Latest Issue: Vol 14, No 3 (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 15.1 (2018) [2019]

Table of Contents

ARTICLES 

GETTING TO 'NO': THREE WAYS TO JOINTLY ACCOMPLISH AN ANSWER TO QUESTIONS IN A QUESTIONNAIRE IN DOCTOR-PATIENT INTERACTION

Elisabeth Muth Andersen, Gitte Rasmussen, Catherine E. Brouwer and Jytte Isaksen


INSULIN RESTRICTION, MEDICALISATION AND THE INTERNET: A CORPUS-ASSISTED STUDY OF DIABULIMIA DISCOURSE IN ONLINE SUPPORT GROUPS

Gavin Brookes


PATIENTS’ REPRESENTATIONS OF DEPRESSIVE SYMPTOMS AND PHYSICIANS’ RESPONSES IN CLINICAL ENCOUNTERS

Christina Fogtmann Fosgerau and Annette Sofie Davidsen

 

INTERACTIONS IN PSYCHIATRIC CARE CONSULTATION IN AKAN SPEAKING COMMUNITIES

Ekua Essumanma Houphouet, Nana Aba Appiah Amfo, Eugene K. Dordoye and Rachel Thompson

 

NURTURING ANAESTHETIC EXPERTISE: ON NARRATIVE, AFFECT AND PROFESSIONAL INCLUSIVITY

Rick Iedema and Christine Jorm


INTER-ORGANISATIONAL USE OF THE ELECTRONIC HEALTH RECORD IN MENTAL HEALTH

Jenni-Mari Räsänen and Kirsi Günther


VERBAL AND NONVERBAL COMMUNICATION OF AGENCY IN ILLNESS NARRATIVES OF PATIENTS SUFFERING FROM MEDICALLY UNEXPLAINED SYMPTOMS (MUS)

Agnieszka Sowińska

 

PERCEPTIONS OF THE NEED FOR MINORITY LANGUAGES BY NURSES IN SOUTHERN TAIWAN

Mei-hui Tsai, Huan-Fang Lee, Shuen-Lin Jeng, Sheng-Che Lin, Li-Wei Hsieh, Jen-Pin Chuang and Elizabeth A. Jacobs

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

 

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...
 

The third speaker: The body as interlocutor in conventional, complementary, and integrative medicine encounters

This paper examines talk about the body in interactions between patients and their complementary/ alternative providers (CAM), integrative physicians (IM), or conventional physicians. In an analysis of 603 consultations, we focus on instances where the body is spoken of in agentive terms. We thus examine particular micro-interactive moments where the body is constituted as an agent that speaks, responds, and otherwise acts in ways that direct the flow of conversation or the medical decision-making process. With this data, we demonstrate how body-as-agent metaphors in the clinical encounter underscore the communicative agency of providers and position the body as an interlocutor or ‘third speaker’ in conversation with the patient and provider. We further note that we found only limited differences in the ways body-as-agent metaphors were used by CAM/IM and conventional providers. Rather than arguing that such differences demonstrate a fundamental divide between CAM/IM and conventional approaches, we therefore suggest that these kinds of supportive body-as-agent talk exist as opportunities for all providers to support patients in taking a more active stance in managing their relationship with their body.
Posted: 2018-04-16More...
 

Testing for resistance: Point-of-care testing as a communicational tool in antibiotic prescribing

As antibiotic resistance becomes a growing health emergency, effective strategies are needed to reduce inappropriate antibiotic use. In this article, one such strategy – communicative practices associated with the C-reactive protein point-of care test – is investigated. Building on a collection of 31 videorecorded consultations from Danish primary care, and using conversation analysis, this study finds that the rapid test can be used throughout the consultation to incrementally build the case for a nonantibiotic treatment recommendation, both when the test result is forecast and reported. The study also finds that the format of reports of elevated results differs from that of ‘normal’ results, resulting in a subtle shift of authority from doctor to test.
Posted: 2018-04-16More...
 

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...
 

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...
 
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