Ways of meaning
A case study of two oncologists’ answers to questions asked by advanced cancer patients and their companions
This paper explores one aspect of the operationalisation of a patient-centred ideology of care by examining an
oncologist’s answers to questions asked by her patient and his companion during a palliative oncology consultation and comparing her answers
to the markedly different answers of another oncologist. Halliday’s concept of register and Hasan’s semantic networks are used to examine
the oncologists’ answers. Patients’ questions create the semiotic environment for clinicians to provide the information patients need for
informed decision-making – an important aspect of patient-centredness. The answers clinicians provide construe their position towards this
ideology of care. Findings suggest that one way patient-centredness can be operationalised, at the level of semantics, is through providing
elaborated answers that explicitly display the reasoning employed by the oncologist.
Keywords: answer, cancer care, healthcare communication, ideology of care, oncology, palliative care, patient-centred care, question, register, relation enactment, semantic networks, semantics, systemic functional linguistics
Article outline
- 1.Introduction
- 2.A register analysis of oncology consultation
- 3.A brief review of work on semantic networks in Hallidayan SFL
- 4.Hasan’s semantic networks
- 5.Oncology consultation from round about: a case study of two oncologists, two patients with advanced incurable cancer and their companions
- 5.1The context of Yvette’s consultations
- 5.2Differential selection of semantic options in answers to [confirm] questions
- 5.3Differential selections of semantic options in [specify] answers
- 5.4Rationality, elaboration and relatedness: Semantic realisations of a patient-centred ideology of care
- Ethics approval
- Acknowledgements
- Notes
-
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