Companions' dilemma of intervention when they mediate between patients with intellectual disabilities and health staff

Antaki, Charles; Chinn, Deborah

doi:10.1016/j.pec.2019.05.020

Cited by 13 publications

(20 citation statements)

References 24 publications

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“…Although such other-corrections may occur regularly in close relationships, in our data, it is the partners who initiate and carry out most of the corrections, suggesting an asymmetric distribution of epistemic rights. This is in line with what has been found in other asymmetrical relations (Antaki and Chinn, 2019; Drew, 1981; Kurhila, 2001; Macbeth, 2004; McHoul, 1990; Williams and Porter, 2015). Since the spouses here do not display other forms of asymmetry, the relevant source of their asymmetric rights thus seems to be their status (at least with respect to their roles in these interactions) as cognitively healthy versus challenged.…”

Section: Discussionsupporting

confidence: 92%

“…A more symmetrical distribution of epistemic rights was achieved in the cases where the partners invited the PWD to correct or revise their claim, thus giving them the opportunity to self-repair and thereby maintain epistemic authority (extract 4). This is in line with Antaki and Chinn’s (2019) findings from medical consultations with patients with intellectual disabilities. The study shows how companions adopted a continuum of practices that to a larger or lesser degree displayed epistemic authority over the disabled person when responding to questions directed to the latter.…”

Section: Discussionsupporting

confidence: 89%

“….) adopt different epistemic stances to manage the matter with more delicacy’ (Antaki and Chinn, 2019: 2026). In our study, the partners did substantial interactional work to mitigate both their epistemic authority, and the ‘incorrectness’ of the PWD’s problematic claim.…”

Section: Discussionmentioning

confidence: 99%

“…This sensitivity may be related to the fact that exposing a lack of veracity makes the dementia condition salient (Lindholm and Stevanovic, 2020). In addition, the information being corrected is often within the PWD’s privileged epistemic domain (type 1 knowables), and thus the correction may be considered as epistemic trespassing (Antaki and Chinn, 2019; Bristol and Rossano, 2020). In Haakana and Kurhila (2009), the unmitigated (or unmodulated) corrections were carried out by speakers with first-hand knowledge of the matter.…”

Section: Discussionmentioning

confidence: 99%

“…Other-corrections are claimed to be rather uncommon in everyday interaction among peers (Schegloff et al, 1977). They seem more common (and acceptable) in certain contexts involving clear asymmetries of knowledge, such as teacher-student interaction (Macbeth, 2004; McHoul, 1990), conversations between children and adults (Drew, 1981) first and second language speakers (Kurhila, 2001) as well as in conversations involving persons with disabilities (Williams and Porter, 2015; Antaki and Chinn, 2019). Of special relevance to the current study, Haakana and Kurhila (2009) found that other-corrections occur regularly and without modulation in conversations between parties in close relationships, such as spouses and friends, and suggest that such unmitigated other-correction may be an index of such a relationship.…”

Section: Introductionmentioning

confidence: 99%

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Couples living with dementia managing conflicting knowledge claims

et al. 2021

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This conversation analytic study investigates how couples manage conflicting knowledge claims when one of the persons has dementia (PWD). The data are video-recordings of 16 couples talking with a third party. The analysis focuses on the negotiation of epistemic rights, more precisely how partners initiate repair and correct claims made by the PWD on matters belonging to the latter’s epistemic domain. We identified three main practices for correcting the PWD: (1) correcting the statement, thereby claiming epistemic authority for oneself and denying it to the PWD, (2) inviting the PWD to self-correct, thereby attributing some epistemic authority to the PWD, and (3) disagreeing and providing reasons for one’s alternative claim, establishing a more symmetric epistemic gradient. The PWDs responses to the corrections displayed different degrees of acceptance, ranging from self-denigration to resistance and insistence.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Couples living with dementia managing conflicting knowledge claims

et al. 2021

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Practices of Inclusion in Primary Care Visits of Unaccompanied Foreign Minors: Allocating Agency as an Interprofessionally Distributed Intercultural Competence

Caronia

Colla

Ranzani

2022

Interculturality in Institutions

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The presence of unaccompanied foreign minors (hereafter UFMs) is a challenge for the Italian welfare and foreigner reception systems. The chapter builds on an exploratory study on the ways in which professional educators interact with other professionals to manage UFMs' access to care. In particular, it investigates triadic medical visits involving a general practitioner, an unaccompanied foreign minor, and his educator whose mandatory presence is aimed to support UFM patients throughout the encounter and make patient-physician communication as smooth as possible. Indeed, these institutional encounters constitute a perspicuous case to study how inclusion is performed (or not) through interprofessional interaction and the communicative resources whereby care professionals manage their oftenincompatible goals and mandates. Adopting a Conversation Analysis-informed approach to a corpus of video-recorded visits, we describe the "pivot sequence ", a distributed discursive and multimodal practice whereby the educator(s) and the physician differently, but cooperatively manage the inclusion of the UFM as an active participant and intersubjectively overcome the "gathering information vs. allocating agency" dilemma typical of these institutional encounters. By enlightening the "interactive vigilance" of the educators (i.e., their capability to restore the UFM's agency whenever appropriate), we make a case for interprofessionally managed health care as a means to accomplish inclusion in interaction.

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