2016/11/02 by Laura L. S. O’Hara · 1 citation
Arts and Humanities · Health Professions · #Hermeneutics and Narrative Identity #Mental Health and Patient Involvement #Mental Health and Psychiatry
paper · doi:10.1080/10570314.2016.1241425
openalex publication_date 2016/11/02 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/28
This case study employs Relational Dialectics 2.0 as a theoretical framework, deeply analyzing one patient–physician dyad over the course of three visits as the meanings of “diabetes management” are discursively contested. This study examines two understudied links on the chain of speech communion: the proximal-already-spoken and the proximal not-yet-spoken. The analysis reveals two primary contested discourses: “change for the better” (subdiscourses: “personal control over one’s circumstances” and “rational science”) and “stasis” (subdiscourses: “helplessness” and “shame”). Understanding the discourse occurring at these sites can move patient/physician dyads from repeating unproductive conversations to working as partners to achieve better patient health outcomes.