Communication and Medicine最新文献

COMET 2021 Researcher Award This paper presents a discourse analysis of the public's response to UK press coverage of the debate surrounding the measles, mumps and rubella (MMR) vaccine and its alleged link to autism from 1998 to 2019. The analysis focuses on published readers' letters to the editor in a newspaper corpus comprising 12 national British newspapers, and on comments posted by users on the Guardian's and the Daily Mail's Facebook pages. These social media pages are dialogic sites of individual participation that allow users to discuss how the latest events and debates affect their daily lives, as well as how they interpret them through their own ideological, cultural, social and personal lenses. The findings show that medico-scientific issues such as vaccination are often personalised by the parents and legal guardians of young children, and that they regard individual experiences with vaccination or with vaccine-preventable diseases as valid evidence on which to base their argumentation. The findings thus highlight the need to devise effective communication to foster the science of vaccines and to counter vaccine hesitancy without belittling a person's genuine experiences and sincere beliefs.

This exploratory study analyses studies pertaining to the risk communication strategies adopted by Spanish public hospitals to inform their stakeholders during the first COVID-19 wave, in order to better understand effective communication of 'health messages' during a pandemic. After reviewing 155 academic works, 12 articles that were published between January 2020 and September 2020 met full inclusion criteria. Implementing a thematic synthesis approach yielded five themes: (1) transparency of crisis; (2) hospital health leadership crisis; (3) crisis management communication; (4) crisis management strategy; and (5) crisis management stakeholders. Based on these identified themes, 10 evidence-based recommendations for hospital communication preparedness and implementation during health crises are offered.

Prolonged pause duration in speech is a typical phenomenon of schizophrenia. Despite this, however, studies have not previously focused on prolonged pause in clinical diagnostic interviews, nor has there been any consideration of whether silences occur within turns or in turn-transitions. The present study is based on videotaped semi-structured clinical diagnostic interviews with three persons with schizophrenia. We measured duration of silence or overlap in every turn-transition using Praat software. The participants differed considerably from each other. All of them seemed to display more delays in responding to manual-based questions taken from the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) and to questions concerning supra-categories and proverbs. Qualitative analysis of the interview with the most dysfluent participant showed that topic-shifting and new-sequence-beginning questions caused more prolonged latencies than sequence-continuing questions. Moreover, questions that required more detailed description or reflection of psychotic experiences seemed to be problematic. We observed that the doctor adapted his tempo to the participant's fluency. In addition, the doctor often produced expansions or tag questions when he noticed that the participant had difficulties in responding without a latency. Based on the measures and findings of the qualitative analyses, we presume that both individual psychopathology and contextual factors affect turn-transitional response patterns.

The aim of this study is to describe the communicative strategies nurses and patients use on a micro level to ensure patient understanding during discharge discussions. The data of the study consist of 16 videotaped discharge encounters (total duration 1 h 40 mins) between nurses and patients in Finland, which were analyzed using conversation analysis. The findings reveal that patients express understanding or troubles in understanding by subtle means, such as response particles. Nurses monitor patients' reactions and adapt their subsequent actions to them, for instance by moving on to the next topic or by giving additional explanations. They also pursue expressions of understanding when needed, e.g., by prolonging the topic. This gives the patient time to react and more material to get a grip on the topic, thus facilitating displays of understanding. As a result, even if the discharge discussions consist mostly of information delivery that resembles a monological practice, the interaction is collaboratively constructed to secure patient understanding. A raised awareness of good practices already in use to secure understanding can contribute to further developing the guidelines for discharge education.

Electronic communication between patients and general practitioners (GPs), known as e-consultations, was introduced in Denmark as a cost-effective and convenient means for patients to access their GP and receive test results as well as answers to quick questions. Research on e-consultations internationally has found that patients are generally very positive, while doctors are more hesitant. Most studies of e-consultations have involved survey or interview methodologies, while studies of their content, form or language are limited. In this study, we address this gap by proposing that genre may be a productive concept for comprehending textual aspects of e-consultations. We explore the following two questions: (1) what are the generic characteristics of the e-consultation?; and (2) do e-consultations belong to the email genre? Based on an analysis of two Danish corpora of patients' first turns in e-consultations with their GPs, we identify an underlying move structure: subject, opening, update, problem presentation, request, argumentation, closing. We argue that the e-consultation is an example of an email genre with identifiable conventions, which are both specific to the communicative function of e-consultations and aligned with generic features of emails.

