Forme di riduzione dell’asimmetria nella comunicazione medico-paziente: le iniziative dei pazienti nel corso di visite specialistiche

Journal title SALUTE E SOCIETÀ
Author/s Piera Margutti, Renata Galatolo
Publishing Year 2013 Issue 2013/1 Language Italian
Pages 14 P. 19-32 File size 117 KB
DOI 10.3280/SES2013-001003
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

This study identifies a specific multimodal practice that patients use during medical encounters with a team of doctor in an Italian specialized centre for prosthesis construction and application. Focusing on the early stages of these encounters, the paper analyses the way in which patients delicately orchestrate their gaze, gesture and verbal behaviour to gain some extra speaking space, beyond that of mere respondents to doctors’ questions. By using Conversation Analysis, we show that patients produce this recurrent multimodal pattern, in methodically produced and recognizable ways. Patients manage to acquire the interactional role of "action initiators"; thus constraining doctors to respond: for instance, by producing unrequested information about their health status, by correcting implicit assumptions in the doctors’ questions, or by producing independent assessments. The paper contributes to previous research on patients’ agency and initiative, revising the notion of asymmetry in medical settings and highlighting the active role of the patient in every stage of these encounters.

Keywords: Patient initiative, asymmetry, mitigation, multimodality, medical interaction, specialized medical encounters

  1. Atkinson J.M. and Heritage J., editors (1984). Structures of Social Actions: Studies in Conversation Analysis. Cambridge: Cambridge University Press
  2. Boyd E., Heritage J. (2006). Taking the Patient’s Medical History: Questioning During Comprehensive History Taking. In: Heritage J. and Maynard D. editors, Communication in Medical Care: Interactions between Primary Care Physicians and Patients. Cambridge: Cambridge University Press
  3. Brown P., Levinson S. (1987). Politeness: Some Universals in Language Usage. Cambridge: Cambridge University Press
  4. Caffi C. 2001. La mitigazione. Un approccio pragmatico alla comunicazione nei contesti terapeutici. Münster: LIT Verlag
  5. Costello B.A., Roberts F. (2001). Medical Recommendations as Joint Social Practice. Health Communication 13, 3: 241-260
  6. Drew P. and Heritage J. editors (1992). Talk at Work: Interaction in Institutional Settings (Studies in Interactional Linguistics). Cambridge: Cambridge University Press
  7. Gili Fivela B. e Bazzanella C., a cura di (2009). Fenomeni di intensità nell’italiano parlato. Firenze: Franco Cesati Editore
  8. Gill V. (1998). Doing attributions in medical interaction: Patients’ explanations for illness and doctors’ responses. Social Psychology Quarterly, 61, 4: 342
  9. Gill V., Maynard D. (2006). Patients’ Explanations for Health problems and physicians’ Responsiveness in the Medical Interview. In: Heritage J. and Maynard D., editors, Communication in Medical Care: Interaction between Primary Care Physicians and Patients (Studies in Interactional Sociolinguistics). Cambridge: Cambridge University Press
  10. Have ten P. (1991). Talk and institution: A reconsideration of the “asymmetry” of doctor-patient interaction. In: Boden D. and Zimmerman D.H., editors, Talk and Social Structure: Studies in Ethnomethodology and Conversation Analysis. Los Angeles, California: University of California Press
  11. Lindström A., Mondada L., editors (2009). Assessments in Social Interaction: Introduction to the Special Issue. Research on Language and Social Interaction, 42, 4: 299-308
  12. Pomerantz A. (1984). Agreeing and disagreeing with assessments: some features of preferred/dispreferred turn shapes. In: Atkinson J.M. and Heritage J., editors, Structures of Social Actions: Studies in Conversation Analysis. Cambridge: Cambridge University Press
  13. Robinson J.D. (2001). Asymmetry in action: Sequential resources in the negotiation of a prescription request. Text, 2, 1/2: 19-54

Piera Margutti, Renata Galatolo, Forme di riduzione dell’asimmetria nella comunicazione medico-paziente: le iniziative dei pazienti nel corso di visite specialistiche in "SALUTE E SOCIETÀ" 1/2013, pp 19-32, DOI: 10.3280/SES2013-001003