Listening to patients’ voices: Linguistic indicators related to diabetes self-management


  • Ulla Connor Indiana University -- Indianapolis
  • Marta Antón Indiana University, Indianapolis
  • Elizabeth Goering Indiana University, Indianapolis
  • Kathryn Lauten Indiana University -- Indianapolis
  • Paris Roach Indiana University School of Medicine, Indianapolis
  • Stephanie Balunda Indiana University, Indianapolis Universidad de Talca Universidad de Autonóma
  • Amir Hayat Indiana University, Indianapolis



adherence, agency, control orientation, diabetes, linguistic indicators, patient-centered


A great deal of research in health care has examined a wide range of variables to better understand the degree to which patients follow the advice of medical professionals in managing their health, known as adherence. This paper explains the development of the linguistic systems to describe and evaluate two psychosocial constructs (i.e. control orientation and agency) that have been found to be related to adherence in previous research for subjects with diabetes (Trento et al. 2007; Wangberg 2007; O’Hea et al. 2009). The present data came from 43 semi-structured in-depth interviews of subjects with Type 2 diabetes. One-on-one interviews with open-ended questions elicited subjects’ ‘stories’ about living with diabetes, and the transcribed interviews were analyzed to develop the linguistic systems of control orientation and agency. The resultant systems were applied to the 43 interviews by raters with high inter-rater reliability. The results showed demarcations of clearly identified codings of patient types. The paper presents the linguistic coding systems developed in the study, the results of their application to the patient interview data, and recommendations for improved communication with patients.

Author Biographies

Ulla Connor, Indiana University -- Indianapolis

Ulla M. Connor, PhD, is the Barbara E. and Karl R. Zimmer Chair in Intercultural Communication, Professor of English, and Director of the Indiana Center for Intercultural Communication. She is the author of Contrastive Rhetoric (1996) and Intercultural Rhetoric in the Writing Classroom (2011). Her research interests focus on intercultural communication, English for Specific Purposes, and corpus linguistics.

Marta Antón, Indiana University, Indianapolis

Marta Antón received her PhD from the University of Massachusetts at Amherst and is Associate Professor of Spanish at Indiana University-Purdue University Indianapolis. Her research interests include sociocultural theory, discourse and social interaction, assessment, and sociolinguistics. Recent publications have appeared in the International Journal of Applied Linguistics and the International Journal of Ibero-American Linguistics.

Elizabeth Goering, Indiana University, Indianapolis

Elizabeth Goering received her PhD in communication from Purdue University and is currently an Associate Professor in the Department of Communication Studies at IUPUI. Her research interests include intercultural, organizational, and health communication.

Kathryn Lauten, Indiana University -- Indianapolis

Kathryn Lauten is the Associate Director of the Indiana Center for Intercultural Communication at Indiana University Purdue University Indianapolis. She received her BA from Dartmouth College and her PhD from the University of Michigan. Her current research involves combining her background in linguistics and intercultural communication with her work in health communication in order to improve patient outcomes.

Paris Roach, Indiana University School of Medicine, Indianapolis

Paris Roach, MD, is Associate Professor of Clinical Medicine at the Indiana University School of Medicine. He attended medical school at the IU School of Medicine and completed an endocrinology fellowship at the National Institutes of Health. He worked on insulin products for Eli Lilly and Company before joining the IU School of Medicine. His primary clinical interest is diabetes care.

Stephanie Balunda, Indiana University, Indianapolis Universidad de Talca Universidad de Autonóma

Stephanie Alexis Balunda received her MA in English from Indiana-University Purdue University. She was a Visiting Research Associate at the Indiana Center for Intercultural Communication before moving to Chile where she is currently working at the Universidad de Talca and the Universidad de Autonóma teaching English as a Foreign Language (EFL) courses and training future teachers of English.

Amir Hayat, Indiana University, Indianapolis

Amir D. Hayat received his MS in Applied Statistics and MA in Economics from Indiana University Purdue University Indianapolis (IUPUI). He is currently an applied statistician at the Center of Philanthropy at Indiana University. His research interests include health outcomes, philanthropic behavior, and survey methodologies.



How to Cite

Connor, U., Antón, M., Goering, E., Lauten, K., Roach, P., Balunda, S., & Hayat, A. (2013). Listening to patients’ voices: Linguistic indicators related to diabetes self-management. Communication and Medicine, 9(1), 1–12.




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