In:A Pragmatic Agenda for Healthcare: Fostering inclusion and active participation through shared understanding
Edited by Sarah Bigi and Maria Grazia Rossi
[Pragmatics & Beyond New Series 338] 2023
► pp. 373–394
Chapter 16How uncertainty can be turned into shared understanding
Evidence from online medical consultations in Taiwan
Published online: 17 November 2023
https://doi.org/10.1075/pbns.338.16tse
https://doi.org/10.1075/pbns.338.16tse
Abstract
This chapter investigates how uncertainty is communicated in highly-rated medical answers. Particular attention is paid to the discourse elements that may render the use of vague language to be more positively than negatively received during the delivery of helpful answers to health information seekers in online medical consultations (OMCs). We argue that uncertainty does not equate to an evasive answer; instead, uncertainty can be turned into shared understanding with the use of effective strategies. Data in Chinese were collected from a government-funded website based in Taiwan. The findings suggest that vague language can facilitate the successful delivery of health information when it is used in conjunction with higher-order stretching of a medical reply, aimed at offering a patient-centered medical answer.
Article outline
- 1.Introduction
- 2.Literature review
- 2.1Uncertainty
- 2.2Uncertainty in health communication
- 2.3Higher-order stretching as a notion to uncertainty management
- 3.Methodology
- 3.1Data and data collection rationales
- 3.2Participants
- 3.3The data analysis
- 4.Analysis and discussion
- 4.1The failure of lowly-rated cases: patients’ uncertainty untackled
- 4.1.1Evasive answers
- 4.1.2Answers that are not relevant enough
- 4.1.3Answers that lack emotional support
- 4.2The success of highly-rated cases: From uncertainty to shared understanding
- 4.2.1Cognitive and emotive answers
- 4.2.2Relevant and specific answers
- 4.2.3Pragmatic answers
- 4.2.4Socially appropriate answers
- 4.3Discussion
- 4.1The failure of lowly-rated cases: patients’ uncertainty untackled
- 5.Conclusion
Notes References
References (37)
Adams, Trevor. 2000. “The Discursive Construction of Identity by Community Psychiatric Nurses and Family Members Caring for People with Dementia.” Journal of Advanced Nursing 32: 794–798.
Albert, Steven M., Grant Shevchik, Suzanne Paone, and G. Daniel Martich. 2011. “Internet-Based Medical Visit and Diagnosis for Common Medical Problems: Experience of First User Cohort.” Telemedicine and E-Health 17: 304–308.
Babrow, Austin S., Chris R. Kasch, and Leigh A. Ford. 1998. “The Many Meanings of Uncertainty in Illness: Toward a Systematic Accounting.” Health Communication 10, 1–23.
Barnlund, Dean C. 1976. “The Mystification of Meaning: Doctor-Patient Encounters.” Journal of Medical Education 51 (9): 716–725.
Biber, Douglas, Stig Johansson, Geoffrey Leech, Susan Conrad, and Edward Finegan. 2010. Longman Grammar of Spoken and Written English (8th edition). London: Longman.
Brashers, Dale E. 2001. “Communication and Uncertainty Management.” Journal of Communication 51 (3): 477–497.
Brashers, Dale E., Judith L. Neidig, Nancy R. Reynolds, and Stephen M. Haas. 1998. “Uncertainty in Illness across the HIV/AIDS Trajectory.” Journal of the Association of Nurses in AIDS Care 9: 66–77.
Brashers, Dale E., Stephen M. Haas, Renee S. Klingle, and Judith L. Neidig. 2000. “Collective AIDS Activism and Individuals’ Perceived Self-Advocacy in Physician-Patient Communication.” Human Communication Research 26: 372–402.
Cotterill, Janet. 2007. “‘I Think He Was Kind of Shouting or Something’: Uses and Abuses of Vagueness in the British Courtroom.” In Vague Language Explored, edited by Joan Cutting, 97–114. Basingstoke (UK): Palgrave Macmillan.
Engeström, Yrjö, Ritva Engeström, and Hannele Kerosuo. 2003. “The Discursive Construction of Collaborative Care.” Applied Linguistics 24 (3): 286–315.
Garrett, Cameryn C., Jane S Hocking, Marcus Y. Chen, Christopher Kincaid Fairley, and Maggie Kirkman. 2011. “Young People’s Views on the Potential Use of Telemedicine Consultations for Sexual Health: Results of a National Survey.” BMC Infectious Diseases 11, 285.
