Do Nurses Use Discourse Markers Differently when Using Their Second Language as Opposed to Their First while Interviewing Patients?

This study examined whether discourse-marker use changes in nurse-patient interactions as a function of nurses using their first (L1) or second (L2) language. Discourse markers were analyzed as turn-maintenance markers that indicate acknowledgement and discourse-shift markers that signal shifts of a topic or speaker in the conversation. These two categories differ in terms of degree of discourse management and interactional control. Sixteen nurses conducted a pain-assessment interview with a patient native speaker of English and with a patient native speaker of French, where the nurses used their own L1 in one case and their own weaker L2 in the other. The first hypothesis, that nurses would generally use discourse markers more frequently in the L1 than in the L2, was not supported. The second hypothesis, that nurses would use discourse-shift markers less frequently in their L2 compared to the L1, relative to their (baseline) use of turn-maintenance markers, was supported. The findings, especially the support for the second hypothesis, could have implications for the development of L2 training for health practitioners.</p

Error disclosure and family members&apos; reactions : does the type of error really matter?

OBJECTIVE: To describe how Italian clinicians disclose medical errors with clear and shared lines of responsibility.To describe how Italian clinicians disclose medical errors with clear and shared lines of responsibility. METHODS: Thirty-eight volunteers were video-recorded in a simulated conversation while communicating a medical error to a simulated family member (SFM). They were assigned to a clear responsibility error scenario or a shared responsibility one. Simulations were coded for: mention of the term "error" and apology; communication content and affect using the Roter Interaction Analysis System. SFMs rated their willingness to have the patient continue care with the clinician. RESULTS: Clinicians referred to an error and/or apologized in 55% of the simulations. The error was disclosed more frequently in the clear responsibility scenario (p<0.02). When the "error" was explicitly mentioned, the SFM was more attentive, sad and anxious (p 640.05) and less willing to have the patient continue care (p<0.05). Communication was more patient-centered (p<0.05) and affectively dynamic with the SFMs showing greater anxiety, sadness, attentiveness and respectfulness in the clear responsibility scenario (p<0.05). CONCLUSIONS: Disclosing errors is not a common practice in Italy. Clinicians disclose less frequently when responsibility is shared and indicative of a system failure. PRACTICE IMPLICATIONS: Training programs to improve disclosure practice considering the type of error committed should be implemented

Communication accommodation between patients and health professionals: Themes and strategies in satisfying and unsatisfying encounters

This paper has several goals. One is to introduce and contextualize the papers that contribute to this special issue. All of the papers in the issue are grounded in Communication Accommodation Theory and Coupland, Wiemann & Giles'(1991) typology of miscommunication. These theories are briefly reviewed here, and some links between them are explored in the context of the contributory papers. Another goal of this paper is to discuss some of the themes and issues raised by a reading of the other papers as a set. In this regard, two issues which may be worthy of further research and theoretical attention in the future are selected and highlighted. First, the degree to which communicators are aware of various language and communication strategies, especially accommodation strategies, is considered. The relationship between awareness and research tasks such as self-reporting is important here. Second, the concept of accommodation dilemmas, their relationship to miscommunication and problematic talk, along with possible avenues of dilemma resolution are explored

The value of empathy in dietetic consultations. A pilot study to investigate its effect on satisfaction, autonomy and agreement.

Forty individuals with diabetes and three dietitians completed a questionnaire concerning their consultation. Empathy was examined using the Empathic Communication Coding System (ECCS) (Bylund &amp; Makoul, 2002). The more empathic the professionals' response to emotional opportunities, the more satisfied patients were with their consultations (r = 0.41, d.f. = 15, P = 0.05). There was a nonsignificant trend that the more empathic opportunities that arise during a consultation, the higher the agreement between patient and dietitian on what was discussed (r = 0.28, P = 0.07). The data also suggest that patients reported more autonomy support when they created more empathic opportunities during their consultation (r = ?0.29, P = 0.07). This preliminary study suggests that professionals' responses to empathic opportunities may be a useful component of dietetic consultations