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Title: Implementation of Patient-Centered Research Trends

Implementation of Patient-Centered Research Trends

In collaboration with Sarah Bigi, Zsófia Demjén, Jan Engberg, Pascaline Faure, and Rita Temmerman

by Dániel Mány (Volume editor) Katalin Fogarasi (Volume editor)
©2026 Edited Collection 290 Pages
Linguistics
Open Access
Series: Semmelweis Medical Linguistics Investigations, Volume 2

Summary

This volume brings together international scholars examining how language shapes patients’ understanding, participation, decision-making, and experiences of care across diverse healthcare settings. Papers written by experts in medicine and linguistics include clinical communication, healthcare interpreting and translation, multilingual patient care, medical documentation, terminology management, and healthcare language education. Addressing both spoken and written communication, the volume offers evidence-based insights into improving clarity, accessibility, professional training, and patient engagement. An essential resource for researchers, educators, healthcare professionals, and language practitioners, it highlights the central role of communication in promoting safer, more effective, and more patient-centered healthcare.

Table Of Contents

  • Cover
  • Title Page
  • Copyright Page
  • Table of Contents
  • Preface
  • Part I Medical discourse
  • Agency mitigation in oncological medical interactions (Dominic Hendricks – Wolfgang Imo)
  • 1. Introduction
  • 2. Agency, the agent, and agent mitigation
  • 3. The data
  • 4. Results: agency and its mitigation
  • 4.1. Excerpt 1
  • 4.2. Excerpt 2
  • 4.3. Excerpt 3
  • 4.4. Excerpt 4
  • 4.5. Excerpt 5
  • 4.6. Excerpt 6
  • 4.7. Excerpt 7
  • 4.8. Excerpt 8
  • 4.9. Excerpt 9
  • 5. Conclusion
  • References
  • “Sandra popped her clogs and Bob crossed the bridge.” The use of euphemism in medical discourse around death: Does it negate informed consent? A critical discourse analysis (Ellen Verenieks)
  • 1. Introduction
  • 1.1. Informed consent
  • 2. Euphemism: literature review
  • 3. Data and methodology
  • 3.1. Marie Curie Corpus (MCC)
  • 3.2. Medical Interactions Corpus (MIC)
  • 3.3. Methodology
  • 4. Results and discussions
  • 4.1. Euphemism in societal interactions (Q1): MCC results
  • 4.2. Euphemism in societal interactions (Q1): MCC discussion
  • 4.2.1. Transitioning
  • 4.2.2. Passed away (and its variations)
  • 4.3. Euphemism in medical interactions (Q2): MIC results
  • 4.4. Euphemism in medical interactions (Q2): MIC discussion
  • 4.4.1. Paternalism vs clarity vs autonomy
  • 4.5. Euphemism: negating informed consent in medical care? (Q3)
  • 4.5.1. Linguistic code in EOL care: reinventing medical reality through language
  • 4.5.2. Conclusion: euphemism negates informed consent
  • 5. Conclusion—discussion
  • References
  • The metaphor markers of presuicidal syndrome in Hungarian (Gábor Simon – Tímea Borbála Bajzát – Kata Árvay – Júlia Ballagó – Kitti Hauber – Zsuzsanna Havasi – Ágnes Kuna – Emese K. Molnár – Noémi Prótár – Eszter Szlávich – Zsuzsa Kaló)
  • 1. Introduction
  • 2. Theoretical framework—STB, presuicidal syndrome, the motivational-volitional model, and cognitive metaphor research
  • 3. Material and methods
  • 4. Results and discussion
  • 5. Conclusion
  • References
  • Who says what? The metapragmatic construction muss man sagen (one must say) in German oncological consultations (Dominic Hendricks)
  • 1. Introduction
  • 2. Metapragmatic constructions with man ‘one’
  • 3. The data
  • 4. Results: One must say in oncological consultations
  • 4.1. One must say used to modalize negatively assessed utterances
  • 4.2. One must say to modalize positively assessed utterances
  • 5. Conclusion
  • References
  • Unproductive or “Super Crip”? Persons with disabilities in the academic discourse of human resource management in Hungary (Carmen Svastics)
  • 1. Introduction
  • 2. Methods
  • 3. Results
  • 4. Discussion
  • 4.1. Disability as a negative concept
  • 4.2. Deconstruction of disability stereotypes
  • 4.3. Metaphors
  • 5. Conclusion
  • References
  • Part II Language mediation
  • How healthcare interpreting training (mis)matches the expectations of healthcare providers: A pilot study on postgraduate PSI training in Spain (Sofía Antequera-Manzano)
  • 1. Introduction
  • 2. Methodology
  • 3. Results
  • 4. Discussion
  • 5. Conclusion
  • References
  • Traduttore, traditore? PICU provider perceptions of alterations in interpreted medical communication (Melissa Chiu – Lubna Barakat – Viktorija Bilić – Andrea Maxwell – W. Hobart Davies – Charles B. Rothschild – Amy Olen)
  • 1. Introduction
  • 2. Methods
  • 2.1. Research team
  • 2.2. Procedures
  • 2.3. Data analysis
  • 3. Results
  • 3.1. Theme 1: Provider identification or perception of interpreter alterations
  • 3.1.1. Didn’t know/wouldn’t know
  • 3.1.2. Trust
  • 3.1.3. Length of utterance
  • 3.1.4. Unexpected family response
  • 3.1.5. Provider understands language
  • 3.1.6. Bilingual bystander comments
  • 3.2. Theme 2: PICU provider assessment of perceived interpreter alterations
  • 3.2.1. Appropriate, well-intended changes
  • 3.2.2. Miscommunication or misunderstanding
  • 3.2.3. Culture-specific items
  • 4. Discussion
