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Article published In:
Journal of Argumentation in Context
Vol. 8:3 (2019) ► pp.336–353

“Doctor, I disagree”

Development and preliminary validation of a patient argumentativeness scale

| Vrije Universiteit Amsterdam

In medical consultations, disagreements may arise. Yet, patients’ predisposition to engage in a discussion with their doctors to resolve these disagreements may vary. This study aims to develop and validate a measurement tool to assess patient argumentativeness (P-ARG) in general practice. Starting from the pragma-dialectical theory of argumentation and Infante and Rancer’s (1982) argumentativeness scale, scale items were developed and subsequently administered to 183 participants. Principal component analysis was conducted to explore the scale structure. Also, convergent and concurrent validity were assessed. The results confirmed a two-factor scale structure and provided preliminary support for its validity. While further refinement is required, the (preliminary) P-ARG scale can be used for research purposes by medical argumentation as well as health communication scholars, e.g., to explore the relationships between doctors’ provision of argumentation, patients’ perspectives thereof, and patient argumentativeness.

Keywords: doctor-patient communication, medical consultation, patient argumentativeness, patient-centeredness, scale development
Article outline
  • 1.Introduction
    • 1.1Argumentation in general practice consultation
    • 1.2Patient argumentativeness
    • 1.3Rationale for a new measure
  • 2.Methods
    • 2.1Scale development
    • 2.2Participants
    • 2.3Additional measurements
  • 3.Results
    • 3.1Factor structure
    • 3.2Scale validity
  • 4.Discussion and conclusion
    • 4.1Discussion
    • 4.2Conclusion
  • Notes
  • References
Published online: 24 January 2020
DOI logo
https://doi.org/10.1075/jaic.18018.lab
References
Akkermans, A., Snoeck Henkemans, A. F., Labrie, N., Henselmans, I., & van Laarhoven, H.
2018 “The stereotypicality of symptomatic and pragmatic argumentation in consultations about palliative systemic treatment for advanced cancer”. Journal of Argumentation in Context, 7(2): 181–203. DOI logoGoogle Scholar
Argumentation and Patient Centered Care
2018 Special Issue of the Journal of Argumentation in Context, 7(2), ed. By A. F. Snoeck Henkemans, R. Pilgram, and N. Labrie.Google Scholar
Avtgis, T., & Rancer, A. S.
(Eds.) 2010 Arguments, aggression, and conflict: New directions in theory and research. Routledge. DOI logoGoogle Scholar
Bigi, S.
2010 “Institutional constraints on the (un) sound use of the argument from expert opinion in the medical context”. In Proceedings of the 7th Conference of the International Society for the Study of Argumentation, ed. by F. H. van Eemeren, B. Garssen, D. Godden, and G. Mitchell. Amsterdam: Rozenberg.Google Scholar
2011 “The persuasive role of ethos in doctor-patient interactions”. Communication & Medicine, 8(1): 67. DOI logoGoogle Scholar
2012 “Evaluating argumentative moves in medical consultations”. Journal of Argumentation in Context 1(1): 51–65. DOI logoGoogle Scholar
Charles, C., Gafni, A., and Whelan, T.
1997 “Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)”. Social Science and Medicine, 44(5): 681–692. DOI logoGoogle Scholar
1999 “Decision-making in the physician–patient encounter: Revisiting the shared treatment decision-making model”. Social Science and Medicine, 49(5): 651–661. DOI logoGoogle Scholar
Degner, L. F., and Sloan, J. A.
1992 “Decision making during serious illness: What role do patients really want to play?” Journal of Clinical Epidemiology, 45(9): 941–950. DOI logoGoogle Scholar
DeWine, S., Nicotera, A. M., and Parry, D.
1991 “Argumentativeness and aggressiveness: The flip side of gentle persuasion.” Management Communication Quarterly, 4(3): 386–411. DOI logoGoogle Scholar
Dowling, R. E., and Flint, L. J.
1990 “The argumentativeness scale: Problems and promise”. Communication Studies, 41(2), 183–198. DOI logoGoogle Scholar
Eemeren, F. H. van, and Grootendorst, R.
1984 Speech acts in argumentative discussions: A theoretical model for the analysis of discussions directed towards solving conflicts of opinion (Vol. 11). De Gruyter. DOI logoGoogle Scholar
1992 Argumentation, communication, and fallacies: A pragma-dialectical perspective. Lawrence Erlbaum.Google Scholar
2004 A systematic theory of argumentation: The pragma-dialectical approach (Vol. 141). Cambridge University Press.Google Scholar
Frosch, D. L., and Kaplan, R. M.
1999 “Shared decision making in clinical medicine: past research and future directions”. American Journal of Preventive Medicine, 17(4): 285–294. DOI logoGoogle Scholar
Hample, D.
2018 Interpersonal arguing. Peter Lang. DOI logoGoogle Scholar
Infante, D. A.
1982 “The argumentative student in the speech communication classroom: An investigation and implications”. Communication Education, 31(2): 141–148. DOI logoGoogle Scholar
