Item Details

Escalating the positive in antenatal consultations: Midwife support in (inter)action

Issue: Vol 14 No. 3 (2017)

Journal: Communication & Medicine

Subject Areas: Healthcare Communication Linguistics

DOI: 10.1558/cam.36356

Abstract:

This article investigates the practical accomplishment of support in midwife-led antenatal interactions. Drawing on 16 transcribed antenatal consultations from Australia, and utilizing principles of conversation analysis, we investigate a range of interactional practices that midwives use to support expectant mothers and create a positive interactional environment during the consultations. The interactional practices examined include positive assessments, compliments, enhanced agreements, extended back-channels, good wishing, humor and joking, and brightside formulations. Through these turns, the midwife works to create with the woman a shared positive stance towards the upcoming birth by encouraging her, endorsing her decisions, treating the woman’s progression through pregnancy as an achievement, and selectively focusing on the positive side of situations. As such, the research contributes to understanding the practical management of support, a concept which underpins many health and care professions.

Author: Eleni Petraki, Shannon Clark

View Original Web Page

References :

Albrecht, T. L. and Goldsmith, D. J. (2003) Social support, social networks, and health. In T. L. Thompson, A. Dorsey, K. I. Miller and R. Parrott (eds) Handbook of Health Communication, 263–284: Hillsdale, NJ: Lawrence Erlbaum.

Antaki, C. (2002) ‘Lovely’: Turn-initial high-grade assessments in telephone closings. Discourse Studies 4 (5): 5–23. https://doi.org/10.1177/14614456020040010101

Antaki, C. (2008) Formulations in psychotherapy. In A. Peräklyä, C. Antaki, S. Vehviläinen and I. Leudar (eds) Conversation Analysis and Psychotherapy, 26–42. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511490002.003

Antaki, C., Houtkoop-Steenstra, H. and Rapley, M. (2000) ‘Brilliant. Next question…’: High-grade assessment sequences in the completion of interactional units. Research on Language & Social Interaction 33 (3): 235–262. https://doi.org/10.1207/S15327973RLSI3303_1

Australian Health Ministers’ Advisory Council (2012) Clinical Practice Guidelines: Antenatal Care – Module 1. Canberra: Australian Government Department of Health and Ageing.

Barrera, M. and Ainlay, S. L. (1983) The structure of social support: A conceptual and empirical analysis. Journal of Community Psychology 11 (2): 133–143. https://doi.org/10.1002/1520-6629(198304)11:2<133::AID-JCOP2290110207>3.0.CO;
2-L

Beach, W. A. (2003) Managing optimism. In P. Glenn, C. LeBaron and J. Mandelbaum (eds) Studies in Language and Interaction, 175–194. Mahwah, NJ: Lawrence Erlbaum.

Beck, C. T. (1997) Humor in nursing practice: A phenomenological study. International Journal of Nursing Studies 34 (5): 346–352. https://doi.org/10.1016/S0020-7489(97)00026-6

Botschner, J. V. (2000) Doing Not Providing: A Discourse-Analytic Investigation of Social Support as a Responsive Process. Unpublished doctoral dissertation, University of Guelph, Canada.

Browne, J., O’Brien, M., Taylor, J., Bowman, R. and Davis, D. (2014) ‘You’ve got it within you’: The political act of keeping a wellness focus in the antenatal time. Midwifery 30 (4): 420–426. https://doi.org/10.1016/j.midw.2013.04.003

Burleson, B. R., Albrecht, T. L. and Sarason, I. G. (1994) Communication of Social Support. Thousand Oaks, CA: Sage.

Clark, S. J. and Hudak, P. L. (2011) When surgeons advise against surgery. Research on Language & Social Interaction 44 (4): 385–412. https://doi.org/10.1080/08351813.2011.619313

Coates, J. (2007) Talk in a play frame: More on laughter and intimacy. Journal of Pragmatics 39 (1): 29–49. https://doi.org/10.1016/j.pragma.2006.05.003

Drew, P., Chatwin, J. and Collins, S. (2001) Conversation analysis: A method for research into interactions between patients and health-care professionals. Health Expectations 4 (1): 58–70. https://doi.org/10.1046/j.1369-6513.2001.00125.x

Drew, P. and Heritage, J. (1992) Analyzing talk at work: An introduction. In P. Drew and J. Heritage (eds) Talk at Work: Interaction in Institutional Settings, 3–65. Cambridge: Cambridge University Press.

