Miscommunication in Doctor-Patient Communication.

Topics in Cognitive Science
Rose McCabe, Patrick Healey

Abstract

The effectiveness of medical treatment depends on the quality of the patient-clinician relationship. It has been proposed that this depends on the extent to which the patient and clinician build a shared understanding of illness and treatment. Here, we use the tools of conversation analysis (CA) to explore this idea in the context of psychiatric consultations. The CA "repair" framework provides an analysis of the processes people use to deal with problems in speaking, hearing, and understanding. These problems are especially critical in the treatment of psychosis where patients and health care professionals need to communicate about the disputed meaning of hallucinations and delusion. Patients do not feel understood, they are frequently non-adherent with treatment, and many have poor outcomes. We present an overview of two studies focusing on the role of repair as a mechanism for producing and clarifying meaning in psychiatrist-patient communication and its association with treatment outcomes. The first study shows patient clarification or repair of psychiatrists' talk is associated with better patient adherence to treatment. The second study shows that training which emphasizes the importance of building an understanding of pa...Continue Reading

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