Code-switching in multilinguals with dementia: patterns across speech contexts.

The study investigates code-switching by multilingual persons with dementia in two different speech contexts, picture naming tests and spontaneous conversation. It combines a psycholinguistic perspective on cognitive and linguistic skills with a qualitative conversation analytic approach to understanding the functions and appropriateness of code-switching in social interaction. The analysis shows that code-switching is used as a resource for compensating for word-retrieval problems in both the naming tests and in word search sequences in conversation.

Eliciting patient preferences in shared decision-making (SDM): Comparing conversation analysis and SDM measurements.

Objective: To explore how physicians bring up patient preferences, and how it aligns with assessments of shared decision-making.

Methods: Qualitative conversation analysis of physicians formulating hypotheses about the patient's treatment preference was compared with quantitative scores on SDM and 'patient preferences' using OPTION(5) and MAPPIN'SDM.

Results: Physicians occasionally formulate hypotheses about patients' preferences and then present a treatment option on the basis of that ("if you think X+we can do Y").

Patient involvement and language barriers: Problems of agreement or understanding?

Objective: This study aims to explicate efforts for realizing patient-centeredness (PCC) and involvement (SDM) in a difficult decision-making situation. It investigates what communicative strategies a physician used and the immediate, observable consequences for patient participation.

Methods: From a corpus of videotaped hospital encounters, one case in which the physician and patient used Norwegian as lingua franca was selected for analysis using conversation analysis (CA).

Negotiating treatment preferences: Physicians' formulations of patients' stance.

Eliciting patients' values and treatment preferences is an essential element in models of shared decision making, yet few studies have investigated the interactional realizations of how physicians do this in authentic encounters. Drawing on video-recorded encounters from Norwegian secondary care, the present study uses the fine-grained empirical methodology of conversation analysis (CA) to identify one conversational practice physicians use, namely, formulations of patients' stance, in which physicians summarize or paraphrase their understanding of the patient's stance towards treatment. The purpose of this study is twofold: (1) to explore what objectives formulations of patients' stance achieve while negotiating treatment and (2) to discuss these objectives in relation to core requirements in shared decision making.