Analyzing dialogue moves in chronic care communication
Dialogical intentions and customization of recommendations for the assessment of medical deliberation
Dialogue moves are a pragmatic instrument that captures the most important categories of “dialogical intentions.”
This paper adapts this tool to the conversational setting of chronic care communication, characterized by the general goal of
making reasoned decisions concerning patients’ conditions, shared by the latter. Seven mutually exclusive and comprehensive
categories were identified, whose reliability was tested on an Italian corpus of provider-patient encounters in diabetes care. The
application of this method was illustrated through explorative analyses identifying possible correlations between the dialogical
structure of medical interviews and one of the indicators of personalized decision-making, namely the specificity of the
recommendations given by the provider (“customization”). The statistical analyses show a significant correlation between the
exchange of personal information and very specific and customized recommendations for change. It suggests how the creation of
common ground, exceeding the boundaries of the paternalistic or patient-centered models, can lead to highly effective
communication.
Article outline
- 1.Introduction
- 2.Contextual background: Deliberation in clinical encounters
- 3.Dialogue types and dialogue moves
- 3.1Deliberation sequences in clinical encounters
- 3.2Dialogue moves
- 3.2.1Describing dialogue moves in clinical encounters’ deliberation sequences
- 3.2.2Reliability of the categories for the analysis
- 3.2.3Results of the analysis
- 4.Describing customization of recommendations in clinical encounters
- 4.1Exploring correlations between dialogue moves and customization
- 5.Discussion and conclusions
- 5.1Limitations
- 5.2Practice implications
- Acknowledgements
- Notes
-
References
References
Allan, Keith
2013 What is common ground? In
Perspectives in pragmatics, philosophy & psychology, volume 2, ed.
Alessandro Capone,
Franco Lo Piparo, and
Marco Carapezza, 285–310. Cham, Switzerland: Springer.
Arora, Neeraj, and Colleen McHorney
2000 Patient preferences for medical decision making: who really wants to participate? Medical Care 381: 335–341.
Artstein, Ron, and Massimo Poesio
2008 Inter-coder agreement for computational linguistics.
Computational Linguistics 341: 555–596.
Artstein, Ron, and Massimo Poesio
2009 Bias decreases in proportion to the number of annotators. In
Proceedings of FG-MoL 2005: The 10th conference on Formal Grammar, ed.
Gerhard Jaeger,
Paola Monachesi,
Gerald Penn,
James Rogers, and
Shuly Wintner, 1391:141–150. Edinburgh, UK: CSLI publications.
Asterhan, Christa, and Baruch Schwarz
2009 Argumentation and explanation in conceptual change: Indications from protocol analyses of peer-to-peer dialog.
Cognitive Science 331: 374–400.
Baca-Motes, Katie, Amber Brown, Ayelet Gneezy, Elizabeth A. Keenan, and Leif D. Nelson
2013 Commitment and behavior change: Evidence from the field.
Journal of Consumer Research 391: 1070–1084.
Bigi, Sarah
2014 Healthy reasoning: The role of effective argumentation for enhancing elderly patients’ self-management abilities in chronic care. In
Active ageing and healthy living: A human centered approach in research and innovation as source of quality of life, ed.
Giovanni Riva,
Paolo Ajmone Marsan, and
Claudio Grassi, 193–203. Amsterdam, Netherlands: IOS Press.
Bigi, Sarah
2016 Communicating (with) care: a linguistic approach to doctor-patient interactions. Amsterdam, Netherlands: IOS Press.
Bigi, Sarah, and Nanon Labrie
2016 Criteria for the reconstruction and analysis of doctors’ argumentation in the context of chronic care. In
Argumentation and reasoned action: Proceedings of the 1st European Conference on Argumentation, Lisbon, 2015, ed.
Marcin Lewiński and
Dima Mohammed, 251–265. London, UK: College Publications.
Braddock, Clarence H., Kelly A. Edwards, Nicole M. Hasenberg, Tracy L. Laidley, and Wendy Levinson
1999 Informed decision making in outpatient practice: time to get back to basics.
Journal of the American Medical Informatics Association: JAMA 2821: 2313–2320.
Brennan, Patricia, and Indiana Strombom
1998 Improving health care by understanding patient preferences: the role of computer technology.
Journal of the American Medical Informatics Association : JAMA 51: 257–62.
