Identifying Adherence Behaviors through the Study of Patient Talk in English and Spanish

Abstract

The purpose of this chapter is to use exploratory corpus-based research methods to analyze English and Spanish discourse of patients with Type II diabetes in a US health-care context. The corpora were collected as part of a large project that tried to identify relationships between literacy levels and diabetes self-management (Connor et al., Commun Med 9:1–12, 2012), with patients being identified as adherent and nonadherent to their diabetes treatment when self-reporting the times they missed their medication in a given month. English-speaking and Spanish-speaking patients answered equivalent versions of an oral questionnaire and their answers were recorded and transcribed. Grammatical taggers were used for both the English (Biber, Variations across speech and writing, 1988) and Spanish texts (Biber et al., Corpora 1:1–37, 2006). Tests of significant differences were performed on the normalized tag counts to compare the language production of the patients in the adherent and nonadherent groups in each language. The results of these statistical procedures showed marked differences in the frequency of use of certain linguistic features between the two language groups and adherence level groups. For this exploratory study, we focus on the three most salient features used differently by the two groups in the English corpus, first person pronouns and possessive determiners, second person pronouns and possessive determiners, and the verb do. We also report on the only three features that were found to be significantly different across the two groups in the Spanish corpus: demonstrative pronouns, simple conjunctions and complex conjunctions or subordinators, and augmentative adjectives. These features are analyzed in the language in which they originated and compared to the production of the patients in the counterpart language to try to discover whether their use can bring about more information regarding the way these groups of patients refer to diabetes and their courses of treatment.