Beach Wayne A, Prickett Erin
a School of Communication, San Diego State University, Department of Surgery , Moores Cancer Center, University of California, UCSD/SDSU Joint Doctoral Program in Public Health.
b College of Arts & Sciences , University of San Diego and Department of Communication Studies, University of San Diego.
Health Commun. 2017 Jul;32(7):791-802. doi: 10.1080/10410236.2016.1172291. Epub 2016 Jul 15.
Conversation analysis is employed to examine transcribed excerpts drawn from a subsample of 75 naturally occurring and video recorded interviews between cancer patients and 30 doctors. Close examination is provided of how cancer patients initiate, and doctors respond, to laughter and humor during oncology interviews. Interactions demonstrate that communication about the disease "cancer" shares qualities similar to other medical areas (e.g., primary care): the tendency for patients to initiate laughter or humor to address troubling and challenging circumstances; and that during moments when patients address personal matters, doctors are not invited and do not reciprocate with shared laughter and humor. Prominent in talk about cancer are various precarious circumstances, awkward and delicate moments mirroring the lived experiences of cancer patients (e.g., when patients attempt to minimize fears, justify that they are well when threatened with sickness, claim normality in the midst of chronic conditions, and take stances that weight loss and gain are not problematic). These examples provide a compelling case that routine cancer care involves many poignant situations managed through laughter and humor. Implications are raised for how quality care might be improved through grounded understandings of laughter, humor, and cancer.
会话分析被用于研究从75例癌症患者与30名医生之间自然发生且有视频记录的访谈子样本中提取的转录片段。深入考察了癌症患者在肿瘤学访谈中如何引发笑声和幽默,以及医生如何回应。互动表明,关于“癌症”疾病的交流具有与其他医学领域(如初级保健)相似的特点:患者倾向于通过引发笑声或幽默来应对困扰和具有挑战性的情况;而且在患者谈论个人事务时,医生不会被邀请参与,也不会以共同的笑声和幽默做出回应。在关于癌症的谈话中突出的是各种不稳定的情况、尴尬而微妙的时刻,反映了癌症患者的生活经历(例如,当患者试图减轻恐惧、在面临疾病威胁时证明自己状况良好、在慢性病中声称正常,以及认为体重减轻和增加没有问题时)。这些例子有力地证明了常规癌症护理涉及许多通过笑声和幽默来处理的辛酸情况。文中还提出了关于如何通过对笑声、幽默和癌症的深入理解来改善优质护理的问题。