Gabriele Lucius-Hoene

Nonverbal communication as a compensative strategy for severely nonfluent aphasics?—A quantitative approach ☆

Seven severely nonfluent aphasics and one relative or close friend were investigated in an interview situation. The conversation was videotaped and analyzed for the use of nonverbal communication between aphasic and partner. The results indicate that the group of aphasics used significantly more frequently and for a significantly longer period of time nonverbal channels of communication than their healthy partners. The aphasic patients also used significantly fewer speech-focused movements and significantly more codified gestures. Nonverbal elements were more frequently used as speech substitutes by the group of aphasics.

Doctors' voices in patients' narratives: coping with emotions in storytelling:

Objectives: To understand doctors’ impacts on the emotional coping of patients, their stories about encounters with doctors are used. These accounts reflect meaning-making processes and biographically contextualized experiences. We investigate how patients characterize their doctors by voicing them in their stories, thus assigning them functions in their coping process. Methods: 394 narrated scenes with reported speech of doctors were extracted from interviews with 26 patients with type 2 diabetes and 30 with chronic pain. Constructed speech acts were investigated by means of positioning and narrative analysis, and assigned into thematic categories by a bottom-up coding procedure. Results: Patients use narratives as coping strategies when confronted with illness and their encounters with doctors by constructing them in a supportive and face-saving way. In correspondence with the variance of illness conditions, differing moral problems in dealing with doctors arise. Different evaluative stances towards the same events within interviews show that positionings are not fixed, but vary according to contexts and purposes. Discussion: Our narrative approach deepens the standardized and predominantly cognitive statements of questionnaires in research on doctor–patient relations by individualized emotional and biographical aspects of patients’ perspective. Doctors should be trained to become aware of their impact in patients’ coping processes.

The role of the Internet for people with chronic pain: examples from the DIPEx International Project.

In this article we consider how people with chronic illness are using the internet, drawing on examples from published qualitative interview studies of experiences of chronic pain in the UK, Germany and Israel. Extracts from the interviews can be seen on the websites from the www.dipexinternational.org collaboration which publishes analyses and many thousands of video and audio interview clips on country specific web platforms. The UK branch of the collaboration has been operating for over a decade and currently includes broad based samples of qualitative interviews with patients about their experiences of over 80 health problems. The research has demonstrated that people living with chronic pain are increasingly using the web to find information, support and practical advice for self-management and also for reassurance, encouragement, to compare experiences of treatment and to offer advice and support to others. The internet is changing the way that people are experiencing illness, although access to relevant and reliable online material is not equally distributed. Those who do not speak one of the handful of dominant languages are less likely to find online experiences that resonate with their own.

Auditory Hallucinations as Social Self-Positions: A Theoretical Discussion from a Single-Case Study

This work uses social positioning analysis to investigate the phenomenon of the auditory verbal hallucination (AVH) in schizophrenia in order to describe its social and interactive nature. We focus in detail on a single-case study of a patient who verbalized her AVHs. We analyze 3 significant excerpts from an interview with a person with paranoid schizophrenia. This interview is part of a larger study conducted with 18 participants about life narrative construction in the sociocultural context of care homes. The interaction between the patient and her voices is examined closely to reveal the dynamic between interviewer, patient, and voices. The analysis differentiates the voice of the patient from that of the hallucination and reveals “social interaction” between this dyad and the interviewer. We discuss a possible social and interactive framework to understand the origin of AVHs and the self-construction process.

“And then you start to loose it because you think about Nutella”: The significance of food for people with inflammatory bowel disease - a qualitative study

BackgroundMany patients with inflammatory bowel disease strongly believe that food or certain food products heavily influence the symptoms or even trigger acute flare-ups. Unfortunately, there is no generalizable information for these patients, and therefore no effective diet has been identified to date.MethodsThe narrative interviews we used for this study provide the basis for the German website www.krankheitserfahrungen.de. Maximum-variation sampling was used to include a broad range of experiences and a variety of different factors that might influence people’s experiences. The sample included men and women of different age groups and social and ethnic backgrounds from across Germany. The interviews were analyzed using grounded theory.ResultsFour interrelated categories emerged: managing uncertainty, eating: between craving and aversion, being different and professional help as a further source of uncertainty. The most important issue for our responders was the handling of uncertainty and to find a way between desire for, and aversion against, eating. Many participants described difficulties during formal social occasions such as weddings, birthdays, or when going out to a restaurant.ConclusionsMany of the experiences the participants reported in their daily struggle with food and their illness, such as cravings for and abstaining from certain foods, were rather unusual and often stressful. Because they decided not to go out in public any longer, some of the interviewees experienced even more social isolation than they did before. Health professionals need to become more involved and not only advice about food and eating, but also help their patients find strategies for avoiding social isolation.

