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The paper explored the extent to which hospital appointed official root cause analysis (RCA) panels consider antecedent and proximal events when they investigate communication related sentinel events (CRSEs) in hospitals. It also explored which CRSEs are most common in the hospital setting in Hong Kong and the communication modes most commonly associated with CRSEs. The data consisted of Risk Alert and Annual Report on SEs issued by the Hong Kong Hospital Authority from October 2007 to September 2017. Over the period studied, there were 379 reported sentinel events (SEs). In 186 of these SEs we identified communication as a contributing factor. We examined the RCA panels' reports on contributing factors and subsequent recommendations in these 186 SEs and found that their recommendations only highlighted the proximal contributing factors and not antecedent factors that may be relevant. RCA panels most often recommended that communication should be enhanced or documentation improved. We propose that it is time to review the RCA process to recognize that many CRSEs may occur because of antecedent factors that result from the complex hospital organizational structure and its associated hierarchical culture. We suggest two ways forward, 1) applying a language and social psychology perspective to the investigations of CRSEs and, 2) the involvement of experts from different disciplines who can work with clinicians during RCA investigations. [ABSTRACT FROM AUTHOR]

Patient satisfaction is important to patient outcomes. Previous attempts to conceptualize satisfaction have often taken an atheoretical approach and focused on doctors' communication skills. Patients are becoming more active health consumers involved in their health care and current definitions of patient satisfaction may not accurately reflect patient expectations about their health consultations. Earlier research found that meeting patients' emotional needs - through empathy and patient-centered communication - is important to patient satisfaction. New research is needed to explore how those needs can be met given the changing trend in patient behaviors and the focus on patient-centredness. This study employed two communication theories - the Willingness to Communicate Model and Communication Accommodation Theory - to consider both patients' communicative decisions, and the intergroup features of the health context that can influence communicative behaviors. Two hundred and fiftythree patients from health clinics in Canada and Australia described what satisfaction meant to them, and identified what aspects of their health consultation were satisfying (or not), and we investigated their perceptions of doctor's emotional expression. Results suggest that patient perceptions of their participation in the consultation predicts their perceptions of doctor emotional expression, and their satisfaction with the consultation. Patients want both emotional and medical needs met in an environment that balances interpersonal and intergroup communication. Our findings suggest the need to expand current definitions of patient satisfaction, patient-centredness and emotional expression. We discuss the implications of these findings for health practitioners and consider future research that addresses the need for more individualized health care. [ABSTRACT FROM AUTHOR]

Pharmacists need effective communication skills to provide high-quality patient care. To date, little has been published about hospital pharmacists' communication behaviours, most is atheoretical, and has not studied patients and pharmacists as a dyad. We investigated how well pharmacists' and patients' perspectives of their shared conversation aligned, and how closely these perspectives matched that of an outsider (observer). We invoked communication accommodation theory using audio-recorded, semi-structured interviews, held separately with hospital patients (n = 48) and pharmacists (n = 12). Quantitative analyses indicated where patients, pharmacists, and observer perspectives aligned and occasions where they did not. With some exceptions, most pharmacists and patients held similar opinions about pharmacist communication behaviours. Observer–pharmacist discrepancies highlighted areas for further communication development using communication accommodation theory as a training tool. [ABSTRACT FROM AUTHOR]

