L’emergere e la costruzione delle identità nell’interazione medico-paziente in contesti multiculturali

Journal title SALUTE E SOCIETÀ
Author/s Franca Orletti
Publishing Year 2013 Issue 2013/1 Language Italian
Pages 15 P. 61-75 File size 119 KB
DOI 10.3280/SES2013-001006
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With few exceptions conversational studies have mostly focused on interactions between doctors and native patients. This paper addresses the construction of non-native identity in interactions between a gynecologist and immigrant patients in a public hospital in Italy. Particularly, the paper addresses the question whether the specific structure of the medical interaction involving a non-native patient makes not only institutional identities (patient/doctor) but also language and cultural identities relevant for the members. Data include a corpus of 12 audiorecorded interactions between a gynecologist and a patient, each 6 of them involving, respectively, a native and a non-native patient. Analyses show that pragmatic, linguistic choices index the identity of the patient as an interactant "of a special kind", by making relevant certain aspects related to her ethnic identity.

Keywords: Social construction of identity, membership categorization device, Conversation Analysis, gynecologist-patient interaction, conversational asymmetry, formulations

  1. Gavioli L., a cura di (2009). La mediazione linguistico-culturale: una prospettiva interazionista. Perugia: Guerra
  2. Garfinkel H., Sacks H. (1970) On formal structures of practical action. In: McKinney J.C. and Tiryakian E.A., editors, Theoretical Sociology. New York: Appleton- Century-Crofts, 338-366
  3. Giglioli P.P., Cavicchioli S., Fele G. (1997). Rituali di degradazione. Anatomia del processo Cusani. Bologna: Il Mulino
  4. Gill Teas V. (1998). Doing attributions in medical interaction: patients’ explanations for illness and doctors’ responses. Social Psychology Quarterly, 61: 322-360
  5. Gill Teas V., Maynard D.W. (1995). On ‘labeling’ in actual interaction: Delivering and receiving diagnoses of developmental disabilities. Social Problems, 42: 11-37
  6. Gill Teas V., Maynard D.W. (2006). Explaining illness: patients’ proposals and physicians’ responses. In: Heritage J., Maynard D.W., editors, Communication in Medical Care: Interaction Between Primary Care Physicians and Patients. Cambridge: Cambridge University Press, 115-50
  7. Goffman E. (1981). Forms of talk. Philadelphia: University of Pennsylvania (trad. it. Orletti F., a cura di, Le forme del parlare. Bologna: Il Mulino, 1987)
  8. Heath C. (1992). Diagnosis and assessment in the medical consultation. In: Drew P., Heritage J., editors, Talk at work: interaction in institutional settings. Cambridge: Cambridge University Press, 235-67
  9. Heritage J. (2004). Conversation analysis and institutional talk: analysing data. In: Silverman D., editor, Qualitative research: theory, method and practice. 2nd edition. Thousand Oaks, CA: Sage, 222-245
  10. Heritage J. (2010). Questioning in Medicine. In: Freed A., Ehrlich S., editors, “Why Do You Ask?”: The Function of Questions in Institutional Discourse. New York: Oxford University Press, 42-68
  11. Heritage J., Maynard D.W. (2006a). Problems and Prospects in the Study of Physician- Patient Interaction: Thirty Years of Research. Annual Review of Sociology, 32: 351-74
  12. Heritage J., Maynard D.W., editors (2006b). Communication in medical care: Interaction between primary care physicians and patients. Cambridge: Cambridge University Press
  13. Heritage J., Watson R. (1980). Aspects of the Properties of Formulations. Semiotica, 30: 245-262
  14. Linell P., Adelswärd V., Bredmar M., Lindstedt U. and Sachs L. (2002). Expert talk in medical contexts: Explicit and implicit orientations to risks. Research on Language and Social Interaction, 35: 195-218
  15. McCarthy M. (2000). Mutually captive audiences: small talk and the genre of close-contact service encounters. In Coupland J., editor, Small talk. London: Longman, 84-109
  16. McKenzie P. (2010). Informing relationships: small talk, informing and relationship building in midwife-woman interaction. IR Information research 15, 1
  17. Mishler E.G. (1984). The discourse of medicine: dialectics of medical interviews. Norwood: Ablex Publishing
  18. Montanari M. (2006). Il cibo come cultura. Bari: Laterza
  19. Mori J. (2007). Reconstructing the participants’ treatment of “interculturality”: Variations in data methodologies. Pragmatics, 17, 1: 123-141
  20. Nishizaka A. (1995). The interactive constitution of interculturality: How to be a Japanese with words. Human studies, 18: 301-326
  21. Orletti F. (1993). Pratiche di glossa. In: Orletti F., a cura di, Comunicare nella vita quotidiana. Bologna: Il Mulino, 77-103
  22. Orletti F. (2000). La conversazione diseguale. Roma: Carocci
  23. Sacks H., Garfinkel H. (1970). On formal structures of practical action. In: McKinney J.C., Tiryakian, E.A., editors, Theoretical Sociology. New York: Appleton- Century-Crofts, 338-366
  24. Sacks H., Schegloff E.A., Jefferson G. (1974). A simplest systematics for the organization of turn-taking for conversation. Language, 50: 696-735
  25. Sarangi S. (2001). On demarcating the space between `lay expertise’ and `expert laity’. Text 21, 1-2: 3-12
  26. Schegloff E.A. (1991). Reflections on talk and social structure. In Boden D., Zimmerman D., editors, Talk and Social Structure. Cambridge: Polity Press, 44-70
