Expanding Horizons in Health Communication

An Asian Perspective

Editors: Watson, Bernadette, Krieger, Janice (Eds.)

Table of contents

Author: Hans J. Ladegaard

Abstract

This chapter reports on a research project about Indonesian and Filipina migrant worker returnees. Shortly after their return, they were invited to participate in a sharing session with other migrant workers and a researcher about their experiences as migrant workers and about their homecoming. 107 women participated in 30 sharing sessions and all the stories were transcribed and (for some) translated. A large number of the women were (sexually) assaulted while they worked overseas and return to their home countries deeply traumatised. First, the chapter analyses some narrative excerpts in which the women talk about (sexual) assault and other traumatic experiences. The stories are notably incoherent and disconnected, characterised by voids in the narrative flow. This is typical of trauma storytelling but is sometimes used against the women to discredit their stories. Then the chapter discusses the mental health issues involved in these women’s stories and what scholars can do to address them. The findings from the current dataset suggest that hundreds of traumatised women return to Indonesia every year with no access to proper healthcare or professional therapy, and the chapter discusses what can be done to meet these women’s needs.

Keywords Domestic workers   Trauma   Narrative   Mental health


論回流外傭敘事中的創傷敘述:精神健康

Hans J. Ladegaard

摘要:本章節報道了一份關於印尼和菲律賓回流外傭的研究。歸國不久,他們就受邀參與一個分享會,與研究人員和其他外籍傭工分享他們在外務工的經驗以及歸國的感受。本文共收錄了30個分享會,含107名女性外傭。所收錄的敘事全數錄製,部分已翻譯成英文。大量的女性外傭在外務工期間曾有過凌辱的遭遇,重創歸國。該文首先分析了女性外傭就(性)凌辱和其他創傷的敘述。這些敘述盡顯創傷敘事特征:結構多支離破碎,中間多留有空白。然而此類敘事特征有時也被認為降低了女性受害者的故事可信度。該文還討論了女性外傭敘事中談及的精神健康問題以及有效應對方式。現有數據研究表明每年有數以千計的印尼女性受害者歸國後缺乏適當的醫療保健服務或專業治療。本文就這一情況探討如何保障這類女性受害者的需求。

關鍵詞: 家傭, 創傷, 敘事, 精神健康


回流外佣敘事中的创伤敘述:精神健康

Hans J. Ladegaard

摘要:本章节报道了一份关于印尼和菲律宾回流外佣的研究。归国不久后,这些外佣就受邀参与一个分享会, 与研究人员和其他外籍佣工分享他们在外务工的经验以及归国的感受。本文共收录了30个分享会,含107名女性外佣。所收录的叙事全数录制,部分已翻译成英文。大量的女性外佣在外务工期间有过凌辱的遭遇,重创归国。该文首先分析了女性外佣就(性)凌辱和其他创伤的叙述。镇邪叙述尽显创伤叙事特征:结构多支离破碎,中间多留有空白。然而此类叙事特征有时也被认为降低了女性受害者的故事可信度。该文还讨论了女性外佣叙事中谈及的精神健康问题以及有效应对方式。现有数据研究表明每年有数以千计的印尼女性受害者归国后缺乏适当的医疗保健服务或专业治疗。本文就这一情况探讨如何保障这类女性受害者的需求。

关键词:家佣,创伤,叙事,精神健康

Authors: Dennis Tay, Jin Huang, and Huiheng Zeng 

Abstract

Pictures are an innovative resource in the verbal activity of psychological counseling (Ginicola, Smith, & Trzaska, 2012; Malchiodi, 2011). Counselors often guide clients to interpret and explore them as figurative representations of their situation (Stevens & Spears, 2009). Picture-based counseling is, however, under- explored from both clinical and discourse perspectives, with few published guidelines and analyses of the nature of counselor prompts and client interpretations. Informed by metaphor theory, this paper examines 34 counterbalanced matched-pairs of elicited picture interpretations responding to either a topic-present or topic-absent prompt in Mandarin Chinese. Topic-present metaphor prompts indicate a specific topic to be connected to the picture, while topic-absent metaphor prompts do not. The resulting transcripts were coded for five variables reflecting key aspects of metaphor construction—sources, topics, source–topic connections, uncertainty markers, and metaphor signals. Spearman correlations were calculated and compared across the two prompt conditions, supported by qualitative analysis of examples. Results show stronger correlations and by implication greater integration among the variables in the topic-present condition. This suggests that people are better able to contextualize pictorial elements to a specified target topic of discussion. The present findings motivate follow-up research incorporating more direct counseling outcome measures.

Keywords Pictures, Counselling , Metaphor theory, Mandarin Chinese


基於圖像的心裡諮詢中的提示策略和成果研究

Dennis Tay, Jin Huang, and Huiheng Zeng

摘要:圖片是心理訪談言語活動中的一种新興資源 (Ginicola, Smith, & Trzaska, 2012; Malchiodi, 2011). 心理諮詢師通常會引導來訪者對圖片進行詮釋和探索, 認為圖片含有比喻意義,反映了來訪者自身的狀態 (Stevens & Spears, 2009)。然而基於圖像的心裡訪談研究在臨床和話語分析領域還非常匱乏,僅有為數不多的已發表文獻引導和分析咨詢師如何協助來訪者對圖片進行詮釋。基於隱喻理論,本文對普通話中不同提示策略(話題提示/無提示)下的圖片詮釋進行分析,使用對抗平衡次序,對數據進行配對組合,共計34組。包含主題提示的隱喻指的是就圖片提供相關的話題,無主題提示的隱喻則不提供相關話題。我們之後對謄本進行編碼,使用了五個變量分別對應隱喻構建的五個關鍵要素即始源,主題,始源-主題交互,不確定性標記,和隱喻信號。對於兩種提示下的圖片詮釋,我們採用斯皮爾曼相關係數進行了計算和對比分析,輔之以對個別樣本的定性分析。結果發現主題提示隱喻手法下的變量間相關性更為緊密,即整合性更高。該結果表明人們對於既定話題下的圖像情境討論更為擅長。該結果鼓勵未來有更多的研究能採取更為直接的方法針對心理咨詢成果進行測量。