Cavicchio, Federica, and Massimo Poesio
2009 Multimodal corpora annotation: Validation methods to assess coding scheme reliability. In
Multimodal corpora, ed.
Michael Kipp,
Jean-Claude Martin,
Patrizia Paggio, and
Dirk Heylen, 109–121. Berlin, Germany: Springer.
Charles, Cathy, Amiram Gafni, and Tim Whelan
1997 Shared decision-making in the medical encounter: What does it mean? (Or it takes, at least two to tango).
Social Science and Medicine 441: 681–692.
Chewning, Betty, Carma Bylund, Bupendra Shah, Neeraj Arora, Jennifer Gueguen, and Gregory Makoul
2012 Patient preferences for shared decisions: A systematic review.
Patient Education and Counseling 861: 9–18.
Clayton, Margaret F., Seth Latimer, Todd W. Dunn, and Leonard Haas
2011 Assessing patient-centered communication in a family practice setting: How do we measure it, and whose opinion matters? Patient Education and Counseling 841: 294–302.
Cvengros, Jamie, Christensen, Alan, Cunningham, Cassie, Hillis, Steven, & Kaboli, Peter
2009 Patient preference for and reports of provider behavior: Impact of symmetry on patient outcomes.
Health Psychology, 28(6), 660–667.
Dunin-Keplicz, Barbara, and Rineke Verbrugge
2001 The role of dialogue in cooperative problem solving. In
Proceedings of the 5th International Symposium on Logical Formalizations of Commonsense Reasoning, ed.
Ernest Davis,
John McCarthy,
Leora Morgenstern, and
Raymond Reiter, 89–104. New York, NY: Courant Institute of Mathematical Sciences, New York University.
Durand, Marie Anne, Odette Wegwarth, Jacky Boivin, and Glyn Elwyn
2012 Design and usability of heuristic-based deliberation tools for women facing amniocentesis.
Health Expectations 151: 32–48.
van Eemeren, Frans
2011 In Context: Giving contextualization its rightful place in the study of argumentation.
Argumentation 251: 141–161.
van Eemeren, Frans, and Peter Houtlosser
2005 Theoretical construction and argumentative reality: An analytic model of critical discussion and conventionalised types of argumentative activity. In
The uses of argument. Proceedings of a conference at McMaster University, 18–21 May 2005, ed.
David Hitchcock and
Daniel Farr, 75–84. Hamlilton, ON: Ontario Society for the Study of Argumentation.
Elwyn, Glyn, Adrian Edwards, Paul Kinnersley, and Richard Grol
2000 Shared decision making and the concept of equipoise: The competences of involving patients in healthcare choices.
British Journal of General Practice 501: 892–899.
Elwyn, Glyn, Dominick Frosch, Richard Thomson, Natalie Joseph-Williams, Amy Lloyd, Paul Kinnersley, Emma Cording, et al.
2012 Shared decision making: A model for clinical practice.
Journal of General Internal Medicine 271: 1361–1367.
Elwyn, Glyn, and Talya Miron-Shatz
2010 Deliberation before determination: The definition and evaluation of good decision making.
Health Expectations 131: 139–147.
Emmons, Karen, and Stephen Rollnick
2001 Motivational interviewing in health care settings. Opportunities and limitations.
American Journal of Preventive Medicine 201: 68–74.
Entwistle, Vikki A., Ian S. Watt, Ken Gilhooly, Carol Bugge, Neva Haites, and Anne E. Walker
2004 Assessing patients’ participation and quality of decision-making: Insights from a study of routine practice in diverse settings.
Patient Education and Counseling 551: 105–113.
Epstein, Ronald, and Robert Gramling
2012 What is shared in shared decision making? Complex decisions when the evidence is unclear.
Medical Care Research and Review 701: 94–112.
Epstein, Ronald, and Richard Street
2011 Shared mind: Communication, decision making, and autonomy in serious illness.
Annals of Family Medicine 91: 454–461.
Ervin-Tripp, Susan
1964 An analysis of the interaction of language, topic, and listener.
American Anthropologist 661: 86–102.
Geis, Michael
1995 Speech acts and conversational interaction. Cambridge, UK: Cambridge University Press.
Grice, Paul
1975 Logic and conversation. In
Syntax and semantics 3: Speech acts, ed.