Communication between health professionals and patients is an intergroup phenomenon where the health professional has the most power and status. Over the past few decades, there has been a steady increase in the availability to patients of information about healthcare and specific diseases on the Internet. In this paper, we ask whether the use of Internet health information assists patients to manage their consultations with health professionals better and whether it alters the intergroup dynamic by providing a more equal status for patients. In this study 370 participants from Australia and Canada completed a survey that included a 'willingness to communicate with health professionals' scale. They also commented on their use and trust of Internet health information. Thematic analysis suggests that patients' use of Internet health information serves as a broker between patients and their health provider in health consultations. We discuss the implications of these findings for health practitioners as they address how easier Internet access influences patient interactions with health professionals. We consider future research directions these finding provide in explaining communication behaviour in this context. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The study's objective was to explore hospital pharmacists’ and patients’ views about what constitutes effective communication exchanges between pharmacists and patients. Methods: This was a novel theory‐based qualitative study using semi‐structured interviews to elicit patients’ and pharmacists’ perspectives. Pharmacists providing clinical pharmacy services in either inpatient or outpatient settings were recruited first. Eligible patients had been admitted to a study pharmacist's practice area and were prescribed three or more medications to manage a chronic disease(s). Following each pharmacist–patient medication counselling session, semi‐structured interviews were held separately with patients and pharmacists. Participants were asked questions intended to explore their views about what constitutes an effective pharmacist–patient conversation. Audio recordings were transcribed verbatim, analysed using a process of inductive thematic analysis and then mapped to Communication Accommodation Theory strategies. Observational notes and reflexive note taking were conducted throughout. Key findings: Twelve pharmacists each engaged four individual patients for a total of 48 pharmacist–patient conversations (resulting in 48 separate interviews with pharmacists and patients). An overall shared goal was the assurance of patients’ confidence in managing their medications at home. Themes included shared colloquialisms/slang, well‐explained information, engagement, established rapport and empowerment. Participants provided rich exemplars for each of the themes. Conclusions: Pharmacists and patients provided valuable insights about what makes pharmacist–patient interactions effective. Patient‐identified preferences for pharmacist–patient exchanges may help guide pharmacy students and practitioners to engage patients in effective conversations. [ABSTRACT FROM AUTHOR]

Introduction: Pharmacist-patient communication during medication counselling has been successfully investigated using Communication Accommodation Theory (CAT). Communication researchers in other healthcare professions have utilised Discursis software as an adjunct to their manual qualitative analysis processes. Discursis provides a visual, chronological representation of communication exchanges and identifies patterns of interactant engagement. Aim: The aim of this study was to describe how Discursis software was used to enhance previously conducted qualitative analysis of pharmacist-patient interactions (by visualising pharmacist-patient speech patterns, episodes of engagement, and identifying CAT strategies employed by pharmacists within these episodes). Methods: Visual plots from 48 transcribed audio recordings of pharmacist-patient exchanges were generated by Discursis. Representative plots were selected to show moderate-high and low- level speaker engagement. Details of engagement were investigated for pharmacist application of CAT strategies (approximation, interpretability, discourse management, emotional expression, and interpersonal control). Results: Discursis plots allowed for identification of distinct patterns occurring within pharmacist-patient exchanges. Moderate-high pharmacist-patient engagement was characterised by multiple off-diagonal squares while alternating single coloured squares depicted low engagement. Engagement episodes were associated with multiple CAT strategies such as discourse management (open-ended questions). Patterns reflecting pharmacist or patient speaker dominance were dependant on clinical setting. Discussion and conclusions: Discursis analysis of pharmacist-patient interactions, a novel application of the technology in health communication, was found to be an effective visualisation tool to pin-point episodes for CAT analysis. Discursis has numerous practical and theoretical applications for future health communication research and training. Researchers can use the software to support qualitative analysis where large data sets can be quickly reviewed to identify key areas for concentrated analysis. Because Discursis plots are easily generated from audio recorded transcripts, they are conducive as teaching tools for both students and practitioners to assess and develop their communication skills. [ABSTRACT FROM AUTHOR]

Intergroup relations have been studied systematically for more than 60 years and have become embedded in mainstream communication studies. The intergroup communication (IGC) approach provides a crucial level of understanding beyond the interpersonal and the societal, highlighting the interconnections and mutual influences between groups and individuals. In this paper, we briefly describe the main features and history of IGC, pointing to ways of moving forward in the light of current challenges. We highlight the complexity and messiness of IGC and the need for more diversity in theory and method. The time is right for new thinking in IGC that leads to the improvement of communication within and across groups. [ABSTRACT FROM AUTHOR]

Midwives and doctors require effective information-sharing strategies to provide safe and evidence-based care for women and infants, but this can be difficult to achieve. This article describes maternity care professionals’ perceptions of communication in their current workplace in Australia. We invoke social identity theory (SIT) to explore how these perceptions affect interprofessional practice. A survey was conducted with 337 participants (281 midwives and 56 doctors). Using exploratory factor analysis we developed three scales that measured interprofessional workplace practice collaboration. Results indicated an intergroup environment in maternity care in which the professionals found exchange of ideas difficult, and where differences with respect to decision making and professional skills were apparent. Although scores on some measures of collaboration were high, the two professions differed on their ratings of the importance of team behaviors, information sharing, and interprofessional socialization as indicators of collaborative practice. These results highlight the complexities among maternity care providers with different professional identities, and demonstrate the impact of professional identity on interprofessional communication. [ABSTRACT FROM PUBLISHER]

