The Function of Norms in Doctor-Patient Communication
Open Access
- Author:
- Barnett, Jacqueline M.
- Graduate Program:
- Communication Arts and Sciences
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- August 07, 2006
- Committee Members:
- Michael L Hecht, Committee Chair/Co-Chair
Michelle E Day, Committee Member
Ronald L Jackson Ii, Committee Member
Joe A Miller, Committee Member - Keywords:
- communication
norms
doctor-patient communication
injunctive norms
accounts
account-giving - Abstract:
- Abstract The main purpose of this study is to provide deeper understanding into doctor-patient communication. The emergent focus in this study is on the role of norms and how they function within the discourse of the doctor-patient relationship. A discovery of three major types of injunctive norms, explicit, implicit, and understood, was made. Each major category was defined according to the attributes assigned throughout the analyses: explicit injunctive norms were found to be those that are stated directly by the physician. Implicit injunctive norms were defined as norms indirectly, or not overtly, stated by the physician. Understood norms were those that the patient acknowledged s/he should do, although there is no indication that the patient had indeed adhered to those norms. That is why they were thus Understood Norms rather than labeled personal norms. Explicit and implicit norms were broken further down into more specific categories. Since Understood norms had so few examples, it was not further subdivided. The implicit norms were subdivided into Implicit Norms as Suggestions, Implicit Norms as Questions, and Descriptive Norms Used as Questions. It was posited that since Implicit Norms as Questions were the only type of norms that elicited patient accounts, perhaps doctors should ask more questions versus making suggestions or directly stating what the patient needs to do, in order to gain patient compliance. Since questions are more face-threatening in that they require an answer, they may help function in moving patients from the pre-contemplative stage of behavior change to the contemplative stage, at the very least. Finally, three models, one for each major type of norm, were derived. The most groundbreaking part of the study involved the investigation of patient accounts in normative behavior. To date, there are no known models of doctor-patient communication which include any type of norms and accounts. “Bad behaviors” stemming from patients ignoring injunctive norms were considered norm violations in this study; therefore, approaching compliance from a norms and account perspective in future studies may increase understanding and awareness of patient behavior and lead to testable models of interaction. This study produced several models depicting the use of explicit and implicit injunctive norms; the hope of this researcher is that the models can lead to predict what types of injunctive norms are most effective in patient compliance.