Infante, D. A., and Rancer, A. S.
1982 “A conceptualization and measure of argumentativeness”. Journal of Personality Assessment, 46(1): 72–80. DOI logoGoogle Scholar
1996 Argumentativeness and verbal aggressiveness: A review of recent theory and research. Annals of the International Communication Association, 19(1): 319–352. DOI logoGoogle Scholar
Kazoleas, D.
1993 “The impact of argumentativeness on resistance to persuasion”. Human Communication Research, 20(1), 118–137. DOI logoGoogle Scholar
Labrie, N. H. M.
2012 “Strategic maneuvering in treatment decision-making discussions: Two cases in point”. Argumentation, 26(2): 171–199. DOI logoGoogle Scholar
Labrie, N. H. M., and Schulz, P. J.
2014a “Does argumentation matter? A systematic literature review on the role of argumentation in doctor–patient communication”. Health communication, 29(10): 996–1008. DOI logoGoogle Scholar
2014b “The effects of general practitioners’ use of argumentation to support their treatment advice: Results of an experimental study using video-vignettes”. Health Communication, 30(10): 951–961. DOI logoGoogle Scholar
2014c “Quantifying doctors’ argumentation in general practice consultation through content analysis: Measurement development and preliminary results”. Argumentation, 29(1): 33–55. DOI logoGoogle Scholar
2015 “Exploring the relationships between participatory decision-making, visit duration, and general practitioners’ provision of argumentation to support their medical advice: Results from a content analysis”. Patient Education and Counseling, 98(5): 572–577. DOI logoGoogle Scholar
Levine, T. R., & Kotowski, M. R.
2010 Measuring argumentativeness and verbal aggressiveness: Psychometric concerns and advances. In T. Avtgis & A. S. Rancer (Eds.), Arguments, aggression, and conflict: New directions in theory and research (pp. 67–81). Routledge.Google Scholar
Levinson, W., Kao, A., Kuby, A., Thisted, R. A.
2005 “Not all patients want to participate in decision making”. Journal of General Internal Medicine, 20(6): 531–535. DOI logoGoogle Scholar
Murray, E., Pollack, L., White, M., and Lo, B.
2007 “Clinical decision-making: Patients’ preferences and experiences”. Patient education and counseling, 65(2): 189–196. DOI logoGoogle Scholar
Onyekwere, E. O., Rubin, R. B., & Infante, D. A.
1991 “Interpersonal perception and communication satisfaction as a function of argumentativeness and ego-involvement”. Communication Quarterly, 39(1), 35–47. DOI logoGoogle Scholar
Pilgram, R.
2010 “A doctor’s argumentation by authority as a strategic manoeuvre”. In Proceedings of the 7th Conference of the International Society for the Study of Argumentation, ed. by F. H. van Eemeren, B. Garssen, D. Godden, and G. Mitchell. Amsterdam: Rozenberg.Google Scholar
Pilgram, R. and Snoeck Henkemans, A. F.
2018 “A pragma-dialectical perspective on obstacles to shared decision-making”. Journal of Argumentation in Context, 7(2): 161–176. DOI logoGoogle Scholar
Rancer, A. S., and Avtgis, T. A.
2006 Argumentative and aggressive communication: Theory, research, and application. Sage.Google Scholar
Rubinelli, S.
2013 “Argumentation as rational persuasion in doctor-patient communication”. Philosophy & Rhetoric, 46(4): 550–569. DOI logoGoogle Scholar
Salmon, P.
2015 “Argumentation and persuasion in patient-centred communication”. Patient Education and Counseling, 98(5): 543–544. DOI logoGoogle Scholar
Sandman, L., and Munthe, C.
2010 “Shared decision-making, paternalism and patient choice”. Health Care Analysis, 18(1): 60–84. DOI logoGoogle Scholar
Schultz, B.
1982 “Argumentativeness: Its effect in group decision-making and its role in leadership perception”. Communication Quarterly, 30(4), 368–375. DOI logoGoogle Scholar
Singh, J. A., Sloan, J. A., Atherton, P. J., Smith, T., Hack, T. F., Huschka, M. M., and Degner, L. F.
2010 “Preferred roles in treatment decision making among patients with cancer: a pooled analysis of studies using the Control Preferences Scale.” The American journal of managed care, 16(9): 688.Google Scholar
Snoeck Henkemans, A. F., Labrie, N., and Pilgram, R.
2018 “Argumentation and patient centered care”. Journal of Argumentation in Context, 7(2): 117–119. DOI logoGoogle Scholar
Snoeck Henkemans, A. F., and Wagemans, J.
2012 “The reasonableness of argumentation from expert opinion in medical discussions: institutional safeguards for the quality of shared decision-making”. In Between Scientists and Citizens. Proceedings of a Conference at Iowa State University, ed. by J. Goodwin. Ames, IA: Great Plains Society for the Study of Argumentation. DOI logoGoogle Scholar
Willems, S., De Maesschalck, S., Deveugele, M., Derese, A., and De Maeseneer, J.
2005 “Socio-economic status of the patient and doctor–patient communication: does it make a difference?” Patient education and counseling, 56(2): 139–146. DOI logoGoogle Scholar
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