Informing Evidence: Claimsmaking in Midwives' and Clients' Talk About Interventions

被引:11
作者
McKenzie, Pamela J. [1 ]
Oliphant, Tami [1 ]
机构
[1] Univ Western Ontario, Fac Informat & Media Studies, London, ON N6A 5B7, Canada
关键词
communication; discourse analysis; medical/health care discourse; midwifery; TREATMENT DECISIONS; DISCURSIVE APPROACH; DISCOURSE ANALYSIS; MIDWIFERY; HEALTH; MEDICATION; KNOWLEDGE; MEDICINE; CHOICE; BIRTH;
D O I
10.1177/1049732309355591
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Communication for informed choice is particularly challenging in clinical settings such as direct-entry midwifery, where the care model embraces diverse therapies and forms of knowledge. We identified three discursive moves (explanation, invocation, and evaluation) that Ontario midwives and clients used in making claims about proposed interventions. The analysis was informed by an understanding of communication as an interactionally situated and socially constructed interpretive practice. Both midwives and women called on the authority of biomedical discourse, but they also turned to sources such as women's wisdom to support their cases. The flexible use of these moves afforded participants considerable latitude in accepting or rejecting forms of evidence as authoritative. However, strategies designed to empower clients in making choices could unintentionally serve to enhance the authority of the care provider. Talk about interventions brings into view both the knowledge systems and the broader relations within which regulated midwifery practice operates.
引用
收藏
页码:29 / 41
页数:13
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