關鍵詞: 圖片, 諮詢, 隱喻理論, 普通話


基于图像的心理咨询中的提示策略和成果研究

Dennis Tay, Jin Huang, and Huiheng Zeng

摘要:图片是心理访谈言语活动中的一种新兴资源 (Ginicola, Smith, & Trzaska, 2012; Malchiodi, 2011). 心理咨询师通常会引导来访者对图片进行诠释和探索,认为图片含有比喻意义,反映了来访者自身的状态 (Stevens & Spears, 2009)。然而基于图像的心理访谈研究在临床和话语分析领域还非常匮乏,仅有为数不多的已发表文献引导和分析咨询师如何协助来访者对图片进行诠释。基于隐喻理论,本文对普通话中不同提示策略 (话语提示/无提示)下的图片诠释进行分析,使用对抗平衡次序,对数据进行配对组合,共计34组。包含主题提示的隐喻指的是就图片提供相关的话题。无主题提示的隐喻则不提供相关话题。我们之后对誊本进行编码,使用了5个变量分别对应隐喻构建的五个关键要素即始源,主题,始源-主题交互,不确定性标记,和隐喻信号。对于两种提示下的图片诠释,我们采用斯皮尔曼相关系数进行了计算和对比分析,辅之以对个别样本的定性分析。结果发现主题提示隐喻手法下的变量间相关性更为紧密,即整合性更高。该结果表明人们对于既定话题下的图像情境讨论更为擅长。该结果鼓励未来有更多的研究能采取更为直接的方法针对心理咨询成果进行测量。

关键词:图片,咨询,隐喻理论,普通话

Authors: Mark Harrison and Phoenix Lam 

Abstract

The growing incidence of mental health problems in adolescents is a significant global concern. School-based counselling, where a student meets with an individual, trained counsellor a number of times in a school setting, is a common component of holistic mental health programmes to support the well-being of students. In Hong Kong, however, professional counselling is in general not well-developed, and school-based counselling has been severely under-researched. Drawing on data from interviews with 8 counsellors and 25 student clients in local secondary schools, the present study aims to investigate the perspectives of counsellors and clients on the practice of school-based counselling in Hong Kong. Following a thematic approach, the study compares the key themes identified in the reflections of counsellors and clients on their experience of counselling. Similarities and differences in the discursive construction and realisation of themes are examined in detail. Representative examples are discussed in context to illustrate the views from both the service providers and users of school-based counselling. Findings from this study will inform and enhance understanding of how school-based counselling can help to promote the mental well-being of students in the local educational setting and in the broader Asian context.

Keywords    Mental health, Adolescents, School-based counselling


談香港輔導員和學生如何看待校本輔導

Mark Harrison and Phoenix Lam

摘要:日益嚴重的青少年精神健康問題已引起全球重視。校本輔導(即學生在校內與受過訓練之輔導員多次單獨會面)是英美等國家的全方位精神健康計劃中常見的一部份,旨在支援學生的健全發展。然而,香港的專業輔導服務總體來說尚未完善,而關於校本輔導的研究也極度匱乏。我們於本研究中,透過在香港本地中學訪問8名輔導員和25名學生,旨在深入瞭解香港校本輔導的實踐中,輔導員和學生的觀點。本研究採用主題分析的方法,對輔導員與學生輔導經驗的反思,進行主題辨認和對比,並詳細分析該等主題在話語構造和語言實現中之異同。為了更好地闡釋校本輔導服務供求雙方的觀點,本文列舉了頗具代表性的範例進行討論。本研究結果將有助於進一步瞭解在本地乃至整個亞洲的教育環境下,校本輔導能如何對學生精神健康的發展起重要作用。

關鍵詞: 精神健康,青少年,校本輔導


谈香港辅导员和学生如何看待校本辅导

Mark Harrison and Phoenix Lam

摘要:日益严重的青少年精神健康问题已引起全球重视。校本辅导(即学生在校内与受过训练之辅导员多次单独会面)是英美等国家的全方位精神健康计划中常见的一部份,旨在支持学生的健全发展。然而,香港的专业辅导服务总体来说尚未完善,而关于校本辅导的研究也极度匮乏。我们于本研究中,透过在香港本地中学访问8名辅导员和25名学生,旨在深入了解香港校本辅导的实践中,辅导员和学生的观点。本研究采用主题分析的方法,对辅导员与学生辅导经验的反思,进行主题辨认和对比,并详细分析该等主题在话语构造和语言实现中之异同。为了更好地阐释校本辅导服务供求双方的观点,本文列举了颇具代表性的范例进行讨论。本研究结果将有助于进一步了解在本地乃至整个亚洲的教育环境下,校本辅导能如何对学生精神健康的发展起重要作用。

