Conversation Analytic Methods Research Articles

Who gets to speak: The role of reported speech for identity work in complaint stories

Many studies have shown the role played by reported speech in complaint stories, e.g., adding authenticity to the claim or displaying the egregiousness of the offence. In this paper I build on that research to examine the identity positionings achieved through animations of self and others in complaint stories produced during talk between clients and their stylist in a hair salon. The data at hand comprise 17 complaint sequences directed against specific individuals in which reported speech is used during the telling. Using conversation analytic methods and drawing on the framework of Narrative Positioning Analysis, the paper examines two reported speech situations: those where the complaint target is the last character animated to speak in the complaint; and those where the complainant is given this speaking position. I show that who is animated to speak, and in which order, are important means whereby the complainant achieves positioning of self and others. I also show that recipients receive the complaint differently depending on the positioning achieved by the complainant through their use of reported speech.

Empathy in nurse-patient interaction: a conversation analysis

BackgroundConsiderable attention has been drawn to empathy in nursing and the concept of empathy has firmly been embedded in nursing discourse. However, little has been known about the details of how nurses express empathy to their patients. In this study, we aim to conduct a qualitative study of actual nurse-patient conversations through which empathy was achieved.MethodsThe data in this study was based on audio-recording of sessions of conversations between participating nurses and patients in two Chinese hospitals. The participants in this study involved 6 female nurses and 14 patients. Based on Bachelor’s (1988) categorization of empathy, this study described and analyzed the actual empathic sequences in nursing conversations in an attempt to demonstrate how nursing empathy was interactionally achieved using the method of conversation analysis. Conversation analysis (CA), focusing on the study of talk in interaction, is a useful method for the qualitative analysis of empathic talk in nursing.ResultsBy drawing on prior theoretical work as well as on empathic sequence in nursing, this study described and analyzed some of the conversational resources nurses and patients used in achieving empathy. It has been shown that empathy can be interactionally and sequentially achieved in actual sequences of talk. Specifically, nursing empathy is a collaboratively constructed action instead of the nurse’s own committed action, which is produced in specific interactional contexts.ConclusionConversation analysis is a very useful method for describing and analyzing the nurse-patient interaction, especially for studying empathy in nursing care. The sequences in this study present example of exemplary empathic interaction between nurses and patients, which might shed some light on how nurses express empathy to their patients. Also, this study could help to increase the understanding of the mirco-process of empathy in nursing and contribute to improving nursing communicative skills.

Managing several simultaneous lines of talk in Finnish multi-party mobile messaging

As smartphones have become an integral part of the everyday life of many, we have seen a proliferation of private messaging groups in mobile apps such as WhatsApp. One characteristic of group messaging is the constant presence of multiple simultaneous lines of talk – even more so than in the dyadic mode. In this article, we explore the linguistic and technologically afforded practices of managing simultaneous lines of talk – topics, sequences, larger activities - in mobile group messaging. Specifically, we analyze (i) how new lines of talk are initiated next to already existing ones, (ii) how two prior messages are responded to consecutively, and (iii) how non-adjacent messages are responded to. Our data consist of Finnish instant group messaging, and the analysis was conducted using the Conversation Analytic method. Our study complements previous studies on the management of multiple lines of talk in mobile messaging, and more generally, multiactivity in social interaction. In particular, it presents new insights into how practices such as ‘and’-prefacing, action-labelling and platform-provided reply-marking are utilized for organizing parallel activities.

Interruptions in Roman Comedy: Gender, Status, and Power in Interaction

The article addresses the pragmatic and sociolinguistic constraints of interrupting in Roman comedy. It starts with a redefinition of the phenomenon informed by the methods of Conversation Analysis (CA): apart from syntactically incomplete utterances (as a result of interruptions by others), the analysis also includes the cases of interruptions reported by the characters. Furthermore, a distinction is made between intrusive (disaligning) interventions and other forms of competitive turn encroachments. The term ‘interruptions’, however, has been reserved only for the former, antagonistic type which serves to express disagreement and disinterest or to usurp the speaking turn. Using the revised criteria, the article proceeds to comment on quantitative data extracted from all the extant plays by Plautus and Terence. Accordingly, interruptions are viewed in relation to gender, age and status of the speakers, whereas some more detailed analysis concerns male and female citizens, prostitutes and servants. After comparing every character’s share of talk with their proportional use of turn incursions (both collaborative and disruptive), it is argued that the violation of the turn-exchange system is significantly associated with some interlocutors and less so with others. The last section presents interrupting as a pragmatic means of exerting power in interaction while discussing the phenomenon also from a (sociolinguistic) cross-gender perspective.

