Risk is a crucial concept in healthcare communication. This is attested to by a large
body of research on risk communication in psychology, sociology, and, more recently,
discourse analysis. This previous research has primarily focused on how healthcare
providers manage risk talk, whereas patients’ risk talk has received little attention.
Where it has been researched, it has been presented in an oversimplified way, namely
that the patients have been reported to perceive their risk in a simplified,
‘all-or-nothing manner’. Using theme-oriented discourse analysis (Roberts and
Sarangi, 2005), this study challenges this simplified perception by examining patients’
risk talk in prenatal screening for Down syndrome.
The data for this study comprises 14 video-recorded consultations collected in one
prenatal hospital in Hong Kong. The particular focus of the study is on patients who
have received a ‘positive’ result from the initial screening for Down syndrome that
has put them in a high-risk group by increasing their probability of having a baby with
Down syndrome. In these consultations patients are informed about further testing to
confirm the diagnosis. To examine the patients’ risk talk, the transcripts of the
interactions have been coded along the lines of structural, thematic and interactional
maps (Roberts and Sarangi, 2005) to note down risk talk by patients, what is it
concerned with and the interactional dynamics of how it is managed.
The analysis suggests that patients’ risk talk concerns three types of risks, namely the
“risk of occurrence” (that is the probability of having a child with Down Syndrome)
the “risk of knowing” (that is dealing with the knowledge about having a child with
Down Syndrome) and what has been referred to in this study as the “risk of not
knowing” (that is not finding out about the condition due to the uncertainty
surrounding the tests). In contrast to the findings in the previous studies, the patients
in the data actively initiate risk talk by raising clarification questions and talking
about their concerns. The analysis has revealed the differences in how different types
of risk talk are constructed by the patients. These differences are discussed in regards
to the phases of the consultation in which risk talk occurs and whether risk talk is
aimed at eliciting further information or making a decision about pursuing further
testing. The analysis has also noted that risk communication is a joint activity
involving the patients and the healthcare providers. In addressing patients’ risk talk
the healthcare providers in the data take on an indirect approach, thereby avoiding
influencing the patients’ decision-making and managing the uncertainty surrounding
prenatal screening. The analysis has also pointed out that the patients’ socioeconomic
and cultural backgrounds have a crucial impact on how risk talk is constructed by the
patients. / published_or_final_version / Linguistics / Master / Master of Philosophy
Identifer | oai:union.ndltd.org:HKU/oai:hub.hku.hk:10722/161574 |
Date | January 2012 |
Creators | Yau, Hoi-ying, Alice., 邱凱盈. |
Contributors | Zayts, OA |
Publisher | The University of Hong Kong (Pokfulam, Hong Kong) |
Source Sets | Hong Kong University Theses |
Language | English |
Detected Language | English |
Type | PG_Thesis |
Source | http://hub.hku.hk/bib/B48079790 |
Rights | The author retains all proprietary rights, (such as patent rights) and the right to use in future works., Creative Commons: Attribution 3.0 Hong Kong License |
Relation | HKU Theses Online (HKUTO) |
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