Thoughtful, high-quality clinician-patient communication about starting antiretroviral therapy (ART) is a cornerstone of HIV care, and specific guidelines regarding exactly what ought to be discussed with patients considering ART have been in place since 2006. The extent to which the recommended topics are discussed and how these topics are addressed in observed dialogue in HIV care has not been studied. We conducted a content analysis to describe how these dialogues occur and, secondarily, assessed the frequency with which the recommended topics are discussed. Our study analyzed patient-clinician dialogue regarding ART initiation, comparing the content of 24 audio-recorded dialogues with the recommended guidelines, and describing how communication about the recommended topics takes place. While patient readiness to initiate therapy was discussed in the majority of visits (n = 18), the remaining topics (e.g. patient understanding of HIV and its treatment, motivation to adhere, barriers to and facilitators of adherence, social support, daily schedules, tolerance of pills) were discussed less often. Based on the findings, we suggest that systems be put in place (e.g. checklists) to guide providers in these discussions, and that providers utilize the teach-back method to ensure patient understanding.

Before the COVID-19 pandemic, many medical providers (MPs) turned to social media platforms as an opportunity to interact with colleagues and provide education to patients. When the pandemic flooded social network services (SNSs), such as Facebook, with a great deal of information, both accurate and dubious, MPs continued using SNSs to share information and updates about the infodemic (as defined by the World Health Organization). This study explores how MPs engaged in education and advice giving on Facebook during the early months of the pandemic. For this study, a total of 572 Facebook posts about COVID-19 were collected from the Facebook pages of three medical doctors between 1 January and 15 July, 2020. A total of 79 posts were analyzed, focusing on how advice was discursively constructed. The strategies analyzed included creating a light-hearted tone through moments of levity and making advice more indirect through pronoun shifts and framing devices. We argue that medical providers likely soften the force of advice because of the public/professional confluence that exists on Facebook; this approach may also make the advice more palatable. This study highlights possible implications for current MPs and aid in their overall training.

There is a general assumption that, in the hospital setting, standard surgical masks, unlike transparent masks, prevent effective communication with the hearing-impaired. This study investigates the experience of healthcare professionals (HPs) and hearing-impaired patients using a transparent surgical mask vs. a standard surgical mask in an acute care hospital. Our study design used a cross sectional, mixed-methods survey of 25 adult hearing-impaired patients/visitors and 36 HPs caring for them while wearing a transparent mask. The results demonstrated that 89% of staff and 76% of patients said the mask improved communication. This improvement was due to better ability to interpret nonverbal cues, which led to less need for repetition or volume increase. It was found that 69% of staff said the mask was comfortable and 81% were satisfied; 64% of patients liked being able to see facial expressions of the person wearing the mask; 72% of patients felt more connected to, and 76% understood the speech of, the person using the mask; and 80% of patients and 78% of staff preferred the transparent mask. The findings suggest that hospital staff/providers should use a mask with a clear window around the mouth and face while caring for hearing-impaired patients. This may improve patient satisfaction and prevent errors that are due to miscommunication.

Interpreting is increasingly being used in psychotherapy, but the presence of an interpreter in the therapeutic encounter is an under-researched area. This paper examines interpreter-mediated trauma therapy with Danish-speaking therapists treating Arabic-speaking patients diagnosed with post-traumatic stress disorder (PTSD). We focus on the notion of 'emotion discourse' as a broad term covering how therapists and patients talk about emotional experience, and how interpreters negotiate and mediate it. The data consist of three group interviews with ten therapists and six excerpts from two audio-recorded interpreter-mediated therapy sessions. The detailed interaction analysis explores (1) the therapists' expectations about interpreting emotion discourse and (2) the interactional strategies that the interpreters use to negotiate and render the interaction between therapists and patients who speak different languages. The findings show that the therapists have clear expectations about what needs to be translated and how, but these expectations remain hidden to the interpreters. The interpreters use various interpreting strategies and orient towards meaning rather than towards verbatim translations. We conclude by recommending that both therapists and interpreters engage in a professional collaboration that requires not only training and awareness of mutually relevant information, but also an updated view of interpreter-mediated interaction as a dynamic collaborative process.

Fiction is understood to have unique qualities that emotionally engage the reader, making it suitable as a didactic tool in medical education to help students prepare for the emotional aspects of their future profession. To date, however, little is known about the processes through which talking about fiction, film or poetry can help medical students to co-construct emotional reactions as affective stances and how that might contribute to their professional development. Using a discursive psychology approach, video recordings from 36 fiction seminars collected from 2016 to 2018 were analysed regarding how affective stances related to reading were constructed by medical students. The findings illustrate how students use subject-object relations to account for affective stances, meaning that they attribute their emotional reaction either to an aspect of the book (object-side explanations), or to personal characteristics (subject-side explanations). The way students enact and account for their affective stances can provide opportunities for tutors to create teachable moments for the students. This study contributes to discursive psychology and reader-response research, as well as medical education research.