关键词: 精神健康,青少年,校本辅导

Author: E. Angela Chan

Abstract

Cancer patients suffer from emotional issues and/or distress, for which they require appropriate care. However, effective communication that translates into recognition of patients’ cues/concerns remains an issue. Barriers to effective communication include nurse shortages, time constraints and limited healthcare communication training for cancer nurses. Exploring how nurses fare in communicating with patients by responding to their cues/concerns for emotional and/or informational needs is important. This ethnographic study examined a busy cancer ward and its nursing care as a subculture. Content analysis from patient interviews was conducted, and a statistical analysis of the nurses’ cue-responding behaviours. Findings revealed that despite no emotional counselling, nurses exhibited positive cue-responding behaviours and patients expressed appreciation for this care. This conclusion is striking at a time when nurses stated there was no time to talk to patients and Hong Kong faces a shortage of nurses, even as the emphasis on holistic care is growing. Findings challenge the cultural expectations of emotional care in oncology wards. The perception that emotional care must be addressed separately from the nurses’ everyday physical and technical care is challenged and should be re-assessed with reintegration of the physical with the emotional in the nursing care provided to patients.

Keywords   Nursing, Cancer   Ethnography, Descriptive content analysis


全人關顧在忙碌的癌症病房中的體現

Angela Chan

摘要:癌症患者通常承受很大的情緒壓力因而需要適當的關愛。然而,如何與病人展開有效的溝通,認識到病人的情緒線索/擔憂這一問題仍然懸而未決。阻礙有效溝通的因素包括護理人員短缺,時間有限,以及缺乏對癌症護工的醫患溝通培訓。研究護理人員是如何與癌症病人溝通,如何回應病人情緒線索/困擾或病人對於信息的需求是非常重要的。本文採用民族誌研究法對一個癌症病房以及病房內體現的護理文化展開深入研究,對癌症病人的訪談進行內容分析,對回應情緒線索行為展開統計分析。研究表明雖然護理人員未能提供情緒咨詢,但是對於病人的情緒線索都能做出積極的回應,病人對此也表示感謝。雖然全人關顧這一理念日益推進,香港依然面臨護理人員短缺,護理人員缺乏時間與病人溝通。鑒於這一情況,當前研究結果實屬驚人。本研究認為人們需要重新思考關於要將情緒管理和護理人員日常護理區分看待的這一觀點,提倡應該在護理工作中將情緒關愛和生理關愛結合。

關鍵詞: 護理,癌症,民族誌,描述性內容分析


全人关顾在忙碌的癌症病房中的体现

Angela Chan

摘要:癌症患者通常承受很大的情绪压力因而需要适当的关爱。然而,如何与病人展开有效的沟通,认识到病人的情绪线索/担忧这一问题仍然悬而未决。阻碍有效沟通的因素包括护理人员短缺,时间有限,以及缺乏对癌症护工的医患沟通培训。研究护理人员是如何与癌症病人沟通,如何回应病人情绪线索/困扰或病人对于信息的需求是非常重要的。本文采用民族志研究法对一个癌症病房以及病房内体现的护理文化展开深入研究,对癌症病人的访谈进行内容分析,对回应情绪线索行为展开统计分析。研究表明虽然护理人员未能提供情绪咨询,但是对于病人的情绪线索都能做出积极的回应,病人对此也表示感谢。虽然全人关顾这一理念日益推进,香港依然面临护理人员短缺,护理人员缺乏时间与病人沟通。鉴于这一情况,当前研究结果实属惊人。本研究认为人们需要重新思考关于要将情绪管理和护理人员日常护理区分看待的这一观点,提倡应该在护理工作中将情绪关爱和生理关爱结合。

关键词:护理,癌症,民族志,描述性内容分析

Authors: Wendy Wong, Herbert H. F. Loong, Allyson K. Y. Lee,
Ambrose H. N. Wong, C. H. Sum, Jessica Y. L. Ching,
Justin C. Y. Wu, and Z. X. Lin

Abstract Cancer patients seek help from both Western medicine (WM) and Traditional Chinese Medicine (TCM). This study explored what patients with colorectal cancer (CRC) in Hong Kong (HK) expect from TCM to WM. Twenty purposively sampled CRC patients were interviewed and audio-taped. Interviews were transcribed verbatim in Cantonese. Data were analyzed using the Interpretative phenomenological analysis. Results showed that CRC patients’ goal expectation on WM was not specific. In contrast, the 16 patients who had used TCM had specific goals that stemmed from their desire or requests for treatment continuation. These expectation differences affected their motivation of compliance to the treatment schedule. The motivation for WM patients came from their faith in biomedicine and family, and the desire to live. The motivation for TCM patients’ compliance came from their belief in TCM and its effectiveness and provision of mental support. Although TCM was not the main treatment cancer patient received in HK, their expectations from it were high. Thus, TCM may be more than palliative in cancer treatment. Perceived WM status may hinder TCM development. More resources to ensure safe and effective interdisciplinary collaboration for the development of TCM cancer treatment can assist patients along the pathway of patients of CRC for effective communication.

