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Social understanding of inattention 对注意力不集中的社会理解
Q4 Medicine Pub Date : 2024-01-16 DOI: 10.1558/cam.22379
Sara Vilar-Lluch
Inattention, one of the defining traits of Attention Deficit Hyperactivity-Impulsivity Disorder (ADHD), is occasionally perceived as less worrying than hyperactivity and impulsivity. However, those individuals who manifest it are often targets of negative misjudgements. This paper examines how the symptom of inattention is understood among three social groups with an active role in the ADHD diagnosis: the medical, the educational and the family communities. It pays particular attention to (1) similarities across the groups and (2) evaluations relating to the symptom. As datasets, for the medical community the study considers the section of the DSM-5 concerning ADHD; for the teaching community, educational guidelines; and for the family, forum threads retrieved from addforums.com. A qualitative linguistic analysis was performed for each dataset to examine the representation and evaluation of the behavioural trait. The analysis draws on Systemic Functional Grammar, including Appraisal. Inattention is consistently evaluated negatively in all three datasets, as impacting not only activities that require strong cognitive involvement, but also a wide range of ordinary activities. Differences in the representation of the symptom of inattention are explained by the pragmatic functions of the three textual genres examined.
注意力不集中是注意力缺陷多动障碍(ADHD)的显著特征之一,偶尔会被认为不如多动和冲动那么令人担忧。然而,那些表现出注意力不集中的人往往成为负面误判的目标。本文探讨了在多动症诊断中扮演积极角色的三个社会群体(医学界、教育界和家庭界)是如何理解注意力不集中这一症状的。本文特别关注:(1) 各群体之间的相似性;(2) 与该症状相关的评价。作为数据集,对于医学界,研究考虑了 DSM-5 中有关多动症的部分;对于教育界,研究考虑了教育指南;对于家庭,研究考虑了从 addforums.com 检索到的论坛主题。对每个数据集都进行了定性语言分析,以检查行为特征的表征和评价。分析借鉴了系统功能语法,包括评价。在所有三个数据集中,注意力不集中始终受到负面评价,不仅影响到需要强烈认知参与的活动,还影响到各种普通活动。所研究的三种文本体裁的语用功能解释了注意力不集中症状表征的差异。
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引用次数: 0
The role of electronic leaflets in improving access to medication-related information. 电子传单在改善获得药物相关信息方面的作用。
Q4 Medicine Pub Date : 2024-01-16 DOI: 10.1558/cam.20418
Anna Bryndís Blöndal, Einar Magnússon, Silvia Ravera

Background: Language discrepancies may create barriers to healthcare, compromise the quality of care and worsen health outcomes. This study explored what European countries currently do to ensure that foreign patients receive sufficient information about their medications if they do not understand the country's national language.

Methods: A questionnaire was distributed to the delegates of two Council of Europe committees. The recipients were asked to provide insights on how their country facilitates access to the necessary product information when patients do not understand the national language.

Results: Seventeen out of 39 delegates completed the questionnaire. The majority of the respondents indicated that all healthcare professionals experience difficulties in providing guidance and advice to foreign patients. The results also showed that different methods are used nationally to present the necessary information to foreigners. Finally, the observations from this survey suggested that electronic leaflets in the patient's primary language could be a valuable option to improve access to medication-related information.

Conclusions: Healthcare professionals seem to encounter challenges in providing foreign patients with information associated with medication use. Electronic leaflets can be one of the tools for improving communication between these patients and healthcare professionals to ensure that medicines are used safely and effectively.

