Article published in:
Journal of Argumentation in Context
Vol. 9:2 (2020) ► pp. 167–198

Analyzing dialogue moves in chronic care communication

Dialogical intentions and customization of recommendations for the assessment of medical deliberation

| Universidade Nova de Lisboa
| Università Cattolica del Sacro Cuore
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.
Keywords: argumentation, chronic care, decision making, dialogue, dialogue moves, discourse analysis, health communication, pragmatics
Published online: 28 October 2020
https://doi.org/10.1075/jaic.18044.mac
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.Google Scholar
Arora, Neeraj, and Colleen McHorney
2000 Patient preferences for medical decision making: who really wants to participate? Medical Care 38: 335–341. CrossrefGoogle Scholar
Artstein, Ron, and Massimo Poesio
2008 Inter-coder agreement for computational linguistics. Computational Linguistics 34: 555–596. CrossrefGoogle Scholar
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, 139:141–150. Edinburgh, UK: CSLI publications.Google Scholar
Asterhan, Christa, and Baruch Schwarz
2009 Argumentation and explanation in conceptual change: Indications from protocol analyses of peer-to-peer dialog. Cognitive Science 33: 374–400. CrossrefGoogle Scholar
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 39: 1070–1084. CrossrefGoogle Scholar
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.Google Scholar
2016 Communicating (with) care: a linguistic approach to doctor-patient interactions. Amsterdam, Netherlands: IOS Press.Google Scholar
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.Google Scholar
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 282: 2313–2320. CrossrefGoogle Scholar
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 5: 257–62. CrossrefGoogle Scholar
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. CrossrefGoogle Scholar
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 44: 681–692. CrossrefGoogle Scholar
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 86: 9–18. CrossrefGoogle Scholar
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 84: 294–302. CrossrefGoogle Scholar
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. CrossrefGoogle Scholar
Dascal, Marcelo
1992 On the pragmatic structure of conversation. In (On) Searle on conversation, ed. Herman Parret and Jef Verschueren, 35–57. Amsterdam, Netherlands-Philadelphia, PA: John Benjamins Publishing. CrossrefGoogle Scholar
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.Google Scholar
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 15: 32–48. CrossrefGoogle Scholar
van Eemeren, Frans
2010 Strategic maneuvering in argumentative discourse. Extending the pragma- dialectical theory of argumentation. Amsterdam, Netherlands-Philadelphia, PA: John Benjamins Publishing Company. CrossrefGoogle Scholar
2011 In Context: Giving contextualization its rightful place in the study of argumentation. Argumentation 25: 141–161. CrossrefGoogle Scholar
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.Google Scholar
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 50: 892–899. CrossrefGoogle Scholar
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 27: 1361–1367. CrossrefGoogle Scholar
Elwyn, Glyn, and Talya Miron-Shatz
2010 Deliberation before determination: The definition and evaluation of good decision making. Health Expectations 13: 139–147. CrossrefGoogle Scholar
Emmons, Karen, and Stephen Rollnick
2001 Motivational interviewing in health care settings. Opportunities and limitations. American Journal of Preventive Medicine 20: 68–74. CrossrefGoogle Scholar
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 55: 105–113. CrossrefGoogle Scholar
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 70: 94–112. CrossrefGoogle Scholar
Epstein, Ronald, and Richard Street
2011 Shared mind: Communication, decision making, and autonomy in serious illness. Annals of Family Medicine 9: 454–461. CrossrefGoogle Scholar
Ervin-Tripp, Susan
1964 An analysis of the interaction of language, topic, and listener. American Anthropologist 66: 86–102. CrossrefGoogle Scholar
Geis, Michael
1995 Speech acts and conversational interaction. Cambridge, UK: Cambridge University Press. CrossrefGoogle Scholar
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.Google Scholar
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. CrossrefGoogle Scholar
Hayes, Andrew, and Klaus Krippendorff
