Improving clinical communication in inflammatory bowel disease: Functional linguistics and research impact

Dr Neda Karimi, University of New South Wales

At the Ingham Institute for Applied Medical Research and the University of New South Wales in Sydney Australia, we have developed a programme of research on clinical communication in inflammatory bowel disease (IBD) featuring collaboration between functional linguists and experts in health communication research as well as IBD clinicians and researchers at Liverpool Hospital and across Australia. IBD is a chronic inflammatory condition of the gastrointestinal tract characterised by intermittent periods of active disease with symptoms that undermine patients’ quality of life and emotional well-being. Previously, there had been no sustained program of research on how gastroenterologists and patients talk together about IBD. Our programme of research is grounded in systemic functional linguistic theory and focused on discovery and translation with the aim of improving the quality of care and the patient and clinician experience of care. Our goal is to provide empirical evidence on communication in IBD that will inform the development of recommendations and interventions that improve patient safety and result in value-based, high-quality care for patients with IBD.

In addition to presenting an overview of this programme of research and its position within the IBD literature, I will present some of the preliminary findings from an ongoing project. In this project, Halliday’s concept of register (Halliday, 1985, 2002 [1977]), Hasan’s concept of generic structure potential (GSP) (Hasan, 1985, 1996) and her semantic networks (Hasan, 1983; Hasan & Webster, 2009), and Moore’s GSP account of shared decision making in HIV (Moore, Forthcoming, 2004) are used to analyse audio-recorded face-to-face and telehealth IBD specialist consultations. Consultations are analysed to uncover the differences in how consultants and patients interact with each other when dealing with similar situations. The aim is to identify effective styles of communication by mapping out the existing variations and pairing them with the degree of consultant-patient agreement on what the consultation achieved. The degree of agreement is measured through contrastive analysis of patient and consultant debrief interviews conducted immediately after the recorded consultation. The project is expected to result in a series of short scripted videos based on our analysis of the consultations and the interviews, to be rated by clinicians and patients and included in a multimodal evidence-based and consensus-based guideline document on effective communication in IBD specialist consultations.