By emphasizing the value of health professionals’ communication skills in creating positive health care experiences, researchers have tended to study health communication as an interpersonal encounter. Interactions in the health context, though, are inherently intergroup. Using the language and social psychology approach, this study emphasizes those intergroup features of health communication. We used mixed methods and applied communication accommodation theory and the willingness to communicate construct to the health context. Participants in Canada and Australia (N = 371) were asked about their perceptions of their health consultations. Multiple regression analyses revealed that health communication competence was the best predictor of patient willingness to communicate. Differences between patients’ accounts of positive and negative health care experiences were clearly differentiated by their perceptions of the health professionals’ communication strategies. The potential effects of these strategies on patient participation are discussed. [ABSTRACT FROM AUTHOR]

The articles presented in this special issue bring attention to important sociocultural variables and language strategies present in the ever-changing and complex health care system. These articles were selected from the health communication symposium of the 14th International Conference of Language and Social Psychology held in Hawaii in 2014. The articles each concentrate on different aspects of health communication and employ different theoretical and analytical approaches, but they all call for more education and better interventions to improve relations in the health context and patient care. [ABSTRACT FROM AUTHOR]

Clinical handover is a key communication event in patient care and a major contributing factor in adverse events in hospitals. Current research on handover emphasizes communication skills training. We investigate the intergroup context and systemic factors of the hospital environment that also affect handover. We explore the responses of 707 health professionals about handover practice. We invoke Coupland and colleagues’ integrative model of “miscommunication” to interpret these. Results support the model. Responses reflect a lack of communication competency, intergroup group relations, and the hidden ideology of the health care system. Health professionals in hospitals are often unaware of the socio-structural element in health care and so cannot bring about cultural change. We suggest that clinicians work with communication and interdisciplinary scholars to bring about system improvement. [ABSTRACT FROM AUTHOR]

Identity threat can be understood from a social identity perspective where people interrelate based on group memberships. Language use may indicate the presence of identity threat. We explored reactions of doctors to planned expanded roles for nurses to perform gastrointestinal endoscopy in Australia. Specialist doctors have traditionally performed endoscopic procedures, yet the level of doctor support for nurse endoscopy is relatively unknown. We present results of our valence and discourse analyses of text box responses in a national survey that explored doctors’ attitudes toward this role expansion. We found low levels of support for the role, and frequent expression of identity threat in three main areas: (1) framing nurses as incompetent, (2) use of contracted statements to evoke authority, and (3) emotive expression. Findings indicated that stakeholders should consider intergroup attitudes when facilitating changes in health professional scope of practice. [ABSTRACT FROM AUTHOR]

This epilogue to the 30-year Commemorative Issue of the journal of Language and Social Psychology draws on four articles represented in this Issue to demonstrate the role this journal, in conjunction with the International Association of Language and Social Psychology, has had in identifying, examining, and shaping a research agenda of socially significant issues. Exigencies of the 21st century are examined to offer predictions for the future of the subdiscipline of the social psychology of language and make recommendations of topics for study [ABSTRACT FROM AUTHOR]

In this article, five papers that formed the Special Issue for the fourth International Association of Language and Social Psychology Taskforce on health communication are revisited. Our starting point is Gallois's epilogue and the six themes she identified from those papers. These themes are invoked to explore where health communication is moving in the 21st century. Burgeoning work on intergroup communication in this context, patient voice, minority groups, and the role of the carer are highlighted [ABSTRACT FROM AUTHOR]

This article explores the predictive properties of talk as an indicator of failure to change. As part of the exploration of organizational change, researchers regularly focus on how discourse is used and applied to achieve certain processes and outcomes. This position presents change as a function of particular types of communication and its interpretation. Using longitudinal data of an organization’s technology change, we propose that the way employees talk about planned organizational change, as a group, signals and can be used to recognize eventual failure to change. Extending current trends in discursive analyses, we establish talk as a reflective device, in the context of tracking failure while it occurs, by combining social identity theory (SIT) with a language and social psychology (LASP) approach. In doing so, the discourse of failure can be viewed as part of an intergroup phenomenon experienced and interpreted through organizational memberships. [ABSTRACT FROM PUBLISHER]

