2004
Volume 43, Issue 2
  • ISSN: 1573-9775
  • E-ISSN: 2352-1236

Abstract

Abstract

Cancer survivors often experience heightened emotional distress, resulting in reduced quality of life. However, previous research has shown that oncologists tend to avoid discussing emotional issues with these patients. In this paper we analyse doctor-patient interaction in follow-up head-and-neck cancer consultations in a major cancer centre in The Netherlands, comparing data from a Control group and a group that used the Distress Thermometer and Problem List (DT+PL) to stimulate the discussion of emotional concerns. We found that, although emotional problems were addressed in both conditions, the change in the doctors’ epistemic status occasioned by the DT+PL caused there to be a marked difference in who first nominated the concerns as topics. When and how which issues were discussed was mutually, discursively, negotiated by the participants in the situation. Doctors were seen to rely in these negotiations on their bio-medical knowledge, while patients and companions used their own lived experience and the experiences of third parties. Detailed analysis of the data shows that when there was a disjunct between the knowledge that patients and doctors relied upon, both doctors and patients were very diffident when expressing disagreement.

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References

  1. Arora, N.K.(2003). Interacting with cancer patients: the significance of physicians’ communication behavior. Social Science & Medicine, 57, 791-806.
    [Google Scholar]
  2. Beach, W.A.(2013). Patients' efforts to justify wellness in a comprehensive cancer clinic. Health Communication, 28(6), 577-592.
    [Google Scholar]
  3. Beach, W. A. & Dozier, D. M.(2015). Fears, uncertainties, and hopes: Patient-initiated actions and doctors’ responses during oncology interviews. Journal of Health Communication, 20(11), 1243-1254.
    [Google Scholar]
  4. Beach, W. A., Easter, D. W., Good, J. S. & Pigeron, E.(2005). Disclosing and responding to cancer “fears” during oncology interviews. Social Science & Medicine, 60(4), 893-910.
    [Google Scholar]
  5. Biddle, L., Paramasivan, S., Harris, S., Campbell, R., Brennan, J. & Hollingworth, W.(2016). Patients’ and clinicians’ experiences of holistic needs assessment using a cancer distress thermometer and problem list: A qualitative study. European Journal of Oncology Nursing, 23, 59–65.
    [Google Scholar]
  6. Boyd, E. & Heritage. J.(2006). Taking the history: questioning during comprehensive history taking. In J.Heritage & D.W.Maynard (Red.) Communication in medical care: Interaction between primary care physicians and patients (pp. 150-184). Cambridge: Cambridge University Press.
    [Google Scholar]
  7. Brown, P., & Levinson, S. (1987/2009). Politeness: Some universals in language usage. In N.Coupland & A.Jaworski (Red.), Sociolinguistics: Critical Concepts. (Vol. 3, pp. 311-323). Routledge.
    [Google Scholar]
  8. Buchhold, B., Wiesmann, U., Bahlmann, J., Lutze, S., Eggert, C., Arnold, A., et al. (2016). Psychosocial burden and desire for support in outpatients with skin cancer. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 14(4), 405-414.
    [Google Scholar]
  9. Cameron, R. A., Mazer, B. L., DeLuca, J. M., Mohile, S. G. & Epstein, R. M.(2015). In search of compassion: a new taxonomy of compassionate physician behaviours. Health Expectations, 18(5), 1672-1685.
    [Google Scholar]
  10. Clift, R.(2016). Conversation Analysis. Cambridge: Cambridge University Press.
    [Google Scholar]
  11. Clover, K. A., Mitchell, A. J., Britton, B., & Carter, G.(2015). Why do oncology outpatients who report emotional distress decline help?Psycho‐Oncology, 24(7), 812-818.
    [Google Scholar]
  12. Easter, D.W. & Beach, W.(2004). Competent patient care is dependent upon attending to empathic opportunities presented during interview sessions. Current Surgery, 61(3), 313-318.
    [Google Scholar]
  13. Epstein, R.M. & Street Jr., R.L.(2007). Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering. Bethesda: National Cancer Institute.
    [Google Scholar]
  14. Finset, A., Heyn, L. & Ruland, C.(2013). Patterns in clinicians’ responses to patient emotion in cancer care. Patient Education and Counseling, 93(1), 80-85.
    [Google Scholar]
