Treatment Recommendations In Chinese Outpatient Clinical Interaction

Treatment decision-making is a significant phase in outpatient interaction. Distinct formats of treatment recommendations may exert influences on both opportunities and consequences for patient participation in the process. Taking naturally occurring Chinese outpatient clinical conversations as the data and drawing from the analytic apparatuses provided by Conversation Analysis, this book represents an attempt to conduct a systematically descriptive and analytic study of the position and composition of treatment recommendations in doctor-patient interactions in Chinese outpatient clinics. By incorporating the analysis of epistemic and deontic orientations into the examination of particular linguistic resources employed to formulate the initiation, construction of, and responses to treatment recommendations, the study uncovers how Chinese doctors and patients steer the interactional trajectories of treatment decision-making through talk-in-interaction. The book can serve as a reference to the research on treatment decision-making in various kinds of Chinese medical settings. In addition, the insights from the study could provide a reference for understanding how Chinese doctors’ medical authority and patients’ agency are generally executed, challenged, and sustained via talk in the new era of patient-centered medical care.

Active patient participation is of great importance to providing high-quality medical care. By employing the method of conversation analysis, this book has probed into patient participation in Chinese community clinics. Declarative expressions, imperative expressions, and interrogative expressions are those frequently used by patients when they participate in consultations. Patients participate in all stages of communication: history taking, diagnosis, or treatment recommendations. There are four types of social actions performed by patients when they participate in the interaction: making requests, expressing concerns, showing alignment, or showing resistance to doctors. There exist two types of initiations of patient participation in the interaction: self-initiated patient participation and doctor-initiated patient participation. Self-initiated patient participation is closely related to patient agency, while doctor-initiated patient participation indicates the influence of doctors’ communicative behaviors on the involvement of patients.

As the editors of this volume point out, one certainty in life is that people must interact with others from very different cultural backgrounds--whether or not they are prepared to do so. The modules in this volume encourage productive and effective intercultural interactions in business, educational, social, and health services settings. Each module--a collection of materials for cross-cultural training programs--has a similar structure. They all have a combination of experiential exercises, self-assessment instruments, traditional "text" material describing concepts and the research methods necessary in using a given module, and case studies and/or critical incidents. Among the subjects Improving Intercultural Interactions addresses are gender relations in the workplace, intercultural education at the university level, intercultural communication for health care professionals, multicultural counseling, and nonverbal behavior in intercultural interaction. Improving Intercultural Interactions is a valuable resource for consultants, counselors, personnel officers, and others who offer various kinds of cross-cultural training programs. It is also useful as a supplemental text in graduate and undergraduate courses dealing with culture and behavior. "The present volume . . . aims at supplying not only valuable ideas and ideals but most of all practical guidelines to all those interested in carrying out satisfactory training programs." --Language, Culture, and Curriculum "An excellent practical guide to intercultural sensitivity, in the business world; elementary, secondary, and tertiary level schools; and social service and health delivery agencies. Each chapter provides opportunities for self-assessment, cases, critical incidents, constructs that can develop skills in analyzing intercultural situations, opportunities to practice these skills, and field exercises to test the newly acquired sensitivity. It increases awareness of culture and cultural differences, provides facts that can help adjustment, suggests ways to feel appropriately for interaction with members of other cultures, and opportunities to identify and practice skills that can assist in adjustment to other cultures." --Harry C. Triandis, University of Illinois "Improving Intercultural Interactions represents the next step forward in resource books for trainers, teachers, professors, organizational developers and the like who are in constant need of upgrading the results of their cross-cultural training programs. . . . It presents sequences of training processes from self-assessment and critical incidents through the development of an understanding of cultural concepts and frameworks to exercises targeted to cause the learner to experience and practice an array of behaviors or actions in appropriate cross-cultural problem situations. The fact that each of the books′ modules ends with suggested actions based on specific examples helps lead the learner to a position where he or she can develop personally and culturally relevant strategies for their workplace situation. This book will serve as a resource for persons in culturally diverse work situations, whether it be business, education, health, or a broad array of other public and private organizations." --Sheldon Varney, University of Hawaii at Manoa

Offering a rarely seen glimpse into the realities of one of the biggest global public health crises in modern time, Wang’s book focuses on doctor–patient interactions in China to demonstrate the potential effects of health communication, doctor–patient relationship, and a matrix of social factors on overprescription of antibiotics. Based on a community-based survey, the book describes empirical findings regarding the high prevalence of non-prescribed antibiotics use for common colds among children in China. It covers the potential effects of overprescription on caregivers' attitudes and how physicians make prescribing decisions in medical consultations. Drawing from evidence in medical interaction data, readers are introduced to further empirical findings regarding the communicative behaviors that patient caregivers use to pressure for antibiotic prescriptions in real medical consultations. Following this, Wang reports findings regarding the communicative behaviors that physicians use to make treatment recommendations and caregivers use to launch treatment negotiations, leading to a discussion of the effect of the doctor–patient relationship on antibiotic overprescription. The book culminates in practice recommendations and provides teaching scenarios in which physicians successfully engage the caregivers into conversations to shape their expectations for antibiotic prescriptions in medical consultations. An important resource for scholars and students in health communication, linguistics, medical humanities, and medical sociology. Practitioners who are interested in understanding and improving clinical practices as well as policymakers aiming to combat antibiotic resistance will also find this book useful.

This book is written for patients and their doctors by an internationally acclaimed gastroenterologist and patient advocate. It contains up-to-date knowledge on the science, diagnosis, and treatment of all the Disorders of Gut-Brain Interaction (formerly called Functional GI Disorders) and offers techniques to maximize the patient-doctor relationship. For the patient, it will help you to: • Understand and manage your GI symptoms and improve the care you receive • Talk with your doctors—learn what to say, what to ask, and what to do when the visit is not going well • Find the best clinical programs for treating DGBI • Understand why you have symptoms when all tests are negative For the doctor, it will help you to: • Learn the pathophysiology, diagnosis, and treatment of all Disorders of Gut-Brain Interaction (DGBI) • Elicit accurate information from the medical interview to make a precise diagnosis • Acquire communication skills to better connect with your patients