Experiences of food abstinence in patients with type 2 diabetes: a qualitative study.

Objective People with type 2 diabetes often report pressure to abstain from many of lifes pleasures. We tried to reconstruct these patients’ sense of pressure to better understand how people with diabetes make sense of, and integrate, these feelings into their life. Design, setting and participants A secondary analysis of narrative interviews with 14 patients with type 2 diabetes who are part of a website project. Main outcome measures Grounded theory-based analysis of narrative interviews, consisting of open, axial and selective coding. Results People with type 2 diabetes felt obliged to give up many pleasures and live a life of abstinence. They perceived a pressure to display a modest culinary lifestyle via improved laboratory test results and weight. Their verbal efforts to reassure and distance themselves from excessiveness indicate a high moral pressure. With regard to the question of how to abstain, food and behaviour were classified into healthy and unhealthy. Personal rules sometimes led to surprising experiences of freedom. Conclusions People with diabetes have internalised that their behaviour is a barrier to successful treatment. They experience an intensive pressure to show abstinence and feel misjudged when their efforts have no visible effect. Taking into account this moral pressure, and listening to patients’ personal efforts and strategies to establish healthy behaviours, might help to build a trusting relationship with healthcare providers.

Wirkfaktoren einer tagesklinischen Behandlung aus der Sicht alkoholabhängiger Patienten – eine qualitative narrative Interviewstudie

Day treatment for alcohol dependent patients is still uncommon in Germany. The presented study aims to answer the question how patients experience this kind of treatment and which factors they perceive as important for their treatment success.7 interviews with alcohol-dependent patients were conducted. Data were analysed with qualitative methods and the help of a computer-supported coding system.We found several factors that are relevant for patients, especially important are factors concerning the therapeutical relationship as well as factors that are specific for day treatment.We can conclude that day treatment is seen as helpful to improve dependency symptoms by the patients.

Bewältigen von Erlebnissen

In seiner Frankfurter Poetik-Vorlesung (1981) formulierte Adolf Muschg uber seine schriftstellerische Tatigkeit: »Schreiben war mein Abwesenheitsverfahren, mit dem ich Anwesenheit simulierte: hergestellte Gelegenheit nach verpasster Gelegenheit, Nahe aus der Ferne, Dispens, der mit Kunst zahlte, was ich einem Menschen schuldig geblieben war [...] Papier und Stift waren zugleich Mittel und Verhinderer der Rede – einer ungestorten, aber auch ungehorten und im Stillen schon verlorenen Rede« (Muschg 1981, 372 f.). Was Muschg hier in biographischer Selbstoffenbarung beschreibt, ist, dass im Einzelfall Schreiben und Erzahlen aus einer Erfahrung des Mangels entsteht.

Hirnschädigung, Identität und Biographie

Neurologie, Neuropsychologie und Psychiatrie beschreiben die Folgen einer zerebralen Schadigung auf der Ebene von Organlasionen, Symptomen und Verhaltensauffalligkeiten, in der Bemuhung um Objektivitat ihrer Daten.

Die Mikrostruktur von Textausschnitten: Basisstrategien und Positionierungsanalyse

In der strukturellen Analyse sind die chronologischen und thematischen Gliederungen der Erzahlung und der Wechsel von Zeitperspektiven und Textsorten rekonstruiert worden. Vor diesem Hintergrund werden nun einzelne Passagen des Interviews, die fur die Forschungsfrage besonders fruchtbar zu sein scheinen, ausgewahlt (s. Kap. 12.2.2) und einer detaillierten Feinanalyse unterzogen. Die Feinanalyse macht sich zwei Zugange zunutze: Sie stutzt sich auf allgemeine Heuristiken, die bei jeder Passage des Interviews benutzt werden (Kap. 8.1) und sie fokussiert mit der Analyse der Positionierungen sprachliche Phano- mene, die zentral fur die Konstitution narrativer Identitat sind (Kap. 8.2).