Comparing doctor–elderly patient communication between traditional Chinese medicine and Western medicine encounters: Data from China

Authors

  • Ying Jin Hong Kong Polytechnic University
  • Dennis Tay Hong Kong Polytechnic University

DOI:

https://doi.org/10.1558/cam.31872

Keywords:

elderly patients, lifestyle and psychosocial topics, RIAS, traditional Chinese Medicine, western medicine

Abstract

Effective doctor–patient communication has been widely endorsed as pivotal for optimal medical care and the building of a positive and lasting relationship between caregivers and patients. While the literature suggests that traditional Chinese medicine (TCM) doctors have better interpersonal skills than Western medicine (WM) doctors, and that the doctor–patient relationship in TCM is more lasting, a comparison of specific communication behaviors in both encounters has not yet been carried out. This paper examines the similarities and differences in communication behaviors between these two types of consultations in relation to doctor–elderly patient communication. Forty-five consultations were included for analysis using the Roter Interaction Analysis System (RIAS). Significant differences were found in communication behaviors at the level of lifestyle and psychosocial exchanges, type of questions, non-medical small talk, and emotional disclosure. The study’s limitations and implications are discussed.

Author Biographies

  • Ying Jin, Hong Kong Polytechnic University
    Ying Jin is currently a PhD candidate at the Hong Kong Polytechnic University. Her main research interest is in doctor–patient communication.
  • Dennis Tay, Hong Kong Polytechnic University
    Dennis Tay is Associate Professor at the Department of English, The Hong Kong Polytechnic University. He is a cognitive linguist and discourse analyst, and has been researching the linguistic and discursive characteristics of psychotherapeutic metaphors in different cultural contexts including the United States, New Zealand, Hong Kong, and China.

References

Adelman, R. D., Greene, M. G. and Charon, R. (1991) Issues in physician–elderly patient interaction. Aging and Society 11 (2): 127–148. https://doi.org/10.1017/S0144686X00003974

Adelman, R. D., Greene, M. G., Charon, R. and Friedman, E. (1990) Issues in the physician-geriatric patient relationship. In H. Giles, N. Coupland and J. M. Wiemann (eds) Communication, Health and the Elderly, 126–134. Manchester: Manchester University Press.

Ainsworth-Vaughn, N. (1998) Claiming Power in Doctor-Patient Talk. Oxford: Oxford University Press.

Ainsworth-Vaughn, N. (2001) The discourse of medical encounters. In D. Schiffrin, D. Tannen and H. E. Hamilton (eds) The Handbook of Discourse Analysis, 453–469. Malden, MA: Blackwell.

Beckman, H. B. and Frankel, R. M. (1984) The effect of physician behavior on the collection of data. Annals of Internal Medicine 101 (5): 692–696. https://doi.org/10.7326/0003-4819-101-5-692

Boyd, E. and Heritage, J. (2006) Taking the history: Questioning during comprehensive history-taking. In J. Heritage and D. W. Maynard (eds) Communication in Medical Care: Interaction between Primary Care Physicians and Patients, 151–184. Cambridge: Cambridge University Press.

Chung, C. H., Lau, C. H., Wong, M. C., Yeoh, E. K. and Griffiths, S. M. (2009) Perceived quality of communication amongst outpatients in western and traditional Chinese medicine clinics in a Chinese population. Health Policy 90 (1): 66–72. https://doi.org/10.1016/j.healthpol.2008.09.005

Cohen, J. (1992) A power primer. Psychological Bulletin 112 (1): 155–159. https://doi.org/10.1037/0033-2909.112.1.155

Frankel, R. M. (1990) Talking in interviews: A dispreference for patient-initiated questions. In G. Psathas (eds) Interaction Competence, 231–261. Lanham, MD: University of American Press.

Greene, M. G. and Adelman, R. (1996) Psychosocial factors in older patients’ medical encounters. Research on Aging 18 (1): 84–102. https://doi.org/10.1177/0164027596181006

Greene, M. G., Adelman, R., Charon, R. and Hoffman, S. (1986) Ageism in the medical encounter: An exploratory study of the doctor-elderly patient relationship. Language and Com­munication 6 (1–2): 113–124. https://doi.org/10.1016/0271-5309(86)90010-8

Greene, M. G., Adelman, R. D., Friedmann, E. and Charon, R. (1994) Older patient satisfaction with communication during an initial medical encounter. Social Science and Medicine 38 (9): 1279–1288. https://doi.org/10.1016/0277-9536(94)90191-0

Greene, M. G., Hoffman, S., Charon, R. and Adelman, R. D. (1987) Psychosocial concerns in the medical encounter: A comparison of the inter­actions of doctors with their old and young patients. Gerontologist 27 (2): 164–168. https://doi.org/10.1093/geront/27.2.164

Gu, Y. G. (1996) Doctor-patient interaction as goal-directed discourse in Chinese sociocultural context. Journal of Asian Pacific Communication 7 (3–4): 156–176.

Gu, Y. G. (1999) A brief introduction to the Chinese health care system. Health Communication 11 (3): 203–208. https://doi.org/10.1207/S15327027HC110302

Jefferson, G. (1984) Transcription notation. In J. M. Atkinson and J. Heritage (eds) Structures of Social Action, ix–xvi. Cambridge: Cambridge University Press.

