Theme-oriented discourse analysis of medical encounters

2017

Using ethnographic discourse analysis in an Emergency Department in Hong Kong, this study explored the features of doctor-patient interactions in a hospital setting. By audio-recording 10 patient journeys, from triage to disposition, we analyzed the complexity of turn-taking patterns in spoken interactions between patients and doctors, as well as the subsequent complexities in this communication process. In particular, we traced the flow of communication surrounding the patients' medical conditions at different stages of their journeys (e.g., taking patient history, making diagnosis and translating medical information in a bilingual environment). Communication in this Emergency Department, as in all Emergency Departments in Hong Kong, involves repeated translation from spoken Cantonese interactions to the written English patient notes and vice versa. For this study, the ethnographic discourse analysis includes different layers of detailed language diagnoses of the observed interactions (e.g., turn-taking strategies, speech functions and exchange structures). In this analysis, we examined the strategies that doctors used to transfer medical knowledge to their patients and with other clinicians; this research illustrated how a series of contextual factors (e.g., time pressure, staff shortages) were linked with the quality of doctor-patient communication. To illuminate the path for future research, we developed a dual-goal communication framework focusing on both medical and interpersonal aspects of the doctor-patient relationship. We strongly recommend the application of this framework for training medical students, junior clinicians and clinicians in practice. Learning Outcomes By the end of this case students should be able to Identify the discrete stages of a patient journey as a series of communicative events and highlight the key contextual features that contribute to the complexity of the journey Analyze the flow of information from spoken interactions, from healthcare professionals to patients and between healthcare professionals within a bilingual context; (this research focused on Hong Kong, which is a multicultural city with two official languages: Chinese and English) Identify the breakdowns in communication (i.e., misunderstandings) that occurred in these spoken interactions Explain how language and communication research can improve healthcare practitioners' understanding of communicative styles in culturally diverse societies Contribute to advances in applied linguistic research by developing a discourse analysis framework for healthcare interactions in high-stress contexts; the key communicative SAGE Research Methods Cases Part 2 SAGE

Discourse plays an important role in medicine, and medical discourse in the broadest sense (discourse in and about healing, curing, or therapy; expressions of suffering; and relevant language ideologies) has profound anthropological significance. As modes of social action, writing and speaking help constitute medical institutions, curative practices, and relations of authority in and beyond particular healing encounters. This review describes cultural variation in medical discourse and variation across genres and registers. It then surveys two approaches to analyzing medical discourse: conversation analysis (CA) and discourse studies echoing Foucault’s work, attempting to spur dialogue between them. Such dialogue could be fruitful because, despite hesitancy to invoke macrosocial variables, conversation analysts as well as Foucaultian discourse analysts have reflected on medical authority. Finally, the article reviews recent attempts to contextualize closely analyzed interactions— written exchanges as well as face-to-face clinical encounters—vis-`a-vis the global circulation of linguistic forms and ideologies.

Discourse is a language context that exists in a dialogue or communication interaction. Discourse is also part of pragmatic analysis. Discourse takes a role in medical side broadly. It exits in medical context about curing, healing, therapy, curative practices, speaking and writing that can help medical institution, social action, and etc. this paper reviews a description about cultural variation in medical discourse and variation between register and genres. This study examines two approaches to analyzing Medical Discourse namely Conversation Analysis (CA) Foucaults' theory.

Journal of Medicine, Physiology and Biophysics, 2020

The study undertook a critical analysis of the discourse of doctor-patient interaction under the ENT (Ear, Nose, and Throat) clinic of Gondar Hospital. Specifically, the study investigated the recurrent interactional features in the doctor-patient interactions, the manifestations of power relations through language use, as well as the ideological assumptions which are held by doctors and patients. To achieve these objectives, qualitative methods were used during data collection and analysis. Purposeful sampling was used to select the clinic where the study took place. Data were gathered through audio-recording and field notes. Before analysis, the audio recordings were transcribed using and then translated. The translated data were analyzed thoroughly using Fairclough's (1992) three-dimensional model of Critical Discourse Analysis. The study, thus, showed that interpersonal relationships between discourse interactants could be an indicative of their social and power relations. Therefore, institutional discourse, specially, that of doctor-patient, could be a place for power struggle.

