The emergence and the construction of identity in doctor-patient interaction in multicultural settings

Titolo Rivista SALUTE E SOCIETÀ
Autori/Curatori Franca Orletti
Anno di pubblicazione 2013 Fascicolo 2013/1EN
Lingua Inglese Numero pagine 15 P. 67-81 Dimensione file 247 KB
DOI 10.3280/SES2013-001006EN
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FrancoAngeli è membro della Publishers International Linking Association, Inc (PILA)associazione indipendente e non profit per facilitare (attraverso i servizi tecnologici implementati da CrossRef.org) l’accesso degli studiosi ai contenuti digitali nelle pubblicazioni professionali e scientifiche

With few exceptions conversational studies have mostly focused on interactions between doctors and native patients. This paper addresses the construction of nonnative identity in interactions between a gynecologist and immigrant patients in a public hospital in Italy. Particularly, the paper addresses the question whether the specific structure of the medical interaction involving a non-native patient makes not only institutional identities (patient/doctor) but also language and cultural identities relevant for the members. Data include a corpus of 12 audio-recorded interactions between a gynecologist and a patient, each 6 of them involving, respectively, a native and a non-native patient. Analyses show that pragmatic, linguistic choices index the identity of the patient as an interactant "of a special kind", by making relevant certain aspects related to her ethnic identity.

Keywords:Social construction of identity, membership categorization device, Conversation Analysis, gynecologist-patient interaction, conversational asymmetry, formulations

