SAĞLIĞIN DEMOKRATİKLEŞMESİ: DİŞ HEKİMLİĞİNİN DİLİNE ELEŞTİREL BİR BAKIŞ

Yıl 2017, Cilt: 25 Sayı: 2, 80 - 96, 01.04.2017

Gökhan Gökgöz

Öz

Hasta-Hekim iletişimi, çoğunlukla hastanın tedavi sürecine dönük halkla ilişkiler stratejisinin bir uğrağı olarak ele alınır. Ancak bu nihai uğrağa varana değin, insana özgü çok katmanlı bir güzergâhı takip eder. Dil, anlam, ideoloji, iktidar vb. eksenindeki farklı kavramların konuşulabileceği bir alandır burası; her ne kadar nihai amaç, iki aktör arasındaki güveni inşa etmek olsa da, esasen bu süreçte hekimlerin toplum tasavvurları ve bu tasavvur içerisinde kendilerini konumlandırdıkları pozisyon ile belli bir hikayeyi deneyimlemekte olan insanların bu pozisyonu görme biçimleri karşılaşır; nitekim hasta sandalyesine oturmakla başlayan süreç, bu karşılaşma esnasında inşa edilen anlamı somutlaştırır, pratiğe tahvil eder. Dolayısıyla dilsel bir süreçtir bu; dil, konuşmanın, anlam inşasının ve iktidarın üzerinde yer aldığı bir omurga olarak çalışır; toplumsal aktörleri, aynı muhayyilenin içerisine yerleştirir, farklı öznelik deneyimlerini kurar ve bu haliyle ideolojik bir rolü yerine getirir. En nihayetinde hekimliğin iktidar alanı da buraya kurulur. Çalışmada da görüleceği üzere, örneğin beyaz önlük, bu iktidarla ilişkili olarak kendisinden öte bir simgeselliğe haizdir. Nitekim bu çalışma, sağlık iletişimi ile de ilişkili bir biçimde buradaki iktidar alanına odaklanacak; özellikle diş hekimliği öğrencilerinde yerleşik bu iktidarın dilsel kaynaklarını aramaya yönelecektir. En nihayetinde, sağlık iletişimini, sağlığın demokratikleşmesi gibi sosyolojik bir tahayyülün içerisinden görme amacındadır

Anahtar Kelimeler

Diş Hekimliği, Sağlık İletişimi, İktidar, Söylem, Anlam

THE DEMOCRATIZATION OF HEALTH: A CRITICAL APPROACH TO LANGUAGE OF DENTISTRY

Öz

Patient-Physician communication is often addressed as a haunt of the public relations strategy towards the patient’s treatment process. However, this follows a multi-layered route specific to humans, to the final destination. This is a field where you can talk about different concepts on the axis of language, meaning, ideology, power etc. Although the ultimate goal is to build trust between the two actors; essentially in this process, the physicians’ conception of society and their position within this conception and viewpoints of people who are experiencing a certain story encounters; as a matter of fact, the process that begins with sitting in the patient chair embodies the meaning built during this encounter and bonds it to practice. Therefore, this is a linguistic process; language works as a backbone which included the construction of meaning, speech and power; it places social actors in the same imagination, establishes different subjectivity experiences and fulfills an ideological role. Eventually, the field of power of medicine is also established here. As will be seen in the study, for example, the white apron has a symbolism related to this power that is more than itself. This work will focus on the area of power, in relation to health communication; it will seek to find the linguistic resources of this power, built especially in dental students. Finally, it aims to see health communication within a sociological imagination, such as the democratization of health

