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Communication Practices and Face Negotiation in Patient-Pharmacist Interactions Open Access


Other title
Audio recording
Face-Work Theory
Patient-Pharmacist Interactions
Type of item
Degree grantor
University of Alberta
Author or creator
Murad, Muna S.
Supervisor and department
Lisa Guirguis/Faculty of Pharmacy-Pharmacy Practice
Examining committee member and department
Dr. Jude Spiers/ Faculty of Nursing
Dr. Ken Cor/Faculty of Pharmacy-Pharmacy Practice
Faculty of Pharmacy and Pharmaceutical Sciences
Pharmacy Practice
Date accepted
Graduation date
Doctor of Philosophy
Degree level
Pharmacists’ roles are evolving from dispensing to providing patient-centred care. Appropriate patient-pharmacist communication is important in achieving patient-centred care aims. The research in this dissertation explored audiotaped recordings of pharmacist-patient interactions to determine communicative practices and how pharmacist and patient use strategic communication to achieve instrumental and interpersonal goals. In the first published study of this dissertation, recorded interactions provided insight into the extent of biomedical versus patient-centred communication in patient-pharmacist exchanges. Studies were identified by searching: Medline, Embase, International Pharmaceutical Abstracts (IPA), Web of Science, and Academic Search Complete. Inclusion criteria were that studies were published in English. Key search terms included: “audio recording”, “video recording”, “communication”, “patient counselling”, “patient interaction”, “discourse analysis”, “conversation analysis”, “narrative analysis”, and “content analysis”. The review the included 41 studies found that biomedical and patient centred communication focused researches were framed within quantitative, qualitative methods, including conversational analysis. Twenty-three studies presented evidence of a biomedical model, whereas eight studies characterized a patient-centred focus. Respect, dignity, autonomy, and acknowledgment affect patient-pharmacist communication process and no study explored the effect of neither these factors nor the social context on this communication process. In the second study in this thesis, the advantages of using face-work theory to analyze patient-pharmacist interactions were identified. The second study described the concept of face and the three types of face needs. Pharmacists and patients demonstrated these three types of face needs during their interaction with each other and the third study in this thesis explored how these face needs are negotiated and challenged by both parties. The study used an exploratory descriptive design to identify the major contexts of expressing and negotiating face in audio-recorded community pharmacist-patient interactions. Its results explained how certain speech acts linked with face needs in order to avoid or mitigate face threat and how successful pharmacist-patient relationships are established when both pharmacist and patient have mutual understanding of their face needs. The research results contained in this dissertation contribute to knowledge about how pharmacists combine instrumental communication strategies to achieve patience centred goals for patient education, medication assessment and self-care management. Simultaneously, pharmacists attend to interpersonal face needs in the domains of competence, autonomy and solidarity, because without attention to these facets of interaction, instrumental goals are more difficult to achieve. Although the data from the empirical studies in this dissertation are limited by sample size and audio-only recording format, this research provides a unique insight into face-work interaction in the context of pharmacy practice. Face-Work Theory provides a useful mechanism by which to understand how professional pharmacy interactions are most effective when mutual face needs are supported and actual or potential face threats are avoided or mitigated. These findings may be useful to guide pharmacy education to support patient centred practice. Further research using video-recorded pharmacy interactions is required to confirm and extended these findings.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
Citation for previous publication
Muna S. Murad, Trish Lyn Chatterley, and Lisa Guirguis. “A meta-narrative review of recorded patient–pharmacist interactions: Exploring biomedical or patient-centred communication?” Research in Social and Administrative Pharmacy, 10 (1), 1-20.

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