Helping aphasic patients accomplish greeting exchanges
Implications for stroke care in Thailand
Keywords:Aphasia, Conversation Analysis, Wai, Sawatdi, Gesture, Thailand
Background: This study explores greeting exchanges in stroke care, in particular the use of the ‘wai’ gesture.
Method: Seventeen patients with Broca’s aphasia, some family members, six nurses from district public health centers, and four nurses from a district hospital in northern Thailand were given written consent forms for participation. Thirty counseling sessions were video-recorded in patients’ homes and analyzed using conversation analysis. Direct observation and in-depth interview were also used for supplementary data collection.
Results: These showed a patient’s daughter helping her to accomplish a greeting. She was encouraged to use one hand to raise the other hand up. Another patient was only able to raise one hand to conduct the normal ‘wai,’ a potential cause of embarrassment for the patient, as the greeting is always formed by putting the two palms of the hands together. The nurse encouraged him to perform the greeting using one hand through different questions and statements.
Discussion and conclusion: While the ‘wai’ gesture and the spoken greeting ‘sawatdi’ used for social functions plays an important role in stroke counseling, the nursing guidelines in the Barthel Index excluded them in the section on non-verbal communication assessment. This article suggests that they should be taken into account, in order to improve the nursing guidelines to fit the Thai context.
Aroonmanakun, W. (2005). Thai-English and English-Thai transliteration system: Approaches and development. Bangkok: Thailand Research Fund.
Beeke, S., Wilkinson, R., and Maxim, J. (2001). Context as a resource for the construction of turns at talk in aphasia. Clinical Linguistics & Phonetics, 15(1–2), 79–83. https://doi.org/10.3109/02699200109167635 DOI: https://doi.org/10.3109/02699200109167635
Cameron, D. (2006). Working with spoken discourse. London: Sage.
Cooper, R. (2012). Culture shock! Thailand: A survival guide to customs and etiquette (9th ed.). Singapore: Marshall Cavendish.
Daumüller, M., and Goldenberg, G. (2010). Therapy to improve gestural expression in aphasia: A controlled clinical trial. Clinical Rehabilitation, 24, 55–65. https://doi.org/10.1177/0269215509343327 DOI: https://doi.org/10.1177/0269215509343327
De Waal, F. (1996). Good natured: The origins of right and wrong in humans and other animals. Cambridge: Harvard University Press. DOI: https://doi.org/10.4159/9780674033177
Drew, P. (2003). Conversation analysis. In Jonathan A. Smith (Ed.), Qualitative psychology: A practical guide to research methods (pp. 132–158). London: Sage.
Duranti, A. (1992). Language and bodies in social space: Samoan ceremonial greetings. American Anthropologist, 94, 657–691. https://doi.org/10.1525/aa.1992.94.3.02a00070 DOI: https://doi.org/10.1525/aa.1992.94.3.02a00070
Goffman, E. (1967). Interaction ritual: Essays in face to face behavior. Garden City: Doubleday.
Goffman, E. (1971). Relations in public: Microstudies of public order. New York: Harper & Row.
Goodwin, C. (1995). Co-constructing meaning in conversations with an aphasic man. Research on Language and Social Interaction, 28(3), 233–260. https://doi.org/10.1207/s15327973rlsi2803_4 DOI: https://doi.org/10.1207/s15327973rlsi2803_4
Goodwin, C. (Ed.) (2003). Introduction. Conversation and brain damage (pp. 3–20). Oxford: Oxford University Press.
Heritage, J. (1984). Garfinkel and ethnomethodology. Cambridge: Polity Press.
Heritage, J., and Maynard, D. W. (2006). Communication in medical care: Interaction between primary care physicians and patients. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511607172 DOI: https://doi.org/10.1017/CBO9780511607172
Howard, K. M. (2010). Social relationships and shifting languages in northern Thailand. Journal of Sociolinguistics, 14(3), 313–340. https://doi.org/10.1111/j.1467-9841.2010.00445.x DOI: https://doi.org/10.1111/j.1467-9841.2010.00445.x
Hutchby, I., and Wooffitt, R. (1998). Conversation analysis: Principles, practices and applications. Cambridge: Polity Press.
Kendon, A. (1990). Conducting interaction: Patterns of behavior in focused encounters. Cambridge: Cambridge University Press.
Klippi, A. (2003). Collaborating in aphasic group conversation: Striving for mutual understanding. In C. Goodwin (Ed.), Conversation and brain damage (pp. 117–143). Oxford: Oxford University Press.