Gardner, R. (2001) When Listeners Talk. Amsterdam: John Benjamins. https://doi.org/10.1075/pbns.92

Goldberg, A. B., Fillmore, N., Andrzejewski, D., Xu, Z., Gibson, B. and Zhu, X. (2009) May all your wishes come true: A study of wishes and how to recognize them. Paper presented at the the 2009 Annual Conference of the North American Chapter of the Association for Computational Linguistics, Boulder, Colorado, 31 May–5 June. https://doi.org/10.3115/1620754.1620793

Hepburn, A. and Potter, J. (2007) Crying receipts: Time, empathy and institutional practice. Research on Language and Social Interaction 40 (1): 89–116. https://doi.org/10.1080/08351810701331299

Heritage, J. (2011) Territories of knowledge, territories of experience: Empathic moments in interaction. In T. Stivers, L. Mondada and J. Steensig (eds) The Morality of Knowledge in Conversation, 159–183. Cambridge: Cambridge University Press.

Heritage, J. (2015) Well-prefaced turns in English conversation: A conversation analytic perspective. Journal of Pragmatics 88: 88–104. https://doi.org/10.1016/j.pragma.2015.08.008

Heritage, J. and Maynard, D. W. (eds) (2006a) Communication in Medical Care: Interaction between Primary Care Physicians and Patients. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511607172

Heritage, J. and Maynard, D. W. (2006b) Introduction: Analyzing interaction between doctors and patients in primary care encounters. In J. Heritage and D. W. Maynard (eds) Communication in Medical Care: Interaction between Primary Care Physicians and Patients, 1–21. Cambridge: Cambridge University Press.

Heritage, J., Robinson, J. D., Elliot, M. N., Beckett, M. and Wilkes, M. (2007) Reducing patients’ unmet concerns in primary care: The difference one word can make. Journal of General Internal Medicine 22 (10): 1429–1433. https://doi.org/10.1007/s11606-007-0279-0

Heritage, J. and Sefi, S. (1992) Dilemmas of advice: Aspects of the delivery and reception of advice in interactions between health visitors and first-time mothers. In J. Heritage and P. Drew (eds) Talk at Work: Interaction in Institutional Settings, 359–417. Cambridge: Cambridge University Press.

Heritage, J. and Watson, D. R. (1979) Formulations as conversational objects. In G. Psathas (ed.) Everyday Language: Studies in Ethnomethodology, 123–162. New York: Irvington.

Holmes, J. (1986) Compliments and compliment responses in New Zealand English. Anthropological Linguistics 28 (4): 485–508.

Holt, E. (1993) The structure of death announcements: Looking on the bright side of death. Text 13 (2): 189–212. https://doi.org/10.1515/text.1.1993.13.2.189

Hutchby, I. (2005) ‘Active listening’: Formulations and the elicitation of feelings-talk in child counselling. Research on Language and Social Interaction 38 (3): 303–329. https://doi.org/10.1207/s15327973rlsi3803_4

Jefferson, G. (1984) On the organization of laughter in talk about troubles. In J. M. Atkinson and J. Heritage (eds) Structures in Social Action: Studies in Conversation Analysis, 346–369. Cambridge: Cambridge University Press.

Jefferson, G. (2004) Glossary of transcript symbols with an introduction. In G. H. Lerner (ed.) Conversation Analysis: Studies from the First Generation, 13–31. Amsterdam: John Benjamins. https://doi.org/10.1075/pbns.125.02jef

Jones, C. M. (1997) ‘That’s a good sign’: Encouraging assessments as a form of social support in medically related encounters. Health Communication 9 (2): 119–153. https://doi.org/10.1207/s15327027hc0902_2

Jones, C. M. (2001) Missing assessments: Lay and professional orientations in medical interviews. Text 21 (1–2): 113–150. https://doi.org/10.1515/text.1.21.1-2.113

Kang, M. A. and Zayts, O. A. (2013) Interactional difficulties as a resource for patient participation in prenatal screening consultations in Hong Kong. Patient Education and Counseling 92 (1): 38–44. https://doi.org/10.1016/j.pec.2013.01.008

Kawashima, M. (2010) Giving instruction on self-care during midwifery consultations in Japan. Journal of Asian Pacific Communication 20 (2): 207–225. https://doi.org/10.1075/japc.20.2.03kaw

