"The result of the exam came": diagnostic news delivery (and how linguistic-interactional investigations can inform professional practices)

Ana Cristina Ostermann Minéia Frezza About the authors

ABSTRACT

Based on the principles offered by ethnomethodological Conversation Analysis, this article describes the delivery of diagnostic news in 54 audio-recorded genetic counseling consultations that happened in a public hospital ward in Brazil (Sistema Único de Saúde, SUS) specialized in moderate and high risk pregnancies. All recorded consultations were fully transcribed, but for the purposes of this study only the 18 interactions that contained diagnostic news delivery sequences were analyzed, regarding to the actions that make up such sequences. The data analysis shows that the news delivery sequence (NDS) bears characteristics of some type of pedagogical sequence that benefits the joint meaning making of the diagnosis and the coconstruction of the news itself, a task that is shared between doctor and patient. In the delivery of bad news, in particular, the processes of agentivity of the test and of disease depersonalization are identified. The study describes different linguistic-interactional practices used to deal with participants' distress and that might be used to subsidize health professionals' trainings to whom diagnosis delivery constitutes an everyday event.

Keywords:
Genetic counseling; News delivery; Pedagogical sequence; Agentivity

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