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This study investigates doctors’ and patients’ usage of three speech functions; namely statements, questions and commands in the American medical drama series House M.D. Furthermore, the study investigates interruptions between doctors and patients. The aim of the study was to ascertain whether the claim that doctors practice power over patients can be verified. The data comprises transcripts of 16 video recorded sessions of doctors and patient interacting where the material was personally collected and analyzed. In their interactions, doctors were found to dominate in making statements, asking questions and uttering commands. In addition, it was detected that the doctors’ and patients’ way to communicate differed given the fact that doctors are trained in their roles as doctors while patients are not. However, both interactants were found to perform the different speech functions similarly. The study also revealed that doctors interrupted more as compared to patients. Furthermore, gendered interruptions were found in the data, all of which came from male participants and it was concluded that the findings could be linked to the social and cultural roles of the participants. Overall, it was concluded that there exists a power relationship between doctors and patients.

Utskrivningssamtalet är den sista kontakten mellan läkare och patient innan patienten åker hem ifrån avdelningen. Syftet med den föreliggande studien är att undersöka ifall det förligger kommunikativa utmaningar i ett utskrivningssamtal mellan en läkare och en patient med afasi.  Den konkreta frågeställningen för studien var hur de potentiella problem som uppkom i samtalet hanterades och vilket utrymme som skapades för patientens deltagande i samtalet samt hur samtalsdeltagarna använde sig av icke-verbal kommunikation för att uppnå förståelse. Den valda metoden för att undersöka detta var Conversation Analysis, CA. I studien deltog två läkare, två patienter med afasi, samt två närstående till patienterna. Patienterna som deltog hade mild till måttlig afasi, svenska som modersmål och var 50 år och 70 år gamla. Läkarna som deltog hade varit anställda på avdelningen och arbetat med patienter med afasi i 2.5 år respektive 3.5 år och hade svenska som andraspråk. Resultatet av analysen var en identifiering av kommunikativa handlingar som ledde till sekvenser i samtalet som deltagarna orienterade mot som problematiska. Dessa var bland annat när läkaren inte följde upp på patientens förfrågan för mer information eller patient-initierade ämnen och inte redde ut missförstånd som uppkom. I resultatet identifierades även sekvenser där samtalsdeltagarna använde sin kommunikativa kompetens för att hantera kommunikativa utmaningar, samt sekvenser där samtalsdeltagarna använde sig av icke-verbal kommunikation för att underlätta den gemensamma förståelsen. Resultatet stämde överens med tidigare forskning om hur patienter med afasi och vårdpersonal organiserar interaktion i samtal.

Made available in DSpace on 2015-03-05T18:12:38Z (GMT). No. of bitstreams: 0 Previous issue date: 4 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O presente estudo tem por objetivo descrever as trocas interacionais entre um médico e seus pacientes diagnosticados/as com diabetes. Em pacientes com essa doença, a aderência ao tratamento é fator importante, topicalizado em todas as consultas. Uma alta aderência auxilia o/a paciente a atingir bons níveis de controle da doença e, consequentemente, melhor qualidade de vida. Por isso, objetivamos averiguar de que forma as questões de aderência emergem nas interações. Para tanto, dados foram coletados em dois postos de saúde do SUS localizados na região metropolitana de Porto Alegre e foram analisados através das ferramentas da Análise da Conversa (SACKS, 1992). De acordo com essa metodologia, os dados devem direcionar o olhar da pesquisadora para o que for mais relevante e/ou recorrente de ser analisado. Dessa forma, percebeu-se que momentos de negociação entre o médico e os/as pacientes eram bastante recorrentes e que esses momentos estavam pautados sobre diferentes tópicos relacionados ao tratamento. As anál / This study aims at describing interactional exchanges between a doctor and his patients with diagnosis of diabetes. For patients who have this illness, the adherence to the treatment is an important factor, being a topic in every consultation. High adherence helps the patient to reach good levels of control of the illness and, consequently, have a better quality of life. Therefore, we investigate how issues of adherence emerge in interactions. To do so, data were collected in two public health care buildings located in the metropolitan region of Porto Alegre and where later analyzed through the tools of Conversation Analysis (SACKS, 1992). According to this methodology, the data directs the eye of the researcher to what is more relevant and/or recurrent to be analyzed. Thus, they pointed that moments of negotiation were rather recurrent among the doctor and the patients and it was evident that these moments addressed different topics related to the treatment. The analyses show that these negotiations emerge w

