Where do they stand? Spatial arrangement of patient companions in geriatric out-patient interaction in Taiwan
DOI:
https://doi.org/10.1558/japl.v4i2.239Keywords:
geriatric doctor–patient communication, triadic spatial arrangement, entering sequence, third personAbstract
Using 69 medical encounters collected in southern Taiwan, this research examined two issues related to spatial configurations in geriatric triads: the entering sequence of elderly patients and their companions and the spatial arrangement for companions in the consultation room. The main findings include the following. The prevalent entering sequence of patients entering the room followed by their companions (78.3%) reflects the elderly patient’s role as the legitimate party for medical service, a dependent on the companion, and a superior/senior family member to their adult child. Exceptions to this sequence also suggest a potentially marked relationship, e.g., companions with a hidden agenda, of doctor’s acquaintance, or without close rapport with the patient. As most companions’ physical locations are not arranged by doctors (87%), they tend to stand near the door (47.8%) or between doctors and patients (20.3%). These two configurations reflect a fast opening pattern observed in Taiwanese context, in which neither companions’ identities are introduced nor are their physical positions arranged. This research sheds light on cross-cultural studies by showing how socio-economic variants shape verbal and nonverbal interaction in medical encounters.
References
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Woolfson, P. (1991) Aspects of non-verbal accommodation to language in a bilingual Montreal hospital setting. Journal of Linguistic Anthropology 1 (2): 178–188. doi:10.1525/ jlin.1991.1.2.178
Billings, J. A. and Stoeckle, J. D. (1999) The Clinical Encounter: A Guide to the Medical Interview and Case Presentation, 2nd edn. St Louis, MO: Mosby.
Carson, C. A. (1988) A Course in Nonverbal Communication for Medical Education. Rochester, NY: Hospital Corp of America.
Chan, Y. C. (1997) A study of doctor-patient conversation. Research Papers in Linguistics and Literature 6: 35–54.
Cheng, S. H. and Chiang, T. L. (1998) Disparity of medical care utilization among different health insurance schemes in Taiwan. Social Science and Medicine 47 (5): 613–620. doi: 10.1016/S0277-9536(98)00103-8
Chou, Y. H. (1991) A study of family care for the elderly. In C. Chaou (ed.) Chinese Family in Transition 371–380. Hong Kong: Chinese University Press.
Coe, R. M. and Prendergast, C. G. (1985) The formation of coalitions: Interaction strategies in triad. Sociology of Health and Illness 7 (2): 236–247. doi:10.1111/1467-9566. ep10949087
Cole, S. A. and Bird, J. (2000) The Medical Interview: The Three-function Approach. St Louis, MO: Mosby, Inc.
Coupland, J. and Coupland, N. (2001) Roles, responsibilities and alignments: Multi-party talk in geriatric care. In M. L. Hummert and J. Nussbaum (eds) Aging, Communication and Health 121–156, Mahwah NJ: Lawrence Erlbaum.
Dickson, D., Hargie, O. and Morrow, N. (1997) Communication Skills Training for Health Professionals. New York: Chapman & Hall.
Dimatteo, M. R., Taranta, A., Friedman, H. S. and Prince, L. M. (1980) Predicting patient satisfaction from physicians’ nonverbal communication skills. Medical Care 18 (4): 376– 387. doi:10.1097/00005650-198004000-00003
Erickson, F. and Shultz, J. (1982) The Counselor as Gatekeeper: Social Interaction in Interviews. New York: Academic Press.
Ferguson, C. A. (1976) The structure and use of politeness formulas. Language in Society 5 (2): 137–151. doi:10.1017/S0047404500006989
Firth, R. (1972) Verbal and bodily rituals of greeting and parting. In J. S. L. Fontaine (ed.) The Interpretation of Ritual: Essays in Honour of A. I. Richards 1–38. London: Tavistock.
Frankel, R., Altschuler, A., George, S., Kinsman, J., Jimison, H., Robertson, N. R. and Hsu, J. (2005) Effects of exam-room computing on clinician-patient communication: A longitudinal qualitative study. Journal of General Internal Medicine 20 (8): 677–682. doi:10.1111/j.1525-1497.2005.0163.x
Gu, Y. (1996) Doctor-patient interaction as goal-directed discourse. Journal of Asian Pacific Communication 7 (3 & 4): 156–176.
