Latest Issue: Vol 15, No 1 (2018) RSS2 logo

Communication & Medicine

Editor Srikant Sarangi Aalborg University, Denmark

Since its inception in 2004, Communication & Medicine has been consistently interrogating the `black box’ of what is routinely characterised as `the communicative turn’ in healthcare practice in clinical and public health domains. It is now firmly established as a leading forum for these critical debates.

The journal is adopted by The COMET Society which hosts annual conferences every July. The editor is supported by an internationally acclaimed, interdisciplinary advisory board, selectively drawn to represent the well-established traditions of the medical, social and human sciences.

Aims and Scope
Communication & Medicine continues to abide by the following distinctive aims:

• To consolidate different traditions of discourse and communication research in its commitment to an understanding of psychosocial, cultural and ethical aspects of healthcare in contemporary societies.

• To cover the different specialities within medicine and allied healthcare studies.

• To underscore the significance of specific areas and themes by bringing out special issues from time to time.

• To be fully committed to publishing evidence-based, data-driven original studies with practical application and relevance as key guiding principles.

• To be targeted at an interdisciplinary audience, which will include healthcare professionals and researchers and students in the medical, social and human sciences.

• To promote a reader-friendly style and format, including engagements with debates and dialogues on crosscutting themes of topical significance.

Forthcoming Issue 

Communication & Medicine 15.2 (2018) [2019]

Special Issue: Interpreter-Mediated Healthcare Encounters

Table of Contents


Srikant Sarangi

Claudia V. Angelelli

Cecilia Wadensjö

Galina B. Bolden

Claudio Baraldi and Laura Gavioli

Sione Twilt, Ludwien Meeuwesen, Jan D. ten Thije and Hans Harmsen

Celia Roberts and Srikant Sarangi

Charlene Pope and Jason Roberson

Louisa Willoughby, Marisa Cordella, Simon Musgrave and Julie Bradshaw

Peter Roger and Chris Code


Indexing & Abstracting/Metrics
CiteScore 2018: 0.4
SJR 2018: 0.123
SNIP 2018: 0.481

H-index: 14 (2015)
Bibliography of Linguistic Literature / Bibliographie Linguistischer Literature (BLL)
EBSCO Communication and Mass Media Index
EBSCO Current Abstracts
IBZ International Bibliography of Periodical Literature in the Humanities and Social Sciences
IBR International Bilbiography of Book Reviews of Scholarly Literature in the Humanities and Social Sciences
Linguistics and Language Behaviour Abstracts
OCLC Electronic Collections Online
European Reference Index (ERIH Plus)

Publication and Frequency: 3 issues per year from 2011 (volume 8)
ISSN: 1612-1783 (print)
ISSN: 1613-3625 (online)

Professor Srikant Sarangi
Faculty of Humanities
Aalborg University
Kroghstræde 3
DK-9220 Aalborg Ø

Notice Regarding Volumes 1-4
For print copies of Volumes 1-4 as well as online access for those issues please contact the former publisher, Mouton De Gruyter.

Most Recent Articles


Perceptions of the need for minority languages by nurses in Southern Taiwan

Background: While language barriers between healthcare providers and minority-language-speaking patients often lead to miscommunication and jeopardize patient safety, language audits of the former have received little attention.

Goal: Based on the context in Southern Taiwan, where the elderly population mainly speaks the local dialect Taiwanese, this study examines nurses' perceptions of their proficiency in and need for medical Taiwanese (‘MED-TW'), and attitudes toward it.

Method: A questionnaire survey was conducted among 859 nurses from three levels of healthcare units: primary care stations (H1), a regional hospital (H2) and a medical center (H3).

Results: Nurses from the rural-based H1 unit displayed significantly stronger needs for Taiwanese (TW) than those from urban-based H2 and H3. Specifically, H1 nurses reported encounters with the largest proportion of TW-speaking clients (p<0.001) and the highest frequency of using TW with clients (p<0.001). However, H1 nurses' self-evaluation of their TW proficiency revealed a lower score than those of the H2 and H3 nurses, especially with regard to medical TW proficiency (p<0.05). Finally, while nurses with a high command of TW felt it helped their work, those with a low level did not feel this impacted their performance.

Conclusion: Nurses working in locations where the use of the minority language is prevalent would benefit more from learning this language.

Posted: 2018-11-26More...

Insulin restriction, medicalisation and the Internet: A corpus-assisted study of diabulimia discourse in online support groups

Diabulimia is a contested eating disorder characterised by the deliberate restriction of insulin by people with type 1 diabetes in order to lose and control body weight. This article reports the first discourse-based study of diabulimia. It employs a combination of quantitative and qualitative techniques afforded by corpus linguistics, a methodology for examining extensive collections of digitised language data, to interrogate the discourse surrounding diabulimia in an approx. 120,000-word collection of messages posted to three English-speaking online diabetes support groups. The analysis shows how, despite lacking official disease status, diabulimia was nonetheless linguistically constructed by the support group contributors as if it were a medically legitimate mental illness. This article explores some of the consequences that such medicalising conceptions are likely to have for people experiencing diabulimia, as well as their implications for health professionals caring for people presenting with this emerging health concern in the future.