  27. Schegloff E.A. (1992). In another context. In: Duranti A., Goodwin C. editors, Rethinking context. Language as an interactive phenomenon, Cambridge, 191- 228
  28. Stivers T. (2005a). Non-antibiotic treatment recommendations:delivery formats and implications for parent resistance. Social Science and Medicine, 60: 949- 64
  29. Stivers T. (2005b). Parent resistance to physicians’ treatment recommendations: one resource for initiating a negotiation of the treatment decision. Health Communication, 18, 1: 41-74
  30. Stivers T., Majid A. (2007). Questioning children: Interactional evidence of implicit bias in medical interviews. Social Psychology Quarterly, 70, 4: 424-441
  31. ten Have P. (1991). Talk and institution: a reconsideration of the ‘asymmetry’ of doctor-patient interaction. In: Boden D., Zimmerman D., editors, Talk and social structure: studies in ethnomethodology and conversation analysis. Cambridge: Polity Press, 138-63
  32. van Dijk T. (2000). Ideologies, racism, discourse: Debates on immigration and ethnic issues. In: Wal ter J., Verkuyten M., editors, Comparative perspectives on racism. Aldershot: Ashgate, 91-116
  33. Zimmerman E. (2007). Constructing Korean and Japanese interculturality in talk: Ethnic membership categorization among users of Japanese. Pragmatics, 17, 1: 71-94
  34. Sacks H. (1992). Lectures on Conversation. Volumes I and II. Edited by G. Jefferson with Introduction by E.A. Schegloff. Oxford: Blackwell
  35. Sacks H. (1972). An initial investigation of the usability of conversational data for doing sociology. In: Sudnow D., editor, Studies in social interaction. New York: Free Press, 31-74
  36. Robinson J.D. (2003). An interactional structure of medical activities during acute visits and its implications for patients’ participation. Health Communication, 15: 27-59
  37. Ragan S.L. (2000). Sociable talk in women’s health care contexts: two forms of non-medical talk. In: Coupland J., editor, Small talk. London: Longman, 269-287
  38. Radley A. (1994). Making sense of illness: the social psychology of health and disease. London: Sage Publications
  39. Psathas G. (1999). Studying the organization in action: Membership categorization and interaction analysis. Human Studies, 22, 2-4: 139-162
  40. Pilnick A., Hindmarsh J., Gill Teas V. (2009). Beyond ‘doctor and patient’ developments in the study of healthcare interactions. Sociology of Health and Illness, 31, 6: 787-802
  41. Perakyla A. (2002). Agency and authority: extended responses to diagnostic statements in primary care encounters. Research on Language and Social Interaction, 35, 2: 219-47
  42. Perakyla A. (1998). Authority and accountability: the delivery of diagnosis in primary health care. Social Psychology Quarterly, 61, 4: 301-20
  43. Parsons T. (1951). The Social System. New York: Free Press
  44. Orletti F., Fatigante M. (2010). Constructing institutional identities at the thresholds of different cultural contexts: analyses of medical interactions with nonnative patients. Paper presented at the International Meeting New Challenges for Multilingualism in Europe, Dubrovnik 11-15 aprile 2010
  45. Orletti F. (2010). Formulating identities in multicultural therapeutic contexts. Invited lecture at the International Workshop “Formulation and Epistemic Authority”, Modena, 9-10 settembre 2010
  46. Fukuda C. (2006). Resistance against being formulated as cultural other: The case of a Chinese student in Japan. Pragmatics, 16, 4: 429-456
  47. Fisher S., Todd A., editors (1993). The social organization of Doctor-Patient Communication. Norwood: Ablex Publishing
  48. Fele G. (2009). Glosse e formulazioni. In: Fatigante M., Mariottini L., Sciubba M.E., a cura di, Lingua e Società. Scritti in onore di Franca Orletti. Milano: Franco Angeli editore, 49-59
  49. Fele G. (1997). Strategie discorsive e forme della degradazione pubblica in tribunale, In: Giglioli P.P., Cavicchioli S., Fele G., Rituali di degradazione. Anatomia del processo Cusani. Bologna: Il Mulino
  50. Fatigante M., Orletti F. (in stampa). Laughter and smiling in a three-party medical encounter: negotiating participants’ alignment in delicate moments of the interaction. In: Glenn P. and Holt E., editors, On Laughing: Studies of Laughter in Interactioni. Continuum Press
  51. Drew P., Heritage J., editors (1992). Talk at work: interaction in institutional settings. Cambridge: Cambridge University Press
  52. Drew P. (2003). Comparative analysis of talk-in-interaction in different institutional settings: a sketch. In: Glenn P., LeBaron C.D. and Mandelbaum J., editors, Studies in Language and Social Interaction. In honour of Robert Hopper. Mahwah, New Jersey: Lawrence Erlbaum, 293-308
  53. Day D. (1998). Being ascribed, and resisting, membership of an ethnic group. In: Antaki C. and Widdicombe S., editors, Identities in talk. London: Sage, 151-170
  54. Coupland J. (2000). Small Talk. London: Longman
  55. Bersani Berselli G. (2009). Selezione lessicale e mediazione orale in consultazioni mediche presso ospedali pubblici, in: La mediazione linguistica e culturale: una prospettiva interazionista, Perugia: Guerra Edizioni, 151-170
  56. Baraldi C., Gavioli L. (questo volume). La mediazione nell’interazione centrata sul paziente: il caso delle domande del medico
  57. Antaki C., Widdicombe, S., editors (1998). Identities in Talk. London: Sage

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Franca Orletti, L’emergere e la costruzione delle identità nell’interazione medico-paziente in contesti multiculturali in "SALUTE E SOCIETÀ" 1/2013, pp 61-75, DOI: 10.3280/SES2013-001006