Keywords   Colorectal cancer, Western medicine, Traditional Chinese medicine


香港大腸癌病人對中西醫診療的偏好

Wendy Wong, Herbert H. F. Loong, Allyson K. Y. Lee, Ambrose H. N. Wong, C. H. Sum, Jessica Y. L. Ching, Justin C. Y. Wu, and Z. X. Lin

摘要:香港大腸癌病人,在治療過程中會分別向中、西醫求診。本研究旨在探討香港大腸癌患者在不同過程中選擇中、西醫的期望。研究採用立意取樣,與20名早中晚期大腸癌患者進行面談並錄音。面談內容逐字謄寫成廣東話。數據採用詮釋現象學的分析方法進行分析。結果發現大腸癌患者對於西醫的期望並無特別意向。大腸癌病人願意積極配合治療乃是因為一種實在的求生慾望,他們相信實體的生物醫學,相信家人。相對而言,16名大腸癌病人對中醫就診經驗表現出了特有的期望,他們希望在西醫以外尋求持續治療。這種差異影響到患者是否積極遵從西醫的治療計劃。若病人相信傳統中醫的療效,及其在心理上的治療的成效,病人即覺滿足。雖然中醫並非香港主流治療癌症的方式,患者對於中醫仍然抱有很高的期望,甚至希望中醫可治癒癌症。因此,相較於西醫,病人相信中醫在香港癌症治療上或許不僅是一種舒緩治療。當前中醫職能的限制,及受西醫的影響,我們需要更多的資源來推動和確保中西醫協作治療癌症在病人上的安全、有效及跨領域合作及溝通,才可達至三贏的局面。

關鍵詞:大腸癌,西醫,中醫


香港大肠癌病人对于中西医诊疗的偏好

Wendy Wong, Herbert H. F. Loong, Allyson K. Y. Lee, Ambrose H. N. Wong, C. H. Sum, Jessica Y. L. Ching, Justin C. Y. Wu, and Z. X. Lin

摘要:香港大肠癌病人,在治疗过程中会分别向中、西医求诊。本研究旨在探讨香港大肠癌患者在不同过程中选择中、西医的期望。研究采用立意取样,与20名早中晚期大肠癌患者进行面谈并录音。面谈内容逐字誊写成广东话。数据采用诠释现象学的分析方法进行分析。结果发现大肠癌患者对于西医的期望并无特别意向。大肠癌病人愿意积极配合治疗乃是因为一种实在的求生欲望,他们相信实体的生物医学,相信家人。相对而言,16名大肠癌病人对于中医就诊经验表现出了特有的期望,他们希望在西医以外寻求持续治疗。这种差异影响到患者是否积极遵从西医的治疗计划。若病人相信传统中医的疗效,及其在心理上的治疗的成效,病人即觉满足。虽然中医并非香港主流治疗癌症的方式,患者对于中医仍然抱有很高的期望,甚至希望中医可以治愈癌症。因此,相较于西医,病人相信中医在香港癌症治疗上或许不仅是一种舒缓治疗。当前中医职能的限制,及受西医的影响,我们需要更多的资源来推动和确认中西医协作治疗癌症在病人上的安全,有效及跨领域合作及沟通,才可达到三赢的局面。

关键词:大肠癌,西医,中医

Author: Ying Jin

Abstract There has been extensive research on doctors’ preference to foreground the medical frame over the medical interactions, however, little attention has been paid to how different frames are entered and closed at the boundaries of medical talk. Much less is known about the situation in traditional Chinese medicine, causing a great amount of speculation and unwarranted claims. This article uses frame analysis to investigate the opening and closing stages of 45 visits of doctor–older patient consultations in Mainland China, focusing on how participants in both traditional Chinese medicine and western medicine practices collaborate in and navigate between the construction of medical and relational frames of talk. All interactions were audio-recorded and transcribed verbatim. Findings reported in this chapter show variations between different clinical practices in relation to sequential attributes and framing priorities. It is suggested that these variations could possibly be explained by broader clinical differences in pathology and philosophy.

Keywords   Medical interactions, China, Frame, Communication


醫患會話結語框架分析:中文會話

Ying Jin

摘要:大量的研究表明,醫生在醫患互動時著重於醫藥會話框架。然而,很少有研究討論關於醫患雙方如何進入和結束不同的框架。此類研究在中醫會話中更為罕見,導致大量無依據的猜疑。本文於中國大陸收集45份醫生/年長患者會話,含中西醫,採用框架分析方法,著重關注會話開始和結束部分,探討會話雙方是如何共同構建和徘徊於醫藥和人際兩大框架。所有的會話全部被錄音而後謄寫。研究表明中西醫會話在會話順序和框架優先性上存在差異。該研究認為這些差異可能是由於中西醫在病理學和原理上的差異導致的。

關鍵詞:醫患會話,中國,Goffman, 溝通


医患会话结语框架分析:中文会话

Ying Jin

摘要:大量的研究表明,医生在医患互动时着重于医药会话框架。然而很少有研究讨论关于医患双方如何进入和结束不同的框架。此类研究在中医会话中更为罕见,导致大量无依据的猜测。本文于中国大陆收集45份医生/年长者患者会话,含中西医,采用框架分析方法,着重关注会话开始和会话结束部分,探讨会话双方是如何共同构建和徘徊于医药和人际两大框架。所有的会话全部被录音而后誊写。研究表明中西医在会话顺序和框架优先性上存在差异。该研究认为这些差异可能是由于中西医在病理学和原理上的差异导致而成的。

