Communication and Medicine最新文献

The present study examines newspaper coverage of hand, food and mouth disease (HFMD) and cancer, to compare how infectious and non-infectious diseases are represented in Malaysia. The Health Belief Model was used as the framework for selecting themes relevant to health actions for the content analysis of 69 articles (32,808 words in total) from the New Straits Times. It was found that more emphasis was given to HFMD (51 articles) than to cancer (18 articles). The information most frequently included in the articles was recommended health actions (3.8 mentions per article for HFMD; 1.1 for cancer). The articles represented HFMD as posing a greater threat than cancer, as more information on susceptibility (1.6 for HFMD; 0.3 for cancer) was included compared to severity (0.5 for HFMD; 0.2 for cancer). The HFMD articles stressed the outbreak of HFMD: incidence and deaths, symptoms, causes and preventive measures. However, the cancer articles were usually not incident-specific and focused on promoting a healthy lifestyle to avoid cancer and to warn readers of cancer prevalence. Only 17% of the cancer articles carried treatment themes. The findings suggest that news coverage of cancer should include medical research and advances to create better awareness of cancer.

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Small talk (ST) refers to talk that is seen as space filling or aimless because of its non-goal-oriented purpose in comparison with work-related talk. This article examines ST in Jordanian medical encounters to explore the sequence structure in which ST occurs in combination with goal-oriented talk and the different forms and contexts of its occurrence. The framework of conversation analysis is used to analyze naturally occurring data, in particular exploring how talk orients to and departs from the medical agenda. The findings reveal both the forms and functions of ST in the dataset. The findings show various aspects related to ST: compliments, joking, laughter and ST linked to personal biography. This study offers insights into Arabic medical interaction in terms of the occurrence of ST, and it offers the possibility of designing training courses to employ ST as a communication technique in medical encounters.

When investigating intercultural communication in healthcare settings, interprofessional communication has received very little scholarly attention compared to doctor-patient interactions. Interactions among doctors, however, are an important locus for the organizational life of a hospital as the way these professionals communicate will promote (or hinder) professional effectiveness and efficiency. This paper presents the findings of a study that explores the perceptions concerning the degree and frequency of communicative conflict of 61 migrant doctors working in public healthcare institutions in the central region of El Maule in Chile. Drawing on data from a survey on communicative conflicts, the study analyses the perceptions of the migrant doctors in relation to one particular style of conflict management, namely, adaptability. Findings show that although communicative conflicts seem to occur only occasionally, moderate scores are reported for how such perceptions are believed to affect work performance. Also, the demands of communicative adaptability are perceived to be met largely by migrant doctors alone. The paper then offers considerations about the possible impact that these adaptability efforts could have on migrant doctors' integration processes.

Training for effective communication in high-stakes environments actively promotes targeted communicative strategies. One oft-recommended strategy is closed-loop communication (CLC), which emphasises three components to signal understanding: call-out, checkback and closing of the loop. Using CLC is suggested to improve clinical outcomes, but research indicates that medical practitioners do not always apply CLC in team communication. Our paper analyses a context in which speakers' linguistic choices are guided by explicit recommendations during training, namely out-of-hospital cardiac arrest (OHCA) resuscitation. We examined 20 real-life OHCA resuscitations to determine whether paramedics adopt CLC in the critical first five minutes after the arrival of the designated team leader (a paramedic specially trained in handling OHCA resuscitation), and what other related communication strategies may be used. The findings revealed that the standard form of CLC was not consistently present in any of the resuscitations despite opportunities to use it. Instead, we found evidence of non-standard forms of CLC and closed-ended communication (containing the first two components of standard CLC). These findings may be representative of what happens when medical practitioners communicate in time-critical, real-life contexts where responses to directives can be immediately observed, and suggest that CLC may not always be necessary for effective communication in these contexts.

