Communication in medicine 

About: Communication in medicine is an academic journal published by Equinox Publishing. The journal publishes majorly in the area(s): Conversation analysis & Health care. It has an ISSN identifier of 1612-1783. Over the lifetime, 358 publications have been published receiving 3266 citations. The journal is also known as: Communication and medicine (Internet) & Communication and medicine (Print).

Listening to people with seizures: how can linguistic analysis help in the differential diagnosis of seizure disorders?

Abstract: Despite advances in medical technology, the patients’ history remains the most crucial tool in the differential diagnosis of epileptic or non-epileptic seizures (NES). The distinction of these two types of seizures is a common and important task for neurologists. Whereas epileptic seizures would be treated with antiepileptic drugs, non-epileptic seizures are thought to be a manifestation of psychological or social distress and can improve with psychotherapy. This paper summarizes the findings of a series of multidisciplinary research studies undertaken at the Bethel Epilepsy Centre and the University of Bielefeld in Germany in which linguistic analysis was carried out to identify and describe linguistic and interactional features in clinical exchanges between doctors and patients with seizures. Two distinct communication profiles emerged in these studies based on the analysis of transcripts of over 110 doctor-patient encounters. Epileptic seizure descriptions are characterized by formulation effort, provide the doctor with a coherent account of individual seizures, relate subjective seizure experiences and use consistent metaphoric conceptualizations. Patients with NES tend not to volunteer subjective seizure symptoms, give accounts of their seizures which are difficult to understand and are inconsistent in their choice of metaphors.

Journalists and jabs: media coverage of the MMR vaccine.

Abstract: The MMR vaccine became front-page news in early February 2002, in a much reported controversy about alleged links between MMR and autism. We examine both media content and public opinion and knowledge to explore how this controversy was presented, and, in turn, how this coverage influenced public perceptions. The news coverage of MMR was monitored over a seven and a half month period from 28 January to 15 Septembez 2002. Two national surveys were conducted--in April and in Octobez 2002--both based on over 1000 face to face interviews, with the purpose of exploring what the public learned from the coverage, and how this information may have influenced attitudes towards the vaccine. We will argue that the media ~ critical scrutiny of those supporting MMR was not matched by a rigorous examination of the case against it, and that the public was, as a consequence, often misinformed about the level of risk involved.

Patients' responses to interpretations: a dialogue between conversation analysis and psychoanalytic theory.

Abstract: The paper reports a conversation analytical study of patients' responses to interpretations in psychoanalysis. The data come from 27 tape-recorded and transcribed psychoanalytic sessions involving three analyst-patient dyads. The study seeks to facilitate dialogue between conversation analytical (CA) findings and psychoanalytic theory by using CA to describe the practices in and through which the psychoanalytic theory concerning interpretation is realized in actual interactions. Four empirical observations are reported in the paper: (1) The analysts actively pursue a more than minimal response from the patient to their interpretations. (2) A typical extended response to an interpretation involves an elaboration, which is an utterance in which the patient takes up some aspect of the interpretation and continues discussion on that. (3) Even though elaborations convey agreement with the interpretation, they often also involve different degrees of discontinuity with what the interpretation initially aimed at. (4) This discontinuity is sometimes facilitated by the analyst's own actions. These observations invite some specifications in the picture of interpretations provided by psychoanalytic theory.

Presentation of self and symptoms in primary care consultations involving patients from non-English speaking backgrounds.

Abstract: This paper draws on the PLEDGE research project (Patients with Limited English and Doctors in General Practice) 1 The Patients with Limited English and Doctors in General Practice (PLEDGE) project was funded by Sir Siegmund Warburg's Voluntary Settlement (2001-2003). The research team was: Celia Roberts, Roger Jones, Becky Moss, Srikant Sarangi and Val Wass. which has a database of 232 video-recorded interactions from GP surgeries in South East London. We focus on the opening episodes-the first opportunity the patient has to report on why they have come to see the doctor-to explore some of the contrasts in self presentation and the interactional work that doctors do when faced with the unexpected. Patients who speak a local London or standard variety of English present three aspects: a description of symptoms, the context in which they occurred, and an affective or epistemic stance. These 'micro discourse routines' are accomplished interactionally through the design of figure/ground relationships, framing and metacommunication and presentation of the 'moral self'. Although some patients from non-English speaking backgrounds use broadly similar 'micro discourse routines', the majority configure the relationship between medically salient facts, adequate contextual information and the stance which conveys the 'moral self' in different and apparently less 'orderly' ways. So openings often become protracted and harder work interactionally for both sides. While conversation analytic studies and communication skills textbooks represent the medical consultations as orderly, we suggest that such apparent orderliness must, at least, be partly the result of ironing out linguistic and cultural diversity. Interactional sociolinguistic analysis is used to shed light on the design of these routines and to provide analytic frameworks for doctors in reflecting on their own practice in ways which challenge patient-centred models.