Volume 25, Issue 3
  • ISSN 0929-0907
  • E-ISSN: 1569-9943
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This study investigates the cognitive-pragmatic motivations for the emergence of a genre of health communication called (PDA). It elucidates , i.e. how the emerging genre exemplifies various struggles on three strata: the difficulties facing patients, doctors, and health providers at practice level; the changes anticipated to take place at discourse level; and the tensions in the pragmatics-cognition-society nexus. Particularly illustrated here are five struggles that characterize changes or breakthroughs that PDAs are anticipated to make. It suggests that the five struggles roughly correspond to five principles for genre theory proposed by Berkenkotter and Huckin (1993), with some modification of the latter. It also illustrates that genre intervenes in the complexity between social issues and social cognition and that PDAs as a new genre involve restructuring, reshaping and redesigning the key discourse facets (e.g. prior discourse, participants, language, medium, the world, and purpose). Based on examples of Chinese-language PDAs officially released in Taiwan and on information from health professionals, policy makers, and PDA developers, this study contributes empirical evidence toward a better understanding of an emerging genre.


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  1. Bazerman, Charles
    1988Shaping written knowledge: The genre and activity of the experimental article in science. Madison, WI: University of Wisconsin Press.
    [Google Scholar]
  2. 1994 Systems of genres and the enactment of social intentions. InAviva Freedman & Peter Medway (eds.), Genre and the new rhetoric, 79–101. London: Taylor & Francis.
    [Google Scholar]
  3. 1997 The life of genre, the life in the classroom. InWendy Bishop & Hans A. Ostrom (eds.), Genre and writing: Issues, arguments, alternatives, 19–26. Portsmouth, NH: Boynton/Cook.
    [Google Scholar]
  4. Berkenkotter, Carol & Thomas N. Huckin
    1993 Rethinking genre from a sociocognitive perspective. Written Communication10(4). 475–509. 10.1177/0741088393010004001
    https://doi.org/10.1177/0741088393010004001 [Google Scholar]
  5. 1995Genre knowledge in disciplinary communication: Cognition, culture, power. Hillsdale, NJ: Lawrence Erlbaum Associates.
    [Google Scholar]
  6. Britain, Conor
    2009Raising reality to the mythic on the Web: The future of interactive documentary film. North Carolina: Elon University.
    [Google Scholar]
  7. Brown, John Seely, Allan Collins & Paul Duguid
    1989 Situated cognition and the culture of learning. Educational Researcher18(1). 32–42. 10.3102/0013189X018001032
    https://doi.org/10.3102/0013189X018001032 [Google Scholar]
  8. Charles, Cathy, Amiram Gafni & Tim Whelan
    1997 Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango). Social Science and Medicine44(5). 681–692. 10.1016/S0277‑9536(96)00221‑3
    https://doi.org/10.1016/S0277-9536(96)00221-3 [Google Scholar]
  9. Clever, Sarah L., Daniel E. Ford, Lisa V. Rubenstein, Kathryn M. Rost, Lisa S. Meredith, Cathy D. Sherbourne, Nae-Yuh Wang, Jose J. Arbelaez & Lisa A. Cooper
    2006 Primary care patients’ involvement in decision-making is associated with improvement in depression. Medical Care44(5). 398–405. 10.1097/01.mlr.0000208117.15531.da
    https://doi.org/10.1097/01.mlr.0000208117.15531.da [Google Scholar]
  10. Coulter, Angela
    1999 Paternalism or partnership? Patients have grown up – and there’s no going back. BMJ319(7212). 719–720. 10.1136/bmj.319.7212.719
    https://doi.org/10.1136/bmj.319.7212.719 [Google Scholar]
  11. Crawford Camiciottoli, Belinda
    2010 Earnings calls: Exploring an emerging financial reporting genre. Discourse & Communication4(4). 343–359. 10.1177/1750481310381681
    https://doi.org/10.1177/1750481310381681 [Google Scholar]
  12. Devitt, Amy J.
    1997 Genre as language standard. InWendy Bishop & Hans A. Ostrom (eds.), Genre and writing: Issues, arguments, alternatives, 45–55. Portsmouth, NH: Boynton/ Cook.
    [Google Scholar]
  13. Elwyn, Glyn, Dominick L. Frosch, Richard G. Thomson, Natalie Joseph-Williams, Amy Lloyd, Paul Kinnersley, Emma Cording, Dave Tomson, Carole M. Dodd, Stephen Rollnick, Adrian G. K. Edwards & Michael J. Barry
    2012 Shared decision making: A model for clinical practice. Journal of General Internal Medicine27(10). 1361–1367. 10.1007/s11606‑012‑2077‑6
    https://doi.org/10.1007/s11606-012-2077-6 [Google Scholar]
  14. Emanuel, Ezekiel J. & Linda L. Emanuel
    1992 Four models of the physician-patient relationship. Journal of the American Medical Association267. 2221–2226. 10.1001/jama.1992.03480160079038
    https://doi.org/10.1001/jama.1992.03480160079038 [Google Scholar]
  15. Fishelov, David
    1993Metaphors of genre: The role of analogies in genre theory. University Park, PA: Pennsylvania State University Press.