Le projet ANR ACORFORMed, dans lequel s’inscrit cette thèse, a pour objectif la création (par des informaticiens) d’un agent conversationnel animé « patient » comme outil de formation à l’annonce, par la simulation et à l’aide d’un environnement virtuel. A l’aide de la méthodologie issue des études de la gestuelle et des apports de la littérature sur l’organisation des interactions, nous tentons de répondre à la question suivante : quelle est l’organisation structurelle globale de l’interaction patient-médecin, lorsque ce dernier se forme à l’annonce d’un dommage associé aux soins ? Les analyses menées dans cette thèse nous permettent de décrire l’interaction patient/médecin lors de formations à l’annonce en proposant différentes phases composants l’interaction, ainsi que des précisions quant à leur découpage et leurs articulations. Elles constituent une base indispensable et utilisable par les informaticiens pour concevoir et implémenter un agent conversationnel « patient » crédible qui pourra être utilisé dans la formation des médecins. Située au coeur d’un projet interdisciplinaire, cette thèse en linguistique permet donc de transposer les pratiques interactionnelles des médecins en vue de l’implémentation d’un agent virtuel par des informaticiens. / The ACORFORMed ANR project, in which this PhD project is integrated, aims at the creation (by computer scientists) of a "patient" animated conversational agent as a training tool for announcing, simulating and using a virtual environment. Using the methodology resulting from gestures studies and contributions of the literature on the organisation of interactions, we try to answer the following question: what is the overall structural organisation of the doctor/patient interaction, when this last is training to break the news of a damage associated with care? The analyses carried out in this thesis allow us to describe the doctor/patient interaction during training to break the news by proposing different phases that make up the interaction, as well as details about their division and their articulations. They are an indispensable and usable base for computer scientists to design and implement a credible "patient" conversational agent that can be used in physician training. Located at the heart of an interdisciplinary project, this thesis in linguistics makes it possible to transpose the interactional practices of physicians with a view to the implementation of a virtual agent by computer scientists.

The presence of a device meant to enhance the medical encounter may alter the nature of the doctor-patient interaction in a way that affects patient satisfaction. The focus of this study was to examine the social impact of introducing advanced exam-room technologies to the doctor-patient interaction. By comparing cohorts (young: 18-39 and older: 62-89) we examined a possible age-related interaction. Participants viewed one of several video conditions portraying a physician conducting a medical interview in which he uses one of various documenting technologies (Nothing, Pen and Paper, PDA, Desktop Computer, Wearable Computer). After viewing the interaction, participants completed a series of questionnaires evaluating their general satisfaction with the quality of care (QoC) given during the medical interview. Patient satisfaction levels did significantly vary depending on the technology condition, participant cohort, and participant gender. Overall, young adults and females rated the doctor more favorably. The favorability of ratings for each technology condition depended on the aspect of QoC examined.

In this thesis research, we investigate the usability of hand-held display (Tablet PC) and wearable head-mounted display (Google Glass) interfaces and their effect on doctor-patient interaction during clinical ward round in the hospital. We looked at existing literature to identify existing research about our topic. Using a User Centered Interaction Design process we developed a prototype hybrid system that used both a hand-held and head-mounted display. An evaluation of this prototype with a hand-held system and a paper based interface was performed in a simulated patient room with 20 doctors and 5 patients. The participants were observed, surveyed, and interviewed about their experiences. Generally, the patients had a high satisfaction rate and felt the interfaces were not causing the doctors to lose focus on them. The doctors found the hand-held display by itself and existing paper-based interface to be the most usable and least distracting interfaces for accessing patient information during clinical ward rounds.

Made available in DSpace on 2016-04-28T18:23:27Z (GMT). No. of bitstreams: 1 Ana Maria Rodrigues Alves Kuninari.pdf: 417495 bytes, checksum: 65973ea976a576fe0053d8f3a0602375 (MD5) Previous issue date: 2006-11-27 / The present work aims to reflect on the doctor-patient interaction based on the analysis of the fictional text Domingo a Tarde, a novel by Fernando Namora, written from October 1959 and October 1960. Its action is passed at a public hospital of Lisbon. The purpose of this study is to verify how the utterances multivocal character is esthetically constituted through the narrator's verbal communication with himself, with his friends and with a specific patient, in situations that happen in several spaces and in different times, in the narrative context of the romance. The research is justified because the analyzed work, presenting a graphic literary reconstitution of the doctor-patient interaction, makes available some of the main aspects of this interaction, one to which we can only have access as doctor and/or patient, for the contract implied there in is a private one which no researcher can violate, neither directly nor by means of questionaries interviews and so on. The methodology consisted on the chapters' organization from the perspective of the relation between text and context, from the point of view of dialogical relations: the narrator's memory, the comment that reviews his past, the self-criticism, the metaspeech, from the one hand, and the plot itself, the history, from the other. As analytical category, the work uses reported speech, according to Bakhtin and his Circle: trought the narrator's voice, other voices are recovered through direct, indirect and free indirect speechs. One can perceive that the literary text that constitutes the corpus of the research can be understood as an esthetic representation of social dissymmetries in the doctorpatient interaction (in the social-cultural context and in the historical moment of Domingo à Tarde). Besides, in the literary language of this novel one sees represented the transformation of the professional's posture that humanizes herself - and suffers due to her incapacity of saving and/or to cure incurable sick people -, when evaluating the "other" be the "other" the doctor-narrator himself, that recognizes and identifies in and by the "others" glance, or the other doctors, the patient, the friends, or patients in general / Este trabalho tem o objetivo de refletir sobre a interação médico-paciente, a partir da análise do texto ficcional Domingo à tarde, romance de Fernando Namora, escrito entre outubro de 1959 e outubro de 1960, e ambientado em um hospital público de Lisboa. A finalidade deste estudo é verificar como vai se constituindo, esteticamente, o caráter multivocal dos enunciados, por meio da comunicação linguageira do narrador consigo mesmo, com seus colegas, e com uma paciente específica, em situações que ocorrem em vários espaços e em diferentes tempos, no contexto narrativo daquele romance. A pesquisa se justifica, porque a obra examinada, ao apresentar uma vívida reconstituição literária da complexidade da interação médicopaciente, torna acessíveis alguns importantes aspectos dessa interação a que não se pode ter acesso direto exceto na condição de paciente e/ou médico - dada a natureza sigilosa do contrato entre os participantes, que exclui a presença de um pesquisador, seja diretamente ou na forma de, por exemplo, questionários, entrevistas, etc. A metodologia consistiu na leitura do livro e para a análise mantivemos a sub-divisão em capítulos, utilizada por Namora, de modo a se estabelecer a relação texto/contexto, sob a perspectiva de relações dialógicas: a memória do narrador, o comentário que retoma o seu passado, a autocrítica, o metadiscurso, de um lado, e a própria trama, a história, de outro. Como categoria de análise, foi usado o conceito teórico de discurso relatado, segundo Bakhtin e seu Círculo: pela voz do narrador, outras vozes são recuperadas por meio de discurso direto, discurso indireto e discurso indireto livre. O comentário final é que o texto literário - corpus desta pesquisa, pode ser entendido como representação estética de dessimetrias sociais na interação médico-paciente (no contexto sócio-cultural e no momento histórico de Domingo à tarde). Além disso, na linguagem literária deste romance está representada a transformação de postura do profissional que se humaniza - e sofre por sua incapacidade de salvar e/ou curar, doentes incuráveis -, ao valorizar o outro (seja o outro o próprio médico-narrador, que se reconhece e se identifica no e pelo olhar do outro ; sejam os outros os médicos, a paciente, a colega, ou os doentes)

