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

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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
Published online: 28 October 2020
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https://doi.org/10.1075/jaic.18044.mac
Abstract
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
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