Visualising Conversation Structure across Time: Insights into Effective Doctor-Patient Consultations

Angus, Daniel; Watson, Bernadette Maria; Smith, Andrew; Gallois, Cindy; Wiles, Janet

doi:10.1371/journal.pone.0038014

Cited by 80 publications

(84 citation statements)

References 23 publications

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“…NLP research has now begun to examine both. Wallace et al (2013) model speech acts to characterise doctor-patient consultations on medication adherence; Angus et al (2012) use unsupervised topic models to visualise shared content in clinical dialogue; Cretchley et al (2010) use a similar approach for a qualititative analysis of topic and communication style between patients with schizophrenia and carers. DeVault et al (2013) use features of speech, and Yu et al (2013) multimodal features, from video-mediated dialogue to detect depression and PTSD with promising accuracies (0.66 to 0.74 depending on condition and task).…”

Section: Computational Analysis and Mental Healthmentioning

confidence: 99%

Proceedings of the Workshop on Computational Linguistics and Clinical Psychology: From Linguistic Signal to Clinical Reality

2014

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ii Introduction Mental health problems are among the costliest challenges we face, in every possible sense of cost. The numbers are staggering: to cite just a few, in the United States mental health spending accounted for $33 billion in 1986, $100 billion in 2003, and is projected to increase to $203 billion for 2014; some 25 million American adults will have an episode of major depression this year; and suicide is the third leading cause of death for people between 10 and 24 years old. The importance of clinical psychology as a problem space cannot be overstated.For clinical psychologists, language plays a central role in diagnosis. Indeed, many clinical instruments fundamentally rely on what is, in effect, manual annotation of patient language. Applying language technology in this domain, e.g. in language-based assessment, could potentially have an enormous impact, because many individuals are motivated to underreport psychiatric symptoms (consider active duty soldiers, for example) or lack the self-awareness to report accurately (consider individuals involved in substance abuse who do not recognize their own addiction), and because many people -e.g. those without adequate insurance or in rural areas -cannot even obtain access to a clinician who is qualified to perform a psychological evaluation. Bringing language technology to bear on these problems could potentially lead to inexpensive screening measures that could be administered by a wider array of healthcare professionals, which is particularly important since the majority of individuals who present with symptoms of mental health problems do so in a primary care physician's office. Given the burden on primary care physicians to diagnose mental health disorders in very little time, the American Academy of Family Physicians has recognized the need for diagnostic tools for physicians that are "suited to the realities of their practice".Although automated language analysis connected with mental health conditions goes back at least as far as the 1990s, it has not been a major focus for computational linguistics compared with other application domains. However, recently there has been noticable uptick in research activity on this topic. One recent shared task brings together research on the Big-5 personality traits, and another involved research on identification of emotion in suicide notes. Research has been done on language analysis in the context of, for example, autistic spectrum disorders, dementia, depression, post-partum depression, general life satisfaction , and suicide risk. This increase in attention is consistent with, and gains power from, the recent rise in computational linguistics activity connected with computational social science more broadly.With computational linguistics research on this topic moving toward critical mass, one key goal of this workshop was to bring together researchers to discuss the current state of the art, share methods, and set directions for the future. The workshop had a second goal also, though: to directly engage cli...

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Section: Computational Analysis and Mental Healthmentioning

confidence: 99%

Proceedings of the Workshop on Computational Linguistics and Clinical Psychology: From Linguistic Signal to Clinical Reality

2014

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“…Although there are no published reports utilising Discursis in the analysis of pharmacistpatient medication counselling sessions, the software has been used in the healthcare communication context. Discursis has effectively been applied in the analyses of physicianpatient consultations, 250 conversations between dementia patients and residential care-givers, care-givers, 253 and healthcare provider-patient exchanges around disclosure of adverse events. 266 In addition, these research studies used CAT as the theoretical framework.…”

Section: Discussionmentioning

confidence: 99%

“…266 In addition, these research studies used CAT as the theoretical framework. 250,253,266 The Discursis analysis of pharmacist-patient interactions presented here will be a novel application of this technology. Discursis software may help identify patterns of effective communication between pharmacists and patients through visual representation of these exchanges.…”

Section: Discussionmentioning

confidence: 99%

“…These findings provided an enhanced perspective and interpretation of the exchanges already analysed in Chapter 5 from audio recordings, transcripts and observational notes. 365 This technology, which has been previously validated and used in other health settings, 250,253,266 permitted the identification of distinct conversation patterns in pharmacist-patient interactions.…”

Section: Discussionmentioning

confidence: 99%

“…The software is not intended to replace, but to augment qualitative analysis. 250,256,265,266 In this research project, Discursis was used to confirm speech patterns where both speakers are effectively engaged, identify the points of time in which these are occurring and provide a visual representation of the exchanges.…”

