Department of Communication Sciences and Disorders, North Carolina Central University, Durham.
Department of Statistical Science, Duke University, Durham, NC.
J Speech Lang Hear Res. 2023 Jan 12;66(1):314-324. doi: 10.1044/2022_JSLHR-22-00327. Epub 2023 Jan 5.
Atypical pragmatic language can impede quality health care access. Right hemisphere brain damage (RHD) results in changes in pragmatic language use; however, little is known about whether there are racial/ethnic influences. Recent research indicated differences in question-asking when RHD survivors were compared with healthy controls, prompting the current examination of question production in women by race/ethnicity and the presence of RHD.
Participants were eight Black and eight White women who sustained a single right hemisphere stroke at least 6 months prior to data collection (2016-2020), and eight Black and eight White control participants from the Right Hemisphere Damage Bank (https://rhd.talkbank.org). Videos of informal, first-encounter conversational discourse tasks were transcribed and coded. Analyses were conducted for frequency of questions and question type.
Race/ethnicity had a statistically significant effect on the total number of questions and number of content and polar questions. The mean total of questions, number of content questions, and mean number of polar questions for Black participants was significantly less than White participants. There was less variability in question type for Black participants than White participants, and a tendency for Black participants to ask fewer questions regardless of RHD or control status.
Acquisition of health information and ensuing health care might be less fruitful for Black women communicating with someone who may not know to conduct comprehension checks and be proactive in provision of information. To be culturally responsive to Black patients with communication disorders, providers might apply this awareness of reduced question-asking to their strategies to improve patient-provider communication.
不典型的语用语言能力会阻碍获得高质量的医疗保健。右脑损伤(RHD)会导致语用语言使用的变化;然而,对于是否存在种族/民族影响知之甚少。最近的研究表明,在比较 RHD 幸存者和健康对照组时,在提问方面存在差异,这促使我们目前根据种族/民族和 RHD 的存在情况检查女性的问题生成。
参与者为 8 名黑人和 8 名白人女性,她们在数据收集(2016-2020 年)至少 6 个月前发生了单侧右半球中风,以及来自右半球损伤银行(https://rhd.talkbank.org)的 8 名黑人和 8 名白人对照组参与者。非正式的、初次遇到的会话话语任务的视频被转录和编码。对问题的频率和问题类型进行了分析。
种族/民族对问题总数和内容问题与极性问题的数量有统计学显著影响。黑人参与者的问题总数、内容问题数和极性问题平均数明显少于白人参与者。黑人参与者的问题类型变化较少,与白人参与者相比,黑人参与者倾向于提出较少的问题,无论是否存在 RHD 或控制状态。
与可能不知道进行理解检查并积极提供信息的人交流时,黑人女性获取健康信息和随后的医疗保健可能效果不佳。为了对有沟通障碍的黑人患者做出文化响应,提供者可能会将对减少提问的这种认识应用于改善患者-提供者沟通的策略中。