LIBRI DI MARILENA FATIGANTE

La prima visita in oncologia è un evento istituzionale (Drew e Heritage, 1992) altamente complesso sia per medico che per paziente e accompagnatori coinvolti. Il lavoro presenta uno studio conversazionale su un corpus di prime visite oncologiche volto all’esame delle distinte fasi che compongono questo evento. Il corpus di dati è costituito da 36 video registrazioni di visite oncologiche, condotte da due oncologi senior in due differenti ospedali romani. Lo stu-dio aderisce alla prospettiva teorico-metodologica dell’Analisi Conversazionale (Schegloff, 2007), in particolare applicata al contesto medico (Heritage e Maynard, 2006). A partire da indicatori empirici discorsivi e multimodali, sono state identificate 8 fasi attraverso le quali, con diverse durate e complessità, si realizza la visita oncologica: Apertura, Anamnesi, Presentazio-ne della malattia, Stadiazione, Indicazione di trattamento, Prescrizioni e Chiusura. L’analisi qualitativa mostra come paziente e accompagnatore si orientino ai passaggi tra fasi distinte, cooperando con il medico ad assolvere la specifica agenda di attività della visita. Sono discusse le implicazioni dello studio per la ricerca e la comprensione delle forme di partecipazione e strategie di empowerment disponibili ai pazienti per fronteggiare la complessità comunicativa dell’incontro con l’oncologo e ridurre possibili stati d’ansia che si associano a questo evento.

This article analyzes instances of misunderstanding between doctor, patient and accompanying person during the history taking of ‘first time’ oncology visits. History taking is a fundamental activity in these visits since it targets useful information for the oncologist to determine the patients’ current and general health status and then arrange the treatment plan most suitable for their cancer. The authors show how this activity involves all participants in the interaction: the oncologist, the patients and their care-givers. The management of this activity is not plain and straightforward: it requires complex negotiations between participants in order for them to find a shared understanding of what information is relevant to the medical history, and what is the purpose of the activity in progress. The analyses help to identify, on one hand, the characteristics of the diseases that patients do not recognize as relevant, and on the other hand, the investigative strategies and communication skills that the doctor uses to track the information. These strategies are discussed as resources to socialize patients to effectively contribute to the present visit and the future ones.

Negli ultimi decenni abbiamo assistito ad un massiccio ingresso delle donne nel mondo del lavoro. Questo fenomeno ha comportato sostanziali riorganizzazioni nella vita familiare e nei modi con cui le persone impiegano il loro tempo suddividendolo fra lavoro pagato, tempo libero e attivita familiari. La pressione temporale causata dal coordinare tali diverse attivita e particolarmente pesante nel caso delle famiglie con figli in cui entrambi i genitori lavorano. L’articolo si inserisce in una linea di ricerca che esplora la divisione del lavoro domestico e familiare nella coppia e nel filone degli studi etnografici della vita quotidiana delle famiglie. I risultati, basati su analisi di diari, interviste e di interazioni videoregistrate in famiglia, si focalizzano su: 1) le rappresentazioni da parte di madri e padri delle loro pratiche di gestione e coordinamento delle attivita familiari 2) la natura cognitiva del lavoro che tale attivita di gestione e coordinamento implica, 3) le rappresentazioni identitarie delle madri e dei padri.

The paper presents analyses conducted on a corpus of doctor-patient interactions that was carried on in a outward department of Obstetrics and Gynecology in a public hospital in Italy. The corpus includes medical visits with both native and non native patients, (audio) recorded and fully transcribed according to the jeffersonian conventions (Sacks, Schegloff & Jefferson, 1974). We focus on the doctors’ strategies employed to elicit information from the patients with particular regards to the patient’s job status and the likelihood that she continues to work during pregnancy. Applying Conversation Analytic principles to the analysis of both the sequential structure and the design of the question, the authors highlights how the activity of questioning about the patient’s job includes larger sequences with non native patients as compared to native patients, in which not only the patient’s physical conditions but also her juridical status is questioned. The paper finally discusses the implications of the analyses on the doctors’ training on one hand, and on the social representation of the migrant identity on the other.

The paper presents analyses conducted on a corpus of (audio) recorded and fully transcribed doctor-patient interactions with native and non native patients, carried on in a outward department of Obstetrics and Gynechology in a public hospital in Italy. The focus is on the doctors’ strategies employed to elicit information from the patients with particular regards to the patient’s job status and the likelihood that she continues to work during pregnancy. Applying CA principles to the analysis of both the sequential structure and the design of the question, the author highlights how the activity of questioning about the patient’s job includes larger sequences with non native patients as compared to native patients, in which not only the patient’s physical conditions but also her juridical status is questioned. The paper finally discusses the implications of the analyses on the doctors’ training on one hand, and on the social representation of the migrant identity on the other.