Coding Problematic Understanding in Patient-provider Interactions

Area of Science:

• Linguistics
• Health Communication
• Pragmatics

Background:

• Effective communication is crucial in managing type 2 diabetes mellitus.
• Misunderstandings in health-care provider-patient interactions can negatively impact patient outcomes.
• Existing literature in pragmatics and linguistics offers frameworks for analyzing communication.

Purpose of the Study:

• To propose a novel coding scheme for identifying and assessing linguistic evidence of problematic understanding in health-care communication.
• To analyze communication patterns between health-care providers and patients with type 2 diabetes mellitus.
• To develop an evidence-based tool for improving health-care communication.

Main Methods:

• Development of a coding scheme based on linguistic evidence of misunderstandings, categorized by probative force (stronger, acceptable, weak).
• Pilot study utilizing a corpus of 46 Italian transcripts of videotaped consultations.
• Analysis of communication between six health-care providers and 13 patients with type 2 diabetes mellitus.

Main Results:

• The coding scheme identified 'acceptable' (58%) and 'strong' (35%) evidence of problematic understanding as most frequent.
• Patients exhibited significantly more problematic understanding than health-care providers.
• Health-care providers demonstrated greater awareness of potential misunderstandings and more frequent verification of their interpretations.

Conclusions:

• Problematic understanding is prevalent in patient-provider communication regarding type 2 diabetes.
• The developed coding scheme is a foundational tool for detecting communication issues.
• Findings suggest specific linguistic strategies can mitigate misunderstandings, improving health-care provider communicative skills.