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- 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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- 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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- 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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- Rahm, Henrik, et al.
(författare)
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The collective voice : legitimation strategies in focus group discussion with nurses in municipal palliative care for older people in Sweden
- 2014
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Ingår i: Communication & Medicine. - 1612-1783 .- 1613-3625. ; 11:2, s. 167-177
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores focus group discussions of registered nurses in municipal palliative care for older people, using data collected by researchers with an interest in health sciences. The linguistically based discourse analyis builds on a combination of Bakhtinian notions of dialogicity, the Other and addressivity, the use of quotations, and also van Leeuwen’s framework for legitimation in discourse. The aim is to investigate strategies of addressing and legitimizing palliative care. Three types of narrative are discerned: the cautionary tale, fictionalization of professional experiences and the enactment of a fictive dialogue. The other professions involved (physicians, assistant nurses) are positioned as the Other as a means of legitimizing the perspectives of the registered nurses. As the patients and their next of kin are the objects of professional activities, the notion of the Third (connecting to the Other) is proposed. The objectification is a manifestation of commitment with routinized and professional distance to the patients.
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- Rahm, Henrik, et al.
(författare)
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The Collective Voice Legitimation Strategies in Focus Group Discussions with Nurses in Municipal Palliative Care for Older People in Sweden
- 2014
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Ingår i: Communication & Medicine. An Interdisciplinary Journal of Healthcare, Ethics and Society. - : Equinox Publishing. - 1613-3625. ; Volume 11(2) (2014), s. 167-177
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores focus group discussions of registered nurses in municipal palliative care for older people, using data collected by researchers with an interest in health sciences. The linguisti- cally based discourse analyis builds on a combi- nation of Bakhtinian notions of dialogicity, the Other and addressivity, the use of quotations, and also van Leeuwen’s framework for legitima- tion in discourse. The aim is to investigate strat- egies of addressing and legitimizing palliative care. Three types of narrative are discerned: the cautionary tale, fictionalization of profession- al experiences and the enactment of a fictive dialogue. The other professions involved (phy- sicians, assistant nurses) are positioned as the Other as a means of legitimizing the perspec- tives of the registered nurses. As the patients and their next of kin are the objects of profes- sional activities, the notion of the Third (con- necting to the Other) is proposed. The objectifi- cation is a manifestation of commitment with routinized and professional distance to the patients.
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- Rindstedt, Camilla, 1960-
(författare)
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Pain and nurses' emotion work in a paediatric clinic : Treatment procedures and nurse-child alignments
- 2013
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Ingår i: Communication & Medicine. - : Equinox Publishing. - 1612-1783 .- 1613-3625. ; 10:1, s. 51-61
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Tidskriftsartikel (refereegranskat)abstract
- In the treatment of cancer in children, treatment procedures have been reported to be one of the most feared elements, as more painful than the illness as such. This study draws on a video ethnography of routine needle procedure events, as part of fieldwork at a paediatric oncology clinic documenting everyday treatment negotiations between nurses and young children. On the basis of detailed transcriptions of verbal and nonverbal staff–child interaction, the analyses focus on ways in which pain and anxiety can be seen as phenomena that are partly contingent on nurses’ emotion work. The school-age children did not display fear. In the preschool group, though, pain and fear seemed to be phenomena that were greatly reduced through nurses’ emotion work. This study focuses on three preschoolers facing potentially painful treatment, showing how the nurses engaged in massive emotion work with the children, through online commentaries, interactive formats (delegation of tasks, consent sequences, collaborative‘we’-formats), as well as solidarity-oriented moves (such as praise and endearment terms). Even a young toddler would handle the distress of needle procedures, when interacting with an inventive nurse who mobilized child participation through skilful emotion work.
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- Samuelsson, Christina, 1966-, et al.
(författare)
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Defusing practices as mitigation in speech and language intervention.
- 2014
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Ingår i: Communication & Medicine. - : Equinox Publishing. - 1612-1783 .- 1613-3625. ; 11:3, s. 299-312
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Tidskriftsartikel (refereegranskat)abstract
- In the present paper, speech and language intervention was investigated in order to explore the use and function of defusing practices. Defusing practices may be viewed as a special form of mitigation. In previous research, including studies on clinical interaction, mitigation has been described mainly as devices used in order to reduce the unwelcome effects of an utterance, or reduce the discomfort of bad news. Defusing practices, however, appear to serve somewhat different functions, which are examined here. Data comprises video and audio recordings of eight intervention sessions with children with language impairment (LI), and six intervention sessions with adults with aphasia, The analysis revealed the following kinds of defusing practices: circumscriptions/figurative language, diminutive words, words like ‘try’ or ‘test’, placing the problem outside of the patient, collective pronouns, diminishing the speech and language pathologist’s own competence, encouragement, and references to well-known phenomena. If speech and language therapists (SLPs) are made aware of the practice and function of defusing, they may make conscious use of these practices in order to reduce face-threatening situations in intervention
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- Sandvide, Åsa, 1959-, et al.
(författare)
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How care providers construct and frame problems related to violence in institutional care for older people
- 2010
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Ingår i: Communication & Medicine. - : Walter de Gruyter GmbH. - 1612-1783 .- 1613-3625. ; 7:2, s. 155-164
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to describe how care providers discursively constructed and framed problems related to the occurrence of violence in their interactions with older persons in institutional care. The study followed a social constructionist approach where violence was considered a social phenomenon constructed in discursive processes. It was based on the assumption that in the way in which a problem is articulated is closely connected to solutions that are possible and relevant in a given context. The analysed corpus comprised narrative interviews with 46 care providers who had been involved in violence that occurred in social interactions with older persons. The analysis was inspired by discourse theory. The problems concerned legitimization, illness, bodily care, competence and profession and relieved responsibility. The constructions of the problems are manifestations of discourses. The prevailing discourses in the text are the medical and the physical. The construction of problems can be used to challenge dominant ways of thinking as well as the beliefs and common understandings about the subject.
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- Sandvide, Åsa, et al.
(författare)
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How Care Providers' Construct and Frame Problems Related to Violence in Institutional Care for Older People
- 2010
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Ingår i: Communication & Medicine. - : Equinox Publishing. - 1612-1783 .- 1613-3625. ; 7:2, s. 155-164
-
Tidskriftsartikel (refereegranskat)abstract
- The aim was to describe how care providers discursively constructed and framed problems related to the occurrence of violence in their interactions with older persons in institutional care. The study followed a social constructionist approach where violence was considered a social phenomenon constructed in discursive processes. It was based on the assumption that the way in which a problem is articulated is closely connected to beliefs, which in turn create and maintain a space for the support of certain actions and solutions that are possible and relevant in the given context. The analyzed text comprised narrative interviews with 46 care providers who had been involved in violence that occurred in social interactions with older persons. The analysis was inspired by discourse theory. The interactions were presented as a difficult and unavoidable problem related to the illness, caring for the body, competence and profession as well as the social order. The descriptions of the violence and related problems are manifestations of discourses. The prevailing discourses in the text were the medical and physical. The presentations of problems can be used to challenge dominant ways of thinking as well as the beliefs and common understandings about the subject.
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