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postgraduate thesis: Risk communication in prenatal screening for Down syndrome: a discourse analytic study of patients'risk talk

TitleRisk communication in prenatal screening for Down syndrome: a discourse analytic study of patients'risk talk
Authors
Advisors
Advisor(s):Zayts, OA
Issue Date2012
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
Abstract
Risk is a crucial concept in healthcare communication. This is attested to by a large body of research on risk communication in psychology, sociology, and, more recently, discourse analysis. This previous research has primarily focused on how healthcare providers manage risk talk, whereas patients’ risk talk has received little attention. Where it has been researched, it has been presented in an oversimplified way, namely that the patients have been reported to perceive their risk in a simplified, ‘all-or-nothing manner’. Using theme-oriented discourse analysis (Roberts and Sarangi, 2005), this study challenges this simplified perception by examining patients’ risk talk in prenatal screening for Down syndrome. The data for this study comprises 14 video-recorded consultations collected in one prenatal hospital in Hong Kong. The particular focus of the study is on patients who have received a ‘positive’ result from the initial screening for Down syndrome that has put them in a high-risk group by increasing their probability of having a baby with Down syndrome. In these consultations patients are informed about further testing to confirm the diagnosis. To examine the patients’ risk talk, the transcripts of the interactions have been coded along the lines of structural, thematic and interactional maps (Roberts and Sarangi, 2005) to note down risk talk by patients, what is it concerned with and the interactional dynamics of how it is managed. The analysis suggests that patients’ risk talk concerns three types of risks, namely the “risk of occurrence” (that is the probability of having a child with Down Syndrome) the “risk of knowing” (that is dealing with the knowledge about having a child with Down Syndrome) and what has been referred to in this study as the “risk of not knowing” (that is not finding out about the condition due to the uncertainty surrounding the tests). In contrast to the findings in the previous studies, the patients in the data actively initiate risk talk by raising clarification questions and talking about their concerns. The analysis has revealed the differences in how different types of risk talk are constructed by the patients. These differences are discussed in regards to the phases of the consultation in which risk talk occurs and whether risk talk is aimed at eliciting further information or making a decision about pursuing further testing. The analysis has also noted that risk communication is a joint activity involving the patients and the healthcare providers. In addressing patients’ risk talk the healthcare providers in the data take on an indirect approach, thereby avoiding influencing the patients’ decision-making and managing the uncertainty surrounding prenatal screening. The analysis has also pointed out that the patients’ socioeconomic and cultural backgrounds have a crucial impact on how risk talk is constructed by the patients.
DegreeMaster of Philosophy
SubjectDown syndrome.
Prenatal diagnosis.
Discourse analysis.
Dept/ProgramLinguistics

 

DC FieldValueLanguage
dc.contributor.advisorZayts, OA-
dc.contributor.authorYau, Hoi-ying, Alice.-
dc.contributor.author邱凱盈.-
dc.date.issued2012-
dc.description.abstractRisk is a crucial concept in healthcare communication. This is attested to by a large body of research on risk communication in psychology, sociology, and, more recently, discourse analysis. This previous research has primarily focused on how healthcare providers manage risk talk, whereas patients’ risk talk has received little attention. Where it has been researched, it has been presented in an oversimplified way, namely that the patients have been reported to perceive their risk in a simplified, ‘all-or-nothing manner’. Using theme-oriented discourse analysis (Roberts and Sarangi, 2005), this study challenges this simplified perception by examining patients’ risk talk in prenatal screening for Down syndrome. The data for this study comprises 14 video-recorded consultations collected in one prenatal hospital in Hong Kong. The particular focus of the study is on patients who have received a ‘positive’ result from the initial screening for Down syndrome that has put them in a high-risk group by increasing their probability of having a baby with Down syndrome. In these consultations patients are informed about further testing to confirm the diagnosis. To examine the patients’ risk talk, the transcripts of the interactions have been coded along the lines of structural, thematic and interactional maps (Roberts and Sarangi, 2005) to note down risk talk by patients, what is it concerned with and the interactional dynamics of how it is managed. The analysis suggests that patients’ risk talk concerns three types of risks, namely the “risk of occurrence” (that is the probability of having a child with Down Syndrome) the “risk of knowing” (that is dealing with the knowledge about having a child with Down Syndrome) and what has been referred to in this study as the “risk of not knowing” (that is not finding out about the condition due to the uncertainty surrounding the tests). In contrast to the findings in the previous studies, the patients in the data actively initiate risk talk by raising clarification questions and talking about their concerns. The analysis has revealed the differences in how different types of risk talk are constructed by the patients. These differences are discussed in regards to the phases of the consultation in which risk talk occurs and whether risk talk is aimed at eliciting further information or making a decision about pursuing further testing. The analysis has also noted that risk communication is a joint activity involving the patients and the healthcare providers. In addressing patients’ risk talk the healthcare providers in the data take on an indirect approach, thereby avoiding influencing the patients’ decision-making and managing the uncertainty surrounding prenatal screening. The analysis has also pointed out that the patients’ socioeconomic and cultural backgrounds have a crucial impact on how risk talk is constructed by the patients.-
dc.languageeng-
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)-
dc.relation.ispartofHKU Theses Online (HKUTO)-
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.source.urihttp://hub.hku.hk/bib/B48079790-
dc.subject.lcshDown syndrome.-
dc.subject.lcshPrenatal diagnosis.-
dc.subject.lcshDiscourse analysis.-
dc.titleRisk communication in prenatal screening for Down syndrome: a discourse analytic study of patients'risk talk-
dc.typePG_Thesis-
dc.identifier.hkulb4807979-
dc.description.thesisnameMaster of Philosophy-
dc.description.thesislevelmaster's-
dc.description.thesisdisciplineLinguistics-
dc.description.naturepublished_or_final_version-
dc.date.hkucongregation2012-

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