关键词:医患回话,中国,Goffman, 沟通

Authors: Jesse W. C. Yip and Chenjie Zhang

Abstract Findings from previous research on Western medical consultations indicate that the doctor–patient relationship involved in these consultations is mostly asymmetrical. This asymmetry of relationship is clearly revealed in the analysis of participants’ conversational dominance in doctor–patient interactions. This chapter argues that the doctor–patient relationship in Traditional Chinese Medicine (TCM) consultations may be different with that in Western medical consultations. With audio recordings and transcriptions of 28 conversations between TCM practitioners and patients, this chapter examines the sequential structure of TCM consultations and speech functions of doctors and patients in the TCM context. The findings show that small talk contributes to a more symmetrical doctor–patient relationship because both the TCM practitioners and patient are engaged in it. The prevalence of explanations indicates the feature of patient-centered approach in TCM consultations. Moreover, the statistical test in speech function frequencies of doctors and patients further supports the claim that the doctor–patient relationship in TCM consultations may be more symmetrical as insignificant differences of the frequencies are observed. Based on the analyses, this chapter further suggests that TCM consultations are co-constructed by both TCM practitioners and patients.

Keywords   Discourse analysis, Doctor–patient relationship, Medical consultations, Traditional Chinese medicine


解析中醫諮詢會話構建:話語結構分析

Jesse W. C. Yip and Chenjie Zhang

 摘要:對於西醫醫療問詢的現有研究指出,醫患關係存在不對稱性。這種不對稱關係在對醫患會話中談話者的會話主導的分析上得到了充分的揭示。該章節認為,中醫諮詢中醫患關係可能區別於西醫。通過對28份中醫問詢的錄音和謄寫,該研究分析了中醫諮詢的會話順序結構,以及醫患雙方的話語功能。研究表明,在中醫醫患諮詢中,醫生和病人展開的閒聊有助於構建更為對稱的醫患關係。大量的解釋也說明了中醫咨詢的一個特點,即病人為本。此外,通過對醫患雙方話語功能的統計性測試發現,會話中談話雙方的話語功能的頻率未存在顯著差異。這一發現也證實了在中醫會話中醫患關係更為對稱。基於這些分析,該研究認為中醫諮詢是由醫生和病人共同構建的。

關鍵詞:醫患互動,中醫,中國,話語分析


解析中医咨询会话构建:话语结构分析

Jesse W. C. Yip and Chenjie Zhang

 摘要:对于西医医疗问询的现有研究指出,医患关系存在不对称性。这种不对称关系在对医患回话中谈话者会话主导的分析上得到了充分的揭示。本章节认为,中医咨询中医患关系可能区别于西医。通过对28份中医问询的录音和誊写,该研究分析了中医咨询的会话顺序结构,以及医患双方的话语功能。研究表明,在中医医患咨询中,医生和病人展开的闲聊有助于构建更为对称的医患关系。大量的解释也说明了中医咨询中的一个特点,即病人为本。此外,通过对医患双方话语功能的统计性测试发现,会话中谈话双方的话语功能频率未存在显著差异。这一发现也证实了在中医会话中医患关系更为对称。基于这些分析,该研究认为中医咨询是由医生和病人共同构建完成的。

关键词:医患互动,中医,中国,话语分析

Authors: Veronika Schoeb and Adrian Yip Abstract Background: Instruction in exercise therapy aims at patients being able to correctly perform exercises. The analysis of instructional sequences (i.e., questions) examines the achievement of social actions during exercise therapy. This study investigated physiotherapists’ questions for patients’ initiations of exercises and analyzed patients’ verbal and embodied responses, focusing on actions per- formed by physiotherapists’ question designs and patients’ responses. Study findings add to the evidence of underrepresented Chinese population. Methods: Data were collected from two Hong Kong rehabilitation centers. Forty-seven consultations (6 physiotherapists; 16 patients) were video-recorded and analyzed using Conversation Analysis. Interactional features including verbal (e.g., vocabulary, grammar, turn-taking) and nonverbal aspects (e.g., gaze and gesture) were examined. Results: Ninety-eight questions were posed by physiotherapist during the initial phase of exercise. Five categories were identified: invitations, memory check, information seeking, understanding check, or adherence check. Physiotherapists’ questions led to a variety of embodied and verbal outcomes. Implications: The multimodal analysis of exercise instruction demonstrates that initiations of exercises are situated in task-relevant actions. Physiotherapists set the agenda regarding the exercise choice. Overall, physiotherapists and patients orient to verbal and non- verbal resources without precedence from either. The importance of non-verbal communication during exercises is highlighted. Keywords   Instruction, Exercise therapy, Conversation analysis, Chinese
論運動治療教學如何幫助香港物理治療病人展開運動 Veronika Schoeb and Adrian Yip  摘要:運動治療教學旨在幫助病人能夠正確的做運動。分析運動教學順序(例如:提問) 有助研究運動治療過程中社會行動是如何完成的。該研究探討物理治療師如何以提問讓病人開始運動並分析病人回覆中的言語行為和具身行為,著力於物理治療師問題設計與病人回覆所作出的行動。研究結果進一步證實有關方面的知識在中國尚未得到充分認知。方法:數據選自香港兩所復康中心,對47次諮詢(6名物理治療師,16名病人)進行影像錄製,透過會話分析研究會話互動特徵,包括言語 (如:詞彙,語法,輪替) 和非言語特徵 (如:眼神和手勢)。結果:物理治療師在運動初期提出98個問題,共分為5類行動:邀請﹑記憶查看﹑資訊尋求﹑理解檢查,以及依從性檢查。物理治療師的提問導致不同的言語和具身行為。意義:運動教學的多模態分析顯示,物理治療師會就運動的選擇作出安排,以提問讓病人開始運動,當中涉及與任務相關的行動。總括來說,物理治療師和病人使用各種言語和非言語的資源。該研究強調非言語交流在運動中的重要性。 關鍵詞:教學,運動治療,會話分析,中文
论运动治疗教学如何帮助香港物理治疗病人展开运动 Veronika Schoeb and Adrian Yip  摘要:运动治疗教学旨在帮助病人能够正确的做运动。分析运动教学顺序(例如:提问)有助研究运动治疗过程中社会行动是如何完成的。该研究探讨物理治疗师如何以提问让病人开始运动并分析病人回复重的言语行为和具身行为,着力于物理治疗师问题设计与病人回复所作出的行动。研究结果进一步正视有关方面的知识在中国尚未得到充分认知。方法:数据玄子香港两所康复中心,对47次咨询(6名物理治疗师,16名病人)进行影响录制,透过会话分析研究会话互动特征,包括言语(如:词汇,语法,轮替)和非言语特征(如:眼神和手势)。结果:物理治疗师在运动初期提出98个问题,共分为5类行动:邀请,记忆查看,资讯寻求,理解检查,以及依从性检查。物理治疗师的提问导致不同的言语和具身行为。意义:运动教学的多模态分析显示,物理治疗师会就运动的选择作出安排,以提问让病人开始运动,当中涉及与任务相关的行动。总括来说,物理治疗师和病人使用各种言语和非言语的资源。该研究强调非言语交流在运动中的重要性。 关键词:教学,运动治疗,会话分析,中文

