Latest Issue: Vol 14, No 2 (2017) RSS2 logo

Communication & Medicine

Editor Srikant Sarangi Aalborg University, Denmark

Editorial Assistant Bettina Jensen 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 14-3 (2017) [2018]

Table of Contents

EDITORIAL

Srikant Sarangi

ARTICLES

SHARED DECISION OR DECISION SHARED?: INTERACTIONAL TRAJECTORIES IN HUNTINGTON'S DISEASE MANAGEMENT CLINICS
Donna Duffin and Srikant Sarangi

WHAT DOES SHARED DECISION MAKING LOOK LIKE IN NATURAL SETTINGS? A MIXED METHODS STUDY OF PATIENT-PROVIDER CONVERSATIONS
Joy Lee, Wynne Callon, Carlton Haywood, Jr., Sophie M. Lanzkron, Pål Gulbrandsen and Mary Catherine Beach

TESTING FOR RESISTANCE: THE CRP TEST AS A COMMUNICATIONAL TOOL IN ANTIBIOTIC PRESCRIBING
Johanna Lindell

ESCALATING THE POSITIVE IN ANTENATAL CONSULTATIONS: MIDWIFE SUPPORT IN (INTER)ACTION
Eleni Petraki and Shannon Clark

THE THIRD SPEAKER: THE BODY AS INTERLOCUTOR IN CONVENTIONAL, COMPLEMENTARY, AND INTEGRATIVE MEDICINE ENCOUNTERS
Sonya E. Pritzker, Jennifer Guzmán, Ka-Kit Hui and Derjung M. Tarn

RESEARCH NOTE

FROM SENSE-MAKING TO DECISION-MAKING WHEN LIVING WITH CANCER
Elizabeth M. Goering and Andrea Krause

FORUM DISCUSSION

A REJOINDER TO “CONCEPTS OF HEALTH, ETHICS, AND COMMUNICATION IN SHARED DECISION MAKING” BY LAURIS KALDJIAN
Angus Clarke

THE ROAD NOT TAKEN: FORGOING DISEASE-DIRECTED TREATMENTS IN ADVANCED CANCER. A REJOINDER TO “CONCEPTS OF HEALTH, ETHICS, AND COMMUNICATION IN SHARED DECISION MAKING” BY LAURIS KALDJIAN
Larry D. Cripe and Richard M. Frankel

A REJOINDER TO ‘CONCEPTS OF HEALTH, ETHICS AND COMMUNICATION IN SHARED DECISION MAKING’ BY L. C. KALDJIAN
Martin Richards

SHARED DECISION MAKING IS AN ETHICAL IMPERATIVE, BUT IMPLEMENTATION CHALLENGES PERSIST: A REJOINDER TO “CONCEPTS OF HEALTH, ETHICS, AND COMMUNICATION IN SHARED DECISION MAKING” BY LAURIS KALDJIAN
Peter Scalia and Glyn Elwyn

IN SUPPORT OF GOALS OF CARE DISCUSSIONS IN SHARED DECISION MAKING – AN EXTENDED RESPONSE TO THE REJOINDERS
Lauris C. Kaldjian

Indexing & Abstracting/Metrics
 
SCOPUS:
CiteScore 2016: 0.35
SJR 2015: 0.176
SNIP 2015: 0.264

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

 

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

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.
Posted: 2017-11-01More...
 

Small talk as work talk: Enacting the patient-centered approach in nurse-practitioner-patient visits

Small talk in medical visits has received ample attention; however, small talk that occurs at the close of a medical visit has not been explored. Small talk, with its focus on relational work, is an important aspect of medical care, particularly so considering the current focus in the US on the patient-centered approach and the desire to construct positive provider– patient relationships, which have been shown to contribute to higher patient satisfaction and better health outcomes. Therefore, even small talk that is unrelated to the transactional aspect of the medical visit in fact serves an important function. In this article, I analyze small talk exchanges between nurse practitioners (NPs) and their patients which occur after the transactional work of the visit is completed. I focus on two exchanges which highlight different interactional goals. I argue that these examples illustrate a willingness on the part of all participants to extend the visit solely for the purpose of constructing positive provider–patient relationships. Furthermore, because exchanges occur after the ‘work’ of the visit has been completed, they have the potential to construct positive relationships that extend beyond the individual visit.
Posted: 2017-11-01More...
 

