Nanon Labrie

Does Argumentation Matter? A Systematic Literature Review on the Role of Argumentation in Doctor–Patient Communication

In view of a growing interest in argumentative discourse in the context of patient-centered consultation and shared decision making, this article explores the role that argumentation has been attributed in the literature on doctor–patient consultation so far. It studies to what extent theories and concepts of argumentation have been applied by scholars from various fields in order to analyze, understand, facilitate, and improve the argumentative nature of medical consultation. It reports on an extensive and systematic literature search—using eight online databases, expert suggestions, and a manual search—and the subsequent evaluation of 1,330 abstracts on the basis of strict inclusion and exclusion criteria. Forty relevant scientific contributions are grouped into four main categories and discussed accordingly: (a) argumentation theory, (b) discourse analysis, (c) medical informatics, and (d) medical ethics. Because of its systematic approach, this study forms a solid starting point for further integration of argumentation theoretical insights into contemporary views of patient-centered medicine and evidence-based medicine. It provides suggestions for further interdisciplinary and theory-driven research with a strong focus on empirical reality. Doing so, a preliminary model is proposed that outlines the potential effects of the quality of doctors’ communication on proximal, intermediate, and long-term consultation outcomes.

The Effects of General Practitioners’ Use of Argumentation to Support Their Treatment Advice: Results of an Experimental Study Using Video-Vignettes

In recent years, general practice consultation has often been characterized as an argumentative activity. It has been argued that, guided by the ethical and legal principle of informed consent and the ideal standards of participatory and evidence-based medicine, doctors should provide argumentative support for their recommendations in order to encourage patients to actively take part in the treatment decision-making discussion. Thus far, however, it has remained unclear what causal effect general practitioners’ provision of argumentation may have on consultation outcomes, such as patients’ perceptions of their doctors’ decision-making style and credibility, their acceptance and recall of the medical advice, and subsequently their intention to adhere to the advice. In this study, therefore, the effect of general practitioners’ argumentative support for their treatment recommendations is studied experimentally using scripted video-vignettes. Moreover, rather than focusing merely on the presence of argumentation, the role of the pragma-dialectical reasonableness of general practitioners’ argumentation is also taken into account.

‘What matters to Andrew’. The problem of premissary relevance in automated health advisors. Insights from pragma-dialectics

OBJECTIVE To influence health behavior, communication has to be relevant on an individual level and, thus, fulfill the requirement of premissary relevance. This paper attempts to enrich the design of automated health advisors by, first, reviewing main solutions to the challenge of premissary relevance found in the literature and, second, highlighting the value in this field of the theory of argumentation known as pragma-dialectics. METHODS A conceptual paper grounded in persuasion research and argumentation theory. RESULTS Automated health advisors enable argumentative exchanges with users. But there is a need to design these systems as to make them work in an audience-centered perspective. The theory of pragma-dialectics can be used to analyze the factors that favor or hinder the agreement of users to engage in certain health behaviors, and to identify argumentation strategies targeted to behavior change. CONCLUSION Pragma-dialectics can be used to enhance the design of automated health advisors as it operationalizes the dialogical nature of the reasoning process that can influence health behavior. PRACTICE IMPLICATIONS Premissary relevance is a challenge of communication for health promotion at large that can be promisingly addressed through synergies among persuasion research, argumentation theory and Artificial Intelligence.

Investigating young women’s motivations to engage in early mammography screening in Switzerland: results of a cross-sectional study

BackgroundThe scientific and public debate concerning organized mammography screening is unprecedentedly strong. With research evidence concerning its efficacy being ambiguous, the recommendations pertaining to the age-thresholds for program inclusion vary between – and even within – countries. Data shows that young women who are not yet eligible for systematic screening, have opportunistic mammograms relatively often and, moreover, want to be included in organized programs. Yet, to date, little is known about the precise motivations underlying young women’s desire and intentions to go for, not medically indicated, mammographic screening.MethodsA cross-sectional online survey was carried out among women aged 30-49 years (n = 918) from Switzerland.ResultsThe findings show that high fear (β = .08, p ≤ .05), perceived susceptibility (β = .10, p ≤ .05), and ego-involvement (β = .34, p ≤ .001) are the main predictors of screening intentions among women who are not yet eligible for the systematic program. Also, geographical location (Swiss-French group: β = .15, p ≤ .001; Swiss-Italian group: β = .26, p ≤ .001) and age (β = .11, p ≤ .001) play a role. In turn, breast cancer knowledge, risk perceptions, and educational status do not have a significant impact.ConclusionsYoung women seem to differ inherently from those who are already eligible for systematic screening in terms of the factors underlying their intentions to engage in mammographic screening. Thus, when striving to promote adherence to systematic screening guidelines – whether based on unequivocal scientific evidence or policy decisions – and to allow women to make evidence-based, informed decisions about mammography, differential strategies are needed to reach different age-groups.

The promise and prospects of argumentation for public health communication

Over the past decades, health communication has become central to public health research and practice. There is a growing consensus that theoretical thinking about the communicative aspects inherent to our efforts to promote health and to protect the public can, for instance, guide the development and implementation of successful health campaigns and social marketing initiatives; aid the dissemination of risk information; contribute to legislation concerning commercial health messages; and improve the communication between individual health practitioners and their patients. Moreover, there is good scientific evidence that effective public health communication can affect health behaviors.

Measurement invariance of the Short Wake Forest Physician Trust Scale and of the Health Empowerment Scale in German and French women

Measurement invariance is a crucial prerequisite to carry out cross-cultural research and to provide knowledge that enables culturally diverse patients to feel comfortable with their health providers. Although trust in doctors and health empowerment are widely studied, no previous research has examined their measurement invariance. The Short Wake Forest Physician Trust scale and the Health Empowerment scale were administered online. Participants were 217 German-speaking women (M = 39.07, standard deviation = 5.71) and 217 French-speaking women (M = 39.11, standard deviation = 5.82). Demonstration of partial scalar invariance was met and reasons for non-invariant items are discussed. The study was evaluated applying COnsensus-based Standards for the selection of health status Measurement INstruments checklist.