Authors: Phillip R. Della, Fazila Aloweni, Shin Yuh Ang, Mei Ling Lim, Thendral Uthaman, Tracey Carol Ayre, and Huaqiong Zhou

Abstract Ineffective communication, during handover, is a major factor in sub- sequent incidents and patient harm. There is a dearth of evidence on the quality of handovers in a multi-cultural, multi-lingual and cohort care setting, such as in Singapore. This is the first Singaporean study aimed to observe, analyse and evaluate clinical handover by nurses. Fifty shift-to-shift handovers were observed and video-recorded. Content and discourse analyses were used and focused on informational, structural and interactional dimensions of handover. Findings revealed that patient safety information was sometimes missed out. The transfer of responsibility and accountability for ongoing patient care was not explicit and poor information framework and flow during the handover process were observed. Some nurses preferred to perform physical assessments prior to handover instead of during or afterwards. Patients’ background and medical history were either not mentioned at handover commencement or excluded. Some nurses appeared apprehensive to bedside handover and had poor patient engagement. Few nurses effectively involved patients or reinforced patient education. Results highlight that nurses need support and training to master some aspects of handover, focused on reducing clinical errors.

Keywords   Handover, Ineffective communication,  Patient harm, Patient safety, Nurses


新加坡三級醫院中多元文化和多種語言的護理

床旁交接班:一項觀察性研究

 摘要:溝通不良是造成後續不良事件和病人危害的主要因素。目前尚缺乏針對多文化,多語言和集中護理環境下(如:新加坡)的交班質量相關證據。本文作為首個在新加坡展開的研究,旨在觀察,分析和評估護士臨床交接班質量。本研究觀察並錄像了50份護士交班情況,對其進行了內容分析和話語分析,重點關注與醫護交班中的信息,結構和互動層面。結果發現,護士交班中有關患者安全的信息時有被遺漏。結果發現,護士交班中國年有關患者安全的信息時有被遺漏。研究發現,在交班過程中對持續的患者護理責任移交不明確,信息框架和流程不完善。一些護士會在交班前對患者進行身體評估,而不是在交接期間或交接後。交班初始階段,患者的背景和病史未被提及或被排除。部分護士在床邊交班時表現出了焦慮,患者參與度較低。很少有護士能有效地使患者參與其中或加強對患者的教育。本研究結果強調了需要對護士提供支持和培訓以便更好的掌握交接班工作,減少臨床差錯。


新加坡三级医院中多元文化和多种语言的护理床旁交

接班:一项观察性研究

 摘要:沟通不良是造成后续不良事件和病人危害的主要因素。目前尚缺乏针对多文化、多语言和集中护理环境下(如:新加坡)的交班质量相关证据。本文作为首个在新加坡展开的研究,旨在观察、分析和评估护士临床交接班质量。本研究观察并录像了50份护士交班情况,对其进行了内容分析和话语分析,重点关注与医护交班中的信息、结构和互动层面。结果发现,护士交班中有关患者安全的信息时有被遗漏。研究发现,在交班过程中对持续的患者护理责任移交不明确,信息框架和流程不完善。一些护士会在交班前对患者进行身体评估,而不是在交接期间或交接后。交班初始阶段,患者的背景和病史未被提及或被排除。部分护士在床边交班时表现出了焦虑,患者参与度较低。很少有护士能有效地使患者参与其中或加强对患者的教育。本研究结果强调了需要对护士提供支持和培训以便更好的掌握交接班工作,减少临床差错。

Authors: Phillip R. Della, Lina Ma, Pamela A. Roberts, Huaqiong Zhou, Rene Michael, and Satvinder S. Dhaliwal

