Doctors' and interpreters' conversational styles in paediatric diabetes encounters: A case study of empowering...

During the last few decades, ideas of empowerment, person centered care (PCC) and shared decision-making (SDM) have informed western health care. An increasing interest in conversational styles aligned with these ideas is visible e.g. in the work to make motivational interviewing (MI) an evidence based communicative practice. But linguistic competence is needed to identify the subtle nuances of the communicative practices in a doctor-patient consultation. It is therefore particularly important to investigate conversation styles in mediated encounters with immigrant patients. Mitigation strategies (indirect speech, hedging etc.) and confirming strategies (back-channelling, encouragement etc.) are considered to be typical of an 'empowering' conversation style. The distribution of these features in encounters with or without interpreters was analysed in a case study of two consultations with the same doctor in a children's diabetes clinic in Sweden. The results of this study indicate that the mitigation strategies and confirming strategies characteristic of a conversation style aimed at strengthening and encouraging the patient tend to get lost in mediation. The implications of these findings are discussed.