| 1. |
- Bårdsgjerde, Elise Kvalsund, et al.
(författare)
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Physicians’ perceptions of patient participation in the myocardial infarction pathway
- 2021
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Ingår i: Communication & Medicine. - : Equinox Publishing. - 1612-1783 .- 1613-3625. ; 18:2, s. 111-125
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Tidskriftsartikel (refereegranskat)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.
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| 2. |
- Gustafsson, Anna W.
(författare)
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Doctors' and interpreters' conversational styles in paediatric diabetes encounters : A case study of empowering language use
- 2016
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Ingår i: Communication & Medicine. An Interdisciplinary Journal of Healthcare, Ethics and Society. - : Equinox Publishing. - 1613-3625. ; 13:2, s. 155-167
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Tidskriftsartikel (refereegranskat)abstract
- During the last few decades, ideas of empowerment, person-centred care (PCC) and shared decision-making (SDM) have informed western health care. An increasing interest in conversational styles aligned with these ideas is visible e.g. in the work to make motivational interviewing (MI) an evidence-based communicative practice. But linguistic competence is needed to identify the subtle nuances of the communicative practices in a doctor-patient consultation. It is therefore particularly important to investigate conversation styles in mediated encounters with immigrant patients. Mitigation strategies (indirect speech, hedging etc.) and confirming strategies (back-channelling, encouragement etc.) are considered to be typical of an 'empowering' conversation style. The distribution of these features in encounters with or without interpreters was analysed in a case study of two consultations with the same doctor in a children's diabetes clinic in Sweden. The results of this study indicate that the mitigation strategies and confirming strategies characteristic of a conversation style aimed at strengthening and encouraging the patient tend to get lost in mediation. The implications of these findings are discussed.
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| 3. |
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| 4. |
- Hellström Muhli, Ulla
(författare)
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Accounts of pain experience in an elderly care context
- 2010
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Ingår i: Communication & Medicine. - : Equinox Publishing. - 1612-1783 .- 1613-3625. ; 7:1, s. 55-64
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Tidskriftsartikel (refereegranskat)abstract
- This article aims to show how a discourse and communication based approach in the context of the care of the elderly provides a basis for reflecting on pain. Based on six hours of data from talk encounters between care professionals and elderly clients, an activity analysis of institutional settings and categorization of interactional discourse was undertaken. The focus was: (a) how elderly people initiated painful accounts, and (b) how the professionals oriented to such accounts. It is found that pain-talks are governed by the institutional practice of different phases: framing; mapping troubles and symptoms; clients’ self presentations; counseling, and concluding. This phase structure exemplifies knowledge of communicative activities and is part of practical knowledge which the party, or at least the professional, is expected to become acquainted with. A thematic interactional map of critical moments related to pain as (a) social death and hope, and (b) presentation of self as past and self as present emerges. The caring aspect is to support hope and to change the focus from social death to life and recovering. In foregrounding health, it is important for the elderly people to affirm their identity of themselves as being good and honest persons.
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| 5. |
- Hydén, Lars-Christer, 1954-, et al.
(författare)
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Joint working relationships : Children, parents and child healthcare nurses at work.
- 2004
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Ingår i: Communication & Medicine. - : Walter de Gruyter GmbH. - 1612-1783 .- 1613-3625. ; 1:1, s. 71-83
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- In child healthcare children's development is examined and assessed. The main aim of this article is to explore the different ways in which a child health nurse establishes joint working relationships with children and parents. Few studies in child healthcare include nonverbal interaction. It was found that a child often responds to the actions of the nurse and the parent by physical and bodily actions and by the direction of his/her gaze. The nurse has to be able to shift between several different interactional modes using various nonverbal communicative means. She uses her body to shift positions together with shifts in gaze in order to establish an interactional focus and a relationship with the child. The nurse also uses different artifacts in the room as well as the child's spontaneous activities during the assessment of the child's development. In addition, she uses the parents' relationships with their children in order to gain their support and to encourage their children in performing tasks. An important methodological consequence of this study is that it is necessary to use video-recorded data when interactions of this kind are analyzed.
