Repetition in the Health History Segment of Spanish Language Clinical Consultations: A Conversation Analysis.

Background: Patient history-taking sequences may be repeated across medical speech events with different healthcare providers and subsequently co-constructed differently, which can lead to disparate patient history information with implications for patient care outcomes. Encounters that include language discordance between patients with limited English language proficiency and healthcare workers can also impact patient outcomes.

Objectives: We examined the repetition of patient history-taking sequences in consultations in which healthcare providers used Spanish as a first and second language with monolingual Spanish-speaking patients.

Third Party Interaction in the Medical Context: Code-switching and Control.

The purpose of this paper is to examine the micro-interactional co-construction of power within Spanish language concordant medical consultations in California involving a third party family member. Findings indicate the third party instigates code-switching to English on the part of medical providers, a language that the patient does not understand, rendering the patient a non-participant in the medical consultation. In these consultations involving a third party family member, monolingual Spanish-speaking patients are stripped of control in ways that are similar to other powerless groups in medical consultations.

‘Shift’ ‘n ‘control’: The computer as a third interactant in Spanish-language medical consultations.

The purpose of this paper is to examine the role of the computer in medical consultations in which English- Spanish-bilingual medical providers interact with Spanish-monolingual patients. Following previous studies that have revealed that the presence of the computer in consultations detracts from direct provider– patient communication, we pay specific attention to how the use of the computer in Spanish-language medical consultations can complement or adversely affect the co-construction of the patient’s health narrative. The data for the present study consist of 36 Spanish-language medical consultations in Southern California.

Constructing language normativity through the animation of stance in Spanish-language medical consultations.

The purpose of this study is to examine the construction of language normativity as medical providers interact with patients and animate stance within Spanish-language medical consultations. The context of the study is a clinic in which providers use Spanish to communicate with monolingual Spanish-speaking patients. This clinic is in the United States, an English-speaking macro-societal context.

Narrative co-construction in the medical consultation: how agency and control affect the diagnosis.

The purpose of this paper is to examine patient-provider narrative co-construction of symptoms, diagnosis and treatment in the medical consultation. Narrative scholarship has demonstrated that conversational narratives, including those that take place in medical consultations, are typically co-constructed by all participants within the conversation. In the context of the medical consultation, this means that patient narratives are co-constructed with providers, and that at times, provider contributions to the patient narrative can hide patient contributions.

Well, Now, Okey Dokey: English Discourse Markers in Spanish Language Medical Consultations.

The purpose of this paper is to examine use of English discourse markers in otherwise Spanish language consultations. Data is derived from an audio-recorded corpus of Spanish language consultations that took place in a small community clinic in the United States as well as post-consultation interviews with patients and providers. Through quantification of the use of discourse makers in the corpus and discourse analysis of transcripts, we demonstrate that English-speaking dominant medical providers use English discourse markers more frequently and with a broader range of functions than do Spanish-speaking dominant medical providers and patients.

Living with pain: narrating an ideological position toward healthcare.

The purpose of this study is to demonstrate how individual experiences shape ideologies toward healthcare. To demonstrate, we analyze conversational narrative data about health and healthcare between a dominant Spanish-speaking Mexican immigrant woman, Maria, and the researcher, Caroline. Findings demonstrate that Maria's narrative about her experience receiving healthcare for a knee injury reveals her ideological stance toward healthcare in both the United States and Mexico.