Computerized Content Analysis of Conversational Interactions

Abstract

The emotional impact of illness sustained by patients, their families, and friends is increasingly recognized as an important dimension of clinical evaluation and intervention. This study first attempted to extend a computerized technique of measuring the magnitude of mental events from a content analysis of speech initially designed for use on single verbal samples or verbal texts to the analysis of conversational interactions. The study then applied this method of extended measurement to conversations concerning seriously ill surgical patients. The authors' objective was to develop a graphic method that illustrates the neuropsychological interchanges occurring in these conversations. Speech samples were recorded during discussions among nurses, surgeons, intensivists, and family members involved in the care and treatment of seriously ill patients hospitalized in the surgical intensive care unit at Barnes-Jewish Hospitals associated with Washington University School of Medicine, St. Louis, Missouri. These samples then were transcribed into computer-readable text files and divided into utterances: uninterrupted speech by a single individual. The utterances were assigned numeric scores by a computer program on each of 14 validated content analysis scales measuring various neuropsychological dimensions. The scores are presented graphically in chronological sequence to illustrate the emotional interactions in these conversations. The graphic representations depicting sequences of computerized content analysis-derived scores for the mental reactions of the speakers in such conversations provide insights into the psychodynamics occurring in such stressful situations.

Communication of bed allocation decisions in a critical care unit and accountability for reasonableness

“…While there are many possible reasons, including the impact of anxiety and depression on family members' capacity to understand complex information about their loved one [13], physician related factors, such as meetings of short duration are also highlighted [14]. Even when surgical intensive care unit doctors do have meetings, they dominate the dialogue and utter more words per conversational turn than family members [15]. Within the critical care unit, the environment is noisy [16] and there are frequent disruptions by simultaneous events, which present problems not only for patients but also for researchers [17].…”