Abstract Background: Despite a significant amount of attention towards the safety and quality of acute care, little focus has been paid to the residential aged care sector, especially in the Asian region. This research aimed to assess the safety and quality culture within two nursing homes in Singapore. Methods: A cross-sectional study used a validated 42-item Nursing Home Survey on Patient Safety Culture (NHSPSC) tool. Minor linguistic adjustments were made to the tool, and its internal reliability was assessed using Cronbach’s alpha. Results: The Cronbach’s alpha values for the 12 PSC Composites ranged from 0.519 to 0.781, nine PSC Composites were >0.6 (adequate), indicating NHSPSC had acceptable internal reliability in the Singapore context. Of the 12 PSC Composites calculated for the two Singapore nursing homes, six were >90th percentile, four were >75th percentile and two >50th percentile. Conclusion: The NHSPSC tool provided an assessment of residential aged care safety and quality culture of the two nursing homes in Singapore. In general, the staff at the nursing homes in Singapore per- ceived a higher percentile residential safety culture compared to the US Comparative Database. The findings of this study demonstrated the importance of communication openness in residential safety culture.

Keywords   Patient safety, Quality culture, Singapore aged care, Cross-sectional, Communication openness


安全文化評估:一項新加坡養老院橫斷面研究

摘要

背景:雖然急性照護的安全性和質量已被廣為關注,但對養老院特別是在亞洲地區的養老院卻鮮有研究。本研究旨在評估新加坡兩所養老院的安全和品質文化。方法:採用橫斷面研究方法,選用經過驗證的養老院中患者安全文化調查問卷(NHSPSC),共計42個條目。問卷語言稍加調適,內部一致性度採用Cronbach’s α 係數評估。結果:患者安全文化量表12個緯度Cronbach’s α係數為0.519至0.781,9個緯度高於0.6(合格),證明NHSPSC在新加坡環境中的內部一致性信度是可以接受的。在用以測量兩所新加坡養老院的12緯度患者安全文化量表中,6組高於前90%,4組高於前75%,2組高於前50%。結論:NHSPSC可用以評估新加坡兩所養老院的患者安全和品質文化。概言之,與美國相比,新加坡養老院的員工展現了更好的安全文化。該研究說明開放性溝通對於提高居住安全文化的重要性。

關鍵詞:患者安全,品質文化,新加坡老齡護理,橫斷面研究,開放性溝通


安全文化评估:一项新加坡养老院横断面研究

摘要  

背景:虽然急性照护的安全性和质量已被广为关注,但对养老院特别是在亚洲地区的养老院却鲜有研究。本研究旨在评估新加坡两所养老院的安全和品质文化。方法:采用横断面研究方法,选用经过验证的养老院中患者安全文化调查问卷(NHSPSC),共计42个条目。问卷语言稍加调适,内部一致性信度采用Cronbach’ s α系数评估。结果:患者安全文化量表12个维度Cronbach’s α系数为0.519至0.781, 9 个维度高于0.6 (合格),证明NHSPSC在新加坡环境中的内部一致性信度是可以接受的。在用以测量两所新加坡养老院的12维度患者安全文化量表中,6组高于前90%,4组高于前75%,2组高于前50%。结论:NHSPSC可用以评估新加坡两所养老院的患者安全和品质文化。概言之,与美国相比,新加坡养老院的员工展现了更好的安全文化。该研究说明开放性沟通对于提高居住安全文化的重要性。

关键词 患者安全, 品质文化, 新加坡老龄护理, 横断面研究,开放性沟通

Authors: Aantaki Raisa, Carma Bylund, Sabrina Islam, and Janice Krieger

Abstract While most cancer deaths occur in Low-to-Middle-Income countries (LMICs), little is known about cancer prevention in such places. Empirical research shows that culturally appropriate and theory-driven communication interventions for cancer prevention can produce expected health outcomes, but how it is done in LMICs like Bangladesh has not been scientifically studied. In this chapter, we conducted a systematic scoping review to reduce that knowledge gap. Out of 985 articles on cancer prevention in Bangladesh, 35 were selected for review based on the selection criteria of covering at least one concept of the transactional model of communication. These articles were coded for the four constructs of the Extended Parallel Process Model (EPPM): perceived severity and susceptibility of cancer, and perceived response and self-efficacy of cancer screening. Such a limited number of studies demonstrate the lack of research focused on Bangladesh. Only four articles mentioned the need for cultural appropriateness and none included theory. Thematic summary of the articles found that perceived susceptibility of cancer and self-efficacy of cancer screening are low among Bangladeshis. Future cancer prevention campaigns should address these two key factors in message design to improve effectiveness and integrate a sociocultural context that considers its target population.

Keywords   Awareness raising, Cancer, Bangladesh

Author: Louise Cummings

Abstract Public health communications are an everyday occurrence. However, compliance with them and the recommendations they contain is often limited. One reason for poor compliance is the failure on the part of experts to construct public health messages that accord with the rational resources of the public. This chapter examines how one set of rational strategies, a group of cognitive heuristics based on the informal fallacies, has the potential to facilitate decision-making about public health issues. Among the informal fallacies, the argument from ignorance plays an important role in public health communication. A comparative analysis is undertaken of the use of this argument in the public health communications issued by the Department of Health in Hong Kong and Public Health England in the UK. It is argued that there are qualitative differences in the use of the argument from ignorance across these two contexts. Specifically, the public in Hong Kong is encouraged to reflect on epistemic conditions that are integral to the rational warrant of this argument. These conditions are less often acknowledged by public health agencies in the UK. Greater rational evaluation of these conditions, it is argued, leads to better decision-making in matters relating to public health.

