“[She] said : ‘take the test’ and I took the test”. Relational work as a framework to approach directiveness in prenatal screening of Chinese clients in Hong Kong

In this paper we apply the framework of relational work, or the work individuals invest in maintaining their relationships (Locher and Watts 2005), to the analysis of prenatal screening (PS) for Down Syndrome of Chinese clients in Hong Kong. PS has traditionally followed a nondirective principle that calls for an unbiased presentation of information and women’s autonomous decision- making regarding testing. However, in Chinese contexts, healthcare providers appear extremely directive; and women, in turn, explicitly express their expectations of being led in decision-making (Zayts et al. 2013). These observations lend support to previous politeness studies of Chinese institutional contexts wherein hierarchical communication has been described as “listening-centered, asymmetrical and differential” (Gao and Ting-Toomey 1998: 48). More recent politeness studies, however, warn against such stereotyping at a cultural level (Eelen 2001; Mills 2003, 2004; Watts 2003). In this paper, rather than using culture as an a priori explanatory variable to account for the directive stance of the healthcare providers, we argue that using the framework of relational work enables researchers to focus on how meaning is created and negotiated at the micro-level of an interaction, and to move away from “grand generalizations” about culture specific behaviors and expectations

“I can't remember them ever not doing what I tell them!” : Negotiating face and power relations in ‘upward’ refusals in multicultural workplaces in Hong Kong

This paper explores how refusals are constructed and negotiated in multicultural workplaces in Hong Kong. A particular focus is on the ways in which Hong Kong Chinese subordinates negotiate issues of face and power relations when refusing their expatriate superiors. Despite abundant research on refusals in a variety of contexts across cultures, there are very few studies of multicultural workplaces. This is particularly surprising considering that refusals have been described as a frequent “ ‘sticking point’ in cross-cultural communication” (Beebe et al. 1990). This paper addresses this gap by drawing on more than 80 hours of authentic audio- and video-recorded spoken workplace discourse and a corpus of emails collected in multicultural workplaces in Hong Kong. Findings of this exploratory study indicate that refusals are complex communicative activities that are carefully negotiated among participants. We argue that in contrast to earlier studies, participants' socio-cultural backgrounds do not appear to be the main determining factor of how issues of face and power relations are negotiated in upward refusals. Rather, a range of other factors, including media of communication, normative ways of interacting in a workplace, the relationship between interlocutors, as well as the content of the refusal, are more relevant for explaining participants’ communicative behavior

'You have to be adaptable, obviously' : constructing professional identities in multicultural workplaces in Hong Kong

In spite of the increasing globalisation of the work domain and the mobilization of the workforce (Wong et al. 2007) only very little attention has been paid to the interplay between culture and professional identities in workplace contexts. This paper addresses this gap by exploring some of the ways through which professionals are required to construct and negotiate their various identities in increasingly multicultural contexts where notions of culture may become particularly salient. We focus on multicultural workplaces where, we believe, the intricate and complex relationship between culture and identity is particularly well reflected: In these contexts members are on a daily basis exposed to culture-specific perceptions, assumptions, expectations, and practices which may ultimately be reflected in workplace communication, and which impact on how professional identities are constructed. Drawing on a corpus of more than 80 hours of authentic workplace discourse and follow-up interviews conducted with professionals we explore how expatriates who work in Hong Kong with a team of local Chinese construct, negotiate and combine aspects of their professional and cultural identities in their workplace discourse. Our particular focus is on two issues that have been identified in participants’ interviews: Sharing decision making responsibilities and negotiating a work-life balance. Our analysis of these two aspects illustrates the complex processes of identity construction from two different but complementary perspectives: i) the ways in which participants portray themselves as adapting to, negotiating or rejecting the new culture in which they work and live; and ii) the ways in which these perceived identity construction processes are actually reflected in participants’ workplace discourse

Laughter as a 'serious business' : clients’ laughter in prenatal screening for Down’s syndrome

This chapter examines the use of laughter in the context of prenatal screening (PS) for Down’s syndrome in Hong Kong. Scholars interested in humor typically approach laughter as a phenomenon that accompanies funny, amusing, and humorous situations. In our previous work on nurses’ laughter in PS (Zayts and Schnurr, 2011) we have shown that laughter may also be used to perform ‘serious business’, for example, it may be employed by nurses to help them facilitate clients’ decision-making process regarding testing for Down’s syndrome. This chapter focuses on the second part of the laughter sequences, in particular it examines what is interactionally achieved through the reciprocation of the nurses’ laughter by their clients. Drawing on 34 video-recorded consultations between nurses and pregnant women, and using conversation analysis, we show that the reciprocated laughter in these sequences can be affiliative and serve to establish rapport between the participants. It can also be disaffilitative, particularly in interactional contexts when participants engage in negotiating their epistemic and deontic statuses and authority. The negotiation of epistemic statuses is observed in consultations with more experienced and knowledgeable clients who use laughter to terminate the topic of ‘inquiring about their knowledge’. The negotiation of deontic authority happens in decision-making phases of these consultations and through laughter the clients affirm their right and sufficient knowledge to make a decision