  1. Mori J. (2007). Reconstructing the participants’ treatment of “interculturality”: Variations in data methodologies. Pragmatics, 17, 1: 123-141.
  2. Antaki C., Widdicombe, S., editors (1998). Identities in Talk. London: Sage
  3. Beach W. A., Dixson C.N. (2001). Revealing moments: Formulating understandings of adverse experiences in a health appraisal interview. Social Science & Medicine, 52: 25-44 DOI: 10.1016/S0277-9536(00)00118-0
  4. Bersani Berselli G. (2009). Selezione lessicale e mediazione orale in consultazioni mediche presso ospedali pubblici, in: La mediazione linguistica e culturale: una prospettiva interazionista, Perugia: Guerra Edizioni
  5. Coupland J. (2000). Small Talk. London: Longman.
  6. Day D. (1998). Being ascribed, and resisting, membership of an ethnic group. In: Antaki C. and Widdicombe S., editors, Identities in talk. London: Sage.
  7. Drew P. (2003). Comparative analysis of talk-in-interaction in different institutional settings: a sketch. In: Glenn P., LeBaron C.D. and Mandelbaum J., editors, Studies in Language and Social Interaction. In honour of Robert Hopper. Mahwah, New Jersey: Lawrence Erlbaum
  8. Drew P., Heritage J., editors (1992). Talk at work: interaction in institutional settings. Cambridge: Cambridge University Press
  9. Fatigante M., Orletti F. (in press). Laughter and smiling in a three-party medical encounter: negotiating participants’ alignment in delicate moments of the interaction. In: Glenn P. and Holt E., editors, On Laughing: Studies of Laughter in Interactioni. Continuum Press
  10. Fele G. (1997). Strategie discorsive e forme della degradazione pubblica in tribunale, In: Giglioli P.P., Cavicchioli S., Fele G., Rituali di degradazione. Anatomia del processo Cusani. Bologna: Il Mulino.
  11. Fele G. (2009). Glosse e formulazioni. In: Fatigante M., Mariottini L., Sciubba M. E., a cura di, Lingua e Società. Scritti in onore di Franca Orletti. Milano: FrancoAngeli
  12. Fisher S., Todd A., editors (1993). The social organization of Doctor-Patient Communication. Norwood: Ablex Publishing
  13. Fukuda C. (2006). Resistance against being formulated as cultural other: The case of a Chinese student in Japan. Pragmatics, 16, 4: 429-456
  14. Galatolo, R., Margutti, P. Gavioli L. (2009). La mediazione Linguistico-Culturale: una prospettiva interazionista. Perugia: Guerra
  15. Gavioli L., a cura di (2009). La mediazione linguistico-culturale: una prospettiva interazionista. Perugia: Guerra
  16. Garfinkel H., Sacks H. (1970). On formal structures of practical action. In: McKinney J.C. and Tiryakian E.A., editors, Theoretical Sociology. New York: Appleton-Century-Crofts
  17. Giglioli P.P., Cavicchioli S., Fele, G. (1997). Rituali di degradazione. Anatomia del processo Cusani. Bologna: Il Mulino
  18. Gill Teas V. (1998). Doing attributions in medical interaction: patients' explanations for illness and doctors' responses. Social Psychology Quarterly, 61: 322-360.
  19. Gill Teas V., Maynard D. W. (1995). On ‘labeling’ in actual interaction: Delivering and receiving diagnoses of developmental disabilities. Social Problems, 42: 11–37 DOI: 10.2307/3097003
  20. Gill Teas V., Maynard D.W. (2006). Explaining illness: patients' proposals and physicians' responses. In: Heritage J., Maynard D.W., editors, Communication in Medical Care: Interaction Between Primary Care Physicians and Patients. Cambridge: Cambridge University Press DOI: 10.1017/CBO9780511607172.007
  21. Goffman E. (1981). Forms of talk. Philadelphia: University of Pennsylvania. [tr. it. Orletti F., a cura di, Le forme del parlare. Bologna: Il Mulino, 1987]
  22. Have ten P. (1991). Talk and institution: a reconsideration of the 'asymmetry' of doctor-patient interaction. In: Boden D., Zimmerman D., editors, Talk and social structure: studies in ethnomethodology and conversation analysis. Cambridge: Polity Press
  23. Have ten P. (1995). Medical ethnomethodology: An Overview. Human Studies, 18: 245-61
  24. Heath C. (1992). Diagnosis and assessment in the medical consultation. In: Drew P., Heritage J., editors, Talk at work: interaction in institutional settings. Cambridge: Cambridge University Press
  25. Heritage J. (2004). Conversation analysis and institutional talk: analysing data. In: Silverman D., editor, Qualitative research: theory, method and practice. 2nd edition. Thousand Oaks, CA: Sage
  26. Heritage J. (2010). Questioning in Medicine. In: Freed A., Ehrlich S., editors, "Why Do You Ask?": The Function of Questions in Institutional Discourse. New York: Oxford University Press
  27. Heritage J, Maynard D.W. (2006a). Problems and Prospects in the Study of Physician-Patient Interaction: Thirty Years of Research. Annual Review of Sociology, 32: 351–74 DOI: 10.1146/annurev.soc.32.082905.093959
  28. Heritage J., Maynard D. W., editors (2006b). Communication in medical care: Interaction between primary care physicians and patients. Cambridge: Cambridge University Press DOI: 10.1017/CBO9780511607172
  29. Heritage J., Watson R. (1980). Aspects of the Properties of Formulations. Semiotica, 30: 245-262
  30. Linell P., Adelswärd V., Bredmar M., Lindstedt U. and Sachs L. (2002). Expert talk in medical contexts: Explicit and implicit orientations to risks. Research on Language and Social Interaction 35: 195-218 DOI: 10.1515/semi.1980.30.3-4.245
