W. Callon, S. Saha, I. Wilson, M. B. Laws, Michele Massa, P. Korthuis, Richard D. Moore, M. Beach
{"title":"Communication prior to antiretroviral initiation","authors":"W. Callon, S. Saha, I. Wilson, M. B. Laws, Michele Massa, P. Korthuis, Richard D. Moore, M. Beach","doi":"10.1558/cam.19081","DOIUrl":"https://doi.org/10.1558/cam.19081","url":null,"abstract":"Thoughtful, high-quality clinician–patient communication about starting antiretroviral therapy (ART) is a cornerstone of HIV care, and specific guidelines regarding exactly what ought to be discussed with patients considering ART have been in place since 2006. The extent to which the recommended topics are discussed and how these topics are addressed in observed dialogue in HIV care has not been studied. We conducted a content analysis to describe how these dialogues occur and, secondarily, assessed the frequency with which the recommended topics are discussed. Our study analyzed patient–clinician dialogue regarding ART initiation, comparing the content of 24 audio-recorded dialogues with the recommended guidelines, and describing how communication about the recommended topics takes place. While patient readiness to initiate therapy was discussed in the majority of visits (n = 18), the remaining topics (e.g. patient understanding of HIV and its treatment, motivation to adhere, barriers to and facilitators of adherence, social support, daily schedules, tolerance of pills) were discussed less often. Based on the findings, we suggest that systems be put in place (e.g. checklists) to guide providers in these discussions, and that providers utilize the teach-back method to ensure patient understanding.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78204083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"new Face(book) of medicine","authors":"Staci Defibaugh, S. Gut, Elizabeth E. Weems","doi":"10.1558/cam.20979","DOIUrl":"https://doi.org/10.1558/cam.20979","url":null,"abstract":"Before the COVID-19 pandemic, many medical providers (MPs) turned to social media platforms as an opportunity to interact with colleagues and provide education to patients. When the pandemic flooded social network services (SNSs), such as Facebook, with a great deal of information, both accurate and dubious, MPs continued using SNSs to share information and updates about the infodemic (as defined by the World Health Organization). This study explores how MPs engaged in education and advice giving on Facebook during the early months of the pandemic. For this study, a total of 572 Facebook posts about COVID-19 were collected from the Facebook pages of three medical doctors between 1 January and 15 July, 2020. A total of 79 posts were analyzed, focusing on how advice was discursively constructed. The strategies analyzed included creating a light-hearted tone through moments of levity and making advice more indirect through pronoun shifts and framing devices. We argue that medical providers likely soften the force of advice because of the public/professional confluence that exists on Facebook; this approach may also make the advice more palatable. This study highlights possible implications for current MPs and aid in their overall training.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74617545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"initial investigation of improving acute care for hearing-impaired patients through the use of a transparent surgical mask","authors":"Karen Bradbury, Rachyy Pines","doi":"10.1558/cam.20514","DOIUrl":"https://doi.org/10.1558/cam.20514","url":null,"abstract":"There is a general assumption that, in the hospital setting, standard surgical masks, unlike transparent masks, prevent effective communication with the hearing-impaired. This study investigates the experience of healthcare professionals (HPs) and hearing-impaired patients using a transparent surgical mask vs. a standard surgical mask in an acute care hospital. Our study design used a cross sectional, mixed-methods survey of 25 adult hearing-impaired patients/visitors and 36 HPs caring for them while wearing a transparent mask. The results demonstrated that 89% of staff and 76% of patients said the mask improved communication. This improvement was due to better ability to interpret nonverbal cues, which led to less need for repetition or volume increase. It was found that 69% of staff said the mask was comfortable and 81% were satisfied; 64% of patients liked being able to see facial expressions of the person wearing the mask; 72% of patients felt more connected to, and 76% understood the speech of, the person using the mask; and 80% of patients and 78% of staff preferred the transparent mask. The findings suggest that hospital staff/providers should use a mask with a clear window around the mouth and face while caring for hearing-impaired patients. This may improve patient satisfaction and prevent errors that are due to miscommunication.