Open Access: CC BY

This research was supported by the Economic and Social Research Council (ESRC) (grant number: ES/J500100/1). Open Access funding was provided by the ESRC Centre for Corpus Approaches to Social Science (grant number ES/K002155/1).



Posted: 2018-11-26More...

Nurturing anaesthetic expertise: On narrative, affect and professional inclusivity

This article seeks to establish the educational and social significance of narrative and affect in anaesthetic training. Data were obtained from focus group discussions involving three groups of eight (total 24) young anaesthetists from around Australia held at an Australian and New Zealand College of Anaesthetists (ANZCA) residential conference. Analysis applied to transcripts of the discussions revealed the prominence of narratives used among trainees and supervisors as a medium for explaining and nurturing anaesthetic expertise. Nurturing expertise was accomplished by sharing narratives about extreme circumstances that highlighted a need for constant vigilance directed towards not just clinical circumstances but also colleagues. The article suggests that the narrative emphasis on remaining vigilant and maintaining personal resourcefulness may explain graduands' tendency towards social exclusivity (avoidance of non-colleague others), and contribute to a better understanding of medicine's professional inclusivity (strong in-group bonding).
Posted: 2018-11-26More...

Patients’ representations of depressive symptoms and physicians’ responses in clinical encounters

Depression is defined by a list of symptoms. However, patients' experiences of these symptoms and the ways they are represented in medical consultations are not well described. Applying the methods of systemic functional linguistics and conversation analysis, we aim to explore how patients diagnosed with depression represent their depressive symptoms in medical consultations, and how physicians respond to patients' representations.

We analyzed 30 video-recorded consultations between general practitioners or psychiatrists and patients with moderate depression, and found that one third of the patients represented experiences of activity located in the head or brain. The patients' representations of such head/brain symptoms were instantiated through a delimited set of transitivity patterns - material Processes and relational Processes - without any specification of agency. The transitivity patterns reflected experiences of head/brain symptoms taking place outside the patients' control. When physicians engaged with patients' head/brain experiences, they tried to make them fit into their own understanding of depression, which did not include head/brain symptoms detached from the patients' agency.

Linguistic and interactional methods could promote insights into patients' experiences of depressive illness and we suggest that more focus should be placed on understanding patients' experiences, and that the intersubjective understanding of the patient could be further studied using linguistic methods.

Posted: 2018-11-26More...

Getting to ‘no’: Three ways to jointly accomplish an answer to questions in a questionnaire in doctor–patient interaction

This paper aims to describe the interactional processes through which a medical professional and a patient collaboratively accomplish filling out answers to a questionnaire. Empirical analysis of three different sequences from a video-recorded doctor-patient interaction in which questions of a questionnaire were answered with a ‘no' reveals three different ways (or methods) in which doctor and patient accomplish this jointly. Applying ethnomethodological conversation analysis (EMCA) as our methodological framework, we conclude that the three interactional practices are fitted in relation to the constraints of the interview that is itself methodically aligned to the practices and organizational structures of the institution, a Danish hospital. Furthermore, we make the case that questionnaires are designed as idealizations of question-answer sequences, and as such do not operate at the same level of detail as the actual question-answer situation. Details that are crucial for the objective of the questionnaire (in this case providing information to a third party) may not be included in the recorded answer. Thus, we argue that in order to understand the informational value of recorded answers in questionnaires, we need to diagnose the interaction in which they were produced, i.e. to critically examine it.
Posted: 2018-11-26More...

Most Viewed Articles


The use of abbreviations in medical records in a multidisciplinary world -- an imminent disaster

Abbreviations are commonly used in the medical world to save time and space whilst writing in the patients’ medical records. As various specialties have evolved, each has developed a collection of commonly used abbreviations within its practice, which may not be recognizable to those not working within the same field. The purpose of this study was to assess whether we, the multidisciplinary team members, correctly interpret the abbreviations used in the medical records. We analysed one week of orthopaedic surgical medical records for the use of abbreviations and assessed their appreciation by other members of the multidisciplinary team by means of a standardized questionnaire. We found great variability in the understanding of these abbreviations by different groups of health care professionals. As expected, the orthopaedic surgeons produced significantly more right answers when compared to the other groups, but even they could correctly interpret just over half (57.24 per cent) of the abbreviations. There were many misinterpretations of the abbreviations across the specialties posing imminent clinical risk. Whilst abbreviations may indeed save time, the observed inter-group variation in correct interpretation of these abbreviations is unacceptable. We recommend that the abbreviations have no place in the multidisciplinary world and their continued use will only lead to eventual clinical error.
Posted: 2008-11-25More...

