract":"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.\u0000The 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.\u0000The 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.\u0000In 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.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":"34 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140732376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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