Jefferson, G. (2004). Glossary of transcript symbols with an introduction. In G. H. Lerner (eds) Conversation Analysis: Studies from the First Generation, 13–31. Philadelphia, PA: John Benjamins. https://doi.org/10.1075/pbns.125.02jef

Lam, T. P. (2001) Strengths and weaknesses of tradi­tional Chinese medicine and western medicine in the eyes of some Hong Kong Chinese. Journal of Epidemiology and Community Health 55 (10): 762–765. https://doi.org/10.1136/jech.55.10.762

Li, C. N. and Thompson, S. A. (1981) Mandarin Chinese: A Functional Reference Grammar. Berkeley: University of California Press.

Luo, J., Xu. H. and Chen, K. J. (2013) Potential benefits of Chinese herbal medicine for elderly patients with cardiovascular diseases. Journal of Geriatric Cardiology 10 (4): 305–309.

Nakayama, C., Kimata, S., Oshima, T., Kato, A. and Nitta, A. (2016) Analysis of pharmacist-patient communication using the Roter method of inter­action process analysis system. Research in Social and Administrative Pharmacy 12 (2): 319–326. https://doi.org/10.1016/j.sapharm.2015.05.007

Ong, L. M. L., Visser, M. R. M., Kruyver, I. P. M., Bensing, J. M., Brink-Muinen, A. V. D., Stouthhard, J. M. L., Lammes, F. B. and de Haes, J. C. J. M. (1998) The Roter interaction analysis system (RIAS) in oncological consultations: Psych­ometric properties. Psycho-Oncology 7 (5): 387–401. https://doi.org/10.1002/(SICI)1099-1611(1998090)7:5<387::AID-PON316>3.0.CO;2-G

Pahal, J. S. and Li, H. Z. (2006) The dynamics of resident-patient communication: Data from Canada. Communication & Medicine 3 (2): 161–170. https://doi.org/10.1515/CAM.2006.018

Pelicano-Romano, J., Neves, M. R., Amado, A. and Cavaco, A. M. (2013) Do community pharmacists actively engage elderly patients in the dialogue? Results from pharmaceutical care consultations. Health Expectations 18 (5): 1721–1734. https://doi.org/10.1111/hex.12165

Robinson, J. D. (2011) Conversation analysis and health communication. In T. L. Thompson, R. Parrott and J. F. Nussbaum (eds) The Routledge Handbook of Health Communication, 501–518. London and New York: Routledge.

Rost, K. and Frankel, R. (1993) The introduction of the older patient’s problems in the medical visit. Journal of Aging and Health 5 (3): 387–401. https://doi.org/10.1177/089826439300500306

Roter, D. L. (2008) The Roter Method of Interaction Process Analysis (RIAS Manual). Baltimore, MD: Johns Hopkins University, Department of Health Policy and Management.

Roter, D. L., Hall, J. A. and Katz, N. R. (1987) Relations between physicians’ behaviors and analogue patients’ satisfaction, recall, and impressions. Medical Care 25 (5): 437–451. https://doi.org/10.1097/00005650-198705000-00007

Roter, D. L. and Larson, S. (2001) The relationship between residents’ and attending physicians’ communication during primary care visits: An illustrative use of the Roter Interaction Analysis System. Health Communication 13 (1): 33–48. https://doi.org/10.1207/S15327027HC1301_04

Sandvik, M., Eide, H., Lind, M., Graugaard, P. K., Torper, J. and Finset, A. (2002) Analyzing medical dialogues: Strength and weakness of Roter’s interaction analysis system (RIAS). Patient Education and Counseling 46 (4): 235–241. https://doi.org/10.1016/S0738-3991(02)00014-9

Schegloff, E. A. (2007) Sequence Organization in Interaction: A Primer in Conversation Analysis. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511791208

Tang, L. Y. (2011) The influences of patient’s trust in medical service and attitude towards health policy on patient’s overall satisfaction with medical service and sub satisfaction in China. BMC Public Health 11 (1): 472–472. https://doi.org/10.1186/1471-2458-11-472

Wang, Q. (2010) Doctor-Patient Communication and Patient Satisfaction: A Cross-Cultural Comparative Study between China and the US. Unpublished doctoral dissertation, Purdue University, Indiana.

Wang, S. B. and Li, Y. M. (2005) Traditional Chinese medicine. In O. Devinsky, S. V. Pacia and S. C. Shachter (eds) Complementary and Alternative Therapies for Epilepsy, 177–182. New York: Demos Medical.

West, C. (1984). Questions and answers between doctors and patients. In C. West (eds) Routine Complications: Troubles with Talk between Doctors and Patients, 71–96. Blooomington: Indiana University Press.

Williams, S. L., Haskard, K. B. and DiMatteo, M. R. (2007) The therapeutic effects of the physician-older patient relationship: Effective communication with vulnerable older patients. Clinical Interventions in Aging 2 (3): 453–467.

Xu, J. and Yang, Y. (2009) Traditional Chinese medicine in the Chinese health care system. Health Policy 90 (2): 133–139. https://doi.org/10.1016/j.healthpol.2008.09.003

Zhang, X. Q. and Sleeboom-Faulkner, M. (2011) Tensions between medical professional and patients in mainland China. Cambridge Quarterly of Healthcare Ethics 20 (3): 458–465. https://doi.org/10.1017/S0963180111000144

Zhang, Y. H. (2007) Negotiating a path to efficacy at a clinic of traditional Chinese medicine. Culture, Medicine and Psychiatry 31 (1): 73–100. https://doi.org/10.1007/s11013-006-9039-6

Published

2018-03-27

Issue

Section

Articles

How to Cite

Jin, Y., & Tay, D. (2018). Comparing doctor–elderly patient communication between traditional Chinese medicine and Western medicine encounters: Data from China. Communication and Medicine, 14(2), 121-134. https://doi.org/10.1558/cam.31872