Anahtar Kelimeler

Dentistry, Health Communication, Power, Discourse, Meaning

Kaynakça

• Anderson, R. (2004). “Patient Expectations of Emergency Dental Services: A Qualitative Interview Study”. British Dental Journal, 197: 331-4.
• Atkinson, P. (1984). “Training for Certainity”. Social Science and Medicine, 19: 949-56.
• Aull, F. (1993). Mission Statement, Medical Humanities. New York: University School of Medicine.
• Boelen, C. (2005). The Five-Star Doctor: An Asset to Health Care Reform. Geneva: World Health Organization. http://www.who.int/hrh/en/HRDJ_1_1_02.pdf(Erişim Tarihi. 01.11.2016). Borland, L. R. (1962). “Odontophobia-inordinate Fear of Dental Treatment”. Dental Clinics North America, 6: 609-21.
• Bornstein, D. (2013). “Medicine’s Search of Meaning”. The New York Times. 18 September. http://opinionator.blogs.nytimes.com/2013/09/18/medicines-search-for-meaning/ Tarihi. 01.11.2016
• Erişim Byrne, P.S., Long, B.E.L. (1976). Doctors Talking to Patients. London: Her Majestry’s Stationery Office.
• Carter, W.B., Inui T.S., Kukull W.A., Haigh, V.H. (1982). “Outcome-based Doctor-Patient Interaction Analysis: II. Identifying Effective Provider and Patient Behavior”. Medical Care, 20: 550-66.
• Gaines, A. ve Schillace, B. (2013). “Meaning and Medicine in a New Key: Trauma, Disability and Embodied Discourse Through Cross-Cultural Narrative Modes”. Culture, Medicine and Psychiatry, 37: 580-586.
• Geertz, C. (1973). The Interpretation of Cultures. New York: Basic.
• Good, Byron J. (1994). Medicine, Rationality and Experience. Cambridge: Cambridge University.
• Graugaard, P.K., Finset, A. (2000). “Trait Anxiety and Reactions to Patient-Centered and Doctor-Centered Styles of Communication: An Experimental Study”. Psychosomatic Medicine, 62(1): 33-9.
• Haak, R., Rosenbohm, J., Koerfer, A., Obliers, R., Wicht, M.J. (2008). “The Effect of Undergraduate Education in Communication Skills: A Randomised Controlled Clinical Trial”. European Journal of Dental Education, 12: 213-8.
• Hall, J.A., Roter, D., Rand, C.S. (1981). “Communication of Affect Between Patient and Physician”. Journal of Health and Social Behavior, 22: 18-30.
• Henszen-Kelemens, I., Lapinska, E. (1984). “Doctor-Patient Interaction, Patients’ Health Behavior and Effects of Treatment”. Social Science & Medicine, 19: 9-18.
• Klages, U., Sergl, H.G., Burucker, I. (1992). “Relations between Verbal Behavior of the Orthodontist and Communicative Cooperation of the Patient in Regular Visits”. American Journal of Orthodontics and Dentofacial Orthopedics, 102: 265-9.
• Kleinman, A. (1988). The Illness Narratives. New York: Basic.
• Kurtz, S. Silverman, J. Draper, J. (2005). Teaching and Learning Communication Skills in Medicine. Oxford: Radcliffe.
• Lahti, S. Tuutti, H. Hausen, H. Kaariainen, R. (1995). “Comparision of Ideal and Actual Behavior of Patients and Dentists During Dental Treatment”. Community Dentistry and Oral Epidemiology, 23(6): 374-8.
• Lewis, M.A. (2013). “From Victim to Victor: ‘Breaking Bad’ and the Dark Potential of the Terminally Empowered”. Culture, Medicine and Psychiatry, 37(4): 656-69.
• Ley, P. (1979). “Memory for Medical Information”. British Journal of Social and Clinical Psychology, 18(2): 245-55.
• Ley, P. (1985). “Doctor-Patient Communication: Some Quantitative Estimates of the Role of Cognitive Factors in None-Compliance”. Journal of Hypertension, 3(1): 51-5.
• Lukoschek, P., Fazzari, M., Marantz, P. (2003). “Patient and Physician Factors Predict Patients’ Comprehension of Health Information”. Patient Education and Counseling, 50: 201- 10.
• Makoul, G. (2001). “Essential Elements of Communication in Medical Encounters: The Kalamazoo Consensus Statement”. Academic Medicine, 76(4): 390-3.
