Who gets to talk? An alternative framework evaluating companion effects in geriatric triads

Abstract

Most studies evaluating companion effects on medical triadic interaction focus on the doctors' part, e.g., how the companion's presence diverts doctors' attention away from the patient. In contrast to this mainstream approach, the current research proposes an alternative framework by focusing on the patient parties—especially on how companion participation reshapes the discourse sequences where patient parties provide information, and how it affects patient full turns and priority in providing complete first-hand information to doctors. By examining fifteen geriatric triadic conversations collected in a teaching hospital in southern Taiwan, this proposed framework concludes that in the companion's presence, the information providing sequences are restructured into eight patterns, among which sole information provider is preferred to joint providers. Furthermore, the more companions participate in providing information, the less patients by themselves volunteer information or respond to doctors' questions prior to companions' verbal involvement. A more striking companion effect shows that even in the triads with a low-participation companion, whenever the companion does participate, the patient rarely has a full turn or priority to complete an information unit. The patient's turns are either taken, are simultaneous with, or cut-off by the companion's participation.

Examination of standardized patient performance: Accuracy and consistency of six standardized patients over time

“…While the role of third parties in medical communication has been explored in several studies of actual patient provider communication [21–23], the impact of the presence of a standardized spouse on the performance of SPs has not been previously reported. The degree of tailoring within genetic counseling communication must also be considered when interpreting these observed differences.…”

“Speaking-for” and “speaking-as”: Pseudo-surrogacy in physician–patient–companion medical encounters about advanced cancer

“…Green(14) found that patients who were accompanied raised fewer conversational topics and participated less often in decision-making. Tsai(15) found that when Taiwanese patients were accompanied, they volunteered less information to physicians. Wolff(2) concluded that multiple studies have indicated accompanied patients are less verbally active and discussion is shifted toward biomedical information-giving and away from psychosocial exploration.…”

Age-Telling in Intergenerational First-encounter Talks between College Students and Older Adults in Taiwan: A Gerontological Sociolinguistic Study

“…Moreover, Taiwan's proportion of older people is expected to rise further in the coming years, given increases in its population's longevity and recent sharp decreases in its birthrate. Nevertheless, language and communication studies which focused on ageing, older age or older people are still relatively rare in Taiwan, with important exceptions related to health/medical communication (Tsai, 2003(Tsai, , 2005(Tsai, , 2007(Tsai, , 2010(Tsai, , 2017(Tsai, , 2018, teacher-older-student communication (Chen, 2015a;Chen, 2019), in media communication (Chen, 2015b;Chen, 2015c;Chen, 2016), intergenerational first-encounter talks (Chen, 2017) and the discourse features of senior Alzheimer's patients (Lai, 2014, Lai & Lin, 2012. Uniquely, the current study examines casual talks between younger and older adults at their first encounters, with an interest on the cultural conceptualisation of older age and the discursive management of age-telling by older people.…”