Oggi, l'Italia è un paese multietnico. Dietro i movimenti migratori non vi sono però solo dati statistici, ma persone con culture e storie personali diverse, con cui gli operatori a contatto con gli immigrati devono confrontarsi. Ciò ha condotto alla nascita della mediazione linguistico-culturale, un settore sorto nella fase più acuta del fenomeno dell'immigrazione, gli anni Novanta, per rispondere alle esigenze specifiche di assistenza medica e legale degli immigrati. L'intento del presente lavoro di ricerca è quello di studiare l'interazione verbale e non verbale tra medico o infermiere e paziente straniero nel contesto della mediazione linguistica-culturale in una struttura socio-sanitaria. All'interno dell'interazione verbale si analizzeranno le teorie della cortesia linguistica applicate a un contesto socio-sanitario multietnico. Si andrà a verificare se esiste una lingua di mediazione, se la lingua inglese funge da lingua franca nell'interazione verbale medico o infermiere e paziente straniero e se esistano strategie empatiche comunicative verbali e non verbali comunemente utilizzate in corsia dal personale ospedaliero. Si studierà inoltre come l'analisi della conversazione, in particolare l'analisi delle strategie empatiche comunicative verbali e non verbali, possa essere utilizzata a fini didattici e pedagogici nella formazione linguistica e interculturale di studenti di medicina nel nuovo contesto sociosanitario multiculturale. / Italian society has undergone massive transformation, arising today as a true multiethnic society. Migration movements are not simply a phenomenon of statistical data but involve people from different cultures and personal backgrounds. Immigration is behind the onset of community interpreting in Italy at the beginning of the '90s. Community interpreters catered for all medical and legal needs of immigrants. Today, it is common practice in Italy that doctors and nurses interact with immigrant patients. The aim of the thesis is to study verbal and non-verbal strategies of communication between doctors or nurses and immigrant patients in this new multiethnic medical environment. The study will examine strategies of politeness theory, whether English is a lingua franca in the doctor or nurse and immigrant patient interaction and whether there are empathic verbal and non-verbal strategies of communication commonly used in the hospital ward by doctors and nurses. The study will also examine how conversational analysis, in particular the analysis of empathic verbal and non-verbal strategies of communication can be used for didactic and pedagogical purposes so as to prepare medical students linguistically and culturally to interact with their future patients in this new multiethnic medical environment.

In master study is analyzed the problem of code of doctor’s ethics in legal dimension. The relevance of doctor’s ethics is highlighted by the new viewpoints in Lithuanians’ lives, often not corresponding with the old understanding of ethics, which is natural for Lithuanian mentality. The objective of the research is to research the role of doctor’s ethics code in the formation of medical practice and while growing the society’s interest in the quality of doctor-patient relation and to analyze the interaction between Lithuania’s doctor’s ethics principles and law that fine-tunes health care in Lithuania. IN study was made the research with the purpose to analyze the interaction between the principles of doctor’s ethics code and the principles of Lithuania’s law that fine-tunes the health care. The results of the research show that the set of analyzed pieces of legislation does not guarantee the universal definition of doctor’s ethics norms and. For this reason the relevance of doctor’s ethics code exists.