Research suggests that doctors are failing to make use of technologies designed to optimize their decision-making skills in daily clinical activities, despite a proliferation of electronic tools with the potential for decreasing risks of medical and diagnostic errors. This paper addresses this issue by exploring the cognitive basis of medical decision making and its psychosocial context in relation to technology. We then discuss how cognitive-led technologies - in particular, decision support systems and artificial neural networks - may be applied in clinical contexts to improve medical decision making without becoming a substitute for the doctor's judgment. We identify critical issues and make suggestions regarding future developments.

As part of a larger research project on understanding change in helping professions, this paper investigates into therapists' requesting examples and their interactional and sequential contri-bution to clients' change. Requesting examples by therapists in psychodiagnostic interviews explicitly or implicitly criticize the patient's prior turn as insufficient, i.e. as unclear, vague, or as too general. Such a request opens a retro-sequence (Schegloff 2007) and in the following provides for a description that both helps clarify the semantic vagueness and evinces psychic or relational aspects of the topic at hand. While the patient's insufficient presentation is initi-ated by a prior request of the therapist, the patient's example presentation is regularly fol-lowed by the therapist's summarizing comments or by further requests focusing on the pa-tient's problem. Requesting examples thus are a particular case of requests that follow 'ex-pandable responses' as described by Muntigl & Zabala (2008); they follow the same sequential organization, yet, given that they make examples conditionally relevant, they are more specif-ic. With the help of this sequential organization both participants co-construct elements of common knowledge. Such an 'interplay of understanding' (Voutilainen & Peräkylä 2014) al-lows the therapist to pursue the overall aim of therapy, i.e. to increase the patients' awareness of their distorted perceptions, and thus to pave the way for change. The data comprises of 16 videotaped first interviews following the manual of the Operationalized Psychodynamic Di-agnostics (OPD Task Force 2009). It was collected in cooperation with the Clinic for General Internal Medicine and Psychosomatic at the University Clinic of Heidelberg.

Therapeutic alliance is often posed as an explanation for why therapy works, and there seems to be a consistent finding that the stronger the alliance, the greater the therapeutic change. Although extensively documented in the professional literature as an essential aspect of therapeutic alliance, the concept of emotional presence and its actualization in moment-by-moment interaction have not been adequately described. This paper applies integrative qualitative methodology, including tools and insights from discourse analysis and conversation analysis, to five extracts of Relationship-focused Integrative Psychotherapy sessions with three different clients. It examines the concept of emotional presence operationalized in terms of the therapist's invoking the client's immediate experience. The analytical focus falls on an interactive sequence involving the therapist's topicalization of the client's (proffered) non-verbal cues aiming at eliciting emotion talk in the interactional here-and-now and the latter's orientation to it. The psychotherapist's strategy of emotional presence is proposed to play a salient role in promoting the client's (gradual) change by focusing the talk on the client's here-and-now experience. Thus clients are prompted to project their emotions and/or engage in overt self-reflexive examination of emotional and relational patterns in the immediate context of their concrete trouble-telling. By being regularly exposed to such practices in therapy, clients are instilled with a sense of being in touch with how they feel about a particular situation or person.

Tensions between nurses and physicians have been linked to differences in power, hierarchy, education, compensation and gender. Less attention has been paid to the underlying values on which these differences are predicated. Likewise, little is known about how frequently values conflicts are resolved, and the threats to patient safety unresolved conflicts pose. Our aim was to compare the values embedded in affirming and challenging narratives elicited from nurses and physicians from a large health system. We used thematic analysis and descriptive statistics to assess goodness-of-fit of observed differences in themes. Narratives were coded into eight values categories. Nurses felt affirmed by emotional investment, altruism, humanism, and being of service; for physicians, it was humanism and teamwork. Nurse challenges involved respect, altruism/kindness and emotional investment. For physicians it was also respect and, in addition, professionalism, being of service, humanism and teamwork. Some values affirming narratives, e.g., humanism, were indistinguishable, while for some values challenging narratives e.g., respect, there was virtually no overlap. Participant narratives provide important insights into work-life satisfaction and tensions arising from differences in the underlying values of close working professional groups. Unresolved values conflicts are a potential threat to quality, safety and effective relationships.