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

Hai Ming Wong; Susan Margaret Bridges; Kuen Wai Ma; Cynthia Kar Yung Yiu; Colman Patrick McGrath; Olga A Zayts

doi:10.1371/journal.pone.0230575

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

PLoS One. 2020 Mar 20;15(3):e0230575. doi: 10.1371/journal.pone.0230575. eCollection 2020.

Authors

Hai Ming Wong¹, Susan Margaret Bridges², Kuen Wai Ma¹, Cynthia Kar Yung Yiu¹, Colman Patrick McGrath³, Olga A Zayts⁴

Affiliations

¹ Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
² Faculty of Education/Centre for the Enhancement of Teaching and Learning, The University of Hong Kong, Hong Kong SAR, China.
³ Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
⁴ School of English, Faculty of Arts, The University of Hong Kong, Hong Kong SAR, China.

Abstract

Background: 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).

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Caregivers / psychology
Child
Communication
Female
Health Literacy*
Humans
Male
Multilingualism
Oral Health*
Parents / psychology
Patient-Centered Care
Pediatric Dentistry
Physician-Patient Relations
Physicians / psychology*
Video Recording

Grants and funding

This work received funding from the Research Grants Council General Research Fund (GRF) of the Hong Kong Special Administrative Region (Ref: 760112); URL: https://www.ugc.edu.hk/eng/ugc/index.html; funding recipient: SMB; the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.