ИЛЛОКУТИВНЫЙ ПРОФИЛЬ ТЕКСТОВЫХ ЕДИНИЦ С СЕМАНТИКОЙ ЦЕЛИ В АСПЕКТЕ ИХ МОДЕЛИРОВАНИЯ И ИНТЕРПРЕТАЦИИ

The illocutionary complex that determines the pragmatic meaning of text units with purpose semantics as part of the question-answer dialogue was analyzed. Using the methods of conversation analysis, introspection, linguistic modeling and observation, a multifarious analysis of the adjacent pairs in the political interview and talk show fragments was carried out. The factors that define the generation of purpose-related judgments and the choice of indirect ways to convey the communicative intentions of the addresser were singled out, as well as the aspects that are important for understanding the perceived content by the addressee. The organization of the communicative continuum within the framework of interaction was investigated. The functionality of the pragmatic context (the background of spoken interaction) was revealed. The factors influencing the quality of the illocutionary profile of text units (clarity/blur) as it is perceived and interpreted by the addressee were established. The signals of the communicative intentions generated by the addresser were considered. The choice of spoken response in the situations of harsh pressure was discussed. It was demonstrated that the pragmatic context plays a leading role in perceiving of the illocutionary complex during the communicative interaction.

Zachować twarz – analiza konwersacyjna audycji telewizyjnej poświęconej uzależnieniom od operacji plastycznych

Metoda analizy konwersacyjnej została wykorzystana w analizie wywiadu poświęconego uzależnieniom od operacji plastycznych, wyemitowanego w programie TVP2 Pytanie na śniadanie. W rozmowie uczestniczyła kobieta określana mianem polskiej lalki Barbie, chirurg plastyczny, dwoje prezenterów telewizyjnych, występujących w roli moderatorów, oraz partner zaproszonej do studia kobiety. Badane fragmenty rozmowy pozwoliły na prześledzenie, w jaki sposób możliwość pojawienia się sporu była na bieżąco neutralizowana, a różnice zdań i poglądów korygowane. Podstawowym rezultatem analizy jest rekonstrukcja sposobów postępowania uczestników rozmowy w potencjalnie kłopotliwej sytuacji.

Professional Sport and Initial Mental Health Public Disclosure Narratives

The disclosure of absences from professional sporting activities to the media is a routine and generally unproblematic part of a sporting career. However, when the reason for the absence relates to mental health concerns, players can encounter difficulties in trying to define, describe and conceptualise their own issues while attempting to maintain privacy as they undergo assessment and treatment. Drawing on ethnomethodology and conversation analysis principles and methods, this paper explores first/initial public mental health disclosure narratives produced by players and sporting organizations across several professional sports via media interviews, press statements, and social media posts. The analysis focuses on (in)voluntary accounts produced by teams or players themselves during their careers and examines the different communication strategies they employ to categorise and explain their predicament. The analysis reveals how some players provide partial or proxy public disclosure announcements (due to a desire to mask issues or delayed help-seeking and assessment), whereas others prefer fuller disclosure of the problems experienced, including diagnoses and on-going treatment and therapy regimes. The paper outlines the consequences of these disclosure strategies and considers the implications they can have for a player’s wellbeing in these stressful circumstances.