Grice, H. P. 1975. “Logic and Conversation.” In Syntax and Semantics Vol. 3: Speech Acts, edited by Peter Cole, and Jerry L. Morgan, 41–58. New York: Academic Press.
Han, Paul K. J., Brian J. Zikmund-Fisher, Christine W. Duarte, Megan Knaus, Adam Black, Aaron M. Scherer, and Angela Fagerlin. 2018. “Communication of Scientific Uncertainty about a Novel Pandemic Health Threat: Ambiguity Aversion and Its Mechanisms.” Journal of Health Communication 23 (5): 435–444.
Jiwa, Moyez, and Xingqiong Meng. 2013. “Video Consultation Use by Australian General Practitioners: Video Vignette Study.” Journal of Medical Internet Research 15 (6): e117.
Mao, Yansheng, and Xin Zhao. 2020. “By the Mitigation One Knows the Doctor: Mitigation Strategies by Chinese Doctors in Online Medical Consultation.” Health Communication 35 (6): 667–674.
McCarthy, Michael, and Ronald Carter. 2004. “This, That and the Other: Multi-Word Clusters in Spoken English as Visible Patterns of Interaction.” TEANGA 21: 30–52.
Middleton, Ashley V., Nicole R LaVoie, and Laura E Brown. 2012. “Sources of Uncertainty in Type 2 Diabetes: Explication and Implications for Health Communication Theory and Clinical Practice.” Health Communication 27 (6): 591–601.
Mishel, Merle H. 1999. “Uncertainty in Chronic Illness.” Annual Review of Nursing Research 17: 269–294.
Prince, Ellen F., Joel Frader, and Charles Bosk. 1982. “On Hedging in Physician-Physician Discourse.” In Linguistics and the Professions: Proceedings of the Second Annual Delaware Symposium on Language Studies, edited by Robert J. Di Pietro, 83–97. Norwood, NJ: Ablex.
Rains, Stephen A., and Riva Tukachinsky. 2015. “Information Seeking in Uncertainty Management Theory: Exposure to Information about Medical Uncertainty and Information-Processing Orientation as Predictors of Uncertainty Management Success.” Journal of Health Communication 19 (11): 1296–1307.
Richardson, Lisa K., B. Christopher Frueh, Anouk L. Grubaugh, Leonard Egede, and Jon D. Elhai. 2009. “Current Directions in Videoconferencing Tele-Mental Health Research.” Clinical Psychology: Science and Practice 16: 323–338.
Rowland, Tim. 2007. “‘Well Maybe Not Exactly, but It’s Around Fifty Basically?’: Vague Language in Mathematics Classrooms.” In Vague Language Explored, edited by Joan Cutting, 79–96. Basingstoke (UK): Palgrave Macmillan.
Sarangi, Sarangi, and Angus Clarke. 2002. “Zones of Expertise and the Management of Uncertainty in Genetics Risk Communication.” Research on Language and Social Interaction, 35 (2): 139–171.
Schmid, Hans-Jörg. 2015. “A Blueprint of the Entrenchment-and-Conventionalization Model.” Yearbook of the German Cognitive Linguistics Association 3: 1–27.
. 2020. The Dynamics of the Linguistic System: Usage, Conventionalization and Entrenchment. Oxford: Oxford University Press.
Singh, Ajeet Pal, Hari Shanker Joshi, Arun Singh, Medhavi Agarwal, and Palveen Kaur. 2018. “Online Medical Consultation: A Review.” International Journal of Community Medicine and Public Health 5: 1230–1232.
Sperber, Dan, and Deirdre Wilson. 1995. Relevance: Communication and Cognition (2nd edition). Oxford: Blackwell.
Tseng, Ming-Yu. 2021. “Toward a Cognitive-Pragmatic Account of Metonymic Schemes of Thought: Examples from Online Medical Consultation.” Journal of Pragmatics 173: 177–188.
Tseng, Ming-Yu, and Grace Zhang. 2018. “Pragmeme, Adaptability, and Elasticity in Online Medical Consultations.” Journal of Pragmatics 137: 40–56.
. 2022. “Conceptual Metonymy and Emotive-Affective Meaning at the Interface: Examples from Online Medical Consultations.” Lingua.
Whitten, Pamela, David Cook, and Jennifer Cornacchione. 2011. “Telemedicine: Reviewing the Past, Looking Toward the Future.” In Routledge Handbook of Health Communication (2nd edition), edited by Teresa Thompson, Roxanne Parrott, and Jon F. Nussbaum, 84–99. New York: Taylor and Francis.
