Abstract
Background
Patient Companions (PCs) can have both a positive and a negative impact on communication, but studies on multilingual consultations in the unpredictable and stressful context of the Emergency Department (ED) have mainly focused on PCs as interpreters, with less regard to the other roles they may take up. This paper investigates how the patient’s Lifeworld, which is a crucial element for proper history taking and a doctor-patient relationship, is managed in multilingual PC mediated consultations.
Method
Nine recordings (+ ethnographic notes and clinician interviews) of multilingual PC mediated consultations from an ED in Brussels were subjected to a linguistic-ethnographic analysis, and to a codification of communication patterns and PC roles. The PCs’ roles were grouped into four stances (linguistic agent, Lifeworld agent, system agent, and "answers for the patient"). The communication patterns were grouped into three categories (strictly medical, Lifeworld included, and Lifeworld interrupted). The linguistic-ethnographic analysis investigated how situational factors such as (non)verbal linguistic repertoires, contents of the communication, meta communication and other contextual factors shaped the participation framework and corresponding Lifeworld management.
Findings
Irrespective of the role adopted by the PC, the Lifeworld is primarily interrupted, unless it is directly solicited by the clinician. When the PC does adopt the Lifeworld agent stance, it tends to be interrupted. The linguistic-ethnographic analysis revealed how these role changes and correlating Lifeworld management are the result of a nexus of factors such as the complexity of the topic, the available repertoire, the level of meta communication, explicit role negotiation and timing. Many aspects of the communication take place implicitly.
Discussion
Since poor Lifeworld management negatively impacts care, clinicians should be trained to detect and manage the above-mentioned factors at play. Future research should also investigate how patients and PCs themselves experience and perceive these kinds of consultations.
Patient Companions (PCs) can have both a positive and a negative impact on communication, but studies on multilingual consultations in the unpredictable and stressful context of the Emergency Department (ED) have mainly focused on PCs as interpreters, with less regard to the other roles they may take up. This paper investigates how the patient’s Lifeworld, which is a crucial element for proper history taking and a doctor-patient relationship, is managed in multilingual PC mediated consultations.
Method
Nine recordings (+ ethnographic notes and clinician interviews) of multilingual PC mediated consultations from an ED in Brussels were subjected to a linguistic-ethnographic analysis, and to a codification of communication patterns and PC roles. The PCs’ roles were grouped into four stances (linguistic agent, Lifeworld agent, system agent, and "answers for the patient"). The communication patterns were grouped into three categories (strictly medical, Lifeworld included, and Lifeworld interrupted). The linguistic-ethnographic analysis investigated how situational factors such as (non)verbal linguistic repertoires, contents of the communication, meta communication and other contextual factors shaped the participation framework and corresponding Lifeworld management.
Findings
Irrespective of the role adopted by the PC, the Lifeworld is primarily interrupted, unless it is directly solicited by the clinician. When the PC does adopt the Lifeworld agent stance, it tends to be interrupted. The linguistic-ethnographic analysis revealed how these role changes and correlating Lifeworld management are the result of a nexus of factors such as the complexity of the topic, the available repertoire, the level of meta communication, explicit role negotiation and timing. Many aspects of the communication take place implicitly.
Discussion
Since poor Lifeworld management negatively impacts care, clinicians should be trained to detect and manage the above-mentioned factors at play. Future research should also investigate how patients and PCs themselves experience and perceive these kinds of consultations.
| Original language | Undefined/Unknown |
|---|---|
| Title of host publication | Patient Education And Counseling |
| Pages | 145 |
| Number of pages | 1 |
| Volume | 109 |
| Edition | S |
| DOIs | |
| Publication status | Published - Apr 2023 |