Heath, C. (1986) Body Movement and Speech in Medical Interaction. New York: Cambridge University Press.
Kendon, A. (1990) Conducting Interaction: Patterns of Behavior in Focused Encounters. New York: Cambridge University Press.
Kleinman, A. (1980) Patients and Healers in the Context of Culture: An Exploration of the Borderland Between Anthropology, Medicine, and Psychiatry. Los Angeles, CA: University of California Press.
Knapp, M. L. (1978) Nonverbal Communication in Human Interaction. New York: Holt, Rinehart and Winston.
Levinson, D. (1987) A Guide to the Clinical Interview. London: W. B. Saunders Company.
Levinson, D. and Rakel, R. E. (1987) Nonverbal communication. In D. Levinson (ed.) A Guide to the Clinical Interview 134–145. London: W. B. Saunders Company.
Malinowski, B. (1972) Phatic communion. In J. Laver and S. Hutcheson (eds) Communication in Face-to-Face Interaction 146–152. Harmondsworth: Penguin.
Ministry of Interior, ROC (1997) Zhong-Hua-Ming-Guo Lao-Ren Zhong-Kuang Bao-Gao (Report on a survey of the status of old people in Taiwan, Republic of China). Taipei, Taiwan: Ministry of Interior, ROC.
Mcbee, G. W. and Justice, B. (1977) The effect of interviewer bias on mental illness questionnaire responses. The Journal of Psychology 95 (1st half): 67–75.
Modaff, D. P. (1995) Enacting Asymmetry in the Opening Moments of the Doctor-Patient Interview. Unpublished Ph.D. dissertation, University of Texas, Austin.
Parsons, T. (1951) The Social System. New York: The Free Press.
Robinson, J. D. (1998) Getting Down to Business: Talk, gaze, and body orientation during openings of doctor-patient consultations. Human Communication Research 25 (1): 97– 123.
Robinson, J. D. (1999) The Organization of Action and Activity in Primary-Care, Doctor- Patient Consultations. Unpublished Ph.D. dissertation, University of California, Los Angeles. doi:10.1111/j.1468-2958.1998.tb00438.x
Sacks, H. (1972) On the analyzability of stories by children. In J. Gumperz and D. Hymes (eds), Directions in Sociolinguistics 325–345. New York: Holt, Rinehart and Winston.
Suchman, E. A. (1965) Stages of illness and medical care. Journal of Health and Human Behavior 6 (3): 114–128. doi:10.2307/2948694
Tsai, M. H. (2000). Companions of Elderly Patients: A Sociolinguistic Study of Triadic Medical Encounters in Southern Taiwan. Unpublished Ph.D. dissertation, Georgetown University, Washington, DC.
Tsai, M. H. (2005) Opening stages in triadic medical encounters in Taiwan. Communication and Medicine 2 (1): 53–68. doi:10.1515/come.2005.2.1.53
West, C. (1983) ‘Ask Me No Questions …’: An analysis of queries and replies in physicianpatient dialogues. In S. Fisher and A. D. Todd (eds) The Social Organization of Doctorpatient Communication 75–106. Washington, DC: Center for Applied Linguistics.
Wilson, R. N. (1963) Patient practitioner relationships. In H. Freeman, S. Levine and L. G. Reeder (eds) Handbook of Medical Sociology 273-295. Englewood Cliffs, NJ: Prentice- Hall.
Woolfson, P. (1991) Aspects of non-verbal accommodation to language in a bilingual Montreal hospital setting. Journal of Linguistic Anthropology 1 (2): 178–188. doi:10.1525/ jlin.1991.1.2.178
Published
2015-09-14
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Equinox Publishing Ltd.
How to Cite
Tsai, M.- hui. (2015). Where do they stand? Spatial arrangement of patient companions in geriatric out-patient interaction in Taiwan. Journal of Applied Linguistics and Professional Practice, 4(2), 239-260. https://doi.org/10.1558/japl.v4i2.239