背景:语言差异可能会对医疗保健造成障碍,损害护理质量并使健康结果恶化。这项研究探讨了欧洲国家目前如何确保外国患者在不懂本国语言的情况下获得有关其药物的充分信息。方法:向欧洲理事会两个委员会的代表分发问卷。受助人被要求提供见解,说明在患者不懂本国语言的情况下,他们的国家如何为获取必要的产品信息提供便利。结果:39名代表中有17人完成了问卷调查。大多数答复者表示,所有保健专业人员在向外国病人提供指导和建议方面都遇到困难。研究结果还表明,各国在向外国人展示必要信息时采用了不同的方法。最后,这项调查的观察结果表明,以患者的主要语言制作的电子传单可能是一个有价值的选择,可以改善获得药物相关信息的途径。结论:医疗保健专业人员在向外国患者提供与药物使用相关的信息时似乎遇到了挑战。电子传单可以成为改善这些患者与卫生保健专业人员之间沟通的工具之一,以确保安全有效地使用药物。
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引用次数: 0
Individuals recording clinical encounters. 个人记录临床接触。
Q4 Medicine Pub Date : 2024-01-16 DOI: 10.1558/cam.20257
Glyn Elwyn, Jaclyn Engel, Peter Scalia, Carmel Shachar

Background: Clinicians and their employers, concerned with privacy and liability, are often hesitant to support the recording of clinical encounters. However, many people wish to record encounters with healthcare professionals. It is therefore important to understand how existing law applies to situations where an individual requests to record a clinical encounter.

Methods: We searched for and reviewed relevant legal documents that could apply to recording clinical encounters. We limited the scope by purposefully examining relevant law in nine countries: Australia, Brazil, Canada, France, Germany, India, Mexico, the United Kingdom and the United States. We analyzed legal texts for consents needed to record a conversation, whether laws applied to remote or face-to-face conversations and penalties for violations.

Findings: Most jurisdictions have case law or statutes, derived from a constitutional right to privacy, or a wiretapping or eavesdropping statute, governing the recording of private conversations. However, little to no guidance exists on how to translate constitutional principles and case law into advice for people seeking to record their medical encounters.

Interpretation: The law has not kept pace with people's wish to record clinical interactions, which has been enabled by the arrival of mobile technology.