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86944231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"‘I feel it’s something that irritates her’","authors":"Marta Kirilova, Line Højland","doi":"10.1558/cam.19797","DOIUrl":"https://doi.org/10.1558/cam.19797","url":null,"abstract":"Interpreting is increasingly being used in psychotherapy, but the presence of an interpreter in the therapeutic encounter is an under-researched area. This paper examines interpreter-mediated trauma therapy with Danish-speaking therapists treating Arabic-speaking patients diagnosed with post-traumatic stress disorder (PTSD). We focus on the notion of ‘emotion discourse’ as a broad term covering how therapists and patients talk about emotional experience, and how interpreters negotiate and mediate it. The data consist of three group interviews with ten therapists and six excerpts from two audio-recorded interpreter-mediated therapy sessions. The detailed interaction analysis explores (1) the therapists’ expectations about interpreting emotion discourse and (2) the interactional strategies that the interpreters use to negotiate and render the interaction between therapists and patients who speak different languages. The findings show that the therapists have clear expectations about what needs to be translated and how, but these expectations remain hidden to the interpreters. The interpreters use various interpreting strategies and orient towards meaning rather than towards verbatim translations. We conclude by recommending that both therapists and interpreters engage in a professional collaboration that requires not only training and awareness of mutually relevant information, but also an updated view of interpreter-mediated interaction as a dynamic collaborative process.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80575992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Moving books and sensitive readers","authors":"Anja Rydén Gramner","doi":"10.1558/cam.20400","DOIUrl":"https://doi.org/10.1558/cam.20400","url":null,"abstract":"Fiction is understood to have unique qualities that emotionally engage the reader, making it suitable as a didactic tool in medical education to help students prepare for the emotional aspects of their future profession. To date, however, little is known about the processes through which talking about fiction, film or poetry can help medical students to co-construct emotional reactions as affective stances and how that might contribute to their professional development.\u0000Using a discursive psychology approach, video recordings from 36 fiction seminars collected from 2016 to 2018 were analysed regarding how affective stances related to reading were constructed by medical students. The findings illustrate how students use subject–object relations to account for affective stances, meaning that they attribute their emotional reaction either to an aspect of the book (object-side explanations), or to personal characteristics (subject-side explanations). The way students enact and account for their affective stances can provide opportunities for tutors to create teachable moments for the students. This study contributes to discursive psychology and reader-response research, as well as medical education research.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90857705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"‘Best of luck on your journey to healing’","authors":"M. Ceuterick, J. Declercq","doi":"10.1558/cam.22677","DOIUrl":"https://doi.org/10.1558/cam.22677","url":null,"abstract":"In many countries, including Belgium and the Netherlands, dependence on benzodiazepines (BZDs) is a medical and social issue, and, for long-term users who want to taper off, doing so remains a personal challenge. For these users, online contexts such as forums can be a place to discuss this experience and look for practical and moral support among former users and fellow users trying to reduce or stop BZD use. This paper aims to shed light on the discourses of a Dutch-language benzodiazepine withdrawal forum, examining 133 forum threads (41,516 words). We take a corpus-based approach that combines frequency analyses with qualitative discourse analysis. We explore how the users extensively share lived, experiential knowledge of using and reducing medication and, in doing so, engage with domain-specific biomedical jargon. As such they discursively construct specialised expertise and a medical(ised), health professional-like expert identity, both in relation to their own situation, but also in interaction with other forum members, as advisors to each other. The forum thus not only serves as a site for emotional peer support, but also as a site for detailed informational support on tapering, which is traditionally offered by health professionals. This is especially pervasive, as many forum users also express indignation about the medical establishment and its lack of institutional knowledge support in the process of tapering off.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87377259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Courtney J. Andrews, Valerie M Lawhon, K. Wiseman, G. Rocque
{"title":"‘It sounds very negative’","authors":"Courtney J. Andrews, Valerie M Lawhon, K. Wiseman, G. Rocque","doi":"10.1558/cam.20721","DOIUrl":"https://doi.org/10.1558/cam.20721","url":null,"abstract":"New developments in cancer research provide opportunities to reduce the amount or intensity of chemotherapy for patients with early-stage breast cancer (EBC), with the goal of achieving recurrence-free survival rates equivalent to the current standard of care while reducing the short- and long-term toxicities that are associated with more aggressive chemotherapy regimens. Clinical trials are necessary to determine the lowest effective dosage of chemotherapy, and there is interest from patients and providers to enroll eligible patients in these trials. Currently, the word being used to describe these trials is ‘de-escalation’. This paper considers the reactions of EBC patients and patient advocates to the word ‘de-escalation’ and how best to describe this approach and its anticipated benefits. Based on a patient survey and on interviews that were coded with the assistance of a content analysis program, we found that the participants tended to react negatively to ‘de-escalation’, with many associating this word with giving up in the war against cancer. Instead, the participants prefer positive, patient-centered language. This information will be useful to providers in considering how best to describe de-escalation clinical trials to eligible patients in ways that avoid therapeutic misconception and facilitate the shared decision-making process regarding treatment.