Section: Discursis Analysismentioning

confidence: 99%

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Investigating the effectiveness of communication taking place between hospital pharmacists and patients during medication counselling

Chevalier¹

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However, before these relationships could be explored, it was essential to first investigate what was taking place in these pharmacist-patient interactions.The overall aim of this thesis was to investigate the effectiveness of communication between hospital pharmacists and patients during medication counselling.This theory-driven research employed qualitative, quantitative and mixed methods.Communication accommodation theory (CAT) was the theoretical framework invoked to study, analyse and interpret the pharmacist-patient communication exchanges. There are five CAT strategies which measure whether effective communication has occurred: approximation (speech tone, volume, rate, accent), interpretability (using easy-to-understand language, avoiding jargon), discourse management (asking open-ended questions or repairing conversations), emotional expression (appropriate reassurance to patients' concerns) and interpersonal control (strategies to promote equality between speakers and encourage patients to take active roles in managing their healthcare). In this thesis, effective pharmacist-patient communication refers to the extent pharmacists accommodate, or not, to patients' conversational needs based on accommodative behaviour described within CAT strategies.There were two phases to this thesis. The first involved six focus groups (24 pharmacists) from two large metropolitan hospitals. Pharmacists shared their perceptions of their roles and goals in patient medication counselling, and barriers and facilitators in meeting their goals.Audio recorded transcripts were thematically analysed and goals identified by pharmacists were successfully mapped onto the five CAT strategies. Results of phase one helped inform the contents of the semi-structured interview guides utilised in phase two.iii Phase two represented the major portion of this PhD, and took place at a large hospital with multiple specialities. Twelve pharmacists engaged four patients for a total of 48 medication counselling sessions. Each individual session took place first, followed by separate semistructured interviews with pharmacists and patients. Counselling sessions and interviews were audio recorded and observational field notes were taken. Transcribed recordings were selectively coded for the five CAT strategies in pattern-based discourse analysis. Discursis software, as an adjunct to qualitative analysis, was used to visualise pharmacist-patient speech patterns, episodes of engagement and to detect CAT strategies employed by Analysis of the pharmacist-patient counselling sessions revealed that most pharmacists effectively used all five CAT communication strategies during medication counselling sessions as they adapted to patients' conversational needs. Non-accommodation occurred when pharmacists spoke too quickly, used terms not understood by patients, and did not include patients in the initial, agenda-setting phase. Discursis software identified pharmacistpatient engagement episodes, often revealing effectively applied CAT strategies.Semi-structure...

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Communication Accommodation Theory

Dragojević

Gasiorek

Giles

2015

The International Encyclopedia of Language and Social Interaction

128

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Imagine a conversation between an older male professor of British origin, a male African American undergraduate student, and a female postdoctoral student from Switzerland taking place in an American University. Think of the variety of social dimensions involved in this situation: gender, culture and ethnicity, social and occupational status, age, and so forth. How are the different personal and social identities negotiated during the interaction? Who changes his or her communicative style to accommodate whom? What are the outcomes of such accommodating behaviors on the relationship between the interactants? In what follows, we shall make frequent use of this scenario. Communication Accommodation Theory (CAT) provides a wide-ranging framework aimed at predicting and explaining many of the adjustments individuals make to create, maintain, or decrease social distance in interaction. It explores the different ways in which we accommodate our communication, our motivations for doing so, and the consequences. CAT addresses interpersonal communication issues, yet also links it with the larger context of the intergroup stakes of an encounter. In other words, sometimes our communications are driven by our personal identities as Janet or Richard while at others-and sometimes within the very same interaction-our words, nonverbals, and demeanor are fueled, instead and almost entirely, by our social identities as members of groups; that is Janet now speaks not so much as the individual Janet but as someone who represents communication scholars to groups of chemists, biologists, and physicists. Since its inception in the early 1970s, CAT has undergone several conceptual refinements and theoretical elaborations, as exemplified by moves from speech into the nonlinguistic (Giles, Mulac, Bradac, & Johnson, 1987). Originally a sociopsychological model exploring accent and 293

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Visualising Conversation Structure across Time: Insights into Effective Doctor-Patient Consultations

Cited by 80 publications

References 23 publications

Proceedings of the Workshop on Computational Linguistics and Clinical Psychology: From Linguistic Signal to Clinical Reality

Proceedings of the Workshop on Computational Linguistics and Clinical Psychology: From Linguistic Signal to Clinical Reality

Investigating the effectiveness of communication taking place between hospital pharmacists and patients during medication counselling

Communication Accommodation Theory

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