Peter Cole and
Jerry Morgan, 41–58. New York, NY: Academic Press.
Haugh, Michael, and Kasia Jaszczolt
2012 Speaker intentions and intentionality. In
The Cambridge handbook of pragmatics, ed.
Keith Allan and
Kasia M. Jaszczolt, 87–112. Cambridge, UK: Cambridge University Press.
Hayes, Andrew, and Klaus Krippendorff
2007 Answering the call for a standard reliability measure for coding data.
Communication Methods and Measures 11: 77–89.
Heisler, Michele, Reynard Bouknight, Rodney Hayward, Dylan Smith, and Eve Kerr
2002 The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management.
Journal of General Internal Medicine 171: 243–252.
Heisler, Michele, Sandeep Vijan, Robert M. Anderson, Peter A. Ubel, Steven J. Bernstein, and Timothy P. Hofer
2003 When do patients and their physicians agree on diabetes treatment goals and strategies, and what difference does it make? Journal of General Internal Medicine 181: 893–902.
Hymes, Dell
1964 Introduction: Toward ethnographies of communication.
American Anthropologist 661: 1–34.
Kádár, Dániel, and Michael Haugh
2013 Understanding politeness. New York, NY: Cambridge University Press.
Kaldjian, Lauris
2017 Concepts of health, ethics, and communication in shared decision making.
Communication & Medicine 141: 83–95.
Kecskes, Istvan
2010 Situation-bound utterances as pragmatic acts.
Journal of Pragmatics 421: 2889–2897.
Kecskes, Istvan, and Fenghui Zhang
Kissine, Mikhail
2012 Sentences, utterances, and speech acts. In
Cambridge handbook of pragmatics, ed.
Keith Allan and
Kasia Jaszczolt, 169–190. New York, NY: Cambridge University Press.
Konstantinidou, Aikaterini, and Fabrizio Macagno
2013 Understanding students’ reasoning: argumentation schemes as an interpretation method in science education.
Science & Education 221: 1069–1087.
Krabbe, Erik
1999 Profiles of dialogue. In
JFAK: Essays dedicated to Johan van Benthem on the occasion of his 50th birthday, ed.
Jelly Gerbrandy,
Maarten Marx,
Maarten de Rijke, and
Yde Venema, 31:25–36. Amsterdam, Netherlands: Amsterdam University Press.
Krippendorff, Klaus
2004 Content analysis: An introduction to its methodology. Thousand Oaks, CA: Sage.
Labrie, Nanon, and Peter J. Schulz
2014 Does argumentation matter? A systematic literature review on the role of argumentation in doctor–patient communication.
Health Communication 291: 996–1008.
Lamiani, Giulia, Sarah Bigi, Maria Elisa Mancuso, Antonio Coppola, and Elena Vegni
2017 Applying a deliberation model to the analysis of consultations in haemophilia: Implications for doctor-patient communication.
Patient Education and Counseling 1001: 690–695.
LaNoue, Marianna D., and Debra L. Roter
2018 Exploring patient-centeredness: The relationship between self-reported empathy and patient-centered communication in medical trainees.
Patient Education and Counseling 1011: 1143–1146.
Levinson, Stephen
1992 Activity types and language. In
Talk at work: Interaction in institutional settings, ed.
Paul Drew and
John Heritage, 66–100. Cambridge, UK: Cambridge University Press.
Levinson, Stephen
2012 Action formation and ascription. In
The handbook of conversation analysis, ed.
Jack Sidnell and
Tanya Stivers, 101–130. Chichester, UK: John Wiley & Sons, Ltd.
Locke, Edwin A., and Gary P. Latham
2002 Building a practically useful theory of goal setting and task motivation. A 35-year odyssey.
The American Psychologist 571: 705–717.
Macagno, Fabrizio
2008 Dialectical relevance and dialogical context in Walton’s pragmatic theory.
Informal Logic 281: 102–128.
Macagno, Fabrizio
2018 Assessing relevance.
Lingua 210–2111: 42–64.
Macagno, Fabrizio, and Sarah Bigi
2017 Analyzing the pragmatic structure of dialogues.
Discourse Studies 191: 148–168.
Macagno, Fabrizio, and Sarah Bigi
2018 Types of dialogue and pragmatic ambiguity. In
Argumentation and language, ed.