McNeilis, K. S. (2001). Analyzing communication competence in medical consultations. Health Communication, 13(1), 5–18. https://doi.org/10.1207/S15327027HC1301_02 DOI: https://doi.org/10.1207/S15327027HC1301_02
McNeill, D. (1992). Hand and mind: What gestures reveal about thought. Chicago: Chicago University Press.
Peräkylä, A. (1995). AIDS counselling: Institutional interaction and clinical practice. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511597879 DOI: https://doi.org/10.1017/CBO9780511597879
Peräkylä, A. (1998). Authority and accountability: The delivery of diagnosis in primary health care. Social Psychology Quarterly, 61(4), 301–320. https://doi.org/10.1177/0190272515611054; https://doi.org/10.2307/2787032 DOI: https://doi.org/10.2307/2787032
Peräkylä, A. (2006). Observation, video and ethnography: Case studies in Aids counsellings and greetings. In P. Drew, G. Raymond, and D. Weinberg (Eds.), Talk and interaction in social research methods (pp. 81–96). London: Sage. https://doi.org/10.4135/9781849209991.n6 DOI: https://doi.org/10.4135/9781849209991.n6
Peräkylä, A. (2013). Epilogue: What does the study of interaction offer to emotional research? In A. Peräkylä and M.-L. Sorjonen (Eds.), Emotion in Interaction (pp. 274–289). Oxford: Oxford University Press. https://doi.org/10.1093/acprof:oso/9780199730735.003.0013 DOI: https://doi.org/10.1093/acprof:oso/9780199730735.003.0013
Pomerantz, A., and Fehr, B. J. (2011). Conversation analysis: An approach to the analysis of social interaction. In T. A. Van Dijk (Ed.), Discourse studies: A multidisciplinary introduction (2nd ed., pp. 165–190). Thousand Oaks: Sage. https://doi.org/10.4135/9781446289068.n9 DOI: https://doi.org/10.4135/9781446289068.n9
Poslawsky, I. E., Schuurmans, M. J., Lindeman, E., and Hafsteinsdóttir, T. B. (2010). A systematic review of nursing rehabilitation of stroke patients with aphasia. Journal of Clinical Nursing, 19(1–2), 17–32. https://doi.org/10.1111/j.1365-2702.2009.03023.x DOI: https://doi.org/10.1111/j.1365-2702.2009.03023.x
Powell, L., Amsbary, J., and Mark, H. (2014). The wai in Thai culture: Greeting, status-marking and national identity functions. Journal of Intercultural Communication, 34(1), 7.
Prasat Neurological Institute (2011). Clinical nursing practice guidelines for stroke. Bangkok: Prasat Neurological Institute.
Sacks, H. (1975). Everyone has to lie. In B. Blount and M. Sanches (Eds.), Sociocultural dimensions of language use (pp. 57–80). New York: Academic Press.
Scharp, V. L., Tompkins, C. A., and Iverson, J. M. (2007). Gesture and aphasia: Helping hands? Aphasiology, 21(6–8), 717–725. https://doi.org/10.1080/02687030701192273 DOI: https://doi.org/10.1080/02687030701192273
Ten Have, P. (1999). Doing conversation analysis: A practical guide. London: Sage.
Tompkins, C. A., Scharp, V. L., and Marshall, R. C. (2006) Communicative value of self cues in aphasia: A re-evaluation. Aphasiology, 20(7), 684–704. https://doi.org/10.1080/02687030500334076 DOI: https://doi.org/10.1080/02687030500334076
Wilainuch, P. (2014). Interpersonal communication for rehabilitation and wellbeing between patients after stroke, public health professionals and family members, in Changwat Nan. Bangkok: The Thailand Research Fund.
Wilkinson, R. (2011). Changing interactional behaviour: Using conversation analysis in intervention programmes for aphasic conversation. In C. Antaki (Ed.), Applied conversation analysis: Intervention and change in institutional talk (pp. 32–53). New York: Palgrave Macmillan. https://doi.org/10.1057/9780230316874_3 DOI: https://doi.org/10.1057/9780230316874_3
Wilkinson, R. (2013). Gestural depiction in acquired language disorders: On the form and use of iconic gestures in aphasic talk-in-interaction. Augmentative and Alternative Communication, 29(1), 68–82. https://doi.org/10.3109/07434618.2013.767558 DOI: https://doi.org/10.3109/07434618.2013.767558
Wooffitt, R. (2005). Conversation analysis and discourse analysis: A comparative and critical introduction. London: Sage. https://doi.org/10.4135/9781849208765 DOI: https://doi.org/10.4135/9781849208765
World Health Organization. (2004). The atlas of heart disease and stroke. Geneva: WHO.
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