»DA wurd ich Auch ganz blöde angeguckt«

Selbsthilfegruppen sind Orte, an welchen Personen mit Ausgrenzungserfahrungen einander gezielt suchen. Das erlebte individuelle Abweichen von gesellschaftlich gesetzten Normalitätserwartungen wird dabei oftmals in Begriffen von Moralität verhandelt. Moralisierende Narrative werden eingesetzt, um das Erleben des eigenen Abweichens zu beschreiben, um den Umgang anderer Personen mit diesem Abweichen zu erörtern, aber auch um über das Abweichen anderer Personen zu sprechen. An transkribierten Tonaufnahmen einer Gruppensitzung einer Selbsthilfegruppe für Personen mit starkem Übergewicht wird anhand konversationsanalytischer Methoden gezeigt, dass die hierfür herangezogenen Wertesysteme nicht homogen und stabil erscheinen. Gesellschaftliche Normen in Bezug auf Körperformen und lokale Normen von Gesichtswahrung und Empathie eröffnen ein Spannungsfeld von Erwartungshaltungen, das die Gesprächsbeteiligten in paradoxe Positionen versetzt. Vor diesem Spannungsfeld stellt sich die moralische Integration der Gruppe und Aufrechterhaltung der dortigen Solidarität als stetige und komplexe Arbeitsleistung dar. Eine Strategie hierfür ist spezifische Vagheit in Erzählungen, die affektive Affiliation befördert und inhaltliche Kritik vermeidet.

Introducing an interactional approach to exploring facilitation as an implementation intervention: examining the utility of Conversation Analysis

BackgroundThe widely adopted integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework identifies facilitation as a ‘core ingredient’ for successful implementation. Indeed, most implementation scientists agree that a certain degree of facilitation is required to translate research into clinical practice; that is, there must be some intentional effort to assist the implementation of evidence-based approaches and practices into healthcare. Yet understandings of what constitutes facilitation and how to facilitate effectively remain largely theoretical and, therefore, provide scant practical guidance to ensure facilitator success. Implementation Science theories and frameworks often describe facilitation as an activity accomplished in, and through, formal and informal communication amongst facilitators and those involved in the implementation process (i.e. ‘recipients’). However, the specific communication practices that constitute and enable effective facilitation are currently inadequately understood.AimIn this debate article, we argue that without effective facilitation—a practice requiring significant interactional and interpersonal skills—many implementation projects encounter difficulties. Therefore, we explore whether and how the application of Conversation Analysis, a rigorous research methodology for researching patterns of interaction, could expand existing understandings of facilitation within the Implementation Science field. First, we illustrate how Conversation Analysis methods can be applied to identifying what facilitation looks like in interaction. Second, we draw from existing conversation analytic research into facilitation outside of Implementation Science to expand current understandings of how facilitation might be achieved within implementation.ConclusionIn this paper, we argue that conversation analytic methods show potential to understand and refine facilitation as a critical, and inherently interactional, component of implementation efforts. Conversation analytic investigations of facilitation as it occurs in real-time between participants could inform mechanisms to (1) improve understandings of how to achieve successful implementation through facilitation, (2) overcome difficulties and challenges in implementation related to interpersonal communication and interaction, (3) inform future facilitator training and (4) inform refinement of existing facilitation theories and frameworks (e.g. i-PARIHS) currently used in implementation interventions.

Conversation analytic role-play method (CARM) for early childhood teacher education

ABSTRACT Here the authors explore everyday teaching strategies that work to implement early childhood curriculum frameworks, using published transcripts of video-recorded data of real-life teacher–child interactions in early childhood centres in Australia and New Zealand. The analysis uses a conversation analysis approach to reveal the sequences of action (talk and gesture) in the co-construction of pedagogical interactions. The authors illustrate how this approach builds on Elizabeth Stokoe’s Conversation Analytic Role-play Method (CARM), helping guide early childhood teachers in their interactions with infants, toddlers and young children. They argue that emphasis on real rather than recalled events and close attention to the sequential organisation of talk are central to understanding teaching and learning in early childhood education. The importance of promoting skills and knowledge in the mechanisms of high-quality interactions – that can respond to different contexts, children and concepts for learning – is emphasised, rather than a prescriptive ‘best practice’ template.