Developing a new empathy-specific admissions test for applicants to medical schools: A discourse-pragmatic approach

The ability to empathise with patients is an important professional skill for doctors. Medical students practise this skill as part of their medical education, and are tested on their use of empathy within their final examination. Evidence shows that appropriate training makes a difference but that natural aptitude also plays a role. Most medical schools, therefore, probe applicants’ basic understanding of empathy at admissions interviews. The purpose of the project presented in this paper was to apply existing understanding of how empathy may be communicated in a clinical context (building on a literature review by Pounds [2011]) to develop a new empathy-specific medical admissions interview station, probing applicants’ empathic communicative performance (not just theoretical knowledge) and fitting the widely used Multiple Mini Interview (MMI) format. The paper outlines how this tool was developed, trialled and implemented by: (1) conceptualising empathic communication in discourse-pragmatic terms – that is, as a set of specific but context-dependant empathic speech acts; and (2) formulating and trialling a written and two oral versions of a situational test, capable of probing the applicants’ ability to communicate empathically in everyday conversation and suitable for use at Norwich Medical School and other similar educational institutions.
Posted: 2017-10-20More...
 

‘We are the barriers’: Danish general practitioners’ interpretations of why the existential and spiritual dimensions are neglected in patient care

Although it is broadly recognized that health problems often involve existential and spiritual dimensions, recent research shows that these aspects of illness are rarely attended to by health professionals. Studies explain this in terms of barriers to communication, but health professionals’ firsthand experiences and interpretations have so far been largely unexplored. Drawing on the theoretical traditions of phenomenology and hermeneutics, the present study presents Danish general practitioners’ (GPs’) experiences and interpretations of why the existential and spiritual dimensions are marginalized in patient care. We conducted seven focus groups, constituting a total sample of 31 GPs. Based on the analytic strategy of Interpretative Phenomenological Analysis (IPA), our analysis revealed that the GPs experienced and interpreted individual barriers as created and fostered within dominant biomedical and secular cultures that are characterized as ‘solution focused’ and ‘faith frightened’. Many GPs further understand themselves as barriers, because they are enculturated into these dominating cultures. We discuss these findings through theoretical concepts such as ‘secondary socialization’, ‘system colonization’ and ‘secularization’, and suggest interventions that might challenge current practice culture.
Posted: 2017-10-19More...
 

Two models of ethical alignment through metacommunication in clinical situations

The literature on communication in patient-centred care typically focuses on physicians’ alignment strategies. The goals of these strategies are diagnostic accuracy, effectiveness via compliance and patient-centredness. Although the success of these strategies can to some extent be measured, the ethical standards by which they are evaluated are not sufficiently clear. This article presents two models of alignment through ‘explicit’ metacommunication, derived from two different ethical perspectives on patient-centredness. The article first presents the concept of metacommunication and identifies two ethical perspectives that produce normative stands concerning patient-centredness: the logic of care and internal morality. Second, the article presents two models of how metacommunication can contribute to the visibility and accomplishment of these two ethical perspectives in clinical alignment.
Posted: 2017-09-28More...
 

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...
 

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...
 

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...
 

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...
 

Announcements

 

COMET 2018

 
The University of Birmingham are pleased to be hosting the 2018 Communication, Medicine, and Ethics Conference (COMET), 25-27 June 2018.  
Posted: 2017-08-14 More...
 
More Announcements...



Equinox Publishing Ltd - 415 The Workstation 15 Paternoster Row, Sheffield, S1 2BX United Kingdom
Telephone: +44 (0)114 221-0285 - Email: info@equinoxpub.com

Privacy Policy