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Analysis of Patient Cues in Asynchronous Health Interactions: Pilot Study Combining Empathy Appraisal and Systemic Functional Linguistics
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posted on 2023-02-13, 05:28 authored by ER Velasco, HS Pedersen, T Skinner, Sharleen O'ReillySharleen O'Reilly, AA Geraghty, F Zahoor, FM McAuliffe, M Codd, R Segurado, HT Maindal, NH Jensen, A Davies, C Burden, JE Norman, K Vrangbæk, LE Pirhonen, E Herrera-Viedman, M Bermúdez, C Campoy, A Puertas, FS Molina, DH Laursen, K Angotti, S Jørgensen, Karen CampbellKaren Campbell, Rachel LawsRachel Laws, Vincent VersaceVincent Versace, H Teede, CL Harrison, J Boyle, G SoldartisBackground: Lifestyle-related diseases are among the leading causes of death and disability. Their rapid increase worldwide has called for low-cost, scalable solutions to promote health behavior changes. Digital health coaching has proved to be effective in delivering affordable, scalable programs to support lifestyle change. This approach increasingly relies on asynchronous text-based interventions to motivate and support behavior change. Although we know that empathy is a core element for a successful coach-user relationship and positive patient outcomes, we lack research on how this is realized in text-based interactions. Systemic functional linguistics (SFL) is a linguistic theory that may support the identification of empathy opportunities (EOs) in text-based interactions, as well as the reasoning behind patients' linguistic choices in their formulation. Objective: This study aims to determine whether empathy and SFL approaches correspond and complement each other satisfactorily to study text-based communication in a health coaching context. We sought to explore whether combining empathic assessment with SFL categories can provide a means to understand client-coach interactions in asynchronous text-based coaching interactions. Methods: We retrieved 148 text messages sent by 29 women who participated in a randomized trial of telecoaching for the prevention of gestational diabetes mellitus (GDM) and postnatal weight loss. We conducted a pilot study to identify users' explicit and implicit EOs and further investigated these statements using the SFL approach, focusing on the analysis of transitivity and thematic analysis. Results: We identified 164 EOs present in 42.37% (3478/8209) of the word count in the corpus. These were mainly negative (n=90, 54.88%) and implicit (n=55, 60.00%). We distinguished opening, content and closing messages structures. Most of the wording was found in the content (n=7077, 86.21%) with a declarative structure (n=7084, 86.30%). Processes represented 22.4% (n=1839) of the corpus, with half being material (n=876, 10.67%) and mostly related to food and diet (n=196, 54.92%), physical activity (n=96, 26.89%), and lifestyle goals (n=40, 11.20%). Conclusions: Our findings show that empathy and SFL approaches are compatible. The results from our transitivity analysis reveal novel insights into the meanings of the users' EOs, such as their seek for help or praise, often missed by health care professionals (HCPs), and on the coach-user relationship. The absence of explicit EOs and direct questions could be attributed to low trust on or information about the coach's abilities. In the future, we will conduct further research to explore additional linguistic features and code coach messages.
History
Journal
JMIR Formative ResearchVolume
6Pagination
e40058-e40058Location
CanadaPublisher DOI
ISSN
2561-326XeISSN
2561-326XLanguage
enIssue
12Publisher
JMIR Publications Inc.Usage metrics
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No categories selectedKeywords
asynchronous communicationcoach-user interactioncodingcommunicationempathyhealth promotionlifestyle-related diseaselinguistic analysissystemic functional linguisticstelecoachingtelehealthtool developmentuser experienceImpact Diabetes B2B Collaboration GroupClinical ResearchBehavioral and Social ScienceHealth Services
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