2007 Answering the call for a standard reliability measure for coding data. Communication Methods and Measures 1: 77–89. CrossrefGoogle Scholar
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 17: 243–252. CrossrefGoogle Scholar
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 18: 893–902. CrossrefGoogle Scholar
Hymes, Dell
1964 Introduction: Toward ethnographies of communication. American Anthropologist 66: 1–34. CrossrefGoogle Scholar
Kádár, Dániel, and Michael Haugh
2013 Understanding politeness. New York, NY: Cambridge University Press. CrossrefGoogle Scholar
Kaldjian, Lauris
2017 Concepts of health, ethics, and communication in shared decision making. Communication & Medicine 14: 83–95. CrossrefGoogle Scholar
Kecskes, Istvan
2010 Situation-bound utterances as pragmatic acts. Journal of Pragmatics 42: 2889–2897. CrossrefGoogle Scholar
Kecskes, Istvan, and Fenghui Zhang
2009 Activating, seeking, and creating common ground: A socio-cognitive approach. Pragmatics & Cognition 17: 331–355. CrossrefGoogle Scholar
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. CrossrefGoogle Scholar
Konstantinidou, Aikaterini, and Fabrizio Macagno
2013 Understanding students’ reasoning: argumentation schemes as an interpretation method in science education. Science & Education 22: 1069–1087. CrossrefGoogle Scholar
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, 3:25–36. Amsterdam, Netherlands: Amsterdam University Press.Google Scholar
Krippendorff, Klaus
2004 Content analysis: An introduction to its methodology. Thousand Oaks, CA: Sage.Google Scholar
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 29: 996–1008. CrossrefGoogle Scholar
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 100: 690–695. CrossrefGoogle Scholar
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 101: 1143–1146. CrossrefGoogle Scholar
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.Google Scholar
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. CrossrefGoogle Scholar
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 57: 705–717. CrossrefGoogle Scholar
Macagno, Fabrizio
2008 Dialectical relevance and dialogical context in Walton’s pragmatic theory. Informal Logic 28: 102–128. CrossrefGoogle Scholar
2018 Assessing relevance. Lingua 210–211: 42–64. CrossrefGoogle Scholar
Macagno, Fabrizio, and Sarah Bigi
2017 Analyzing the pragmatic structure of dialogues. Discourse Studies 19: 148–168. CrossrefGoogle Scholar
2018 Types of dialogue and pragmatic ambiguity. In Argumentation and language, ed. Steve Oswald, Jérôme Jacquin, and Thierry Herman, 191–218. Cham, Switzerland: Springer.Google Scholar
Macagno, Fabrizio, and Douglas Walton
2017 Interpreting straw man argumentation. The pragmatics of quotation and reporting. Amsterdam, Netherlands: Springer. CrossrefGoogle Scholar
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 41: 1241–1254. CrossrefGoogle Scholar
Mann, William
1988 Dialogue games: Conventions of human interaction. Argumentation 2: 511–532. CrossrefGoogle Scholar
Mayweg-Paus, Elisabeth, Fabrizio Macagno, and Deanna Kuhn
2016 Developing argumentation strategies in electronic dialogs: Is modeling effective? Discourse Processes 53: 280–297. CrossrefGoogle Scholar
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. CrossrefGoogle Scholar
Mey, Jacob
2001 Pragmatics. An introduction. Oxford, UK: Blackwell.Google Scholar
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. CrossrefGoogle Scholar
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 17: 579–584. CrossrefGoogle Scholar
Al Qassas, Malik, Daniela Fogli, Massimiliano Giacomin, and Giovanni Guida
2015 Analysis of clinical discussions based on argumentation schemes. Procedia Computer Science 64: 282–289. CrossrefGoogle Scholar
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 83: 483–520. CrossrefGoogle Scholar
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 2: 185–197.Google Scholar
Reed, Christopher, Douglas Walton, and Fabrizio Macagno
2007 Argument diagramming in logic, law and artificial intelligence. Artificial Intelligence, and Law 22: 87–109. CrossrefGoogle Scholar
Rimer, Barbara K., and Matthew W. Kreuter
2006 Advancing tailored health communication: A persuasion and message effects perspective. Journal of Communication 56: 184–201. CrossrefGoogle Scholar
Roter, Debra, and Susan Larson
2002 The Roter interaction analysis system (RIAS): utility and flexibility for analysis of medical interactions. Patient Education and Counseling 46: 243–251. CrossrefGoogle Scholar
