A cell is a cell is a cell [Elektronische Ressource] : lay medical understanding and its role in online health tutoring / vorgelegt von Bettina-Maria Becker

Tina

Sujets

• Psychologie

Informations

• Publié par: westfalische_wilhelms-universitat_munster
• Publié le: 01 janvier 2008
• Nombre de lectures: 21
• Langue: English
• Poids de l'ouvrage: 1 Mo

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Fachgebiet:Psychologie



A CELL IS A CELL IS A CELL -
LAYMEDICALUNDERSTANDINGANDITSROLEIN
ONLINEHEALTHTUTORING


Inaugural$Dissertation
zurErlangungdesDoktorgrades
der
PhilosophischenFakultät
der
WestfälischenWilhelms$Universität
zu
Münster(Westf.)

vorgelegtvon
Bettina$MariaBecker
ausMünster(Westf.)
Münster,2008TagdermündlichenPrüfung: 23.Juni2008
Dekan: Prof.Dr.Dr.h.c.WichardWoyke
Referent: Prof.Dr.RainerBromme
Korreferentin: Prof.Dr.ReginaJucks






Dedication
Tomyparents–UrsulaandDr.HeinrichBecker.Acknowledgements
Inthecourseofwritingthisdissertationthesis,Ireceivedencouragementandsupport
frommanypeople.Atthispoint,Iwouldliketotaketheopportunitytosaythankyou.
Firstandforemost,IwanttothankProfessorDr.RainerBrommeforbeingagreat
supervisor.Healwaysshowedinterestinmyideasandprovidedmewithmanyinsight$
ful,criticalandencouragingcomments.Ialsothankhimfortheopportunitytoform
part of his research team, whose creative and respectful working atmosphere has
shapedmyideaofapositiveworkenvironment.
IwishtoexpressmygratitudetoProfessorDr.ReginaJuckswhohasbeenmyother
importantmentor.Ilearnedagreatmanythingsfromher,includinganembracingatti$
tudetowardsthechallengesoftheresearchprocess.
IalsowanttothanktherestoftheBrommeresearchteam,especiallyTobiasBar$
tholomé, Barbara Heinen, Dorothe Kienhues, Torsten Porsch, Petra Schulte$Löbbert,
MarcStadtlerandStephyPieschl.Thanksformanyinspiringdiscussions,bothrelated
andnotrelatedtoeducationalpsychology.Thanksforyourhelponmanythings.
SpecialappreciationgoestoPetraSchulte$Löbbertforproofreadingthedissertation,
for her many useful remarks, and for letting me benefit from her computer skills on
numerousoccasions.
IamgratefultotheGermanResearchFoundation(DFG)forsupportingmydisserta$
tionprojectfinancially.Also,mythanksgototheprofessorsandfellowgraduatestu$
dentsattheVirtualGraduateSchool(VGK)oftheDFG.Thankyouforstimulatingin$
putandexchange.
LenaBeck,HannaFerdinand,MargitSchürmann,PetraSchulte$LöbbertandKatrin
Sommerwereinvolvedasstudentassistantsindatacollectionandanalysis$thanksto
allofyouforyourreliableassistance.
Last,butnotleast,Iwanttothankmyfriendsandmyparents.Thankyouforyour
company,yourloveandsupport.ThankyouformakingthePhDyearsgoodyears.