Enacting and negotiating power relations through teasing in distributed leadership constellations

This paper explores how power relations are enacted and negotiated in the largely under-researched non-hierarchal leadership constellation of distributed leadership. Drawing on more than 300 hours of audio-recorded interactions of a corpus of interdisciplinary research group meetings, we analyse how members of a team that does not have an officially assigned leader or chair regularly draw on teasing thereby enacting and reflecting, as well as sometimes challenging existing power relations. Findings show that the highly ambiguous discursive strategy of teasing enables all members, regardless of their official role or position, to contribute to the team’s leadership performance. However, findings also show that although teasing has the potential to facilitate more collaborative approaches to leadership, the ways in which power is actually enacted in our data resembles more traditional hierarchical leadership constellations

GP perspectives on hospital discharge letters : an interview and focus group study

Background: Written discharge communication following inpatient or outpatient clinic discharge is essential for communicating information to the GP, but GPs’ opinions on discharge communication are seldom sought. Patients are sometimes copied into this communication, but the reasons for this variation, and the resultant effects, remain unclear. Aim: To explore GP perspectives on how discharge letters can be improved in order to enhance patient outcomes. Design & setting: The study used narrative interviews with 26 GPs from 13 GP practices within the West Midlands, England. Method: Interviews were transcribed and data were analysed using corpus linguistics (CL) techniques. Results Elements pivotal to a successful letter were: diagnosis, appropriate follow-up plan, medication changes and reasons, clinical summary, investigations and/or procedures and outcomes, and what information has been given to the patient. GPs supported patients receiving discharge letters and expounded a number of benefits of this practice; for example, increased patient autonomy. Nevertheless, GPs felt that if patients are to receive direct discharge letter copies, modifications such as use of lay language and avoidance of acronyms may be required to increase patient understanding. Conclusion: GPs reported that discharge letters frequently lacked content items they assessed to be important; GPs highlighted that this can have subsequent ramifications on resources and patient experiences. Templates should be devised that put discharge letter elements assessed to be important by GPs to the forefront. Future research needs to consider other perspectives on letter content, particularly those of patients

The management of diagnostic uncertainty and decision-making in genetics case conferences

In this paper we examine one type of intraprofessional collaborative activity, namely case conferences in a specialist genetics clinic. Our specific focus is on how clinical geneticists manage decision-making through team talk in the event of diagnostic uncertainty which is mainly attributable to limitations in the current state of genomic knowledge, ‘uncertain significances’ associated with genetic test results, and a lack of information/ evidence pertaining to cases under discussion. The case conference then becomes a means to minimise the uncertainty and arrive at decisions that optimise the significance of the results in terms of clients’ life trajectories. Adopting theme-oriented activity analysis, we examine video-recorded data from five case conferences in Hong Kong. Beginning with a prototypical structural mapping of the case conference activity type, our analysis focuses on what we call ‘uncertain cases’. Our findings highlight three discourse types constitutive of team talk: pedagogic talk, diagnostic talk and decisional talk. In paying particular attention to how uncertainty is formulated and negotiated, we suggest that access to and assessment of different kinds of evidence as well as the activity-specific expert role-positions of the participants are crucial with regard to establishing a correct diagnosis and/or striving towards a minimisation of current uncertainties

Challenging hegemonic femininities? The discourse of trailing spouses in Hong Kong

While the notion of hegemonic masculinity has received a lot of attention in recent scholarship, hegemonic femininity remains largely under-developed. We aim to address this gap by illustrating the benefits of using the concept of hegemonic femininities in sociolinguistic scholarship. Conducting a case study on the discourse of trailing spouses in Hong Kong, we analyse hegemonic femininities at the local, regional, and global level, and explore how they are interlinked with each other. Findings show how these trailing spouses often challenge and reject hegemonic femininities on the local level, but largely accept and reinforce them on the regional and global level. The specific femininities which are considered to be hegemonic are highly context-dependent, and, unlike masculinities, the hegemony of femininities is a matter of internal degree – i.e. certain femininities take hegemonic status compared to other femininities but do not take a dominant position in the gender order

Just because he’s black’ : identity construction and racial humour in a German U-19 football team

Despite its status as the global game, football has been noted for having problems with racism, and yet relatively little research has actually looked at this topic from a discourse analytical perspective. This paper addresses this gap by exploring the use of racial humour in a German male under-19 football team. Drawing on audio-recordings of interactions among the players on the sideline and substitutes’ bench during, before and after football matches and training, as well as interviews with players, and team observations, we analyse and critically discuss some of the ways in which team members make humorous comments about specific racial, ethnic or national groups when constructing and expressing team membership and negotiating their own and others’ identities within the team. Findings illustrate that, on the one hand, team members express their appreciation of the cultural diversity within their team in an attempt to maintain or enhance team cohesion, but on the other hand, they often use racial humour to create distinctive subgroups thereby fragmenting the team and assigning and foregrounding racial identities