A pragmatic agenda for healthcare: fostering inclusion and active participation through shared understanding

Sarah Bigi, Università Cattolica del Sacro Cuore(Italy)
Maria Grazia Rossi, Universidade Nova de Lisboa (Portugal)

Practical information for submission:
– deadline: October 25, 2020
– abstracts should be min. 250 words and max. 500 words (including data and references) – abstracts should be submitted through the conference website (https://ipra2021.exordo.com), indicating the panel when prompted to do so in the submission procedure at the ‘Topics’ step. 

In many studies on communication in healthcare, asymmetry is identified as one of the primary causes of suboptimal professional-patient interactions. Rather than seeing asymmetry in itself as a problem (Dingwall & Pilnick 2020), we consider ‘knowledge translation’ as the biggest challenge for healthcare professionals. When this fails, the implications are serious: burnout and frustration for healthcare professionals, lack of adherence to healthy behaviors and worsened health for patients. The recent Covid-19 pandemic has shown a particularly painful side of the ‘medical communication issue’, with governments struggling to get correct and complete information to the population in order to contain the infection and to indicate the most appropriate preventive behaviors. Clearly, communication styles that are unable to address the challenges posed by ‘knowledge translation’ favor non-inclusion and reduced access to care.

In this panel, we claim that in healthcare ‘shared understanding’ is a precondition for inclusion and active participation (Rossi & Macagno 2019; Tzanne 2000). We also assume that the micro-level of dialogues between professionals and patients, and the macro-level of institutional communication are linked and interdependent: on the one hand, a well-informed citizen is more likely to be a well-engaged and responsible patient, who knows how to access healthcare services and make good use of the opportunities the system can offer. On the other hand, patients and healthcare professionals who can develop trusting and constructive relationships with each other are more likely to find creative ways of supporting patients’ wellbeing, allowing in return professionals’ own satisfaction.

We would like to further discuss the idea that the achievement of shared understanding through appropriate communication would trigger a virtuous circle leading to more accessible, inclusive, and sustainable healthcare systems. Therefore, we invite presentations that address questions such as the following:

-at the micro-level of analysis:
• which are the greatest challenges in multilingual and multicultural dialogues in the healthcare settings and how can they be overcome?
• which are the dialogical mechanisms that mostly favor or hinder the creation of common ground between participants in a dialogue?
• is it possible to describe indicators of misunderstandings/disagreements in healthcare dialogues?
• how and under which conditions can technological devices favour inclusion and active participation?

– at the macro-level of analysis:
• which are the main challenges for public discourse concerning health in view of achieving shared understanding between institutional actors and the population?
• how should the language of healthcare institutions change in order to foster active citizenship?
• how can pragmatic analyses and findings contribute to the preparation of high-quality teaching materials for medical students?

Finally, is it possible to outline virtuous processes that would allow the micro-and macro-levels of communication in the medical context to support each other towards more inclusive healthcare services?

Dingwall, R., & Pilnick, A. (2020). Shared decision making: doctors have expertise that patients want or need.BMJ, 368.
Rossi, M. G., & Macagno, F. (2019).Coding problematic understanding in patient–provider interactions.Health Communication, 1-10.
Tzanne, A. (2000).Talking at cross-purposes: The dynamics of miscommunication. Amsterdam, Netherlands: John Benjamins Publishing.

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