Kitzinger, C. and Kitzinger, S. (2007) Birth trauma: Talking with women and the value of conversation analysis. British Journal of Midwifery 15 (5): 256–264. https://doi.org/10.12968/bjom.2007.15.5.23397

Kuroshima, S. and Iwata, N. (2016) On displaying empathy: Dilemma, category, and experience. Research on Language and Social Interaction 49 (2): 92–110. https://doi.org/10.1080/08351813.2016.1164395

Lappen, J. R. and Gossett, D. R. (2010) Changes in episiotomy practice: Evidence-based medicine in action. Expert Review of Obstetrics & Gynecology 5 (3): 301–309. https://doi.org/10.1586/eog.10.21

Lee, S.-H. and Tanaka, H. (2016) Affiliation and alignment in responding actions. Journal of Pragmatics 100: 1–7. https://doi.org/10.1016/j.pragma.2016.05.008

Leppänen, V. (1998) The straightforwardness of advice: Advice-giving in interactions between Swedish district nurses and patients. Research on Language and Social Interaction 31 (2): 209–239. https://doi.org/10.1207/s15327973rlsi3102_3

Lindström, A. and Sorjonen, M.-L. (2012) Affiliation in conversation. In J. Sidnell and T. Stivers (eds) The Handbook of Conversation Analysis, 250–369. Chichester, UK: John Wiley & Sons. https://doi.org/10.1002/9781118325001.ch17

Maynard, D. (2003) Bad News, Good News: Conversational Order in Everyday Talk and Clinical Settings. Chicago: University of Chicago Press.

Maynard, D. and Heritage, J. (2005) Conversation analysis, doctor–patient interaction and medical communication. Medical Education 39 (4): 428–435. https://doi.org/10.1111/j.1365-2929.2005.02111.x

McCarthy, M. (2003) Talking back: ‘Small’ interactional response tokens in everyday conversation. Research on Language and Social Interaction 36 (1): 33–63. https://doi.org/10.1207/S15327973RLSI3601_3

McCarthy, M. and Carter, R. (2004) ‘There’s millions of them’: Hyperbole in everyday conversation. Journal of Pragmatics 36 (2): 149–184. https://doi.org/10.1016/S0378-2166(03)00116-4

McKenzie, P. J. and Spoel, P. (2014) Borrowed voices – conversational storytelling in midwifery healthcare visits. Canadian Journal for Studies in Discourse and Writing 25 (1): 26–47.

Nicholls, L., Skirton, H. and Webb, C. (2011) Establishing perceptions of a good midwife: A Delphi study. British Journal of Midwifery 19 (4): 230–236. https://doi.org/10.12968/bjom.2011.19.4.230

Nishizaka, A. (2010) Self-initiated problem presentation in prenatal checkups: Its placement and construction. Research on Language and Social Interaction 43 (3): 283–313. https://doi.org/10.1080/08351813.2010.497992

Nishizaka, A. (2012) Response expansion as a practice for raising a concern during regular prenatal checkups. Communication & Medicine 8 (3): 247–259. https://doi.org/10.1558/cam.v8i3.247

Oxford English Dictionary (2018) ‘Wish, n.1’ OED Online. Oxford: Oxford University Press. Retrieved from http://www.oed.com/view/Entry/229511?rskey=S1WsVh

Peräkylä, A. and Vehviläinen, S. (2003) Conversation analysis and the professional stocks of interactional knowledge. Discourse and Society 14 (6): 727–750. https://doi.org/10.1177/09579265030146003

Petraki, E. and Clark, S. (2016) Affiliating through agreements: The context of antenatal consultations. Australian Journal of Linguistics 36 (2): 273–289. https://doi.org/10.1080/07268602.2015.1121535

Pilnick, A. and Zayts, O. (2014) ‘It’s just a likelihood’: Uncertainty as topic and resource in conveying ‘positive’ results in an antenatal screening clinic. Symbolic Interaction 37 (2): 187–208. https://doi.org/10.1002/symb.99

Pilnick, A. and Zayts, O. (2015) Advice, authority and autonomy in shared decision-making in antenatal screening: The importance of context. Sociology of Health & Illness 38 (3): 343–359. https://doi.org/10.1111/1467-9566.12346

Pomerantz, A. (1984) Agreeing and disagreeing with assessments: Some features of preferred/dispreferred turn shapes. In J. M. Atkinson and J. Heritage (eds) Structures of Social Interaction: Studies in Conversation Analysis, 57–101. Cambridge: Cambridge University Press.

