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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 15.1 (2018) [2019]

Table of Contents

ARTICLES

INSULIN RESTRICTION, MEDICALISATION AND THE INTERNET: A CORPUS-ASSISTED STUDY OF DIABULIMIA DISCOURSE IN ONLINE SUPPORT GROUPS
Gavin Brookes [ONLINE EARLY-OPEN ACCESS] click to view

CONSULTING ROOM INTERACTIONS IN PSYCHIATRIC CARE IN AKAN SPEAKING COMMUNITIES
Nana Aba Appiah Amfo

VERBAL AND NONVERBAL COMMUNICATION OF AGENCY IN ILLNESS NARRATIVES OF PATIENTS SUFFERING FROM MEDICALLY UNEXPLAINED SYMPTOMS (MUS)
Agnieszka Sowinska [ONLINE EARLY] click to view

TRACKING CLIENTS AND WORKERS THROUGH RECORDS
Jenni-Mari Räsänen, Kirsi Günther

GETTING TO 'NO': THREE WAYS TO JOINTLY ACCOMPLISH AN ANSWER TO A QUESTION FROM A QUESTIONNAIRE IN DOCTOR-PATIENT INTERACTION
Elisabeth Muth Andersen

THE VOICE OF DEPRESSION
Christina Fogtmann Fosgerau, Annette Sofie Davidsen

NURTURING ANAESTHETIC EXPERTISE: ON NARRATIVE, AFFECT AND PROFESSIONAL INCLUSIVITY
Roderick Aren Iedema, Christine Jorm

PERCEPTIONS OF THE NEED FOR ETHNIC LANGUAGES BY NURSES FROM THREE LEVELS OF HEALTHCARE UNITS IN SOUTHERN TAIWAN
Mei-hui Tsai, Huan-Fang Lee, Shuen-Lin Jeng, Sheng-Che Lin, Li-Wei Hsieh, Jen-Pin Chuang, Elizabeth A. Jacobs

 

Communication & Medicine 15.2 (2018) [2019]

Special Issue: Interpreter-Mediated Healthcare Encounters

Table of Contents

ARTICLES

INTRODUCTION: MUTABLE INTERPRETER PRACTICES IN MEDIATED HEALTHCARE ENCOUNTERS
Srikant Sarangi

WHO IS TALKING NOW? ROLE EXPECTATIONS AND ROLE MATERIALIZATIONS IN INTERPRETER-MEDIATED HEALTHCARE ENCOUNTERS
Claudia V. Angelelli

INVOLVEMENT, TRUST AND TOPIC CONTROL IN INTERPRETER-MEDIATED HEALTHCARE ENCOUNTERS
Cecilia Wadensjö

UNDERSTANDING INTERPRETERS' ACTIONS IN CONTEXT
Galina B. Bolden

MANAGING UNCERTAINTY IN HEALTHCARE INTERPRETER-MEDIATED INTERACTION: ON RENDERING QUESTION-ANSWER SEQUENCES
Claudio Baraldi and Laura Gavioli

MUTUAL (MIS)UNDERSTANDING IN INTERPRETING IN CONSULTATIONS BETWEEN TURKISH IMMIGRANT PATIENTS AND DUTCH GENERAL PRACTITIONERS
Sione Twilt, Ludwien Meeuwesen, Jan D. ten Thije and Hans Harmsen

THIRD PARTY INSURANCE? INTERACTIONAL ROLE ALIGNMENT IN FAMILY MEMBER MEDIATED PRIMARY CARE CONSULTATIONS
Celia Roberts and Srikant Sarangi

THE COMPARISON OF SHARED DECISION MAKING IN MONOLINGUAL AND BILINGUAL HEALTH ENCOUNTERS
Charlene Pope and Jason Roberson

TRIADIC MEDICAL INTERACTION WITH A BILINGUAL DOCTOR
Louisa Willoughby, Marisa Cordella, Simon Musgrave and Julie Bradshaw

INTERPRETER-MEDIATED APHASIA ASSESSMENTS: MISMATCHES IN FRAMES AND PROFESSIONAL ORIENTATIONS
Peter Roger and Chris Code

 

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

H-index: 14 (2015)
Bibliography of Linguistic Literature / Bibliographie Linguistischer Literature (BLL)
ComAbstracts
ComIndex
EBSCO Communication and Mass Media Index
EBSCO Current Abstracts
EMBASE
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
Pubmed
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
DENMARK

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

 

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...
 