Keywords   Argument from ignorance, Cognitive heuristic, Informal fallacy, Public health communication, Reasoning


消除公眾質疑:公共健康的挑戰

Louise Cummings

摘要:公共健康傳播每天都在上演。然而,依從性和建議卻很少。依從性低的其中一個原因是健康專家未能根據公共合理資源構建相關健康信息。本章節研究理性策略中,一組基於非形式謬誤的認知啟發法,如何能夠推動關於公共健康決策的制定。在這些非形式謬誤中,訴諸無知對公共健康傳播起著重要作用。該研究針對由香港衛生署和英國公共衛生部發佈的公告健康傳播中的訴諸無知進行了對比分析。研究認為香港和英國在此類訴諸的使用上存在著定性差異。具體表現為,香港鼓勵民眾反思構成訴諸無知合理保證的認知條件。然而這些認知條件很少在英國的公共衛生機構被認可。該研究認為,對於這些條件的進一步理性評估能夠更好地推動公共健康決策的制定。

關鍵詞:訴諸無知,認知啟發,非形式謬誤,公共健康傳播,推論


消除公众质疑:公共健康的挑战

Louise Cummings

摘要:公共健康传播每天都在上演。然而,依从性和建议却很少。依从性低的其中一个原因是健康专家未能根据公共合理资源构建相关健康信息。本章节研究理性策略中,一组基于非形式谬误的认知启发法,如何能够推动关于公共健康决策的制定。在这些非形式谬误中,诉诸无知对公共健康传播起着重要作用。该研究针对由香港卫生署和英国公共卫生部发布的公共健康传播中的诉诸无知进行了对比分析。研究认为香港和英国在此类诉诸的使用上存在着定性差异。具体表现为,香港鼓励民众反思构成诉诸无知合理保证的认知条件。然而这些认知条件很少在英国的公共卫生机构被认可。该研究认为,对于这些条件的进一步理性评估能够更好地推动公共健康决策的制定。

关键词:诉诸无知,认知启发,非形式谬误,公共健康传播,推论

Authors: Alice Yau, Margo Turnbull, Daniel Angus, and Bernadette Watson

Abstract Health care is shaped by often complex communication between multiple people such as doctors, nurses, patients and carers. Research has repeatedly shown that effective communication is key to safe and high-quality care yet improving communication remains a challenge across health systems. In recent years, the field of natural language processing has developed analytic tools to supplement the study of verbal communication through visual representation of analysis. To date, these tools have primarily been used on English data. This study used the software tool Discursis to compare visual representations of Cantonese conversational data that were analysed before and after English translation. Results indicate that some linguistic features of Cantonese that carry meaning may be lost in translation into English. Specific concerns relate to the multidimensional issues of equivalence, ranging from cultural and social associations to semantic, lexical and conceptual differences. These results highlight the importance of developing visual analytic tools that can be used on Cantonese data. Generating visual representations of such data contributes to local and international understandings about communication in health care.

Keywords   Discursis, Cantonese, Natural language processing


醫療會話視覺研究:採用Discursis比較粵語和英文會話

Alice Yau, Margo Turnbull, Daniel Angus, and Bernadette Watson

摘要:醫療系統由多方環環相扣而成,包括醫生、護士、病人和看護等,他們之間的溝通往往是複雜多變的。大量研究表明有效溝通是構成安全高質醫護的關鍵。然而,如何在各醫療體系中推動有效溝通依然是一大挑戰。近年來,在自然語言處理學科中開發了各種分析工具,通過視覺表現幫助研究言語交流。迄今為止,這些工具主要用於研究英語。這項研究採用Discursis軟件,研究粵語會話,對其翻譯成英文前後的視覺圖像進行分析對比。結果表明某些粵語中存在的語言現象翻譯成英文後會丟失原本的意義。具體表現在語言對等的多方面因素,包括社會文化對語義,詞彙,和概念的影響。這些結果強調開發可用於分析粵語的視覺分析軟件的重要性。對此類數據的視覺表現有助於我們理解香港本地以及全球醫療溝通。

關鍵詞:Discursis, 粵語,自然語言處理


医疗会话视觉研究:采用Discursis比较粤语和英文会话

Alice Yau, Margo Turnbull, Daniel Angus, and Bernadette Watson

摘要:医疗系统由多方面环环相扣而成,包括医生,护士,病人和看护等, 他们之间的沟通往往是复杂多变的. 大量研究表明有效沟通是构成安全高质医护的关键. 然而, 如何在各医疗体系中推动有效沟通依然是一大挑战. 近年来, 在自然语言处理学科中开发了各种分析工具, 通过视觉表现帮助研究言语交流. 迄今为止, 这些工具主要用于研究英语. 这项研究采用Discursis 软件, 研究粤语会话, 对其翻译成英文前后的视觉图像进行分析对比. 结果表明某些粤语中存在的语言现象翻译成英文后会丢失原本的意义. 具体表现在语言对等的多方面因素, 包括社会文化对语义, 词汇, 和概念的影响. 这些结果强调开发可用于分析粤语的视觉分析软件的重要性. 对此类数据的视觉表现有助于我们理解香港本地以及全球医疗沟通.

关键词: Discursis, 粤语, 自然语言处理