    [Google Scholar]
  16. Gifreu, Arnau
    2011 The interactive multimedia documentary as a discourse on interactive non-fiction: For a proposal of the definition and categorisation of the emerging genre. Hipertext.net9, www.upf.edu/hipertextnet/en/numero-9/interactive-multimedia.html. (28 March 2018).
  17. Grice, H. Paul
    1975 Logic and conversation. InPeter Cole & Jerry L. Morgan (eds.), Syntax and semantics, vol.3, Speech acts, 41–58. New York: Academic Press. 10.1163/9789004368811_003
    https://doi.org/10.1163/9789004368811_003 [Google Scholar]
  18. Hsieh, Hsing-Chun (謝幸㚬)
    2016 November. Sharing the experience of using SDM: Do I need statins to prevent cardiovascular disease? (決策輔助工具分享: 我需要史達汀類降血脂藥物來預防心血管疾病嗎?). https://sdm.patientsafety.mohw.gov.tw/Files/PublicContent/19/04-奇美醫院決策輔助工具分享.pdf (15 February 2018).
  19. Hua, Yi-Ming (花逸茗)
    2017 January. Shared decision making (醫病共享決策). https://www.cgh.org.tw/apply/c1/DL/2017011402.pdf (15 February 2018).
  20. Johnstone, Barbara
    2018Discourse analysis, 3rd edn.London: Blackwell.
    [Google Scholar]
  21. Kress, Gunther
    2012 Genre as social process. InBill Cope & Mary Kalanztis (eds.), The powers of literacy: A genre approach to teaching writing, 22–37. London: Routledge.
    [Google Scholar]
  22. Lee, Kun-Yuan (李堃源)
    2017 November. Sharing the results of implementing SDM (SDM實踐運動成果分享). https://sdm.patientsafety.mohw.gov.tw/Files/PublicContent/19/05_輔英科大附設醫院_實踐運動成果發表.pdf (25 February 2018).
  23. Lee, Yi-Kung (李宜恭)
    2017 June. How to make PDAs? (如何做出病人決策輔助工具?). https://sdm.patientsafety.mohw.gov.tw/Files/PublicContent/19/李宜恭主任-決策輔助工具開發方法(2).pdf (25 March 2018).
  24. Liao, Hsun-Hsiang (廖熏香)
  25. 2017a The current status and an overall review of the implementation of shared decision making in Taiwan in 2017 (2017醫病共享決策國內推行現況與整體回顧). https://sdm.patientsafety.mohw.gov.tw/Files/PublicContent/19/01_廖熏香副執行長_醫病共享決策整體回顧.pdf (25 March 2018).
  26. 2017b Shared decision making: Concepts reviewed and fallacies clarified (醫病共享決 策: 觀念回顧與迷思釐清). https://sdm.patientsafety.mohw.gov.tw/Files/PublicContent/19/廖熏香-SDM觀念回顧與釐清.pdf (1 March 2018).
  27. Liao, Hsun-Hsiang, Huey-Wen Liang, Hou-Chaung Chen, Ching-I. Chang, Pa-Chun Wang & Chung-Liang Shih
    2017 Shared decision making in Taiwan. The Journal of Evidence and Quality in Health Care (ZEFQ)123/124. 95–98.
    [Google Scholar]
  28. Lin, Patria Y., Duncan G. Campbell, Edmund Chaney, Chuan-Fen Liu, Patrick J. Heagerty, Bradford L. Felker & Susan C. Hedrick
    2005 The influence of patient preference on depression treatment in primary care. Annals of Behavioral Medicine30(2). 164–173. 10.1207/s15324796abm3002_9
    https://doi.org/10.1207/s15324796abm3002_9 [Google Scholar]
  29. Malm, Ulf, Bo Ivarsson, Peter Allebeck & Ian Falloon
    2003 Integrated care in schizophrenia: A 2-year randomized controlled study of two community-based treatment programs. Acta Psychiatrica Scandinavica107(6). 415–423. 10.1034/j.1600‑0447.2003.00085.x
    https://doi.org/10.1034/j.1600-0447.2003.00085.x [Google Scholar]
