Communication and Medicine最新文献_第9页

Patients’ representations of depressive symptoms and physicians’ responses in clinical encounters 患者对抑郁症状的描述和医生在临床遭遇中的反应

Communication and Medicine Pub Date : 2019-07-03 DOI: 10.1558/CAM.32486

C. Fosgerau, A. Davidsen

{"title":"Patients’ representations of depressive symptoms and physicians’ responses in clinical encounters","authors":"C. Fosgerau, A. Davidsen","doi":"10.1558/CAM.32486","DOIUrl":"https://doi.org/10.1558/CAM.32486","url":null,"abstract":"Depression is defined by a list of symptoms. However, patients' experiences of these symptoms and the ways they are represented in medical consultations are not well described. Applying the methods of systemic functional linguistics and conversation analysis, we aim to explore how patients diagnosed with depression represent their depressive symptoms in medical consultations, and how physicians respond to patients' representations.We analyzed 30 video-recorded consultations between general practitioners or psychiatrists and patients with moderate depression, and found that one third of the patients represented experiences of activity located in the head or brain. The patients' representations of such head/brain symptoms were instantiated through a delimited set of transitivity patterns - material Processes and relational Processes - without any specification of agency. The transitivity patterns reflected experiences of head/brain symptoms taking place outside the patients' control. When physicians engaged with patients' head/brain experiences, they tried to make them fit into their own understanding of depression, which did not include head/brain symptoms detached from the patients' agency. \u0000Linguistic and interactional methods could promote insights into patients' experiences of depressive illness and we suggest that more focus should be placed on understanding patients' experiences, and that the intersubjective understanding of the patient could be further studied using linguistic methods.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90582771","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}

引用次数: 2

Insulin restriction, medicalisation and the Internet 胰岛素限制、医疗化和互联网

Communication and Medicine Pub Date : 2019-03-25 DOI: 10.1558/CAM.33067

Gavin Brookes

{"title":"Insulin restriction, medicalisation and the Internet","authors":"Gavin Brookes","doi":"10.1558/CAM.33067","DOIUrl":"https://doi.org/10.1558/CAM.33067","url":null,"abstract":"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. \u0000Open Access: CC BY \u0000This 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).","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85857558","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}

引用次数: 4

Getting to ‘no’ 学会说“不”

Communication and Medicine Pub Date : 2018-11-26 DOI: 10.1558/cam.32459

E. Andersen, Gitte Rasmussen, C. E. Brouwer, J. Isaksen

{"title":"Getting to ‘no’","authors":"E. Andersen, Gitte Rasmussen, C. E. Brouwer, J. Isaksen","doi":"10.1558/cam.32459","DOIUrl":"https://doi.org/10.1558/cam.32459","url":null,"abstract":"This paper aims to describe the interactional processes through which a medical professional and a patient collaboratively accomplish filling out answers to a questionnaire. Empirical analysis of three different sequences from a video-recorded doctor-patient interaction in which questions of a questionnaire were answered with a ‘no' reveals three different ways (or methods) in which doctor and patient accomplish this jointly. Applying ethnomethodological conversation analysis (EMCA) as our methodological framework, we conclude that the three interactional practices are fitted in relation to the constraints of the interview that is itself methodically aligned to the practices and organizational structures of the institution, a Danish hospital. Furthermore, we make the case that questionnaires are designed as idealizations of question-answer sequences, and as such do not operate at the same level of detail as the actual question-answer situation. Details that are crucial for the objective of the questionnaire (in this case providing information to a third party) may not be included in the recorded answer. Thus, we argue that in order to understand the informational value of recorded answers in questionnaires, we need to diagnose the interaction in which they were produced, i.e. to critically examine it.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87381361","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}

引用次数: 1

Verbal and nonverbal communication of agency in illness narratives of patients suffering from medically unexplained symptoms (MUS) 医学上无法解释的症状(MUS)患者疾病叙述中能动性的言语和非言语交流

Communication and Medicine Pub Date : 2018-11-26 DOI: 10.1558/cam.32305

A. Sowińska

{"title":"Verbal and nonverbal communication of agency in illness narratives of patients suffering from medically unexplained symptoms (MUS)","authors":"A. Sowińska","doi":"10.1558/cam.32305","DOIUrl":"https://doi.org/10.1558/cam.32305","url":null,"abstract":"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.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74616328","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}

引用次数: 2

Interactions in psychiatric care consultation in Akan speaking communities 阿坎语社区精神科护理咨询的互动

Communication and Medicine Pub Date : 2018-11-26 DOI: 10.1558/CAM.32241

E. Houphouet, N. Amfo, E. Dordoye, R. Thompson

引用次数: 1

Escalating the positive in antenatal consultations: Midwife support in (inter)action 加强产前咨询的积极作用:助产士在(相互)行动中的支持

Communication and Medicine Pub Date : 2018-10-26 DOI: 10.1558/CAM.36356

E. Petraki, S. Clark

引用次数: 1

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 共同决策是一项道德要求，但实施方面的挑战依然存在:对Lauris Kaldjian的《共同决策中的健康、伦理和沟通概念》的反驳

Communication and Medicine Pub Date : 2018-10-26 DOI: 10.1558/CAM.36370

P. Scalia, G. Elwyn