Bernadette Watson

Visualising conversation structure across time: insights into effective doctor-patient consultations.

Effective communication between healthcare professionals and patients is critical to patients’ health outcomes. The doctor/patient dialogue has been extensively researched from different perspectives, with findings emphasising a range of behaviours that lead to effective communication. Much research involves self-reports, however, so that behavioural engagement cannot be disentangled from patients’ ratings of effectiveness. In this study we used a highly efficient and time economic automated computer visualisation measurement technique called Discursis to analyse conversational behaviour in consultations. Discursis automatically builds an internal language model from a transcript, mines the transcript for its conceptual content, and generates an interactive visual account of the discourse. The resultant visual account of the whole consultation can be analysed for patterns of engagement between interactants. The findings from this study show that Discursis is effective at highlighting a range of consultation techniques, including communication accommodation, engagement and repetition.

Prevalence of health behaviours in pregnancy at service entry in a Queensland health service district

Objective: Limited prevalence data for unhealthy pregnancy health behaviours make it difficult to prioritise primary prevention efforts for maternal and infant health. This studys objective was to establish the prevalence of cigarette smoking, sufficient fruit and vegetable intake and sufficient physical activity among women accessing antenatal clinics in a Queensland (Australia) health service district.

The Influence of Perceptions of Social Identity on Information Technology-Enabled Change

Growth in the sophistication of information technology (IT) has led to the increasing importance of information accessibility in the workplace. The pervasiveness of the resultant knowledgebased economy has centered attention on issues of employee group identity. In this article we explore how employee perceptions of group membership guide the change outcomes of an organization implementing new information technology. Using a social identity framework, we investigate the salient intergroup relationships of two groups of employees (management and IT implementation teams) and how employees use their different group memberships to reframe positions of authority or knowledge around technology change. We discuss the extent to which perceptions of social identity legitimate institutional structures already in place despite the potential of new technology.

Language, discourse and social psychology

Language and communication are central features of social behaviour. So, it is somewhat surprising that the social psychological study of language, communication and discourse has a relatively short history. In this book a leading group of language, discourse and social psychology scholars will overview the history, theories and methods of the field. However, the main focus is discussing current developments in the social psychology of language and discourse, showcasing cutting edge empirical work. The target audiences for the series are students, teachers and researchers who want to see whats going on in the field from a wider perspective. The book captures the full potential and excitement of language, discourse and social psychology. For students, the book should encourage them to see the subject in the broad, and their own studies in context. For teachers and researchers it will highlight some of the most exciting current research directions.

Patients' interactions with health providers - A linguistic category model approach

Two studies investigated interactions between health providers and patients, using Semin and Fiedler’s linguistic category model. In Study 1 the linguistic category model was used to examine perceptions of the levels of linguistic intergroup bias in descriptions of conversations with health professionals in hospitals. Results indicated a favourable linguistic bias toward health professionals in satisfactory conversations but low levels of linguistic intergroup bias in unsatisfactory conversations. In Study 2, the language of patients and health professionals in videotaped interactions was examined for levels of linguistic intergroup bias. Interpersonally salient interactions showed less linguistic intergroup bias than did intergroup ones. Results also indicate that health professionals have high levels of control in all types of medical encounters with patients. Nevertheless, the extent to which patients are able to interact with health professionals as individuals, rather than only as professionals, is a key determinant of satisfaction with the interaction.

Physiotherapists demonstrate weight stigma: a cross-sectional survey of Australian physiotherapists.