2010

The progression toward multicultural societies, motivated in part by the rapid increase in migration over a short period of time, is having a noticeable impact on the quality of communication between professionals and their clients. This paper focuses on the analysis of communication in a specific setting, the Spanish healthcare system, from two different perspectives; that of the medic and that of the language specialist (the interpreter). Firstly, the importance given to language and its barriers as seen from both perspectives will be analysed; secondly evaluate the effectiveness of communication in medical contexts will be evaluated through the examination of the different modes of communication found in doctor / non-native patient interaction using a discourseanalytical approach; finally some conclusions about the quality of communication will be presented, together with some suggestions as to the best way of incorporating the results of this research into seminars for healthcar...

At the start of studies on health communication, scholars were primarily concerned with showing the ethical implications of a new approach to care and with collecting evidence to demonstrate its greater effectiveness as opposed to the paternalistic and mechanistic paradigms. Well into the second decade of the 21st century, different issues need to be addressed. Aging populations and the spread of chronic diseases are challenging the sustainability of health care systems worldwide; increased awareness of health issues among the population and greater citizen participation seem to threaten clinicians’ authority. In this new scenario, it is acknowledged that the quality of verbal communication plays a crucial role, but it is still not clear how it impacts on the outcomes of care, which are its constitutive components and how it interacts with the institutional, cultural and social context of interactions. This book suggests that the time is ripe for a fresh start in health communication studies. As Debra Roter points out in her foreword, this proposal “is ambitious in attempting to integrate perspectives derived from pragmatics and argumentation theory with those derived from quantitative methods of medical interaction analysis and its prediction of outcomes”. On the other hand, as Giovanni Gobber explains in his foreword, “health communication can profit from an application of a performance-oriented linguistic analysis that pays attention to the role of the various relevant context factors in speech events related to specific activity types”. In this way, the open questions regarding communication in medical encounters are considered under a new light. The answers provided open up novel lines of research and provide an original perspective to face the new challenges in medical care. http://www.iospress.nl/book/communicating-with-care/

BMJ, 1999

In this chapter, we address, selectively, how applied linguists and those concerned with discourse analysis in particular, have recently approached the study of health care communication, especially in intercultural contexts, and relate these approaches to studies undertaken by researchers in other academic disciplines such as the sociology of medicine and by health care practitioners in the course of their own work. At issue will be questions concerning selected sites and themes, the degree of distinctiveness of research methodologies and different understandings of what counts as data, and questions concerning reflexivity and practical relevance in terms of the use to which findings can be put. Appreciating areas of difference and similarity is a necessary basis for establishing the desirable, but potentially problematic, partnerships among academic disciplines and between such disciplines and the work of professional practitioners, both in research and in professional development. As a sample site in the delivery of health care in the framework of cultural and linguistic diversity, we identify nursing, and use this site and its practices to advocate the collaboration of applied linguists, professional practitioners, and researchers from other areas of social science in the exploration of health care communication in multilingual/multicultural contexts and elsewhere.

Medical Discourse in Professional, Academic and Popular Settings

Medical Discourse in Professional, Academic and Popular Settings is a newly edited volume by PILAR ORDÓñEZ-LÓPEZ and NURIA EDO-MARZÁ and published by Multilingual Matters, particularly as part of the series Language at Work, which, in general terms, seeks to disseminate workplace research. The edited volume reviewed here represents an updated collection of chapters that explore medical discourse from various perspectives. Medical discourse, as shown in this volume, appears not to be exclusively limited to health professionals; rather, it is part of a wider audience, including, for example, patients or professionals of different fields. Nowadays, medical discourse is somehow more accessible to the general public (Pilegaard, 2007) and medical knowledge is then part of society, who may make judgements and evaluate it (Weingart, 2002). This particular edited volume is a relevant and welcome contribution that serves to understand how medical discourse is constructed as well as to reflect upon the issue of successful medical communication.

Global journal of health science, 2015

In many parts of the world, patients may find it difficult to visit doctors who share the same language and culture due to the intermingling of people and international recruitment of doctors among many other reasons. In these multilingual multicultural settings (MMSs), doctor-patient interactions face new communication challenges. This study aims to identify the structure of clinical consultation and its phases in an MMS where both doctors and patients are non-native speakers (NNSs) of English. This study takes on a discourse analytic approach to examine the structure of clinical consultation as an activity type. 25 clinical consultation sessions between non-native speakers of English in a public healthcare centre in Malaysia were audio-recorded. The results show that there are some deviations from the mainstream structure of clinical consultations although, in general, the pattern is compatible with previous studies. Deviations are particularly marked in the opening and closing ph...