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| 6. |
- Hydén, Lars-Christer, 1954-
(författare)
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Non-verbal vocalizations, dementia and social interaction
- 2011
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Ingår i: Communication & Medicine. - : Equinox Publishing Ltd. - 1612-1783 .- 1613-3625. ; 8:2, s. 135-144
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Tidskriftsartikel (refereegranskat)abstract
- In later stages of Alzheimer’s disease many people will engage in noise-making (screaming and other kinds of sounds), often experienced as interruptive by others. A problem with the noise-making is the difficulty in understanding the meaning of the noise. This study addresses two questions: to what extent is noise-making responsive to the ongoing interac- tion and is noise-making regarded as meaningless behavior by other participants? The analysis of selec- tive examples shows that noises may be fitted into the conversational interaction to a certain degree and in some instances is also responsive to interac- tion. The co-participants tend to treat the noises as meaningful. A general conclusion is that if utteranc- es and responses in interaction are treated as if they are meaningful, they will become meaningful in their consequences for all participants.
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| 7. |
- Jansson, Gunilla, 1950-, et al.
(författare)
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Language brokering in multilingual caregiving settings
- 2016
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Ingår i: Communication & Medicine. - : Equinox Publishing. - 1612-1783 .- 1613-3625. ; 13:3, s. 277-290
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Tidskriftsartikel (refereegranskat)abstract
- Using the methodology of conversation analysis to examine audio-recorded multi-party conversations between a Swedish-/Farsi-speaking resident and multilingual staff in a Swedish residential home, this article describes a practice for establishing shared understanding by one caregiver enacting the role of language broker. The focus is on caregiving settings where caregivers assist an elderly person with her personal hygiene. We demonstrate how brokering is used to (1) maintain the conversational flow in a small talk sequence and (2) address the contents in the resident’s complaints. The article thus advances our understanding of language brokering as an activity that multilingual staff in a linguistically asymmetrical workplace setting take on to assist a colleague in performing client-oriented activities.
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| 8. |
- Josephson, Iréne, et al.
(författare)
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Utilization of patient resources in physiotherapy interventions : Analysis of the interaction concerning non-specific low back pain
- 2014
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Ingår i: Communication & Medicine. - : Equinox Publishing. - 1612-1783 .- 1613-3625. ; 11:2, s. 125-137
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Tidskriftsartikel (refereegranskat)abstract
- This paper reports on an empirical study in Sweden of how patient resources come into play in physiotherapy interventions. A qualitative analysis was conducted of five video recorded first encounters between patients with non-specific low back pain (NSLBP) and physiotherapists in primary care, using Conservation of Resource Theory (COR) to identify and focus on how physiotherapists made use of patients’ resources (objects, conditions, personal characteristics and energies). The findings reveal variations in how these resources are utilized during the intervention. Resources with implications for what happens in the examination room during the ongoing encounter and resources characterized by professional familiarity were both employed in the intervention. However, underutilized resources were featured in the broader lifeworld perspective of laypeople and of other professional frames. The findings raise questions about professional challenges that go beyond professional skills. This implies that professionals need to improve skills in understanding and integrating patient resources into interventions.
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| 9. |
- Lundin, Mona, 1976
(författare)
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Getting to know a new protocol in hypertension care: Nurses’ use of patients’ self-generated graphical data in follow-up consultations
- 2019
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Ingår i: Communication & Medicine. An Interdisciplinary Journal of Healthcare, Ethics and Society. - : Equinox Publishing. - 1612-1783 .- 1613-3625. ; 16:1, s. 27-39
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Tidskriftsartikel (refereegranskat)abstract
- This study explores the use of a new protocol in hypertension care, in which continuous patient-generated data reported through digital technology are presented in graphical form and discussed in follow-up consultations with nurses. This protocol is part of an infrastructure design project in which patients and medical professionals are co-designers. The approach used for the study was interaction analysis, which rendered possible detailed in situ examination of local variations in how nurses relate to the protocol. The findings show three distinct engagements: (1) teasing out an average blood pressure, (2) working around the protocol and graph data and (3) delivering an analysis. It was discovered that the graphical representations structured the consultations to a great extent, and that nurses mostly referred to graphs that showed blood pressure values, which is a measurement central to the medical discourse of hypertension. However, it was also found that analysis of the data alone was not sufficient to engage patients: nurses' invisible and inclusion work through eliciting patients' narratives played an important role here. A conclusion of the study is that nurses and patients both need to be more thoroughly introduced to using protocols based on graphs for more productive consultations to be established.
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| 10. |
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