  15. Ford, S., Fallowfield, L. & Lewis, S.(1996). Doctor-patient interactions in oncology. Social Science & Medicine, 42 (11), 1511-1519.
    [Google Scholar]
  16. Ghazali, N., Cadwallader, E., Lowe, D., Humphris, G., Ozakinci, G. & Rogers, S.N.(2013). Fear of recurrence among head and neck cancer survivors: longitudinal trends. Psycho-Oncology22, 807–813
    [Google Scholar]
  17. Gill, V. T.(1998). Doing attributions in medical interaction: Patients' explanations for illness and doctors' responses. Social Psychology Quarterly, 342-360.
    [Google Scholar]
  18. Gill, V. T. & Maynard, D. W.(2006). Explaining illness: patients' proposals and physicians' responses. Studies in Interactional Sociolinguistics, 20, 115-150.
    [Google Scholar]
  19. Goffman, E.(1979). Footing. Semiotica, 25(1/2), 1-29.
    [Google Scholar]
  20. Heritage, J. & Robinson, J.D.(2006). Accounting for the visit: giving reasons for seeking medical care. In J.Heritage & D.W.Maynard (Red.) Communication in Medical care: Interaction between Primary Care Physicians and Patients (pp. 48-85). Cambridge: Cambridge University Press.
    [Google Scholar]
  21. Heritage, J.(2010). Questioning in Medicine. In A.F.Freed & S.Ehrlich (Red.) “Why do you Ask?”: The Function of Questions in Institutional Discourse (pp. 42-68). Oxford: OUP.
    [Google Scholar]
  22. Heritage, J.(2013)Epistemics in Conversation. In J.Sidnell & T.Strivers (Red.) The Handbook of Conversation Analysis (pp. 370-394). Blackwell Publishing.
    [Google Scholar]
  23. Hymes, D.(1964). Directions in (ethno-)linguistic theory. American Anthropologist, 66(3-2), 6-56.
    [Google Scholar]
  24. Integraal Kankercentrum Nederland(2010). Detecteren Behoefte Psychosociale Zorg. Landelijke Richtlijn, Versie: 1.0. Geraadpleegd 31 augustus 2015, www.oncoline.nl/detecteren-behoefte-psychosociale-zorg.
    [Google Scholar]
  25. Jefferson, G.(1978). Sequential aspects of storytelling in conversation. In J.Schenken (Red.) Studies in the Organization of Conversational Interaction (pp. 219-248). New York: Academic Press.
    [Google Scholar]
  26. Jefferson, G.(1980). On ‘trouble-premonitory’ response to inquiry. Sociological Inquiry50, 153-185.
    [Google Scholar]
  27. Jefferson, G.(1988). On the sequential organization of troubles-talk in ordinary conversation. Social Problems, 35(4), 418-441.
    [Google Scholar]
  28. Kirsner, R.S. & Deen, J.(1990). Het mes snijdt aan twee kanten: On the semantics and pragmatics of the Dutch sentence-final particle hoor. In M.Bruijn Lacy (Red.) The Low Countries: Multidisciplinary Studies (pp. 1-12). Lanham: University Press of America.
    [Google Scholar]
  29. Labov, W.(2010). Oral narratives of personal experience. In Hogan, P.C. (Red.) Cambridge Encyclopedia of the Language Sciences (pp. 546–548). Cambridge. Cambridge: Cambridge University Press.
    [Google Scholar]
  30. Maguire, P.(2002). Improving the recognition of concerns and affective disorders in cancer patients. Annals of Oncology, 13(suppl-4), 177-181.
    [Google Scholar]
  31. Mazeland, H.(2016). The positionally sensitive workings of the Dutch particle NOU. In Auer, P. & Maschler, Y. (Red.) “Nu” and “Nå”: A Family of Discourse Markers Across the Language of Europe and Beyond (pp. 377-408). Berlin: De Gruyter.
    [Google Scholar]
  32. Mitchell, K. S., Delfont, S., Bracey, M. L. & Endacott, R.(2018). Top ten concerns burdening people with cancer: perceptions of patients with cancer and the nurses caring for them. European Journal of Oncology Nursing, 33, 102-106.
    [Google Scholar]
  33. NCCN (National Comprehensive Cancer Network)(1999). NCCN practice guidelines for the management of psychosocial distress. Oncology (Huntingt), 13(5A), 113–147.
    [Google Scholar]
  34. Pander Maat, H., Driessen, C. & Mierlo, H. V.(1986). Nou: functie, contexten, vorm en betekenis. Corpus-analyse en experiment. GAGL: Groninger Arbeiten zur germanistischen Linguistik, (27), 144-172.
    [Google Scholar]
  35. Parsons, T.(1975). The sick role and the role of the physician reconsidered. Milbank Memorial Fund Quarterly, Health and Society, 53(3), 275-78.
    [Google Scholar]
  36. Pomerantz, A.(1984). Agreeing and disagreeing with assessments: Some features of preferred/dispreferred turn-shapes. In Atkinson, J.J. & Heritage, J. (Red.) Structures of Social Action (pp. 57-101). Cambridge: Cambridge University Press.
    [Google Scholar]