Pomerantz, A. (1986) Extreme case formulations: A way of legitimizing claims. Human Studies 9 (2–3): 219–229. https://doi.org/10.1007/BF00148128

Psathas, G. (1995) Conversation Analysis. Thousand Oaks, CA: Sage. https://doi.org/10.4135/9781412983792

Pudlinski, C. (2005) Doing empathy and sympathy: Caring responses to troubles telling on a peer support line. Discourse Studies 7 (3): 267–288. https://doi.org/10.1177/1461445605052177

Pudlinski, C. (2008) Encouraging responses to good news on a peer support line. Discourse Studies 10 (6): 795–812. https://doi.org/10.1177/1461445608098203

Risa, C. F., Lidén, E. and Friberg, F. (2011) Communication patterns in antenatal diabetes care: An explorative and descriptive study of midwife-led consultations. Journal of Clinical Nursing 20 (13–14): 2053–2063. https://doi.org/10.1111/j.1365-2702.2010.03552.x

Robinson, J. D. and Heritage, J. (2015) How patients understand physicians’ solicitations of additional concerns: Implications for up-front agenda setting in primary care. Health Communication 31 (4): 434–444. https://doi.org/10.1080/10410236.2014.960060

Ruusuvuori, J. (2005) ‘Empathy’ and ‘sympathy’ in action: Attending to patient’s troubles in Finnish homeopathic and general practice consultations. Social Psychology Quarterly 68 (3): 204–222. https://doi.org/10.1177/019027250506800302

Ruusuvuori, J. (2007) Managing affect: Integration of empathy and problem-solving in health care encounters. Discourse Studies 9 (5): 597–622. https://doi.org/10.1177/1461445607081269

Sacks, H. (1984) Notes on methodology. In J. H. Atkinson (ed.) Structures in Social Action: Studies in Conversation Analysis, 21–27. Cambridge: Cambridge University Press.

Sacks, H. (1987) On the preferences for agreement and contiguity in sequences in conversation. In G. Button and J. R. E. Lee (eds) Talk and Social Organisation, 54–69. Clevedon, UK: Multilingual Matters.

Sacks, H., Schegloff, E. A. and Jefferson, G. (1974) A simplest systematics for the organization of turn-taking for conversation. Language 50 (4): 696–735. https://doi.org/10.1353/lan.1974.0010

Schryer, C. F. and Spoel, P. (2005) Genre theory, health-care discourse, and professional identity formation. Journal of Business and Technical Communication 19 (3): 249–278. https://doi.org/10.1177/1050651905275625

Shaw, R. and Kitzinger, C. (2012) Compliments on a home birth helpline. Research on Language and Social Interaction 45 (3): 213–244. https://doi.org/10.1080/08351813.2012.699251

Silverman, D. (1984) Going private: Ceremonial forms in a private oncology clinic. Sociology 18 (2): 191–204. https://doi.org/10.1177/0038038584018002003

Silverman, D. (1997) Discourses of Counselling: HIV Counselling as Social Interaction. London: Sage.

Silverman, D. (2011) Interpreting Qualitative Research. 4th edn. London: Sage.

Stivers, T. (2008) Stance, alignment, and affiliation during storytelling: When nodding is a token of affiliation. Research on Language and Social Interaction 41 (1): 31–57. https://doi.org/10.1080/08351810701691123

Strong, P. M. (1979) The Ceremonial Order of the Clinic. London and New York: Routledge.

ten Have, P. (1990) Methodological issues in conversation analysis. Bulletin de Méthodologie Sociologique 27: 23–51. https://doi.org/10.1177/075910639002700102

Vernon, B. (2011) The right to a midwife. Health Issues 105: 35–38.

Wall, M. D., Amendt, J. H., Kleckner, T. and Bryant, R. D. (1989) Therapeutic compliments: Setting the stage for successful therapy. Journal of Marital and Family Therapy 15 (2): 159–167. https://doi.org/10.1111/j.1752-0606.1989.tb00795.x

World Health Organization (2015) Nutrition: Feto-maternal nutrition and low birth weight. Retrieved from http://www.who.int/nutrition/topics/feto_maternal/en/

Zayts, O. and Schnurr, S. (2013) ‘[She] said: ‘take the test’ and I took the test’. Relational work as a framework to approach directiveness in prenatal screening of Chinese clients in Hong Kong. Journal of Politeness Research 9 (2): 187–210. https://doi.org/10.1515/pr-2013-0009