The 3rd International E-Symposium on Communication in Health Care
"Advancing Frontiers of Health Communication Research, Education and Practice during the Pandemic"
Session 2: Researching Social Interactions in Clinical Contexts
Talk 1: Adapting and applying linguistics to make hospitals safer: A translational research approach
This paper draws on ten years of linguistic ethnographic research and data collection in wards, intensive care units and emergency departments in Australian and Hong Kong hospitals. We will demonstrate the ways in which we have drawn on linguistics to shape research aims and define communication problems collaboratively with hospital clinicians and managers. We will describe how we have collected and analysed language and contextual data and translated the findings into training, communication protocols and policy recommendations. In particular, the paper will detail our rationale for applying and adapting specific linguistic analyses and the ways in which we have translated theoretical linguistic insights into accessible outcomes for clinicians.
To illustrate our methodological approach we will describe our analyses and translation on doctor-patient consultations in a Hong Kong Emergency Department. We will demonstrate how information is exchanged and relationships are developed in two doctor-patient consultation. Through the language analyses we demonstrate one as effective, with the patient reporting a high level of satisfaction and an understanding of diagnosis and treatment plan and the other as less effective, with the patient expressing a high degree of dissatisfaction with the clinician and indicating that she would not comply with the recommended treatment. We will then detail the challenges and opportunities in doing this kind of research including the many challenges in translating the findings into tangible interventions to improve practice.
Diana Slade is a Professor of Applied Linguistics at the Australian National University and the Director of the ANU Institute for Communication in Health Care. She is an academic researcher and educator in health communication, linguistics, description of spoken English, organisational communication and translational research design. Diana has over 30 years of experience in researching, teaching and publishing in applied linguistics, linguistics and organizational communication.
Talk 2: Communicating about illness progression and end of life
Stuart Ekberg, Ruth Parry, Victoria Land, Katie Ekberg, Marco Pino & Charles Antaki
There is growing recognition that a diverse range of healthcare professionals should adopt a palliative approach to care. Effective communication is a core component of such practice. This presentation reports the findings of a review of studies that directly observe clinicians communicating with patients and families about illness progression and end of life. Following screening, 26 studies were included in the review. Synthesis of the findings of these studies identified ten communication practices. These ten practices underpin five evidence-based recommendations for communicating with patients or family members about illness progression and end of life.
Dr. Stuart Ekberg is Senior Lecturer and Academic Lead for Research in the School of Psychology & Counselling at Queensland University of Technology (QUT). He specialises in conversation analytic studies of real-world clinical encounters involving practitioners, patients, and families. Dr. Ekberg is the QUT lead within the International Consortium for Communication in Health Care.
Talk 3: Dealing with patient reluctance in difficult decision-making process
Decision-making process in medical setting has its significance and complexities. This study examines the decision-making process in two Japanese medical settings; emergency medicine and infertility care. Though two settings have contrastive feature, there is one common feature in these settings; a patient or a family member faces with a difficult life and death choice making in their lives. For example, in the emergency medicine, family members are given an opportunity to decide whether they should withdraw a resuscitation attempt for a patient. For infertility care, patients must decide to “step-up” to use more invasive and highly technical infertility treatment such as IVF (In Vitro Fertilization). In explaining possible treatment options, doctors often show more preferred direction among those treatment options. However, it is not always a case that patients or family members agree with the direction. This study clarifies how doctors manage to establish a collaborative alliance with patients or family members during such difficult and important decision-making process.
Michie Kawashima is Associate Professor at Department of International Studies at Kyoto Sangyo University in Japan. She has mainly worked on areas of conversation analysis and health communication. Her recent publication includes ‘‘Mitori’; Practices at a Japanese Hospital: Interactional analysis of the processes of death and dying in Japan’ (2018) Discourse Studies, 21(2), 159-179.