Culture and (mis)communication : A study of doctor-patient interactions and emotion

Abstract

This thesis investigates interactions observed when patients are not understood in intercultural medical consultations, and further how emotions can be interpreted from these interactions. More knowledge and understanding around minority health is needed as Norway faces challenges in minority health related issues, and doctor-patient communication is highlighted as a specific area of focus. Interpersonal and institutional communication is essential for successful social integration and well-being for individuals, and the recognition and understanding of emotional distress is considered to be a central component of this development. Twelve videotaped medical consultations with six ethnic minority patients and six ethnic Norwegian patients were transcribed and analyzed employing discursive and conversation analytic approaches. This methodological approach was intended to offer a new cultural perspective to earlier findings on the topic. The analysis and results support earlier findings, and has further identified distinct sequences of interaction in doctor-patient communication when patient did not seem understood. These interactions consist of practices around justification, building alliance, rhetorical reasoning, and direct arguing, in addition to some features observed in situations where understanding seemed to be attained. The main findings show that patient concerns and emotional distress are often expressed through indirect expressions as to downplay concerns and worries.