背景:临床医生和他们的雇主,关心隐私和责任,往往犹豫是否支持记录临床遭遇。然而,许多人希望记录与医疗保健专业人员的接触。因此,了解现行法律如何适用于个人要求记录临床遭遇的情况是很重要的。方法:检索并查阅可用于记录临床接触的相关法律文件。我们有目的地考察了澳大利亚、巴西、加拿大、法国、德国、印度、墨西哥、英国和美国这九个国家的相关法律,从而限制了范围。我们分析了记录对话所需的同意的法律文本,法律是否适用于远程或面对面的对话,以及对违规行为的处罚。调查结果:大多数司法管辖区都有判例法或成文法,源自宪法隐私权,或窃听或窃听法规,对私人谈话的录音进行管理。然而,关于如何将宪法原则和判例法转化为为寻求记录其医疗经历的人提供的建议,几乎没有任何指导。解读:由于移动技术的到来,人们希望记录临床互动,而法律并没有跟上这种愿望的步伐。
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引用次数: 0
Subliminal linguistic effects in dementia interaction 痴呆症互动中的潜意识语言效应
Q4 Medicine Pub Date : 2023-12-27 DOI: 10.1558/cam.26767
J. Chatwin, A. Capstick, Katherine Ludwin
Subliminal linguistic effects occur when words or phrases that are overheard by an interlocutor become subconsciously assimilated into their ongoing talk. Such effects are a common feature of everyday interaction. Yet by their nature they are ephemeral, extremely difficult to capture empirically and have not previously been studied at the micro-interactional level. However, broader ethnographic observations made in dementia care settings appear to indicate that subliminal linguistic effects are operationalised differently in people who have dementia, when compared to those without cognitive problems. This exploratory study focuses on over 200 hours of naturalistic multiparty field recordings collected in two UK dementia care settings. It utilises conversation analysis (CA) to examine the reproduction of naturally occurring subliminal linguistic effects in the speech and communication patterns of people with dementia and provides the first systematic micro-analysis of the phenomenon. The position of subliminal linguistic effects in relation to existing sociolinguistic research on overhearing and repetition and the role that features such as intonational emphasis may play in generating subliminal cues are discussed. The study confirms that it is possible to capture examples of subliminal linguistic effects in naturalistic settings and that there are potentially a number of micro-interactional features associated with the phenomenon in dementia communication which could form the basis of a novel, non-intrusive measure of cognitive impairment.
当对话者无意中听到的单词或短语潜移默化地融入他们正在进行的谈话时,就会产生潜意识语言效应。这种效应是日常互动的常见特征。然而,就其本质而言,它们是短暂的,极难用经验来捕捉,而且以前从未在微观互动层面对其进行过研究。然而,在痴呆症护理环境中进行的更广泛的人种学观察似乎表明,与没有认知问题的人相比,痴呆症患者的潜意识语言效应在操作上有所不同。这项探索性研究的重点是在英国两个痴呆症护理机构中收集到的 200 多个小时的多方自然现场录音。它利用会话分析法(CA)研究了痴呆症患者的言语和交流模式中自然出现的潜意识语言效应的再现,并首次对这一现象进行了系统的微观分析。本研究讨论了潜意识语言效应与现有社会语言学研究中关于偷听和重复的关系,以及语调强调等特征在产生潜意识线索中可能扮演的角色。研究证实,在自然环境中捕捉潜意识语言效应的例子是可能的,而且在老年痴呆症的交流中,有可能存在一些与潜意识语言效应现象相关的微观互动特征,这些特征可以构成一种新颖的、非侵入性的认知障碍测量方法的基础。
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引用次数: 0
On knowing what you do (not) know 关于了解你所不知道(不知道)的事情
Q4 Medicine Pub Date : 2023-12-22 DOI: 10.1558/cam.26707
Marilize Pretorius
Overseas educated nurses’ (OENs) professional identity becomes threatened when limited communicative competence in the local language of their host country results in communication problems. While training is essential for increasing OENs’ communicative competence, their own perceptions of their competence should not be neglected. This article focuses on the impact of an English-language training programme on the self-perceived communicative competence of OENs (n = 68) in the United Kingdom. The effects of the training on their actual and self-perceived communicative competence, comprising competence in Task Focus (TF) and Rapport Building (RB), was examined using quantitative analysis based on pre- and post-training questionnaire and test data. It was found that there was a significant increase in the OENs’ self-perceived communicative competence from pre- to post-training. Further, Actual Task Focus (ATF) and Perceived Task Focus (PTF) competence correlated before and after training, whereas Actual Rapport Building (ARB) competence and Perceived Rapport Building (PRB) competence were not correlated before training, but did correlate after training. The pre-training lack of correlation seems to be due to an overestimation of competence. In sum, participants formed more accurate perceptions of their ARB competence through training. The results hold implications for developing OENs’ accommodative competence.
受过海外教育的护士(OENs)在东道国当地语言方面的沟通能力有限,导致沟通出现问题,其专业身份就会受到威胁。虽然培训对提高海外护士的交际能力至关重要,但也不应忽视他们自己对自身能力的看法。本文重点研究了英语培训项目对英国外籍人员(68 人)自我认知的交际能力的影响。通过对培训前后的问卷和测试数据进行定量分析,研究了培训对他们实际交际能力和自我认知交际能力(包括任务焦点(TF)和建立亲和力(RB)的能力)的影响。结果发现,从培训前到培训后,网络教育学院学生的自我认知交际能力有了显著提高。此外,实际任务焦点(ATF)和感知任务焦点(PTF)能力在培训前后存在相关性,而实际融洽关系建立(ARB)能力和感知融洽关系建立(PRB)能力在培训前不存在相关性,但在培训后存在相关性。培训前缺乏相关性似乎是由于学员高估了自己的能力。总之,通过培训,学员对自己的 ARB 能力形成了更准确的认知。这些结果对提高开放教育工作者的适应能力具有重要意义。
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引用次数: 0
The relationship between facilitating emotional cues and medical students' clinical communication performance in qualifying exams. 促进性情绪线索与医学生资格考试临床沟通表现的关系。
Q4 Medicine Pub Date : 2023-07-06 DOI: 10.1558/cam.21492
Peter Leadbetter, Ian Fletcher, Helen O'Sullivan

