Latest Issue: Vol 12, No 1 (2015) RSS2 logo

Communication & Medicine

Editor Srikant Sarangi Aalborg University, Denmark

Please click here to join the COMET Society. COMET 2016 is hosted by the Danish Institute of Humanities and Medicine, Aalborg University, from 4-6 July 2016. For more information, please click here.

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.

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.

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.

Indexing and Abstracting
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
Proquest Academic Research Library
Proquest Central
Proquest Health & Medical Complete
Proquest Health Management
ProQuest Medical Library
ProQuest Nursing & Allied Health Source
Pubmed
Scopus
European Reference Index (ERIH Plus)

Forthcoming Issue 12.2

To be announced... 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

 

Talking about paranoid experiences: Interactional dynamics of accomplishing disclosure of psychotic symptoms in triadic conversation

The present study is the first to investigate, using conversation analysis, the effects of a family member’s participation in conversation regarding the assessment of need for treatment. We aim at describing the course of a treatment negotiation, focusing on interactional dynamics and on disclosure of paranoid symptoms in a clinically challenging situation characterized by an acutely psychotic patient with (1) disorganized discourse, (2) poor insight, (3) aspiration to avoid hospital treatment, and (4) a relative who was supporting in-patient care. In the triadic conversation, in which the patient, his relative, and the psychiatrist participated, different consecutive phases were distinguished. The Relative Prominent Information Phase (RIP) was characterized by the relative’s statements on the patient’s problematic behavior, and conflicting views between the patient and his relative led to denial of symptoms by the patient. When the patient was prominent in the latter Patient Prominent Information Phase (PIP), the display of several different social actions and corresponding linguistic devices were linked with more overt talk about paranoid experiences by the patient, albeit in a disorganized manner. RIP and PIP were followed by an Evaluation and Decision Phase (EDP).
Posted: 2016-04-21More...
 

Third-party turns and shared knowledge: Supports and challenges to disabled people in social care and research settings

Adopting a conversation analysis (CA) perspective, this paper explores data which include disabled people in three-party contexts, where the institutional goal is to focus on the wishes, voice and agency of the disabled person. It explores 274 occasions where a third party self-selects for a turn, during social care planning meetings and research interviews. Five broad action patterns are discussed, showing how third parties used their epistemic closeness to the disabled person in order to (1) clarify, (2) respond, (3) prompt, (4) expand and (5) challenge. The sequential consequence of these turns depended on how they were heard and taken up by other parties in the talk. The vast majority of third-party turns could be glossed as supportive to the disabled person. Third parties displayed their sensitivity towards the precise moment that they were ‘needed’ in the talk. Occasionally, there were challenges and counterinformings done by the third party, which could be analysed as ‘epistemic traps’. These moments signaled tensions between the best interests of the disabled person and the imperative to foreground their voice.
Posted: 2016-02-27More...
 

Can conversation analytic findings help with differential diagnosis in routine seizure clinic interactions?

There are many areas in medicine in which the diagnosis poses significant difficulties and depends essentially on the clinician’s ability to take and interpret the patient’s history. The differential diagnosis of transient loss of consciousness (TLOC) is one such example, in particular the distinction between epilepsy and ‘psychogenic’ non-epileptic seizures (NES) is often difficult. A correct diagnosis is crucial because it determines the choice of treatment. Diagnosis is typically reliant on patients’ (and witnesses’) descriptions; however, conventional methods of history-taking focusing on the factual content of these descriptions are associated with relatively high rates of diagnostic errors. The use of linguistic methods (particularly conversation analysis) in research settings has demonstrated that these approaches can provide hints likely to be useful in the differentiation of epileptic and non-epileptic seizures. This paper explores to what extent (and under which conditions) the findings of these previous studies could be transposed from a research into a routine clinical setting.
Posted: 2016-02-17More...
 

‘Using Chinese medicine in a Western way’: Negotiating integrative Chinese medicine treatment for Type 2 Diabetes

Type 2 diabetes affects Chinese Americans at an alarming rate and many Chinese Americans use Chinese medicine principles to deal with their diabetes. In this article, we examine interviews with Chinese medicine practitioners about the best ways to treat diabetes and xiaoke (Chinese medicine’s closest equivalent to diabetes). These interviews were conducted to examine how practitioners would promote a particular form of integrative medicine – in this case, using Chinese medicinal principles to suggest food treatments for diabetes or xiaoke. Our research expands understandings of integrative medicine and Chinese medicine recognizing that in practice, the static categories of Chinese and Western diagnosis and treatment are not very useful for understanding how integration occurs. Instead, Chinese medicine practitioners negotiate between the poles of individual and standardized on one dimension and physical and energetic on another dimension as a way of practicing Chinese medicine and enregistering their professional identities here in the U.S. Examining these interviews from a language and social interaction perspective, we present integration as a performance and enactment of social personae rather than a product. We highlight the need to attend to differences in what oftentimes is treated as a monolithic community of Chinese medicine in the U.S.
Posted: 2016-02-17More...
 

A stitch in time: Instructing temporality in the operating room

This paper examines how time is made explicitly relevant in the way the attending surgeon monitors and corrects the performance of a resident during a kidney transplant surgery. In so doing, we observe how the attending constitutes time as a significant and constituent feature of the surgical actions performed by the resident. In order to instruct temporal competence in the performance of surgical procedures, the attending surgeon identifies and makes instructably observable the temporally significant features of the surgical work just as that work is performed, by (a) producing countdowns, pace prompts, and temporal accounts when and as avoidable errors occur, and (b) planning and coordinating current and upcoming actions in relation to other actions. Instructing a trainee in the temporal features of his/her performance occurs when the attending (a) coordinates the production of specific verbal tokens, remarks, and accounts with specific actions performed by the resident as the resident performs them, or (b) anticipates the performance of subsequent actions in relation to current surgical actions underway. This case demonstrates how temporality becomes an observably instructable matter in interaction.
Posted: 2016-02-17More...
 

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...
 

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...
 

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...
 

Establishing mutual understanding in interaction: An analysis of conversational repair in psychiatric consultations

The therapeutic relationship is the greatest predictor of treatment outcome, yet its relationship to communication is largely unevaluated. This study explored how psychiatrists and people with a diagnosis of schizophrenia establish mutual understanding in naturalistic communication, and associations with the therapeutic relationship, patient satisfaction and symptoms. In conversation analysis, the concept of repair focuses on how participants in interaction create mutual understanding and address misunderstanding. A standardized protocol measuring the frequency of repair was applied to 15 outpatient consultations. Correlations between repair and the therapeutic relationship, patients’ experience of the consultation and symptoms were explored. Patients made most effort to make their contribution understandable, whereas psychiatrists made most effort to repair misunderstandings. The more positively psychiatrists rated the relationship, the more effort they made to understand patients. Although psychiatrists’ efforts were not associated with patients’ overall view of the relationship, patients felt better emotionally, despite, feeling less understood. Psychiatrists used fewer repairs when patients were more symptomatic. Both parties prioritized understanding similar topics but psychiatrists focused more on medication and patients on voices. Quantifying repair offers a new way of analyzing how mutual understanding is established in interaction, and links communication processes with treatment outcomes.
Posted: 2010-01-16More...
 

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