  37. Pomerantz, A.(1986). Extreme case formulations: A way of legitimizing claims. Human Studies9, 219-229.
    [Google Scholar]
  38. Pomerantz, A., Gill, V. T. & Denvir, P.(2007). When patients present serious health conditions as unlikely: Managing potentially conflicting issues and constraints. In A.Hepburn & S.Wiggins (Red.) Discursive research in practice: New Approaches to Psychology and Interaction (pp. 127-146). Cambridge: Cambridge University Press.
    [Google Scholar]
  39. Raymond, G.(2003). Grammar and social organization: Yes/no interrogatives and the structure of responding. American Sociological Review, 939-967.
    [Google Scholar]
  40. Redeker, G.(2006). Discourse markers as attentional cues at discourse transitions. In K.Fischer (Red.) Approaches to Discourse Particles (pp. 427-447). Amsterdam: Elsevier.
    [Google Scholar]
  41. Sacks, H.(1975). Everyone has to lie. In M.Sanches & B.G.Blount (Red.) Sociocultural Dimensions of Language Use (pp. 57-80). New York: Academic Press.
    [Google Scholar]
  42. Schegloff, E.A.(1982). Discourse as an interactional achievement: Some uses of “uh huh” and other things that come between sentences. In D.Tannen (Red.) Analyzing Discourse: Text and Talk. Georgetown University Roundtable on Languages and Linguistics 1981 (pp. 71–93). Washington, DC: Georgetown University Press.
    [Google Scholar]
  43. Schegloff, E. A.(2007). Sequence Organization in Interaction: A Primer in Conversation Analysis I (Vol. 1). Cambridge: Cambridge University Press.
    [Google Scholar]
  44. Schegloff, E.A. & Sacks, H.(1982). Opening up closings. (Expanded version). In J.Baugh & J.Sherzer (Red.) Language in Use (pp. 69-99). New York: Prentice Hall.
    [Google Scholar]
  45. Sevigny, M.J.(1981). Triangulated inquiry: A methodology for the analysis of classroom interaction. In: J.L.Green & C.Wallat (Red.). Ethnography and Language in Educational Setting (pp. 65-85). Norwood: Ablex Publishing Corporation.
    [Google Scholar]
  46. Tuinman, M.A, Gazendam-Donofrio, S.M. & Hoekstra-Weebers, J.E.(2008). Screening and referral for psychosocial distress in oncologic practice: Use of the Distress Thermometer. Cancer, 113, 870-878.
    [Google Scholar]
  47. Umbach, C.(2004). On the notion of contrast in information structure and discourse structure. Journal of Semantics, 21(2), 155–175.
    [Google Scholar]
  48. Van Bergen, G., & Bosker, H. R.(2018). Linguistic expectation management in online discourse processing: An investigation of Dutch inderdaad 'indeed' and eigenlijk 'actually'. Journal of Memory and Language, 103, 191-209.
    [Google Scholar]
  49. Van der Laaken, M., & Bannink, A.(2020). Openings in follow-up cancer consultations: The ‘How are you?’ question revisited. Discourse Studies, 22(2), 205-220.
    [Google Scholar]
  50. Van der Laaken, M., Bannink, A., & Van den Brekel, M.(2020). Topicalizing psychosocial distress in cancer follow-up consultations: An exploration of the interactional effects of discussion tools. Cogent Arts & Humanities, 7(1), 1812866.
    [Google Scholar]
  51. Van der Laaken & Bannink (under review). Discussing psychosocial distress in follow-up cancer consultations, with and without the Distress Thermometer and Problem List.
    [Google Scholar]
  52. Van der Laaken & Bannink (in voorbereiding). The key of the follow-up cancer consultation.
    [Google Scholar]
  53. Van der Linden, M, Hoekstra-Weebers, J., De Graeff, A. & Mathot, F.(Red.) (2016). Psychosociale Zorg in de Oncologie. Een Praktijkboek voor Dokters. Utrecht: De Tijdstroom.
    [Google Scholar]
  54. Weiste, E. & Peräkylä, A.(2015). Therapeutic Discourse. In K.Tracy, C. Ilie & T.Sandel (Red.) The International Encyclopedia of Language and Social Interaction (pp. 1-10). New York: John Wiley & Sons.
    [Google Scholar]
  55. Zhou, Y., Humphris, G., Ghazali, N., Friderichs, S., Grosset, D. & Rogers, S. N.(2015). How head and neck consultants manage patients’ emotional distress during cancer follow-up consultations: A multilevel study. European Archives of Oto-Rhino-Laryngology, 272(9), 2473-2481.
    [Google Scholar]
  56. Zimmermann, C., Del Piccolo, L. & Finset, A.(2007). Cues and concerns by patients in medical consultations: a literature review. Psychological Bulletin, 133(3), 438-463.
    [Google Scholar]
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