Steve Oswald,
Jérôme Jacquin, and
Thierry Herman, 191–218. Cham, Switzerland: Springer.
Macagno, Fabrizio, and Douglas Walton
2017 Interpreting straw man argumentation. The pragmatics of quotation and reporting. Amsterdam, Netherlands: Springer.
Makoul, G., P. Arntson, and T. Schofield
1995 Health promotion in primary care: physician-patient communication and decision making about prescription medications.
Social Science and Medicine 411: 1241–1254.
Mann, William
1988 Dialogue games: Conventions of human interaction.
Argumentation 21: 511–532.
Mayweg-Paus, Elisabeth, Fabrizio Macagno, and Deanna Kuhn
2016 Developing argumentation strategies in electronic dialogs: Is modeling effective? Discourse Processes 531: 280–297.
McBurney, Peter, and Simon Parsons
2009 Dialogue games for agent argumentation. In
Argumentation in artificial intelligence, ed.
Guillermo Simari and
Iyad Rahwan, 261–280. Heidelberg, Germany: Springer.
Mey, Jacob
2001 Pragmatics. An introduction. Oxford, UK: Blackwell.
Mey, Jacob
2016 Why we need the pragmeme, or: Speech acting and its peripeties. In
Pragmemes and theories of language use, ed.
Keith Allan,
Alessandro Capone, and
Istvan Kecskes, 133–140. Cham, Switzerland: Springer.
Politi, Mary C., and Richard Street
2011 The importance of communication in collaborative decision making: Facilitating shared mind and the management of uncertainty.
Journal of Evaluation in Clinical Practice 171: 579–584.
Al Qassas, Malik, Daniela Fogli, Massimiliano Giacomin, and Giovanni Guida
2015 Analysis of clinical discussions based on argumentation schemes.
Procedia Computer Science 641: 282–289.
Rapanta, Chrysi, Merce Garcia-Mila, and Sandra Gilabert
2013 What is meant by argumentative competence? An integrative review of methods of analysis and assessment in education.
Review of Educational Research 831: 483–520.
Ratliff, Amanda, Marcia Angell, Richard Dow, Miriam Kupperman, Robert Nease, Roger Fisher, Elliott Fisher, et al.
1999 What is a good decision? Effective Clinical Practice 21: 185–197.
Reed, Christopher, Douglas Walton, and Fabrizio Macagno
2007 Argument diagramming in logic, law and artificial intelligence.
Artificial Intelligence, and Law 221: 87–109.
Rimer, Barbara K., and Matthew W. Kreuter
2006 Advancing tailored health communication: A persuasion and message effects perspective.
Journal of Communication 561: 184–201.
Roter, Debra, and Susan Larson
2002 The Roter interaction analysis system (RIAS): utility and flexibility for analysis of medical interactions.
Patient Education and Counseling 461: 243–251.
Rubinelli, Sara, and Claudia Zanini
Ruhi, Şükriye
2007 Higher-order intentions and self-politeness in evaluations of (im)politeness: The relevance of compliment responses.
Australian Journal of Linguistics 271: 107–145.
Sacchi, Lucia, Giordano Lanzola, Natalia Viani, and Silvana Quaglini
2015 Personalization and patient involvement in decision support systems: current trends.
Yearbook of Medical Informatics 241: 106–118.
Sanders, Robert
1987 Cognitive foundations of calculated speech: Controlling understandings in conversation and persuasion. Albany, NY: Suny Press.
Schank, Roger, Gregg Collins, Ernest Davis, Peter Johnson, Steve Lytinen, and Brian Reiser
1982 What’s the point? Cognitive Science 61: 255–275.
Schulz, Peter J., and Bert Meuffels
Searle, John
1969 Speech acts: An essay in the philosophy of language. Cambridge, UK: Cambridge University Press.
Searle, John
2002 Consciousness and language. New York, NY: Cambridge University Press.
Searle, John, and Daniel Vanderveken
1985 Foundations of illocutionary logic. Cambridge, UK: Cambridge University Press.
Seuren, Pieter
2009 Language in cognition: Language from within. Vol. 11. Oxford, UK: Oxford University Press.
Smith, David, and Loyd Pettegrew
1986 Mutual persuasion as a model for doctor-patient communication.
Theoretical Medicine 71: 127–146.
