Advanced informatics understanding of clinician-patient communication: A mixed-method approach to oral health literacy talk in interpreter-mediated pediatric dentistry

• Published in: PloS one 2020-03, Vol.15 (3), p.e0230575-e0230575
• Main Authors: Wong, Hai Ming, Bridges, Susan Margaret, Ma, Kuen Wai, Yiu, Cynthia Kar Yung, McGrath, Colman Patrick, Zayts, Olga A
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Caregivers; Clinical decision making; Conversation analysis; Decision making; Dental caries; Dentistry; Dentists; Discourse strategies; Education; Evidence-based medicine; Evidence-based practice; Health care; Health education; Health literacy; Informatics; Interpersonal communication; Interpreters; Language policy; Linguistics; Literacy; Medical personnel; Medicine and Health Sciences; Methods; Mixed methods research; Multilingualism; Oral health; Oral hygiene; Parent-child relations; Patient communication; Patient education; Patient satisfaction; Patients; Pediatric dentistry; Pediatrics; Physician-patient relations; Professional education; Social Sciences; Teaching; Text analysis; Turn taking; Verbal communication
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0230575

In the clinical dental consultation, multi-party configurations predominate with the presence of parents/ primary caregivers in pediatric dentistry adding another layer of complexity. In managing child oral healthcare, parents/ primary caregivers are critical, especially in dental caries prevention. This study aimed (1) to identify the structure of oral health literacy (OHL) talk in interpreter-mediated pediatric dentistry and (2) to analyze interpreter contributions to the communication strategies: patient-centered direct interpreting (PC-DI), patient-centered mediated interpreting (PC-MI), clinician-centered direct interpreting (CC-DI), and clinician-centered mediated interpreting (CC-MI). Visual text analysis (VTA) of video recorded pediatric clinical consultations in Hong Kong utilized Discursis™ software to illustrate temporal and topical structures and their distribution across turns-at-talk. Conversation analysis (CA) was applied to analyze turn-taking of the identified OHL talk qualitatively. The mixed-method approach of combining VTA and CA was applied to analyze the patterns and features of the recorded OHL talk. The conceptual recurrences of the 77 transcribed video recordings were plotted visually. CC- and PC-OHL talk were identified by the recurrence patterns of monochromatic and multi-colored triangular clusters formed by off-diagonal boxes, respectively. CA of interpreter-mediated turns supported earlier findings regarding patterns of MI in multilingual adult dental consultations; however, the role of the interpreter in parent/ primary caregiver education and patient management was more distinctive in the pediatric dentistry. The mixed-method approach assisted in unpacking the complexities of the multi-party interactions, supported identification of effective communication strategies, and illustrated the roles of the dental professionals in initiating CC- and PC-OHL talk in pediatric dentistry. The intervention showed the implication of the professional education of evidence-based practices for clinicians in balancing agenda management and the communicative dimension of OHL with the help of VTA and CA in multilingual consultations.