Verbal and nonverbal communication of agency in illness narratives of patients suffering from medically unexplained symptoms (MUS)

The objective of the study is to explore how patients presenting medically unexplained symptoms (MUS) - that is, symptoms that do not have an obvious underlying diagnosis - communicate agency. It is assumed that agency can be exercised verbally through narrative structure and content as well as nonverbally through patients' behaviours, in particular their gestures. This, in turn, points to the ways patients conceptualize their identities and selves. Pauses and disfluencies in the patients' accounts as well as an imprecise use of gestures can indicate a cognitive or conceptual conflict and uncertainty related to MUS. This paper reports on preliminary findings obtained from the analysis of 20 video-filmed interviews with Polish patients with MUS, and presents two case studies of patients who, despite fairly similar medical test results, deliver different illness narratives: (1) a narrative indicative of low agency and characterized by fragmentation, vagueness, repetitiveness and redundancy of content, dispreference markers and the imprecise use of gestures; and (2) a narrative reflecting high agency, characterized by specificity, coherence and the precise use of gestures.
Posted: 2018-11-26More...
 

Shared decision or decision shared? Interactional trajectories in Huntington’s disease management clinics

Shared decision making (SDM) as a corrective to paternalism - particularly in relation to treatment options - is a much-discussed theme in healthcare research and practice. The communicative/interactional dimensions of SDM have lately received scholarly attention, albeit limited to a few clinic sites. The Huntington's disease (HD) management clinic, which is the site of this study, involves the co-presence of family members in their carer role, since the patient with HD may lack the cognitive ability to participate adequately in the decision-making process. We closely examine 12 audio-recorded clinic consultation transcripts, using the combined framework of theme-orientated discourse analysis and activity analysis. Our analytical focus is on how decisions are formulated and shared, or not shared, by the co-participants (the consultant, the patient and the carers) and the extent to which the consultant and the carers negotiate their 'expert' assessments of the patient's current and future management scenarios. We first outline a step-wise structure of decision making - to include problem designation, problem confirmation, generation of options and their assessment, and formulation and confirmation of decision. Contrary to how SDM is represented in various models in the literature, these different steps are interactionally dispersed and become negotiable in particular clinic sessions. Our findingssuggest that the consultant routinely uses three main strategies to steer the decision-making process: foregrounding the decision itself, foregrounding the temporal dimension and foregrounding the person/ carer dimension. Moreover, carer participation differs depending on the carer's relationship with the patient and other contingent matters. -
Posted: 2018-05-01More...
 

Escalating the positive in antenatal consultations: Midwife support in (inter)action

This article investigates the practical accomplishment of support in midwife-led antenatal interactions. Drawing on 16 transcribed antenatal consultations from Australia, and utilizing principles of conversation analysis, we investigate a range of interactional practices that midwives use to support expectant mothers and create a positive interactional environment during the consultations. The interactional practices examined include positive assessments, compliments, enhanced agreements, extended back-channels, good wishing, humor and joking, and brightside formulations. Through these turns, the midwife works to create with the woman a shared positive stance towards the upcoming birth by encouraging her, endorsing her decisions, treating the woman’s progression through pregnancy as an achievement, and selectively focusing on the positive side of situations. As such, the research contributes to understanding the practical management of support, a concept which underpins many health and care professions.
Posted: 2018-04-23More...
 

What does shared decision making look like in natural settings? A mixed methods study of patient–provider conversations

Objective: To understand the variability and nature of shared decision making (SDM) regarding a uniform type of serious medical decision, and to make normative judgments about how these conversations might be improved. Methods: This was a mixed-methods sub-analysis of the Improving Patient Outcomes with Respect and Trust (IMPORT) study. We used the Braddock framework to identify and describe seven elements of SDM in audio-recorded encounters regarding initiation of hydroxyurea, and used data from medical records and patient questionnaires to understand whether and how these tasks were achieved. Results: Physicians covered a spectrum of SDM behaviors: all dialogues contained discussion regarding the clinical issue and the pros and cons of treatment; the patient's understanding and role were not explicitly assessed or stated in any encounter. Yet no patient agreed to start hydroxyurea who did not already prefer it. There was no uniform approach to how physicians presented risk; many concerns expressed by patients in a pre-visit questionnaire were not discussed. Conclusion: In this analysis, patients seemed to understand their role in the decision-making process, suggesting that a patient's role may not always need to be explicitly stated. However, shared decision making might be improved with more routine assessment of patient understanding and concerns. Standardized decision aids might help fully inform patients of risks and benefits.
Posted: 2018-04-23More...
 

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...
 

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...
 

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...
 

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