Diagnostic news delivery
A microanalysis of the use of shields
This paper focuses on the issue of diagnostic news delivery by addressing the research questions of how doctors shield language when breaking bad news to patients and how shields are positioned within the sequential order of these interactions. Empirical research was conducted on a collected corpus of authentic interactions through microanalysis of their epistemic organisation. Findings showed that when doctors were uncomfortable in giving bad news they mainly used verbs and verb phrases to shield the seriousness of the news. Different categories of shields were also used according to varying levels of distress. Following the biomedical SPIKES Protocol, different degrees of certainty were found in the step of Knowledge, whereas mitigating devices occurred in the steps of Empathy and Strategy.
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