I think mine is slightly longer but I included all the examples as an aspect of DA.
Seminar 3 – Discourse Analysis
Discourse analysis (DA) is a qualitative research approach to evaluate use of language exploring the various aspects of pronunciation, emphasis, excitement, use of positive/negative words and expression. It is a way of scrutinising language in a social and medical setting.
Through examination of transcripts, meanings and ideological constructions underlying speech are revealed, including cultural understandings, hidden biases, assumptions, prejudices, stereotypes and deeper ‘callings for help.’ Research is not only focused on meta analysis quantitative results but this type of qualitative research can be used to evaluate certain health behaviours and anxieties of patients. This can be seen in the paper discussing medically unexplained symptoms, and the effect of psychology on the patient’s health.
DA can be seen as a laborious research method however it can stimulate deeper understanding of patients and disease, leading to development of teaching strategies and the uncovering of psychosocial determinants of health. In one paper, it was shown that nurses often missed cues from patients and as a result caused an alteration to the teaching scheme. Moreover, the paper on reflections of inequalities with regards to HIV/AIDS in Africa in the Austrailian media showed that carefully chosen language can have different outcomes on the perception of patients and disease.
Furthermore, stepping away from patient discourse, DA can expose the profound effects of language in the doctor-patient relationship. The health professional’s discourse that can influence the perception of information and consequently the patient’s anxieties and psychosocial aspect of illness. This aspect of DA is illustrated in the papers that highlighted the importance communication between health professionals and patients. For example, in relation to the paper about end of life care, it was evident that the sensitivity and empathy needed in the language used by the doctors was imperative in patient care. The paper on communication of students in OSCE settings demonstrated the concept of authority between doctor and patient and the archetype of a patronizing, authoritative doctor figure. Correspondingly, the paper on chronic back pain also explored how patients can feel that doctors can be cynical and judgmental.
In addition, DA is extremely useful when looking at areas where complex and delicate barriers exist. The paper on sexual health discussion amongst young males clearly highlights the significance of ‘masculinity’ in conversation and the importance that these young men do not feel belittled by talking about sexual health in a way that could make them ‘less masculine.’ This is also seen in the paper, which explores health seeking behavior in men and the normative masculine tendencies.
DA can reveal how patients control their disease course and where they perceive their locus of control is. In the paper on managing type 2 diabetes, the language analysis was used to identify patients who felt disempowered by their disease; this was very equivalent to the paper on antenatal care by midwives in diabetic women in Norway. Similarly, the paper on contested illnesses within a family, exposed the struggles that patients, particularly young patients, face when control their disease and the affect it can have in the social dynamics of a household. Interestingly, the lack of conversation or the non verbal communication can also identify certain tensions between family members, the example of the father-son communication clearly shows this. The paper on communication with patients with intellectual disability also shows that communication may also involve the use of signs and pictures to convey certain messages and information.
There is a differentiation between narrative and discourse analysis. Narrative is centric to plot which is the linguistic devices to convey causality, surprise, the unexpected and trouble. Whereas, discourse is the analysis of why those specific words were used with the aim to gain a deeper understanding of the ‘subject.’