Patients' compliance and resistance to medical authority in Nigerian clinical encounters

Studies of doctor–patient interactions have shown that invoking medical authority in clinical consultations presents a recognisable practice with various outcomes. While doctors can impose the authority to make decisions for patients, patients can align or disalign with such rights by determining what constitutes authority in the consultations and negotiating for the preferred or alternate action. Extensive research in this domain has neglected how patients palliate medical authority when doctors' treatment recommendation formats do not set up the possibility for a negotiation. This paper uses the method of conversation analysis to investigate the varying degrees of medical authority being exerted through doctors' treatment recommendations, and the extent to which patients comply or resist. The research data draws on a corpus of 70 audio recorded encounters between doctors and HIV-positive patients in clinics in Southwestern Nigeria. Analyses of the consultations suggest that discussions about patients' adherence to treatment recommendations is predominant in the routine visits of HIV-positive patients. Doctors invoke high and low degrees of medical authority when recommending treatment while patients respond by endorsing or resisting the doctors' authority. For the implications on medical practice, the findings are that doctors seldom pull back with respect to displays of authority, although patients retain the rights to take life- and health-preserving drugs.

'So just to go through the options…': patient choice in the telephone delivery of the NHS Improving Access to Psychological Therapies services.

This article considers patient choice in mental healthcare services, specifically the ways that choice is enabled or constrained in patient-practitioner spoken interaction. Using the method of conversation analysis (CA), we examine the language used by practitioners when presenting treatment delivery options to patients entering the NHS Improving Access to Psychological Therapies (IAPT) service. Analysis of 66 recordings of telephone-delivered IAPT assessment sessions revealed three patterns through which choice of treatment delivery mode was presented to patients: presenting a single delivery mode; incrementally presenting alternative delivery modes, in response to patient resistance; and parallel presentation of multiple delivery mode options. We show that a distinction should be made between (i) a choice to accept or reject the offer of a single option and (ii) a choice that is a selection from a range of options. We show that the three patterns identified are ordered in terms of patient-centredness and shared decision-making. Our findings contribute to sociological work on healthcare interactions that has identified variability in, and variable consequences for, the ways that patients and practitioners negotiate choice and shared decision-making. Findings are discussed in relation to tensions between the political ideology of patient choice and practical service delivery constraints.

Change in Family Therapy

A fundamental theoretical premise in Structural Family Therapy (SFT) is that changes in individual members and improvements in intra-familial relations are realized by repairing the family structure. Dysfunctional families are conceptualized in terms of individuals taking on inappropriate roles (e.g., children acting as if they were parents) and the boundaries between parental executive levels and the children/sibling level are unclear, too rigid, or highly permeable. The therapist’s role is to temporarily engage (join) with family members in a way that generates in-session interactions that exemplify the desirable family structure. While the theory supporting these interventions are well developed, there has been little work done on explicating how such tasks may be interactively accomplished in clinical practice. Drawing from the methods of conversation analysis, our aim for this paper is to show how a master therapist in SFT accomplishes some of these transformations during a single therapy session. We focus on the discursive resources through which the therapist is able to readjust the role relationships between a mother and her daughter (i.e., in such a way that the mother can adopt a more agentive position vis-a-vis her children) and how the therapist’s actions indexed core SFT principles of restructuring the family.

Bi-plurilingual formulation practices in conversational writing interactions

AbstractThe present article approaches the subject of oral formulation practices in multilingual and conversational writing interactions. Within the framework of pluriliteracy in the context of foreign language practice at university, special emphasis is placed on the manifestations of linguistic repairs as a mechanism, integrated in sequences of interactive formulation. By analyzing extracts of an interaction between three students according to the method of conversation analysis (CA), linguistic and interactional particulars of these repairs are identified, allowing for a first typology of formulation procedures with embedded repair operation.A second aim is to demonstrate in what way different languages are being used during the formulation process. By doing so, the question of how students draw on their plurilingual resources is discussed. The overall issue is addressed through a theoretical framework of functional language distribution in conversational writing.