QUESTION Do physiotherapists demonstrate explicit and implicit weight stigma? DESIGN Cross-sectional survey with partial blinding of participants. PARTICIPANTS responded to the Anti-Fat Attitudes questionnaire and physiotherapy case studies with body mass index (BMI) manipulated (normal or overweight/obese). The Anti-Fat Attitudes questionnaire included 13 items scored on a Likert-type scale from 0 to 8. Any score greater than zero indicated explicit weight stigma. Implicit weight stigma was determined by comparing responses to case studies with people of different BMI categories (where responses were quantitative) and by thematic and count analysis for free-text responses. PARTICIPANTS Australian physiotherapists (n=265) recruited via industry networks. RESULTS The mean item score for the Anti-Fat Attitudes questionnaire was 3.2 (SD 1.1), which indicated explicit weight stigma. The Dislike (2.1, SD 1.2) subscale had a lower mean item score than the Fear (3.9, SD 1.8) and Willpower (4.9, SD 1.5) subscales. There was minimal indication from the case studies that people who are overweight receive different treatment from physiotherapists in clinical parameters such as length of treatment time (p=0.73) or amount of hands-on treatment (p=0.88). However, there were indications of implicit weight stigma in the way participants discussed weight in free-text responses about patient management. CONCLUSION Physiotherapists demonstrate weight stigma. This finding is likely to affect the way they communicate with patients about their weight, which may negatively impact their patients. It is recommended that physiotherapists reflect on their own attitudes towards people who are overweight and whether weight stigma influences treatment focus.

Language, Discourse, and Communication About Health and Illness: Intergroup Relations, Role, and Emotional Support

It is no understatement to say that research into communication in health contexts is vast. Finnegan and Viswanath (1990) identified five areas of health communication: professional–patient relations, lifestyle campaigns, interprofessional relations, health professional training, and health information systems. More recently, Beck et al. (2004) reviewed research between 1990 and 2000. They identified three main areas of published research: individuals seeking health information, public health campaigns, and health care delivery. This huge scope reflects the salience and importance to most of society inherent in all aspects of health and illness. Furthermore, in recent times, demographic and technological changes such as the ageing of the population and lower mortality from traumatic injury have produced consequent changes in the relative balance between acute illness on one hand and chronic illness and disability on the other. These changes have led to an increased emphasis on the social and psychological features of the contexts. For example, the Australian National Health and Medical Research Council now asks for a statement of the social impact of each piece of research that is proposed for funding. Similarly, there are now targeted calls for research in most Western countries on specific social or psychological aspects of health, illness and disability.

Developments in Health Communication in the 21st Century

In this article, five papers that formed the Special Issue for the fourth International Association of Language and Social Psychology Taskforce on health communication are revisited. Our starting point is Gallois’s epilogue and the six themes she identified from those papers. These themes are invoked to explore where health communication is moving in the 21st century. Burgeoning work on intergroup communication in this context, patient voice, minority groups, and the role of the carer are highlighted.

Talking up failure: How discourse can signal failure to change

This article explores the predictive properties of talk as an indicator of failure to change. As part of the exploration of organizational change, researchers regularly focus on how discourse is used and applied to achieve certain processes and outcomes. This position presents change as a function of particular types of communication and its interpretation. Using longitudinal data of an organization’s technology change, we propose that the way employees talk about planned organizational change, as a group, signals and can be used to recognize eventual failure to change. Extending current trends in discursive analyses, we establish talk as a reflective device, in the context of tracking failure while it occurs, by combining social identity theory (SIT) with a language and social psychology (LASP) approach. In doing so, the discourse of failure can be viewed as part of an intergroup phenomenon experienced and interpreted through organizational memberships.

An empirical investigation into beliefs about collaborative practice among maternity care providers.

OBJECTIVE To investigate agreement with the National Health and Medical Research Council (NHMRC) definition of collaboration in maternity care by care providers, and to examine their preferences for models of care in order to shed light on the lack of success in implementing collaborative practice. METHODS Maternity care providers completed a survey in Queensland. The final sample consisted of 337 participants, including 281 midwives (83.38%), 35 obstetricians (10.39%), and 21 general practitioners (6.23%). RESULTS Ninety-one percent of the participants agreed with the NHMRC definition of collaboration: Midwives (M=5.97, s.d.=1.2) and doctors (obstetricians and general practitioners: M=5.7, s.d.=1.35) did not differ significantly in their level of agreement with definition (t (332)=-1.8, P=.068). However, 72% of doctors endorsed a doctor-led model of care, whereas only 6.8% of midwives indicated agreement with it. Fewer (56%) doctors agreed with the midwife-led model of care, whereas 99.3% of midwives endorsed it. CONCLUSION The concept of collaboration does not recognise the different interpretations by midwives and doctors of its impact on their roles and behaviours. Successful collaborative practice requires the development of guidelines that recognise these differences and specify the communication behaviour that would assist midwives and doctors to practice collaboratively.