A cross-sectional study design explored the relationship between medical students' Objective Structured Clinical Examination (OSCE) clinical communication ratings and their responsiveness to simulated patient (SP) verbal emotional cues in their qualifying OSCE. Data were collected from two cohorts of fourth-year medical students (n = 37), and responses to patient cues that facilitated further disclosure or related discussion - known as provide space responses - from two OSCE communication stations were measured by coding video footage with the Verona Coding Definition of Emotional Sequences (VR-CoDES). The 37 medical students were representative of the larger cohort (n = 508) in terms of age. A significant positive correlation with a medium effect was found between OSCE clinical communication ratings and provide space responses. OSCE clinical communication ratings could differentiate between students who adopted patient-centred facilitative behaviours and those who did not.

本研究采用横断面研究设计,探讨医学生客观结构化临床检查(OSCE)临床沟通评分与模拟病人(SP)言语情绪线索反应的关系。从两组四年级医学生(n = 37)中收集数据,并通过使用维罗纳情感序列编码定义(VR-CoDES)对视频片段进行编码来测量来自两个欧安组织通讯站的对患者提示的反应,这些提示有助于进一步披露或相关讨论(称为提供空间反应)。37名医学生在年龄方面代表了更大的队列(n = 508)。欧安组织临床沟通评分与提供空间反应之间存在显著的正相关。欧安组织临床沟通评分可以区分采用以病人为中心的促进行为的学生和没有采用的学生。
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引用次数: 0
'One size does not fit all' in organ donation and transplantation. 在器官捐赠和移植领域,“一刀切”是行不通的。
Q4 Medicine Pub Date : 2023-07-06 DOI: 10.1558/cam.21434
Alessandra Agnese Grossi, David Paredes, Vijayanand Palaniswamy, Nichon Jansen, Mario Picozzi, Gurch Randhawa

With increasing immigration to Europe, migrants and ethnic minorities (MEMs) are progressively represented on transplant waiting lists. However, they remain underrepresented among the pools of both deceased and living donors (LD). Further, studies report inferior knowledge and/or understanding of organ donation and transplantation among these populations, with the potential for detrimental impacts on accessibility, quality and outcomes of care. The ethnic and cultural diversity characterising European societies poses additional challenges to the complexity inherent to communication in transplant settings. This study addresses the ethical, theoretical and practical implications of targeting/tailoring interventions for MEM populations in the transplant continuum. It puts forward a call for action on the emergent issue of how institutional actors and healthcare professionals should interact more effectively with MEM publics, potential donors and/or their families and MEM transplant candidates/recipients/LDs.

随着越来越多的移民到欧洲,移民和少数民族(MEMs)越来越多地出现在移植等候名单上。然而,他们在已故和活体捐赠者中所占比例仍然不足。此外,研究报告称,这些人群对器官捐赠和移植的知识和/或理解不足,可能对护理的可及性、质量和结果产生不利影响。欧洲社会的种族和文化多样性特征对移植环境中固有的沟通复杂性提出了额外的挑战。本研究探讨了针对移植连续体中MEM人群的靶向/定制干预的伦理、理论和实践意义。它呼吁就机构行为者和保健专业人员如何更有效地与MEM公众、潜在捐赠者和/或其家属以及MEM移植候选人/接受者/ ld进行互动这一紧急问题采取行动。
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引用次数: 0
Anticipated shame and professional identity formation. 预期羞耻与职业身份形成。
Q4 Medicine Pub Date : 2023-07-06 DOI: 10.1558/cam.21481
Penelope Lusk

Developing a professional identity in physicians-in-training is a central, but contested, outcome of medical education. In recent years scholars have argued for the importance of including affective experiences, especially shame, in the discourse around medical training. This discourse reflects projection and anticipation around both shame and professional identity, and the question of how shame impacts the latter is critical. Shame is an affect that arises when the self is confronted by the gaze, judgment or awareness of an Other; it can have profound impacts on identity and self-concept, and is highly prevalent in medicine and healthcare. This article posits 'anticipated shame' as a potent factor implicit in the experience of developing a medical professional identity, and connects shame to stigma and marginalization in medical training. Shame, and the anticipation of shame in student-teacher and trainee-patient interactions, highlights aspects of interpersonal communication within medical training and then practice. The concept of anticipated shame offers rich ground to theorize the effects of affect in medical education, and how trainees internalize medical cultural values and then enter the field of clinical practice.