Stevenson, Fiona, Christine Barry, Nicky Britten, Nick Barber, and Colin Bradley
2000 Doctor-patient communication about drugs: The evidence for shared decision making.
Social Science and Medicine 501: 829–840.
Stewart, Moira
1995 Effective physician-patient communication and health outcomes: A review.
CMAJ 1521: 1423–1433.
Streeck, Jürgen
1980 Speech acts in interaction: A critique of Searle.
Discourse Processes 31: 133–153.
Street, Richard
2013 How clinician-patient communication contributes to health improvement: Modeling pathways from talk to outcome.
Patient Education and Counseling 921: 286–291.
Street, Richard, Glyn Elwyn, and Ronald Epstein
2012 Patient preferences and healthcare outcomes: an ecological perspective.
Expert Review of Pharmacoeconomics & Outcomes Research 121: 167–180.
Street, Richard, and Paul Haidet
2011 How well do doctors know their patients? Factors affecting physician understanding of patients’ health beliefs.
Journal of General Internal Medicine 261: 21–27.
Street, Richard, Gregory Makoul, Neeraj Arora, Ronald Epstein, Richard Street Jr, Gregory Makoul, Neeraj Arora, and Ronald Epstein
2009 How does communication heal? Pathways linking clinician–patient communication to health outcomes.
Patient Education and Counseling 741: 295–301.
Taylor, Keith
2009 Paternalism, participation and partnership-The evolution of patient centeredness in the consultation.
Patient Education and Counseling 741: 150–155.
Walton, Douglas
1989a Dialogue theory for critical thinking.
Argumentation 31: 169–184.
Walton, Douglas
1989b Informal logic. New York, NY: Cambridge University Press.
Walton, Douglas
1990 What is reasoning? What is an argument? Journal of Philosophy 871: 399–419.
Walton, Douglas
1992 Types of dialogue, dialectical shifts and fallacies. In
Argumentation illuminated, ed.
Frans Van Eemeren,
Rob Grootendorst,
Anthony Blair, and
Charles Willard, 133–147. Amsterdam, Netherlands: Sic Sat.
Walton, Douglas
1998 The New Dialectic. Conversational contexts of argument. Toronto, ON: University of Toronto Press.
Walton, Douglas
1999 Profiles of dialogue for evaluating arguments from ignorance.
Argumentation 131: 53–71.
Walton, Douglas
2010 Types of Dialogue and Burdens of Proof. In
Computational Models of Argument (COMMA), ed.
Pietro Baroni,
Federico Cerutti,
Massimiliano Giacomin, and
Guillermo Simari, 13–24. Amsterdam, Netherlands: IOS Press.
Walton, Douglas, and Erik Krabbe
1995 Commitment in dialogue. Albany, NY: State University of New York Press.
Walton, Douglas, Alice Toniolo, and Tim Norman
2014 Missing phases of deliberation dialogue for real applications. In
Proceedings of the 11th International Workshop on Argumentation in Multi-Agent Systems, ed.
Wiebe van der Hoek,
Lin Padgham,
Vincent Conitzer, and
Michael Winikoff, 1–20. Richland: International Foundation for Autonomous Agents and Multiagent Systems.
Wolpert, Howard, and Barbara Anderson
2001 Management of diabetes: Are doctors framing the benefits from the wrong perspective? BMJ: British Medical Journal 3231: 994–996.
Cited by
Cited by 3 other publications
Macagno, Fabrizio & Sarah Bigi
2021.
The Role of Evidence in Chronic Care Decision-Making.
Topoi 40:2
► pp. 343 ff.
Macagno, Fabrizio & Rosalice Botelho Wakim Souza Pinto
2021.
Reconstructing Multimodal Arguments in Advertisements: Combining Pragmatics and Argumentation Theory.
Argumentation 35:1
► pp. 141 ff.
Rossi, Maria Grazia & Fabrizio Macagno
2021.
Inquiries in Philosophical Pragmatics [
Perspectives in Pragmatics, Philosophy & Psychology, 27],
► pp. 171 ff.
This list is based on CrossRef data as of 27 april 2021. Please note that it may not be complete. Sources presented here have been supplied by the respective publishers.
Any errors therein should be reported to them.