SoIthankyouall…Andhereismythesis:
Table of Contents

1 Introduction and Overview............................................................................ 1

2 Theoretical Background................................................................................ 4
2.1 Expertsandlaypersons–asystematicknowledgedivergence……...................................... 4
2.1.1 Expertknowledge…………………………………………………………………....................................... 4
Expertandexpertise…………………….………………………………………………………………………… 4
Expertisedevelopmentinthedomainofmedicine…………..……………………..……………….. 5
Researchfindingsonexpertknowledge…………………………………………………………………… 5
2.1.2 Layknowledge……………………………………………………………………………………….................... 7
Researchfindingsonlayknowledge…..…………………………………………………………………… 7
Layknowledgeinthedomainofmedicine………………………………………………………………. 9
2.1.3 Systematicknowledgedivergenceandconversation………………………………...................... 10
2.2 Humantutoring…………………………………………………......................................................... 12
Paucityofadjustmentinhumantutoring……………….……………………………….……………… 14
Writtenonlinetutoring………………………………………….……………………………….…………….. 19
2.2.1 Tutoringandexpert$laypersoncommunication.……………….............................................. 19
2.3 Pragmaticprinciplesinconversation.…………..……….......................................................... 21
2.3.1 CooperativePrinciple…………………………….…..................................................................... 21
Sharingcommonground–Clark’stheoryofcommunication………………………………….. 23
Audiencedesignvs.automaticalignment..…………………………………………………………….. 25
2.3.2 PolitenessPrinciple………………..………………….................................................................... 28
Linguisticpoliteness…………………………………………………………..….……………………………… 28
BrownandLevinson’s(1987)accountofpoliteness………….…………………………………….. 29
ResearchbasedonBrownandLevinson’s(1987)politenessaccount..............…………… 36
Politenessinformalandinformaltutorialsettings……………….….…………………………….. 39
2.4 Emailhealthcounseling…………………….…………………………............................................... 45
2.4.1 HealthservicesontheInternet……………………………………….............................................. 45
Onthequalityofhealth3relatedinformationontheInternet..………………………………….. 46
2.4.2 Characteristicsofemailhealthcounseling........…………………............................................ 49
2.4.3 Lexicalalignmentinemailhealthcounseling………………………………………………............. 51
Lexicalalignmentindialogue……….………………………………………………………………………. 52
Lexicalalignmentinemailexpert3laypersoncommunication….….………………….……….. 54

3 Emerging research questions...................................................................... 58

4 Study I: Not quite blank slates – a questionnaire survey of lay medical be-
liefs…………………………………………………………………………………………………… 60
4.1 Introduction........................................................................................................................ 60
4.2 Method…............................................................................................................................. 61
4.2.1 Participants......................................................................................................................... 61
4.2.2 Materials…….…................................................................................................................... 62 Selectionofthetopic.............................................................................................…............62
DevelopmentoftheMetSQuestionnaire..…………………………………….…………………………. 64
4.2.3 Procedure…………................................................................................................................. 68
4.3 DataAnalysesandResults...................................................................................................68
4.4 Discussion………………………………………………………............................................................. 80

5 Study II: The impact of a display of lay beliefs on medical experts’ anticipa-
tion of lay knowledge…………..………………………………………........................... 83
5.1 Introduction......................................................................................................................... 83
5.2 Method….............................................................................................................................. 87
5.2.1 Participants.......................................................................................................................... 87
5.2.2 Materials.……….................................................................................................................... 87
Diabetesquestionnaire..........................................................................................….......... 87
Patientemailquery……………………………...…………………………………….………………………… 88
Knowledgeassessmentquestionnaire..…...…………………………………….………………………. 91
Holisticknowledgeassessmentitem………………………………………….…………….…………….. 94
5.2.3 DesignandProcedure......................................................................................................... 94
5.3 Results................................................................................................................................. 95
5.4 Discussion………………………………………………………............................................................ 97

6 Study III: The impact of a display of lay beliefs on medical experts’ answers
to lay queries……………………..……………………………………….......................... 100
6.1 Introduction.......................................................................................................................100
6.2 Method…............................................................................................................................ 104
6.2.1 Participants........................................................................................................................ 104
6.2.2 Materials.……….................................................................................................................. 105
Diabetesquestionnaire..........................................................................................…........ 105
Patientemailquery……………………………...…………………………………….….…………………… 105
Computer,Internet,&textprocessingsoftwareusequestionnaire…………….…………… 105
Holisticknowledgeassessmentitem………………………………………….…………….…………... 106
6.2.3 DesignandProcedure....................................................................................................... 107
6.2.4 Quantitativedataanalysis................................................................................................. 108
Intercoderagreement…..........................................................................................…....... 108
Dependentmeasures…………………………....…………………………………….….…………………… 109
6.2.5 Qualitativedataanalysis................................................................................................... 112
6.3 Resu