Promoting Patient Engagement in Medical Informed Consent - A Qualitative Study of Chinese Doctors' Communication Strategies.

Patient engagement is now widely endorsed as an essential ingredient for high-quality healthcare, yet there has been limited research on how patient engagement can be facilitated in medical informed consent (IC) communication. To address this gap, a fine-grained discourse analysis was conducted to identify communication strategies adopted by doctors to facilitate information delivery and ascertain patients' understanding, which translate into an increase in patient engagement. Data was collected from a public hospital in mainland China. Nonparticipating observations of 14 IC sessions were audio-recorded, followed by in-depth, semi-structured interviews with those observed patients. Four communication strategies emerged from the analysis: 1) seeking patients' understanding of their condition; 2) explaining medical information by reference to shared knowledge and practice; 3) recognizing and addressing patients' psychological concerns; 4) repeating critical information and checking patients' understanding through teach-back. The adoption of these strategies enables doctors to tailor the scope and delivery of information to accommodate and address patients' preferences, rather than defaulting to one-way information dumping. This study sheds light on the complexity of IC and further contributes to the ongoing endeavors to improve IC communication by raising the awareness of the role of patients in making mutually acceptable decisions. These identified strategies can be incorporated into medical communication training to facilitate delivery of healthcare that is sensitive to patients' needs and expectations.

An ethnographic discourse approach to explore GP-counsellor communication in primary health care settings in Hong Kong.

This study aims to explore the nature of GP-counsellor interaction during discussions of patients' mental health issues in primary care services. An ethnographic discourse analysis of audio-recorded GP-counsellor conversations and the participating counsellor's reflective accounts. Two participating GPs and one counsellor were recruited from a private medical clinic in Hong Kong. The GPs and the counsellor mainly discussed their patients' issues in terms of medication management, the counsellor's case conceptualization, the case management, knowledge transfer and acknowledging the partnership. During case discussions, both the GPs and the counsellor used a range of interactional strategies to clarify a patient's condition and treatment plans for mutual understanding. The GPs and the counsellor co-construct an insider discourse that covers a greater diversity of topics, including both medical and non-medical concerns. The research findings have implications for theory and practice, including the potential of ethnographic discourse analysis in understanding the features of participants' behavior and evaluating the effectiveness of communication in a particular setting, as well as the importance of exploring professionalized discourse during GP-counsellor communication in developing training programs aimed at enhancing staff awareness of effective IPC communication.

An Exploratory Study of Cantonese Learning Strategies Amongst Non-Chinese English-Speaking Ethnic Minority University Students in Hong Kong.

This study investigates the strategies for learning Cantonese that are adopted by non-Chinese English-speaking ethnic minority (EM) university students in Hong Kong. The aim is to identify the challenges these students face in applying their strategies to learn Cantonese and to explore their learning experiences when implementing them. Drawing on questionnaire surveys and semi-structured interviews with 30 EM students at a university in Hong Kong, this study identifies these learners' strategies, elicits their views on the use of these strategies and examines their learning experiences. The findings suggest that EM students are "medium strategy users," with social strategies being their most commonly used types of learning strategies, followed by compensation and metacognitive strategies. The more proficient Cantonese users tend to use metacognitive strategies that promote planning and are goal-oriented. Taken together, this study sheds light on the complex interplay of sociocultural variables in shaping EM university students' Cantonese learning experience in Hong Kong. It also highlights the importance of analysing EM students' linguistic repertoire and the local language ecology in understanding Cantonese learning in a multilingual context like Hong Kong.