scholarly journals Analyzing dialogue moves in chronic care communication

2020 ◽  
Vol 9 (2) ◽  
pp. 167-198
Author(s):  
Fabrizio Macagno ◽  
Sarah Bigi
Keyword(s):  
Decision Making ◽  
Diabetes Care ◽  
Chronic Care ◽  
Common Ground ◽  
Personal Information ◽  
Effective Communication ◽  
Statistical Analyses ◽  
Patient Centered ◽  
Medical Interviews ◽  
General Goal

Abstract Dialogue moves are a pragmatic instrument that captures the most important categories of “dialogical intentions.” This paper adapts this tool to the conversational setting of chronic care communication, characterized by the general goal of making reasoned decisions concerning patients’ conditions, shared by the latter. Seven mutually exclusive and comprehensive categories were identified, whose reliability was tested on an Italian corpus of provider-patient encounters in diabetes care. The application of this method was illustrated through explorative analyses identifying possible correlations between the dialogical structure of medical interviews and one of the indicators of personalized decision-making, namely the specificity of the recommendations given by the provider (“customization”). The statistical analyses show a significant correlation between the exchange of personal information and very specific and customized recommendations for change. It suggests how the creation of common ground, exceeding the boundaries of the paternalistic or patient-centered models, can lead to highly effective communication.

The role of argumentative strategies in the construction of emergent common ground in a patient-centered approach to the medical encounter

2018 ◽  
Vol 7 (2) ◽  
pp. 141-156 ◽  
Author(s):  
Sarah Bigi
Keyword(s):  
Information Sharing ◽  
Chronic Care ◽  
Common Ground ◽  
Care Setting ◽  
Real Life ◽  
Patient Centered ◽  
Medical Encounter ◽  
Argumentative Strategies ◽  
The Common

Abstract In this paper, argumentation practices will be discussed in view of their potential for favoring effective information sharing and the creation of ‘emergent common ground’, i.e. the common ground that is sought, created and co-constructed in the process of communication. Argumentation is usually tightly knit with information sharing: if the parties have not previously shared a sufficient amount of relevant knowledge, it is difficult for them to produce effective argumentation. Based on these premises, in this paper the argumentation stages of medical encounters will be viewed as opportunities to reveal and integrate insufficient common ground between clinicians and patients. By relying on the analysis of a corpus of real life encounters in a chronic care setting, the interaction between information sharing and argumentation will be shown, along with problematic cases of misunderstandings or ineffective argumentation due to lack of common ground. Implications for the clinical practice will be discussed.

The Obligation of Listening: Caring for Patients With Chronic Dysphagia Through Illness Narratives

2020 ◽  
Vol 5 (1) ◽  
pp. 231-235
Author(s):  
Jinxu Bridget Xia
Keyword(s):  
Decision Making ◽  
Chronic Conditions ◽  
Chronic Care ◽  
The United States ◽  
Illness Narratives ◽  
Narrative Approach ◽  
Psychosocial Needs ◽  
Patient Centered ◽  
Treatment Plans ◽  
Provision Of Care

Purpose Chronic conditions affect the lives of thousands of people in the United States. Dysphagia is a symptom that co-occurs with many chronic conditions. This presents unique challenges to speech-language pathologists (SLPs) who work with patients that are physically and psychosocially burdened by chronic dysphagia. Clinical decisions in chronic care are characterized by context-dependent complexities. There is a theoretical framework in bioethics called narrative ethics , which suggests that engaging with patients' illness narratives informs patient-centered decision making and that exploring contexts is essential to provision of care. Conclusion Using a narrative approach in decision making in chronic dysphagia helps contextualize the symptoms and supports clinicians to form individualized treatment plans that better suit patients' health care and psychosocial needs.

scholarly journals Chronic Care Model Strategies In The United States And Germany Deliver Patient-Centered, High-Quality Diabetes Care

2014 ◽  
Vol 33 (9) ◽  
pp. 1540-1548 ◽  
Author(s):  
Stephanie Stock ◽  
James M. Pitcavage ◽  
Dusan Simic ◽  
Sibel Altin ◽  
Christian Graf ◽  
...  
Keyword(s):  
United States ◽  
Diabetes Care ◽  
Chronic Care Model ◽  
Chronic Care ◽  
The United States ◽  
Care Model ◽  
Patient Centered ◽  
High Quality

The Role of Shared Decision-Making in Audiologic Rehabilitation

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Behavior Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Treatment Information ◽  
Centered Care ◽  
Potential Risks ◽  
Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

Can patient-centered communication reduce the effects of medical mistrust on patients’ decision making?

2019 ◽  
Vol 38 (4) ◽  
pp. 325-333 ◽  
Author(s):  
Adolfo G. Cuevas ◽  
Kerth O'Brien ◽  
Somnath Saha
Keyword(s):  
Decision Making ◽  
Medical Mistrust ◽  
Patient Centered

Patient-Centered Care and Autonomy: Shared Decision-Making in Practice and a Suggestion for Practical Application in the Critically Ill

2019 ◽  
Vol 35 (11) ◽  
pp. 1352-1355
Author(s):  
Marianna V. Mapes ◽  
Peter A. DePergola ◽  
William T. McGee
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Critically Ill ◽  
Care Service ◽  
Clinical Care ◽  
Patient Centered Care ◽  
Practical Application ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Centered Care

Decision-making for the hospitalized dying and critically ill is often characterized by an understanding of autonomy that leads to clinical care and outcomes that are antithetical to patients’ preferences around suffering and quality of life. A better understanding of autonomy will facilitate the ultimate goal of a patient-centered approach and ensure compassionate, high-quality care that respects our patients’ values. We reviewed the medical literature and our experiences through the ethics service, palliative care service, and critical care service of a large community teaching hospital. The cumulative experience of a senior intensivist was filtered through the lens of a medical ethicist and the palliative care team. The practical application of patient-centered care was discerned from these interactions. We determined that a clearer understanding of patient-centeredness would improve the experience and outcomes of care for our patients as well as our adherence to ethical practice. The practical applications of autonomy and patient-centered care were evaluated by the authors through clinical interactions on the wards to ascertain problems in understanding their meaning. Clarification of autonomy and patient-centeredness is provided using specific examples to enhance understanding and application of these principles in patient-centered care.

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