Communication failures in the complex environment of hospital care affect the quality of care and occurrence of inadvertent harm. This study investigated doctors' written communication using a sample of medical records, specifically doctors' progress notes, and the frameworks of social identity and communication accommodation theories. These records include standardized and stylized language, and are intended to record assessment and treatment of patients according to known guidelines for practice. An interpretive analysis of the language and discourse in these records revealed that doctors used medical record entries both to express their specialty identity and to negotiate intergroup conflict. Nonaccommodation and interspecialty conflict sometimes took precedence over facilitation of patient treatment and management. Thus, intergroup communication in this context can constitute a serious threat to the quality of patient care. [ABSTRACT FROM AUTHOR]

Growth in the sophistication of information technology (IT) has led to the increasing importance of information accessibility in the workplace. The pervasiveness of the resultant knowledge-based economy has centered attention on issues of employee group identity. In this article we explore how employee perceptions of group membership guide the change outcomes of an organization implementing new information technology. Using a social identity framework, we investigate the salient intergroup relationships of two groups of employees (management and IT implementation teams) and how employees use their different group memberships to reframe positions of authority or knowledge around technology change. We discuss the extent to which perceptions of social identity legitimate institutional structures already in place despite the potential of new technology. [ABSTRACT FROM AUTHOR]

Background: Hong Kong Special Administrative Region is one of the most technologically advanced and interconnected cities in the world in terms of ownership of internet-enabled mobile devices. mHealth programs that make use of mobile devices such as smart phones and tablets to maximise access to health information, have been identified as having great potential for ageing communities for the management of health and social care needs. This paper reports the findings of a two-stage exploratory research project which examined the experiences and perceptions of Hong Kong residents aged over 60 years in relation to mHealth technologies and health literacy., Methods: This study collected data from older Hong Kong residents at a community centre. Data were collected at two stages in July and August 2019. Stage one involved a one-on-one interview at Centre A with each research participant. The self-report surveys included seven questions about mobile phone ownership and a 16-item gerontechnology survey previously used in Hong Kong. Stage two of the data collection involved three discussion groups with the research participants that were run over a 3-week period., Results: (I) Providing health information via digital devices was considered promising and acceptable by most of our participants. (II) Major concerns that impeded the elders' use of digital devices were their lack of the necessary skills to use these gadgets and their loss of memory. (III) Many participants stated their concern that they found it difficult to recall information immediately after being taught. (IV) Most participants had problems in reading because of low literacy levels or some age-related eye-diseases. (V) Video instructions were preferred by participants as audio and visual input is more useful than rather than static written information with heavy reading requirements., Conclusions: Participants were interested in using mHealth technologies. Education and ongoing support in their use is necessary., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/mhealth-20-123). The authors have no conflicts of interest to declare., (2021 mHealth. All rights reserved.)

Background: Nonadherence to medication therapy has been associated with poor health outcomes and increased health care costs. The literature describes pharmacists as key health care professionals in identifying and addressing nonadherence issues but does not explain how and why effective pharmacist-patient communication affects patients' medication adherence. Previously published pathways used in linking effective physician-patient communication to patient outcomes are proposed for the context of pharmacist-patient communication., Objectives: To develop preliminary steps in a pharmacist communication - patient outcome pathway, adapted from a physician-patient communication pathway., Methods: This longitudinal descriptive study, which took place in a large quaternary hospital, involved hospital pharmacists and patients. Patients' assessment of pharmacist communication behaviours and reporting of patient satisfaction occurred after the pharmacist-patient consultation. Medication-taking behaviour questionnaires were administered before the consultation and again 4 weeks after discharge. Developing the preliminary pathway (based on previously established physician communication pathways) involved 2 steps, with investigation of the following associations: (1) between patient-reported effective communication by pharmacists, as per the Communication Accommodation Theory (CAT), and patient satisfaction; and (2) between patient-reported pharmacist communication and satisfaction and patients' medication-taking behaviour., Results: Twelve pharmacists and 48 patients participated. For step 1, almost all patient-reported pharmacist communication behaviours were positively correlated with patient satisfaction statements. Strong associations between CAT-related pharmacist communication behaviours and patient satisfaction highlighted the pharmacists' behaviours that are important to patients and necessary for effective conversations to take place. In step 2, there were fewer correlations of medication-taking behaviour indices with pharmacist communication behaviours and patient satisfaction., Conclusions: This study showed how a preliminary pharmacist communication - patient outcome pathway could be successfully adapted from existing physician communication pathways. Such pathways provide an initial platform upon which future pharmacist communication - patient outcome research can be built., Competing Interests: Competing interests: None declared.