Evidence-Based Health Communication

Evidence-Based Health Communication

Evidence-Based Health Communication

Evidence-Based Health Communication


What is evidence-based health communication and how does it benefit patients? How has communication been taught to health professionals and how might it be improved? How can health care professionals make the most of short encounters in order to maximise their therapeutic effectiveness for clients? This book provides a comprehensive and critical review of the field of health communication and the kinds of evidence that have been collected concerning effective communication. It also critically evaluates the kinds of training health professionals receive in communication skills and examines its relatively limited role in the curriculum. In addition it sets out what has been discovered about the micro-structure of interaction in health care encounters. The book offers vital new agendas for research training and practice in health care, based upon lessons learned from linguistics, using a wide variety of gathered evidence to identify patterns that will lead to improved health care practices. Moreover, the book focuses upon brief, ordinary and effective communicative activity in addition to the formal consultations that have been studied by researchers in the past. Evidence-based Health Communication is key reading for trainee health professionals as well as undergraduate and postgraduate students in the fields of health studies, medical sociology and health psychology. It also provides stimulating reading for health care professionals, policy makers and researchers with an interest in improving health communication.


There are a variety of ways in which we might think about what happens in the myriad encounters of health care and how these might be linked to what happens in the societies within which they are embedded. For health care encounters will inevitably be influenced and shaped by a wide range of social, cultural, political and economic factors. In this opening chapter we will consider how the process of health care communication might be conceptualized to take this into account. After all, it is difficult to leave one's whole life history and socio-economic position outside the consulting room door, whether one is a client or a professional. Equally, many thinkers have been trying to make sense of how social inequalities are manifest in the health care encounter itself.

Health care professionals are often relatively privileged compared with their clients. Most societies show a distinct pattern of health inequality. The less well off a person is, the more likely they will be to suffer a whole variety of illnesses. Indeed, there are suggestions that some indicators of health such as infant mortality and life expectancy are showing a widening gap between rich and poor in the UK (Department of Health 2005a; Shaw et al. 2005). So from the outset, the social and economic context has a bearing on health care activity. There may be other broader social factors at work. People may differ markedly in terms of their access to knowledge, language and 'social capital' in relation to health care (Edmondson 2003). An individual's social and cultural capital can make a substantial difference to how accessible health services are, and how user-friendly they find them to be. The terms 'social capital' and 'cultural capital' refer to resources based on group membership, relationships, networks of influence and social support. They relate to advantages a person might have, linked to their position in networks of social relationships, and might also reflect knowledge, skill, education, and other advantages which give certain people a higher status in society, and possibly higher expectations.

Social factors, then, have an important bearing on health. As we shall see in this volume, they influence health care encounters too. In this first chapter we will begin the task of picking out some of the theories that have been used to make sense of health, and suggest some others which are perhaps less familiar to scholars of health care but which we feel have some potential to offer insights into how one can make sense of the sometimes problematic relationship between what happens in the health care encounter and the wider world.

Originally, in the 1950s and 1960s when the discipline of medical sociology was finding its feet in American universities, social scientists visited hospital settings, with a view to describing, explaining and theorizing what they saw. At that time in . . .

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