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85683681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Agency in endometriosis pain communication in English and Spanish","authors":"Stella Bullo, M. Pascual, Dalia Magaña","doi":"10.1558/cam.20075","DOIUrl":"https://doi.org/10.1558/cam.20075","url":null,"abstract":"This article interrogates the linguistic construction of agency in accounts of endometriosis pain in English and Spanish. Endometriosis is a reproductive condition causing incapacitating pain which is often dismissed or normalised, leading to delayed diagnosis. We take a patient-centred qualitative approach and analyse data gathered from 10 semi-structured interviews with women with endometriosis in British English and Argentine Spanish, using the transitivity and social actor representation frameworks. The findings indicate that the women across the two settings represent pain as an agentive overpowering actor and themselves with varying degrees of decreased agency. However, pain is more closely related to mental representations of the patients’ experiences in Spanish than in English, where it is construed as an actor performing physical actions. The findings of the study have implications for pain communication practices and cross-language healthcare communication and should inform local pain assessment measures.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78004017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Silke Creten, Priscilla C. Heynderickx, Sylvain M Dieltjens
{"title":"‘The monster in the back seat’","authors":"Silke Creten, Priscilla C. Heynderickx, Sylvain M Dieltjens","doi":"10.1558/cam.22492","DOIUrl":"https://doi.org/10.1558/cam.22492","url":null,"abstract":"People living with dementia (PWDs) often experience stigma that is reinforced by negative representations of the condition in discourse. This paper addresses the lack of research into this stigma by analyzing the representation of the condition in naturally occurring texts of people in direct contact with PWDs. Two blogs from Flemish family caregivers and one blog from a Flemish health professional were selected based on word count and keyword relevance, and studied both quantitatively and qualitatively. For the quantitative analysis keywords, n-grams, and collocations were identified in 225 blog posts, using Sketch Engine. For the qualitative analysis, 26 blog posts were analyzed by categorizing conceptual metaphors according to their conceptual mappings. The quantitative analysis indicates that the health professional employs a different approach in reporting, compared to the family caregivers. The qualitative analysis results in five conceptual mappings: PWDs as living dead, PWDs as trees, dementia as concealment, dementia as an acting entity and dementia as an attack. The frequency of these mappings shows that the condition is being dissociated from the PWDs, and described with more negative metaphors than the PWDs themselves.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77959677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elise Kvalsund Bårdsgjerde, M. Kvangarsnes, T. Hole, M. Nylenna, B. Landstad
{"title":"Physicians’ perceptions of patient participation in the myocardial infarction pathway","authors":"Elise Kvalsund Bårdsgjerde, M. Kvangarsnes, T. Hole, M. Nylenna, B. Landstad","doi":"10.1558/cam.20555","DOIUrl":"https://doi.org/10.1558/cam.20555","url":null,"abstract":"Myocardial infarction is an acute, frightening and life-threatening condition for patients who are affected. They need plain and simple information about the disease and the treatment, yet patient participation might be challenging in acute situations. Previous studies have shown that patient participation leads to improved patient satisfaction, cooperation with healthcare professionals and better management of the disease. Physicians have a key role in facilitating patient participation in the healthcare services. This study explores physicians’ perceptions of patient participation in the myocardial infarction pathway. In 2018 we interviewed nine experienced physicians in Norway working in different phases of the pathway. Hermeneutics was chosen as the underpinning analytical framework. Four themes illustrated patient participation in the myocardial infarction pathway. Paternalism characterised the acute phase. During hospitalisation the physicians perceived a lack of continuity in physician–patient communication. In the discharge phase, the physicians focused on strengthening health literacy. In the rehabilitation phase, dialogue and shared decision making was central to achieving treatment adherence. We found variations in the level of patient participation along the different phases of the myocardial infarction pathway. Strengthening continuity to ensure patient participation and collaboration between healthcare professionals is essential. The physicians proposed introducing checklists for patient information to enhance interprofessional collaboration and strengthen patient participation.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90339862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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