Laughter, communication problems and dementia

This article investigates how the elderly with dementia and their professional caregivers use laughter as a device to deal with problems related to language production and comprehension. The data consist of two game-playing situations, used to engage the elderly people in memory work. The article shows how the elderly patients recurrently laugh to acknowledge communication difficulties and to show awareness of their potential non-competency. The professional caregivers are shown to use slightly different strategies for responding to laughter segments initiated by the patients, either making the shortcomings part of the conversation or avoiding referring to the lapse explicitly. The laughter strategies used by the patients are compared to those reported in the CA-literature on laughter. It is well known that laughter is used in sequences of trouble and delicacy in both ordinary and institutional contexts, but my study shows that speakers with dementia laugh when they encounter problems related to language production and comprehension. This functional expansion in relation to premorbid occurrence is evidence that laughter fits the definition of compensatory behaviour utilized to overcome communication barriers. Certain conversational skills are preserved in individuals with dementia, but due to their cognitive impairment these resources are utilized in a slightly different way than by healthy speakers.
Posted: 2008-11-25More...

Moral accounts and membership categorization in primary care medical interviews

Although the link between health and morality has been well established, few studies have examined how issues of morality emerge and are addressed in primary care medical encounters. This paper addresses the need to examine morality as it is (re)constructed in everyday health care interactions. A Membership Categorisation Analysis of 96 medical interviews reveals how patients orient to particular membership categories and distance themselves from others as a means of accounting (Buttny 1993; Scott and Lyman 1968) for morally questionable health behaviours. More specifically, this paper examines how patients use membership categorisations in order to achieve specific social identity(ies) (Schubert et al. 2009) through two primary strategies: defensive detailing and prioritizing alternative membership categories. Thus, this analysis tracks the emergence of cultural and moral knowledge about social life as it takes place in primary care medical encounters.
Posted: 2012-02-24More...

Improving patient information leaflets: Developing and applying an evaluative model of patient centeredness for text

The purpose of this paper is to present an evaluative model of patient-centredness for text and to illustrate how this can be applied to patient information leaflets (PILs) that accompany medication in the European Union. Patients have criticized PILs for sidelining their experiences, knowledge and affective needs, and denying their individuality. The health communication paradigm of patient-centredness provides valuable purchase on these issues, taking its starting point in the dignity and integrity of the patient as a person. Employing this evaluative model involves two stages. First, a Foucauldian Discourse Analysis is performed of sender and receiver and of the main discourses in PILs. These aspects are then evaluated using the perspectives of patient-centredness theory relating to the medical practitioner, patient and content. The evaluative model is illustrated via a PIL for medication for depression and panic attacks. Evaluation reveals a preponderance of biomedical statements, with a cluster of patient-centred statements primarily relating to the construction of the patient. The paper contributes a new method and evaluative approach to PIL and qualitative health research, as well as outlining a method that facilitates the investigation of interdiscursivity, a recent focus of critical genre analysis.
Posted: 2013-12-10More...

The negotiation of the problem statement in Cognitive Behavioural Therapy

Cognitive behavioural therapy (CBT) is a form of psychotherapy which is characterized by being highly structured, outcomes focused and time limited. The literature concerning CBT is extensive but it has primarily focused on the outcomes of therapy with limited qualitative studies investigating the process of CBT. In this present study we investigate how the CBT model is implemented in therapeutic interaction through a focus on the conversion of the client’s problem into CBT terms and its ultimate articulation as the problem statement. The problem statement is an integral part of the form of CBT studied from which the subsequent therapy is derived. Drawing on theme-oriented discourse analysis we examine the first two sessions of the treatment of one client using a number of tools derived from discourse and conversation analysis. This case study was drawn from a larger corpus of the CBT treatment of ten clients. The expertise of the therapist in applying the generic CBT model of therapy to the client’s particular problem is a focus of this study.
Posted: 2010-10-22More...


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Vol 15, No 1 (2018)

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Table of Contents


Getting to ‘no’: Three ways to jointly accomplish an answer to questions in a questionnaire in doctor–patient interaction PDF
Elisabeth Muth Andersen , Gitte Rasmussen , Catherine E. Brouwer , Jytte Isaksen 1-13
Insulin restriction, medicalisation and the Internet: A corpus-assisted study of diabulimia discourse in online support groups OPEN ACCESS: CC-BY PDF
Gavin Brookes 14-27
Patients’ representations of depressive symptoms and physicians’ responses in clinical encounters PDF
Christina Fogtmann Fosgerau , Annette Sofie Davidsen 28-39
Interactions in psychiatric care consultation in Akan speaking communities PDF
Ekua Essumanma Houphouet , Nana Aba Appiah Amfo , Eugene K. Dordoye , Rachel Thompson 40-52
Nurturing anaesthetic expertise: On narrative, affect and professional inclusivity PDF
Rick Iedema , Christine Jorm 53-64
Inter-organisational use of the electronic health record in mental health PDF
Jenni-Mari Räsänen , Kirsi Günther 65-76
Verbal and nonverbal communication of agency in illness narratives of patients suffering from medically unexplained symptoms (MUS) PDF
Agnieszka Sowińska 77-89
Perceptions of the need for minority languages by nurses in Southern Taiwan PDF
Mei-Hui Tsai , Huan-Fang Lee , Shuen-Lin Jeng , Sheng-Che Lin , Li-Wei Hsieh , Jen-Pin Chuang , Elizabeth A. Jacobs 90-104

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