  30. Miller, Carolyn R.
    1984 Genre as social action. Quarterly Journal of Speech70(2). 151–167. 10.1080/00335638409383686
    https://doi.org/10.1080/00335638409383686 [Google Scholar]
  31. 2016 Genre innovation: Evolution, emergence or something else?The Journal of Media Innovations3(2). 4–19. 10.5617/jmi.v3i2.2432
    https://doi.org/10.5617/jmi.v3i2.2432 [Google Scholar]
  32. Miller, Carolyn R. & Ashley R. Kelly
    (eds.) 2017Emerging genres in new media environments. Cham: Palgrave Macmillan. 10.1007/978‑3‑319‑40295‑6
    https://doi.org/10.1007/978-3-319-40295-6 [Google Scholar]
  33. O’Connor, Annette M., Alaa Rostom, Valerie J. Fiset, Jacqueline M. Tetroe, Vikki A. Entwistle, Hilary Llewellyn-Thomas, Margaret Holmes-Rovner, M. Barry & June E. Jones
    1999 Decision aids for patients facing health treatment or screening decisions: A systematic review. BMJ319. 731–734. 10.1136/bmj.319.7212.731
    https://doi.org/10.1136/bmj.319.7212.731 [Google Scholar]
  34. O’Connor, Annette M., Carol Bennett, Dawn Stacey, Michael J. Barry, Nananda F. Col, Karen B. Eden, Vikki A. Entwistle, Valerie J. Fiset, Margaret Holmes-Rovner, Sara D. Khangura, Hilary Llewellyn-Thomas & David R. Rovner
    2007 Do patient decision aids meet effectiveness criteria of the International Patient Decision Aid Standards Collaboration? A systematic review and meta-analysis. Medical Decision Making27(5). 554–574. 10.1177/0272989X07307319
    https://doi.org/10.1177/0272989X07307319 [Google Scholar]
  35. Oravec, Jo A.
    2013 Weblogs as an emerging genre in higher education. Journal of Computing in Higher Education14(2). 21–44. 10.1007/BF02940937
    https://doi.org/10.1007/BF02940937 [Google Scholar]
  36. Østergaard, Svend & Peer F. Bundgaard
    2015 The emergence and nature of genres – a social-dynamic account. Cognitive Semiotics8(2). 97–127. 10.1515/cogsem‑2015‑0007
    https://doi.org/10.1515/cogsem-2015-0007 [Google Scholar]
  37. Ozanne, Elissa M., Rebecca Howe, Bayan Omer & Laura J. Esserman
    2014 Development of a personalized decision aid for breast cancer risk reduction and management. BMC Medical Informatics and Decision Making14(4). doi:  10.1186/1472‑6947‑14‑4
    https://doi.org/10.1186/1472-6947-14-4 [Google Scholar]
  38. Puschmann, Cornelius
    2010The corporate blog as an emerging genre of computer-mediated communication: Features, constraints, discourse situation. Göttingen, Germany: Universitätsverlag Göttingen.
    [Google Scholar]
  39. Sepucha, Karen R., Cornelia M. Borkhoff, Joanne Lally, Carrie A. Levin, Daniel D. Matlock, Chirk Ng, Mary E. Ropka, Dawn Stacey, Natalie Joseph-Williams, Celia E. Wills & Richard Thomson
    2013 Establishing the effectiveness of patient decision aids: Key constructs and measurement instruments. BMC Medical Informatics and Decision Making13(Suppl 2). S12. 10.1186/1472‑6947‑13‑S2‑S12
    https://doi.org/10.1186/1472-6947-13-S2-S12 [Google Scholar]
  40. Steen, Gerard J.
    2011 Genre between the humanities and the sciences. InMarcus Callies, Wolfram R. Keller & Astrid Lohöfer (eds.), Bi-directionality in the cognitive sciences: Examining the interdisciplinary potential of cognitive approaches in linguistics and literary studies, 21–42. Amsterdam/Philadelphia: John Benjamins. 10.1075/hcp.30.03ste
    https://doi.org/10.1075/hcp.30.03ste [Google Scholar]
  41. Swales, John M.
    2004Research genres: Explorations and applications. Cambridge: Cambridge University Press. 10.1017/CBO9781139524827
    https://doi.org/10.1017/CBO9781139524827 [Google Scholar]
  42. Tseng, Ming-Yu
    2011 The genre of research grant proposals: Towards a cognitive-pragmatic analysis. Journal of Pragmatics43(8). 2254–2268. 10.1016/j.pragma.2011.02.015
    https://doi.org/10.1016/j.pragma.2011.02.015 [Google Scholar]
  43. Volk, Robert J., Hilary A. Llewellyn-Thomas, Dawn Stacey & Glyn Elwyn
    2013 Ten years of the International Patient Decision Aid Standards Collaboration: Evolution of the core dimensions for assessing the quality of patient decision aids. BMC Medical Informatics and Decision Making13(Suppl 2). S1. 10.1186/1472‑6947‑13‑S2‑S1
    https://doi.org/10.1186/1472-6947-13-S2-S1 [Google Scholar]
  44. Wu, Pi-Chuan (吳碧娟)
    2016 Shard decision making scheme: PDA competition and promotion (【醫病共享決策計畫】輔助工具競賽及響應辦法). https://sdm.patientsafety.mohw.gov.tw/Files/PublicContent/19/03_輔助工具競賽辦法與響應辦法說明_吳碧娟專案管理師(PDF)(檔案下載).pdf (12 January 2018).
  45. Yates, Joanne & Wanda J. Orlikowski
    1992 Genres of organizational communication: A structurational approach to studying communication and media. Academy of Management Review17(2). 299–326. 10.5465/amr.1992.4279545
    https://doi.org/10.5465/amr.1992.4279545 [Google Scholar]

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  • Article Type: Research Article
Keyword(s): emerging genre; genre as struggle; health communication; patient decision aid
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