  31. McCarthy M. (2000). Mutually captive audiences: small talk and the genre of close-contact service encounters. In Coupland J., editor, Small talk. London: Longman. 84-109.
  32. McKenzie P. (2010). Informing relationships: small talk, informing and relationship building in midwife-woman interaction. IR Information research 15, 1.
  33. Mishler E. G. (1984). The discourse of medicine: dialectics of medical interviews. Norwood: Ablex Publishing
  34. Montanari M. 2006 Il cibo come cultura. Bari: Laterza
  35. Mori J. (2003). The construction of interculturality: A study of initial encounters between Japanese and American students. Research on language and social interaction, 36, 2: 143-184 DOI: 10.1207/S15327973RLSI3602_3
  36. Nishizaka A. (1995). The interactive constitution of interculturality: How to be a Japanese with words. Human studies, 18: 301-326 DOI: 10.1007/BF01323214
  37. Nishizaka A. (1999). Doing interpreting within interaction: The interactive accomplishment of a “henna gaijin” or “strange foreigner”. Human studies, 22: 235-251 DOI: 10.1023/A:1005492518477
  38. Orletti F. (1993). Pratiche di glossa. In: Orletti F., a cura di, Comunicare nella vita quotidiana. Bologna: Il Mulino
  39. Orletti F. (2000). La conversazione diseguale. Roma: Carocci.
  40. Orletti F. (2010) Formulating identities in multicultural therapeutic contexts. Invited lecture at the International Workshop “Formulation and Epistemic Authority”, Modena, 9-10 settembre 2010.
  41. Orletti F., Fatigante M. (2010) Constructing institutional identities at the thresholds of different cultural contexts: analyses of medical interactions with non-native patients. Paper presented at the International Meeting New Challenges for Multilingualism in Europe, Dubrovnik 11-15 aprile 2010
  42. Parsons T. (1951). The Social System. New York: Free Press
  43. Perakyla A. (1998). Authority and accountability: the delivery of diagnosis in primary health care. Social Psychology Quarterly, 61, 4: 301–20 DOI: 10.2307/2787032
  44. Perakyla A. (2002). Agency and authority: extended responses to diagnostic statements in primary care encounters. Research on Language and Social Interaction, 35, 2: 219–47 DOI: 10.1207/S15327973RLSI3502_5
  45. Pilnick A., Hindmarsh J., Gill Teas V. (2009). Beyond 'doctor and patient' developments in the study of healthcare interactions. Sociology of Health and Illness, 31, 6: 787–802 DOI: 10.1111/j.1467-9566.2009.01194.x
  46. Psathas G. (1999). Studying the organization in action: Membership categorization and interaction analysis. Human Studies, 22, 2-4: 139-162
  47. Radley A. (1994). Making sense of illness: the social psychology of health and disease. London: Sage Publications
  48. Ragan S. L. (2000). Sociable talk in women's health care contexts: two forms of non-medical talk. In: Coupland J., editor, Small talk. London: Longman
  49. Robinson J.D. (2003). An interactional structure of medical activities during acute visits and its implications for patients’ participation. Health Communication, 15:27–59 DOI: 10.1207/S15327027HC1501_2
  50. Robinson J.D., Stivers T. (2001). Achieving activity transitions in primary care consultations: from history taking to physical examination. Human Communication Research, 27: 253–98 DOI: 10.1093/hcr/27.2.253
  51. Sacks H. (1972). An initial investigation of the usability of conversational data for doing sociology. In: Sudnow D., editor, Studies in social interaction. New York: Free Press
  52. Sacks H. (1992). Lectures on Conversation. Volumes I and II. Edited by G. Jefferson with Introduction by E.A. Schegloff. Oxford: Blackwell.
  53. Sacks H., Garfinkel H. (1970). On formal structures of practical action. In: McKinney J.C., Tiryakian, E.A., editors, Theoretical Sociology. New York: Appleton-Century-Crofts
  54. Sacks H., Schegloff E. A., Jefferson G. (1974). A simplest systematics for the organization of turn-taking for conversation. Language, 50: 696-735 DOI: 10.2307/412243
  55. Sarangi S. (2001). On demarcating the space between `lay expertise’ and `expert laity’. Text 21, 1-2: 3-12.
  56. Schegloff E.A. (1991). Reflections on talk and social structure. In: Boden D., Zimmerman D., editors, Talk and Social Structure. Cambridge: Polity Press
  57. Schegloff E.A. (1992). In another context. In: Duranti A., Goodwin C. editors, Rethinking context. Language as an interactive phenomenon, Cambridge
  58. Stivers T. (2005a). Non-antibiotic treatment recommendations:delivery formats and implications for parent resistance. Social Science and Medicine, 60: 949– 64 DOI: 10.1016/j.socscimed.2004.06.040
  59. Stivers T, Majid A (2005). Domain. of knowledge and responsibility: questioning in acute care pediatric encounters. Presented at Conf. Int. Assoc. Appl. Linguist., Madison, WI
  60. Zimmerman E. (2007). Constructing Korean and Japanese interculturality in talk: Ethnic membership categorization among users of Japanese. Pragmatics, 17, 1: 71- 94.

Franca Orletti, The emergence and the construction of identity in doctor-patient interaction in multicultural settings in "SALUTE E SOCIETÀ" 1EN/2013, pp 67-81, DOI: 10.3280/SES2013-001006EN