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Communication & Medicine

Kelly H Bruce, Rebecca J Schwei, Linda S Park, Elizabeth A Jacobs
BACKGROUND: Limited English proficient (LEP) patients receive fewer recommended preventive screenings than English-speaking patients. Studies have explored patients' perceptions of the factors that contribute to this disparity, but little research has focused on physicians' perceptions. OBJECTIVE: To describe physicians' perceptions of the barriers and facilitators to preventive cancer screening in LEP patients. DESIGN: Qualitative interview study using a semi-structured interview guide...
2014: Communication & Medicine
Christel Tarber, Lisbeth Frostholm
Common mental disorders often go undetected in primary care. Sharpening general practitioners' (GPs') attention to potential signs thereof is therefore crucial. This conversation-analytic study arises from the observation that the consideration of psychological problems in new-concern visits can be achieved by way of 'gradual topic emergence'. This entails that the problem is not presented directly, but adjunct to somatic symptoms, and is hinted at by way of generic, ambiguous complaints, and furthermore by expressions of frustration and uncertainty and talk about lifeworld problems...
2014: Communication & Medicine
Pamela A Saunders, Erin E Wilhelm, Sinae Lee, Elizabeth Merkhofer, Ira Shoulson
Data sharing is a key biomedical research theme for the 21st century. Biomedical data sharing is the exchange of data among (non)affiliated parties under mutually agreeable terms to promote scientific advancement and the development of safe and effective medical products. Wide sharing of research data is important for scientific discovery, medical product development, and public health. Data sharing enables improvements in development of medical products, more attention to rare diseases, and cost-efficiencies in biomedical research...
2014: Communication & Medicine
Henrik Rahm, Magdalena Andersson, Anna-karin Edberg
This paper explores focus group discussions of registered nurses in municipal palliative care for older people, using data collected by researchers with an interest in health sciences. The linguistically based discourse analyis builds on a combination of Bakhtinian notions of dialogicity, the Other and addressivity, the use of quotations, and also van Leeuwen's framework for legitimation in discourse. The aim is to investigate strategies of addressing and legitimizing palliative care. Three types of narrative are discerned: the cautionary tale, fictionalization of professional experiences and the enactment of a fictive dialogue...
2014: Communication & Medicine
Gabriella Modan, Seuli Bose Brill
Advance Care Planning (ACP) remains extremely low in the US, due to numerous institutional and cultural barriers and discomfort in discussing death. There is a need for guidance about how patient and healthcare providers can effectively engage in ACP discussion. Here we analyze the linguistic strategies that focus-group participants use when discussing ACP in detailed ways. Prevalent linguistic structures in effective ACP discussions were loved ones' end-of-life narratives, hypothetical narratives, and constructed dialogue...
2014: Communication & Medicine
Jessica Nina Lester, Khalid Karim, Michelle O'Reilly
The opposing positions of the social model of disability and the biomedical framework of impairment have created tensions regarding what constitutes 'normality'. In this article, we drew upon focus group data of parents, professionals, and people with autism, to explore how the dilemmatic tensions of normality and abnormality and of disability and ability were managed. Our findings illustrate how the boundaries of normality in relation to autism are blurred, as well as how the autistic identity is fluid. The members of the focus group invoked their epistemic rights to assert their positions and delicately considered the limitations of the rhetoric of cure...
2014: Communication & Medicine
Iréne Josephson, Pia H Bülow
This paper reports on an empirical study in Sweden of how patient resources come into play in physiotherapy interventions. A qualitative analysis was conducted of five video-recorded first encounters between patients with non-specific low back pain (NSLBP) and physiotherapists in primary care, using Conservation of Resource Theory (COR) to identify and focus on how physiotherapists made use of patients' resources (objects, conditions, personal characteristics and energies). The findings reveal variations in how these resources are utilized during the intervention...
2014: Communication & Medicine
Katrina A Bramstedt, Ben N Ierna, Victoria K Woodcroft-Brown
Social media is a valuable tool in the practice of medicine, but it can also be an area of 'treacherous waters' for medical students. Those in their upper years of study are off-site and scattered broadly, undertaking clinical rotations; thus, in-house (university lecture) sessions are impractical. Nonetheless, during these clinical years students are generally high users of social media technology, putting them at risk of harm if they lack appropriate ethical awareness. We created a compulsory session in social media ethics (Doctoring and Social Media) offered in two online modes (narrated PowerPoint file or YouTube video) to fourth- and fifth-year undergraduate medical students...
2014: Communication & Medicine
Sarah Bigi
Collaborative goal setting in patient-provider communication with chronic patients is the phase in which--after collecting the data regarding the patient's health--it is necessary to make a decision regarding the best therapy and behaviors the patient should adopt until the next encounter. Although it is considered a pivotal phase of shared decision making, there remain a few open questions regarding its components and its efficacy: What are the factors that improve or impede agreement on treatment goals and strategies?; What are the 'success conditions' of collaborative goal setting?; How can physicians effectively help patients make their preferences explicit and then co-construct with them informed preferences to help them reach their therapeutic goals? Using the theoretical framework of dialogue types, an approach developed in the field of Argumentation Theory, it will be possible to formulate hypotheses on the success conditions' and effects on patient commitment of collaborative goal setting...