培养培训医师的职业身份是医学教育的核心,但也有争议。近年来,学者们一直认为,在医学培训的讨论中,包括情感体验,尤其是羞耻,是很重要的。这种话语反映了围绕羞耻和职业身份的投射和预期,羞耻如何影响后者的问题至关重要。羞耻感是当自我面对他人的注视、评判或意识时产生的一种情绪;它可以对身份和自我概念产生深远的影响,并且在医学和医疗保健中非常普遍。这篇文章假设“预期羞耻感”是一个潜在的因素,隐含在发展医学专业身份的经历中,并将羞耻感与医学培训中的耻辱和边缘化联系起来。羞耻感,以及在学生与老师和实习生与病人的互动中对羞耻感的预期,突出了医学培训和实践中人际沟通的各个方面。预期羞耻的概念为情感在医学教育中的作用提供了丰富的理论依据,也为学员如何内化医学文化价值观进而进入临床实践领域提供了理论依据。
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引用次数: 0
Dental professionals' role perceptions in relation to periodontal (gum) disease explanations. 牙科专业人员在牙周(牙龈)疾病解释中的角色认知。
Q4 Medicine Pub Date : 2023-07-06 DOI: 10.1558/cam.20929
Marion C Bowman, Isobel Sale, Ruth Payne, Karen Vinall-Collier, Aradhna Tugnait

Objective: To use a discourse analysis approach to identify salient features in the lived experiences of dental professionals in relation to explaining periodontal (gum) disease to patients.

Methods: Interview data from 13 UK-trained and three internationally-trained dental professionals was examined using thematic discourse analysis. The first stage (discourse analysis) focused on the identification of language patterns in the interview data. This stage forms the focus of this paper.

Findings: Six discourse categories (Clinician, Mentor, Educator, Collaborator, Rapport Builder, Professional) were identified that related to the participants' perceived professional roles. The categories were associated with differing worldviews and language use patterns, but with some overlap. All interviewees used a variety of discourse categories in their accounts, but a few relied predominantly on one category, e.g., Clinician or Mentor.

Conclusions: The local discourse categories identified in this study reflect broader discourses in healthcare relating to the roles of providers and patients, which have evolved through time.

Practice implications: Practising dental professionals are faced with a diverse range of patients who have different communication preferences. A suite of discourse categories can act as a 'toolbox' that dental professionals can flexibly draw on when needing to adopt a role that could predispose a particular patient to positive oral health behaviour change.

目的:使用话语分析方法来识别与向患者解释牙周(牙龈)疾病有关的牙科专业人员生活经历的显著特征。方法:采用主题语篇分析对13名英国培训和3名国际培训的牙科专业人员的访谈数据进行检查。第一阶段(语篇分析)侧重于识别访谈数据中的语言模式。这一阶段构成了本文的重点。研究发现:六个话语类别(临床医生、导师、教育者、合作者、融洽建设者、专业人士)与参与者感知到的专业角色有关。这些分类与不同的世界观和语言使用模式有关,但也有一些重叠。所有受访者在他们的叙述中都使用了各种话语类别,但少数人主要依赖于一个类别,例如,Clinician或Mentor。结论:本研究中确定的本地话语类别反映了医疗保健中与提供者和患者角色相关的更广泛的话语,这些话语随着时间的推移而演变。实践意义:执业牙科专业人员面临着不同范围的患者谁有不同的沟通偏好。一套话语类别可以作为一个“工具箱”,牙科专业人员在需要采取一种可能使特定患者倾向于积极口腔健康行为改变的角色时,可以灵活地利用它。
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引用次数: 0
Editorial. 社论。
Q4 Medicine Pub Date : 2023-07-06 DOI: 10.1558/cam.26459
Srikant Sarangi
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引用次数: 0
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Communication and Medicine
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