Rubinelli, Sara, and Claudia Zanini
2012 Teaching argumentation theory to doctors: Why and what. Journal of Argumentation in Context 1: 66–80. CrossrefGoogle Scholar
Ruhi, Şükriye
2007 Higher-order intentions and self-politeness in evaluations of (im)politeness: The relevance of compliment responses. Australian Journal of Linguistics 27: 107–145. CrossrefGoogle Scholar
Sacchi, Lucia, Giordano Lanzola, Natalia Viani, and Silvana Quaglini
2015 Personalization and patient involvement in decision support systems: current trends. Yearbook of Medical Informatics 24: 106–118. CrossrefGoogle Scholar
Sanders, Robert
1987 Cognitive foundations of calculated speech: Controlling understandings in conversation and persuasion. Albany, NY: Suny Press.Google Scholar
Schank, Roger, Gregg Collins, Ernest Davis, Peter Johnson, Steve Lytinen, and Brian Reiser
1982 What’s the point? Cognitive Science 6: 255–275. CrossrefGoogle Scholar
Schulz, Peter J., and Bert Meuffels
2012 “It is about our body, our own body!”: On the difficulty of telling dutch women under 50 that mammography is not for them. Journal of Argumentation in Context 1: 130–142. CrossrefGoogle Scholar
Searle, John
1969 Speech acts: An essay in the philosophy of language. Cambridge, UK: Cambridge University Press. CrossrefGoogle Scholar
2002 Consciousness and language. New York, NY: Cambridge University Press. CrossrefGoogle Scholar
Searle, John, and Daniel Vanderveken
1985 Foundations of illocutionary logic. Cambridge, UK: Cambridge University Press.Google Scholar
Seuren, Pieter
2009 Language in cognition: Language from within. Vol. 1. Oxford, UK: Oxford University Press. CrossrefGoogle Scholar
Smith, David, and Loyd Pettegrew
1986 Mutual persuasion as a model for doctor-patient communication. Theoretical Medicine 7: 127–146. CrossrefGoogle Scholar
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 50: 829–840. CrossrefGoogle Scholar
Stewart, Moira
1995 Effective physician-patient communication and health outcomes: A review. CMAJ 152: 1423–1433.Google Scholar
Streeck, Jürgen
1980 Speech acts in interaction: A critique of Searle. Discourse Processes 3: 133–153. CrossrefGoogle Scholar
Street, Richard
2013 How clinician-patient communication contributes to health improvement: Modeling pathways from talk to outcome. Patient Education and Counseling 92: 286–291. CrossrefGoogle Scholar
Street, Richard, Glyn Elwyn, and Ronald Epstein
2012 Patient preferences and healthcare outcomes: an ecological perspective. Expert Review of Pharmacoeconomics & Outcomes Research 12: 167–180. CrossrefGoogle Scholar
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 26: 21–27. CrossrefGoogle Scholar
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 74: 295–301. CrossrefGoogle Scholar
Taylor, Keith
2009 Paternalism, participation and partnership-The evolution of patient centeredness in the consultation. Patient Education and Counseling 74: 150–155. CrossrefGoogle Scholar
Walton, Douglas
1989a Dialogue theory for critical thinking. Argumentation 3: 169–184. CrossrefGoogle Scholar
1989b Informal logic. New York, NY: Cambridge University Press.Google Scholar
1990 What is reasoning? What is an argument? Journal of Philosophy 87: 399–419. CrossrefGoogle Scholar
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.Google Scholar
1998 The New Dialectic. Conversational contexts of argument. Toronto, ON: University of Toronto Press. CrossrefGoogle Scholar
1999 Profiles of dialogue for evaluating arguments from ignorance. Argumentation 13: 53–71. CrossrefGoogle Scholar
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. CrossrefGoogle Scholar
Walton, Douglas, and Erik Krabbe
1995 Commitment in dialogue. Albany, NY: State University of New York Press.Google Scholar
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.Google Scholar
Wolpert, Howard, and Barbara Anderson
2001 Management of diabetes: Are doctors framing the benefits from the wrong perspective? BMJ: British Medical Journal 323: 994–996. CrossrefGoogle Scholar
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. Crossref logo
Macagno, Fabrizio & Rosalice Botelho Wakim Souza Pinto
2021. Reconstructing Multimodal Arguments in Advertisements: Combining Pragmatics and Argumentation Theory. Argumentation 35:1 ► pp. 141 ff. Crossref logo
Rossi, Maria Grazia & Fabrizio Macagno
2021.  In Inquiries in Philosophical Pragmatics [Perspectives in Pragmatics, Philosophy & Psychology, 27], ► pp. 171 ff. Crossref logo

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.