2014: Communication & Medicine
Andrew Beckwith, Jonathan Crichton
In recent years cognitive behavioral therapy (CBT), a form ofpsychotherapy, has risen to prominence due to a large number of studies attesting to its efficacy. A crucial part of the model of CBT is the use of the therapeutic strategy, homework, in which the client undertakes therapeutic tasks between sessions. The focus of this study is on how homework is implemented in sessions of CBT. This is undertaken through an analysis utilizing theme-orientated discourse analysis of video recorded sessions of CBT of one therapist and a client...
2014: Communication & Medicine
Hannah Shipman, Angus J Clarke, Srikant Sarang
The motivations of those who give consent to bio-banking research have received a great deal of attention in recent years. Previous work draws upon the notion of altruism, though the self and/or family have been proposed as significant factors. Drawing on 11 interviews with staff responsible for seeking consent to cancer bio-banking and 13 observations of staff asking people to consent in routine clinical encounters, we investigate how potential participants are oriented to, and constructed as oriented to, self and other related concerns (Sarangi 2007)...
2014: Communication & Medicine
Heidrun Dorgeloh
This article explores the occurrence and some special patterns of conditional usage in medical discourse produced by doctors and patients. Findings are based on the Journal of the American Medical Association with its section 'Clinical Crossroads' which was founded to further the co-operation of patients with medical professionals. The analysis centers upon the concept of prediction, which is considered both a semantic concept governing verb patterns as well as a communicative act prominent in medical encounters...
2014: Communication & Medicine
Zsófia Demjén
This paper demonstrates how a range of linguistic methods can be harnessed in pursuit of a deeper understanding of the 'lived experience' of psychological disorders. It argues that such methods should be applied more in medical contexts, especially in medical humanities. Key extracts from The Unabridged Journals of Sylvia Plath are examined, as a case study of the experience of depression. Combinations of qualitative and quantitative linguistic methods, and inter- and intra-textual comparisons are used to consider distinctive patterns in the use of metaphor, personal pronouns and (the semantics of) verbs, as well as other relevant aspects of language...
2014: Communication & Medicine
Richard M Frankel, Wendy Levinson
In its monograph Crossing the Quality Chasm, the Institute of Medicine asserted that 44,000 to 98,000 lives are lost every year due to avoidable medical errors, more than 80% of which involved breakdowns in communication. Medical malpractice claims also involve errors that cause harm, including death. Reasons for malpractice claims have been investigated using variables such as age, race, country of origin, and gender none of which are predictive. One promising area that has not systematically been studied is the role of face-to-face communication in malpractice claims...
2014: Communication & Medicine
Juan Eduardo Bonnin
This article is part of a larger research project, the aim of which is to understand the discursive conditions of access and adherence to an outpatient mental health service at a public hospital in Buenos Aires, Argentina. The focus is on the historical conflict between medical discourse and psychoanalytical discourse as it emerges in the negotiation of treatment and diagnostic sequences at first consultations. It can be seen that patients who are socialized in medical discourse--and even in psychiatric discourse--expect the usual procedure in which a diagnosis, however transitory, is offered first and then followed by a treatment recommendation...
2014: Communication & Medicine
Ellen Barton, Susan Eggly, Andrew Winckles, Terrance L Albrecht
Clinical trials are the gold standard in medical research evaluating new treatments in cancer care; however, in the United States, too few patients enroll in trials, especially patients from minority groups. Offering patients the option of a clinical trial is an ethically-charged communicative event for oncologists. One particularly vexed ethical issue is the use of persuasion in trial offers. Based on a corpus of 22 oncology encounters with Caucasian-American (n = 11) and African-American (n = 11) patients, this discourse analysis describes oncologists' use of two persuasive strategies related to the linguistic structure of trial offers: topic placement and topic framing...
2014: Communication & Medicine
Srikant Sarangi
No abstract text is available yet for this article.
2014: Communication & Medicine
Pairote Wilainuch
This article explores communicative practices surrounding how nurses, patients and family members engage when talking about death and dying, based on study conducted in a province in northern Thailand. Data were collected from three environments: a district hospital (nine cases), district public health centres (four cases), and in patients' homes (27 cases). Fourteen nurses, 40 patients and 24 family members gave written consent for participation. Direct observation and in-depth interviews were used for supplementary data collection, and 40 counselling sessions were recorded on video...
2013: Communication & Medicine
Tessa Sanderson, Jo Angouri
The active involvement of patients in decision-making and the focus on patient expertise in managing chronic illness constitutes a priority in many healthcare systems including the NHS in the UK. With easier access to health information, patients are almost expected to be (or present self) as an 'expert patient' (Ziebland 2004). This paper draws on the meta-analysis of interview data collected for identifying treatment outcomes important to patients with rheumatoid arthritis (RA). Taking a discourse approach to identity, the discussion focuses on the resources used in the negotiation and coconstruction of expert identities, including domain-specific knowledge, access to institutional resources, and ability to self-manage...
2013: Communication & Medicine
Suvi Raitakari, Kirsi Günther, Kirsi Juhila, Sirpa Saario
Professionals in human service work are at the centre of complicated client cases. The ways client cases are constructed and the problems explained form the basis for professionals' assessments, decisions, actions and interventions. In this article the ways professionals make sense of dual-diagnosis client cases are examined. Applying the concept of causal accounting, it is argued that 'theories of cause' are embedded in professional discourse and profoundly shape professionals' understandings of social and health problems, as well as of their own roles and responsibilities and of what interventions and outcomes are possible...
2013: Communication & Medicine
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