Enacting ‘Being with You’

AbstractThe German second person personal pronounduis commonly described as a deictic “shifter” or a T-address term, which is incorporated as an argument of a predicate. Exploring the ways in which participants use pronouns in everyday interaction, however, shows that these are not the only uses ofdu. In this paper, we examine vocative uses ofduin German everyday interaction. Drawing on methods of Conversation Analysis and Interactional Linguistics, we will show that speakers use vocativedufor the management of being ‘with’ the other in terms of alignment as well as affiliation. Whatdulocally accomplishes, however, is sensitive to its positioning within the temporal unfolding of turns and sequences as well as to the sequential environments in which it is used. Our findings demonstrate the context-sensitivity ofduand underscore the importance of linguistic resources for the interactional establishment and maintenance of social togetherness and sociability.

The pervasive relevance of COVID-19 within routine paediatric palliative care consultations during the pandemic: A conversation analytic study

Background: The importance of caring for children with complex and serious conditions means that paediatric palliative care must continue during pandemics. The recent pandemic of Coronavirus Disease 2019 (COVID-19) provides a natural experiment to study health communication during pandemic times. However, it is unknown how communication within consultations might change during pandemics. Aim: This study, a sub-study of a larger project, aimed to examine real-world instances of communication in paediatric palliative care consultations prior to and during the COVID-19 pandemic to understand how clinicians and families talk about the pandemic. Design: Paediatric palliative care consultations prior to, during, and immediately following the initial peak of COVID-19 cases in Australia were video recorded and analysed using Conversation Analysis methods. Setting/participants: Twenty-five paediatric palliative care consultations (including face-to-face outpatient, telehealth outpatient and inpatient consultations) were video recorded within a public children’s hospital in Australia. Participants included 14 health professionals, 15 child patients, 23 adult family members and 5 child siblings. Results: There was a pervasive relevance of both serious and non-serious talk about COVID-19 within the consultations recorded during the pandemic. Topics typical of a standard paediatric palliative care consultation often led to discussion of the pandemic. Clinicians (55%) and parents (45%) initiated talk about the pandemic. Conclusions: Clinicians should not be surprised by the pervasiveness of COVID-19 or other pandemic talk within standard paediatric palliative care consultations. This awareness will enable clinicians to flexibly address family needs and concerns about pandemic-related matters that may impact health and wellbeing.

Pain talk in hospice care: a conversation analysis

BackgroundA large number of the hospice patients have been reported to be with symptoms of pain. Thus, managing the patient’s pain is one aspect of hospice care provision. The delivery of pain care services could be facilitated through effective communication. However, little has been done to explore the interactional details of the delivery of pain care services in palliative care.MethodsConversation analysis is a useful method to explore the interactional details of interaction by hospice care providers and terminally ill patients. Using the method of Conversation Analysis (CA), this study aims to demonstrate how the hospice care provider employs different types of interactional practices to address the patient’s pain concerns. The data showed in this study are collected from the Alexander St website http://ctiv.alexanderstreet.com, an educational resource presenting a large collection of psycho-therapeutic videos.ResultsIn this study, an illustrative analysis is demonstrated to show the potential of conversation analysis for research on pain talk in palliative care. It has been shown that conversation analysis could contribute to unfolding the interactional details regarding “pain talk” in hospice care settings. Specifically, conversation analysis could provide a detailed description and interpretation of the conversational practices, which are used to construct hospice care provider participation in delivering pain talk. In addition, conversation analysis could also demonstrate the interactional resources by which patients disclose their experiences of physical or spiritual pain to the hospice care provider and the way how the hospice care provider responds to the patient’s troubles talk or feelings talk.ConclusionsThis study identifies five types of interactional resources which are used to deal with the patient’s pain concerns in hospice care setting. A conversation analytical study of pain talk in hospice care could provide a turn-by-turn description of how the hospice care provider communicates with the terminally ill patient in terms of the patient’s pain concerns. The findings in this study could inform how the hospice care provider initiates, delivers and develops a pain talk with the terminally ill patient effectively.

Presenting treatment options in breast cancer consultations: Advice and consent in Italian medical care.

