Click here to download

Cultural presuppositions in the formulation of doctor’s questions to migrant patients
Journal Title: SALUTE E SOCIETÀ 
Author/s: Marilena Fatigante 
Year:  2013 Issue: 1EN Language: English 
Pages:  19 Pg. 48-66 FullText PDF:  389 KB
DOI:  10.3280/SES2013-001005EN
(DOI is like a bar code for intellectual property: to have more infomation:  clicca qui   and here 


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.
Keywords: Questioning, nonnative patient, job status, pregnancy, Conversation Analysis

  1. 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, 10.1017/CBO9780511607172.008DOI: 10.1017/CBO9780511607172.008
  2. Byrne P., Long B. (1976). Doctors Talking to Patients. London: DHSS
  3. Drew P., Heritage J., editors (1992). Talk at work. Cambridge, England: Cambridge University Press
  4. Fasulo A. (2009). Domande che cominciano per ‘ma’ e per ‘e’. ‘L’epistemica debole’ della conversazione. In: Fatigante M., Mariottini L. e Sciubba M.E., editors, Lingua e Società. Saggi in onore di Franca Orletti. Roma: FrancoAngeli
  5. Fisher S., Todd A.D., editors, (1986). Discourse and institutional authority: Medicine, Education and Law. Norwood, NJ: Ablex.
  6. Haakana M. (2001). Laughter as a patient's resource: Dealing with delicate aspects of medical interaction. Text, 21, 1-2: 187-219,, 10.1080/08351813.2011.544221DOI: 10.1080/08351813.2011.544221
  7. Heath C. (1992). The delivery and reception of diagnosis in the general practice consultation. In: Drew P. and Heritage J., editors, Talk at Work. Cambridge: Cambridge University Press
  8. Heritage J., Raymond G. (in press). Navigating epistemic landscape: Acquiescence, agency and resistance in responses to polar questions. In: deRuiter J. P., editors, Questions: Formal, Functional and Interactional Perspectives. Cambridge: Cambridge University Press
  9. Heritage J. (2010). Questioning in Medicine. In: Freed A. and Ehrlich S., editors, "Why Do You Ask?": The Function of Questions in Institutional Discourse, New York: Oxford University Press, 42-68.
  10. Heritage J., Maynard D. (2006). Problems and prospects in the study of doctorpatient interaction: 30 years of research in primary care. Annual Review of Sociology. 32: 351-374, 10.1146/annurev.soc.32.082905.093959DOI: 10.1146/annurev.soc.32.082905.093959
  11. Heritage J. (1984). A Change-of-State Token and Aspects of its Sequential Placement. In: Atkinson P. and Heritage J., editors, Structures of Social Action. Cambridge: Cambridge University Press
  12. Jefferson G. (1989). Preliminary Notes on a Possible Metric which Provides for a ‘Standard Maximum’ Silence of Approximately one Second in Conversation. In: Roger D., and Bull P., editors, Conversation. An Interdisciplinary Perspective. Clevedon: Multilingual Matters
  13. Linell P., Luckmann T. (1991). Asymmetries in dialogue: some conceptual preliminaries. In: Marková I., and Foppa K., editors, Asymmetries in Dialogue. Hemel Hempstead: Harvester Wheatsheaf, 1-20
  14. Mishler E. G. (1984). The discourse of medicine: dialectics of medical interviews. Norwood, N.J.: Ablex Pub. Corp
  15. Orletti F. (2000). La conversazione diseguale. Roma: Carocci
  16. Parsons T. (1951). The Social System. New York: The Free Press
  17. Pilnick A., Hindmarsh J. and Gill V. (2009). Beyond 'doctor and patient': Developments in the study of healthcare interactions. Sociology of Health and Illness 31, 6: 787-802, 10.1111/j.1467-9566.2009.01194.xDOI: 10.1111/j.1467-9566.2009.01194.x
  18. Pomerantz A.M. (1984). Agreeing and Disagreeing with Assessments: Some Features of Preferred/Dispreferred Turn Shapes. In: Atkinson P. and Heritage J., editors, Structures of Social Action. Cambridge: Cambridge University Press.
  19. Sacks H., Schegloff E.A. and Jefferson G. (1974). A symplest systematics for the organization of turn taking for conversation. Language, 50, 4: 696-735, 10.2307/412243DOI: 10.2307/412243
  20. Schegloff E.A. (1972). Sequencing in Conversational Openings. In: Gumperz J. and Hymes D., editors, Directions in Sociolinguistics: The Ethnography of Communication. New York: Holt Rinehart and Winston
  21. Sorjonen M.L., Raevarra L. Haakana M., Tammi T., and Perakyla A. (2006). Lifestyle Discussions in Medical Interviews. In: Heritage J. and Maynard D., editors, Communication in Medical Care: Interaction between Primary Care Physicians and Patients, New York: Cambridge University Press, 340–78, 10.1017/CBO9780511607172.014DOI: 10.1017/CBO9780511607172.014
  22. Stivers T., Heritage J. (2001). Breaking the sequential mold: Answering “more than the question” during comprehensive history taking. Text, 21, 1-2: 151-185, 10.1177/019027250707000410DOI: 10.1177/019027250707000410
  23. Stivers T., Majid A. (2007). Questioning children: Interactional evidence ofimplicit bias in medical interviews. Social Psychology Quarterly, 70, 4: 424- 441.
  24. Todd A. D. (1989). Intimate adversaries: Cultural conflicts between doctors and women patients. Philadelphia: University of Pennsylvania Press
  25. West C. (1984). Routine Complications: Troubles with Talk Between Doctors and Patients. Bloomington: Indiana University Press

Marilena Fatigante, in "SALUTE E SOCIETÀ" 1EN/2013, pp. 48-66, DOI:10.3280/SES2013-001005EN

   

FrancoAngeli is a member of Publishers International Linking Association a not for profit orgasnization wich runs the CrossRef service, enabing links to and from online scholarly content