• Makoul, G. ve Schofield, T. (1999). “Communication Teaching and Assessment in Medical Education: An International Consensus Statement. Netherlands Institute of Primary Health Care”. Patient Education and Counseling, 37(2):191-5.
• Malloy, D.C., Martin, R., Hadjistavropoulos, T., Liu, P., MacCarthy, E.F., Park, I., Shalani, N., Murakami, M., Paholpak, S. (2014). “Discourse on Medicine: Meditative and Calculative Approaches to Ethics from an International Perspective”. Philosophy, Ethics and Humanities in Medicine, 9-18.
• Misra, S. Daly, B. Dunne, S. Millar, B. Packer, M. ve Asimakopoulou, K. (2013). “Dentist-patient Communication: What Do Patients and Dentists Remember Following a Consultation? Implications for Patient Compliance”. Patient Prefer and Adherence, 17(7): 543-9.
• Newsome, P.R., Wright, G.H. (1999). “A Review of Patient Satisfaction: 1.Concepts of Satisfaction”. British Dental Journal, 186(4): 161-5.
• Oswald, M. Grosjean S. (2004). “Confirmation Bias”. in Cognitive Illusions: A Handbook of Fallacies and Biases in Thinking, Judgement and Memory. ed. Pohl, R.F. Hove: Psychology, pp.79-96.
• Parker, M.A. (2007). “A Perspective on Doctor-Patient Communication in the Dental Office”. North Carolina Medical Journal, 68(5): 365-7.
• Plasschaert, A., Boyd, M., Andrieu, S., Basker, R., Beltran, R.J. et al. (2002). “Development of Professional Competences”. European Journal of Dental Education, 6(3): 33-44.
• Roter, D.L. (1977). “Patient Participation in the Patient-Provider Interaction: The Effects of Patients’ Question Asking on the Quality of Interaction, Satisfaction and Compliance”. Health Education Monographs, 5(4): 281-315.
• Roter, D.L., Hall, J.A. (1992). Doctors Talking with Patients, Patients Talking with Doctors; Improving Communications in Medical Visits. Westport: Auburn House.
• Sondell, K., Söderfeldt, B., Palmqvist, S. (1998). “A method for Communication Analysis in Prosthodontics”. Acta Odontologica Scandinavica, 56: 48-56.
• Stewart M. (1984). “What is a Successful Doctor-Patient Interview? A Study of Interactions and Outcomes”. Social Science & Medicine, 19: 167-75.
• Street, R. (1991). “Information Giving in Medical Consultations: The Influence of Patients Communicative Styles and Personal Characteristics”. Social Science & Medicine, 32(5): 541- 48.
• Szasz, T.S., Hollender, M.H. (1956). “A Contribution to the Philosophy of Medicine: The Basic Models of the Doctor-Patient Relationship”. A.M.A. Archives of Internal Medicine, 97(5): 585- 92.
• Van Dalen, J., Van Hout, J.C.H.M., Wolfhagen H.A.P., Scherpbier, A.J.J.A., Van Der Vleuten, C.P.M. (1999). “Factors Influencing the Effectiveness of Communication Skills Training: Programme Contents Outweigh Teachers’ Skills”. Medical Teacher, 21(3): 308-310.
• Van Dijk, T. (1989). “Structures of Discourse, Structures of Power”. in Communication Yearbook, ed. J.A. Anderson, Newbury Park: Sage, pp.18-59.
• Waitzkin, H. (1985). “Information Giving in Medical Care”. Journal of Health and Social Behavior, 26: 81-101.
• Waitzkin, H. (1991). The Politics of Medical Encounters: How Patients and Doctors Deal with Social Problems. New Haven: Yale University.
• Wanless, M.B., Holloway, P.J. (1994). “An Analysis of Audio-Recordings of General Dental Practitioners’ Consultations with Adolescent Patients”. British Dental Journal, 177: 94-8.
• Willems S., Maesschalck, S.D., Deveugele, M., Derese, A. Maeseneer, J. (2005). “Socio- economic Status of Patient and Doctor-Patient Communication: Does it Make a Difference?” Patient Education and Counseling, 56: 139-46.
• Winefield, H.R., Murrell, T.G., Clifford, J. (1995). “Process and Outcome in General Practice Consultations: Problems in Defining High Quality Care”. Social Science & Medicine, 41: 969- 75.
• Wynn, R. (1995). The Linguistics of Doctor-Patient Communication: An Analysis of the Methodology of Doctor-Patient Communication Research. Oslo: Novus.