Variety, complexity and uncertainty in the therapy outcomes of cancer illness make the treatment recommendation (TR) in oncology a "monumentally difficult task". Previous studies have distinguished unilateral and bilateral formats of treatment recommendations, accordingly to whether, or to what extent, the patient's perspective is included in the consideration of therapeutic options. Others have also shown how the oncologists' presentation of therapeutic options varied accordingly to the severity of the diagnosis and the availability of alternatives. Yet, no study has systemically dentified and compared components of treatment recommendation in oncology on a common set of patients and clinicians. This paper analyzes how different options in breast cancer treatments - radiotherapy, hormone therapy and chemotherapy - are presented and discussed in a set of 12 first post-surgical breast cancer visits carried out by two oncologists of high experience and seniority in two Italian hospitals. Treatment recommendation sequences involving these three option types were analyzed using the methods of conversation analysis. They were also coded for the mention of side effects and treatment burden, and for whether consent to the recommendation was invited, or expressed by the patient. Results show that radiotherapy is presented as presupposed as an extension of surgery and is not further discussed, and hormone therapy is delivered as good news and as not implying any health or lifestyle burdens. Treatment burdens were raised in the much more extensive discussions of chemotherapy, which were also accompanied by a higher chance that the patient was asked for consent to therapy. Implications are drawn as regards the extent to which clinical practice meets theory in communication protocols available in oncology, and how to consider the doctor-patient partnership and the concept of shared decision-making in such an encounter.

When people living with dementia say 'no': Negotiating refusal in the acute hospital setting.

A quarter of UK acute hospital beds are occupied by people living with dementia (PLWD). Concerns have been raised by both policy makers and carers about the quality of communication between hospital staff and PLWD. PLWD may experience communication impairments such as word finding difficulties, limited ability to construct coherent narratives and difficulties understanding others. Since much healthcare delivery occurs through talk, healthcare professionals (HCPs) and PLWD are likely to experience increased communication barriers. Consistent with this, HCPs report stress and reduced job satisfaction associated with difficulty communicating with PLWD. HCPs face these challenges whilst striving to deliver person-centred care, respecting the autonomy and wishes of the patient before them. However, best practice recommendations in the field tend not to be based on actual interactional evidence. This paper investigates recurring interactional difficulties around HCP requests to carry out health and social care tasks and subsequent reluctance or refusal on the part of PLWD. Using conversation analysis, we examined 41 video recordings of HCP/PLWD interactions collected across three acute inpatient wards. We identify both the nature of the refusals, and any mitigation offered, and explore the requests preceding them in terms of entitlement and contingency. We also explore the nature of HCP requests which precede PLWD agreement with a course of action. We conclude that several features of requests can be seen to precede acceptance, principally the use of higher entitlement requests, and the lowering of contingencies. Our findings underline the importance of examining the contextual interactional detail involved in the negotiation of healthcare, which here leads to an understanding of how design of HCP requests can impact on an important healthcare activity being carried out. They also emphasise the power of conversation analytic methods to identify areas of frequent interactional trouble in dementia care which have not previously been articulated.

Traveling through spatial repertoires and mathematics: chronotopes of physics discourse and instructional practices

ABSTRACT This paper examines the chronotopic nature of physics discourse and instructional practices that are mediated through the integration of disciplinary spatial repertoires and mathematical symbolic systems. The paper addresses how meanings are constructed during instruction between bilingual international teaching assistants (ITAs) and undergraduate physics students through the chronotopic (re)contextualization of prior physics reasoning and future applications in present discussions about a physics event. Instructional activities mediated by spatial repertoires and mathematical symbolic systems between ITAs and undergraduates were video recorded. Data were analyzed using a joint method of multimodal conversation analysis and the Bakhtinian concept of chronotope. Findings illustrate that the simultaneous chronotopes of physics discursive practices engaged student participation in ITA-led activities and maintained the sequential chronotopes in instructional practices, demonstrating joint attention between ITAs and undergraduates as co-contributors to meaning making. The chronotopic link creates a dialogic space in which multidiscursive practices of knowledge construction can be achieved through an integration of disciplinary spatial repertoires and mathematical symbolism and images. The present study suggests a spatial repertoire-informed chronotopic turn in analyzing the dynamic multiplicity of physics instructional practices by ITAs in academic contexts.