  • 5. Conclusion
  • References
  • Communicating obesity online to healthcare professionals and to the public: An analysis of the textual strategies to signal the source of information in magazine articles (Sibilla Parlato – Chiara Midea)
  • 1. Introduction
  • 2. Online health communication as a possible intervention
  • 3. Methods
  • 4. Results
  • 4.1. Direct speech and indirect speech
  • 4.2. [Secondo X, Y] ‘According to X, Y’
  • 5. Discussion and conclusion
  • References
  • The most commonly translated medical documents in Hungary: Genres, direction of translation, and guidelines (Ágnes Horváth – Réka Bózsó-Csenki)
  • 1. Introduction
  • 2. Methods
  • 2.1. Participants
  • 2.2. Instruments of data collection and methods of analysis
  • 3. Results
  • 3.1. Most frequently translated genres by translation agencies and the direction of translation
  • 3.2. Most frequently translated genres and language directions among trained medical translators
  • 3.3. Translation guides and templates
  • 4. Discussion
  • 4.1. The most frequently translated healthcare genres
  • 4.2. Resource limitations
  • 4.3. Implications for training and practice
  • 5. Conclusion
  • References
  • Part III LSP teaching
  • Analysis of the speech output of foreign medical students learning Hungarian medical terminology (Hortenzia Halász – Mónika Putz)
  • 1. Introduction
  • 2. Methods—a two-stage study
  • 2.1. First stage: Examination of speaking skills at the end of the first semester (December 2021)
  • 2.2. Second stage: Examination of speaking skills at the end of the third semester (December 2022)
  • 3. Results
  • 3.1. Evaluation of the results of the first stage
  • 3.2. Evaluation of results of the second stage
  • 3.3. Pronunciation characteristics of the problematic sentences
  • 4. Conclusion
  • References
  • New challenges in teaching Hungarian for dental purposes: Insights from measuring students’ attitudes toward communication skills (Mónika Putz – Gábor Gyenes)
  • 1. Introduction
  • 2. Methods
  • 2.1. Methodological framework
  • 2.2. Responders and analyzed data
  • 3. Results
  • 4. Discussion
  • 5. Conclusion
  • References
  • Part IV Documentation
  • Nurses’ perceptions on the transformation of the Hungarian documentation system (Tünde Vágási – Gábor Gyenes – Éva Katalin Varga – Ingrid Lengyel)
  • 1. Introduction
  • 2. Methods
  • 2.1. Statistical analysis
  • 2.2. Ethical considerations
  • 3. Results
  • 4. Conclusions
  • References
  • Terminological inconsistencies in the documentation of blunt-force injuries in Hungary (Judit Császár – Gábor Simon – Gábor Gyenes – Zoltán Patonai – Katalin Fogarasi)
  • 1. Introduction
  • 2. Materials and methods
  • 3. Results
  • 3.1. Terminological inconsistencies
  • 3.2. Subjective symptoms versus morphological injuries
  • 3.3. Differences in descriptions and diagnoses
  • 3.4. Insufficient documentation
  • 4. Conclusion
  • References
  • Clarity in pediatric medical reports in Hungary (Viktória Sirokmány – Katalin Fogarasi – Tamás Kassai – Gábor Gyenes – Zoltán Patonai)
  • 1. Introduction
  • 2. Methods
  • 3. Results
  • 3.1. Terminological limitations of the BNO diagnostic classification
  • 3.1.1. BNO gaps for pediatric injuries
  • 3.2. Hungarian and Latin diagnoses in PCDs
  • 3.2.1. Inclusion of Hungarian and Latin diagnoses
  • 3.2.2. Terminological correspondence between Latin and Hungarian diagnoses
  • 3.2.3. Terminological correspondence between Hungarian and Latin diagnoses for soft-tissue and bone injuries
  • 3.3. Documentation of injury location
  • 3.3.1. Inclusion of injury location in Hungarian diagnoses
  • 3.3.2. Terminological correspondence of injury location between Hungarian and Latin diagnoses
  • 3.3.3. Terminological correspondence of injury location in Hungarian and Latin diagnoses: soft tissue vs. bone injuries
  • 3.4. Documentation of injury characteristics in soft-tissue injury description
  • 3.4.1. Soft-tissue injuries with/without skin-continuity disruption
  • 3.4.2. Presence of injury description by BNO category use
  • 3.4.3. Number and type of injury characteristics in minor injuries (abrasions and hematomas)
  • 4. Discussion
  • 4.1. Clinical and forensic implications
  • 4.2. Linguistic and terminological implications
  • 5. Conclusions
  • References
  • Part V Terminology
  • Methodology of developing an explicit terminological consensus: The case of clinical nutrition (Gašper Tonin)
  • 1. Introduction
  • 2. Terminological project and terminological agreement
  • 3. Explicit and implicit terminological agreement
  • 4. Determining the need for the explicit terminological agreement
  • 5. Methods
  • 6. Guideline
  • 7. Conclusion
  • References
  • “How shall I explain?” Terminology usage in patients’ medical inquiries and doctors’ responses on a Hungarian website (Éva Katalin Varga – Zsuzsa Vladár – Andrea Barta)
  • 1. Introduction
  • 2. Background
  • 3. Material and methods
  • 4. Results
  • 4.1. The proportion of the shared terminology set
  • 4.2. The distribution of the shared terminology set
  • 4.3. Filling the gap: doctors’ explanatory strategies for unfamiliar terms
  • 5. Discussion
  • 6. Conclusion
  • References
  • Medical terminology and cancer patients: A multilingual corpus-based study (Jennifer Moreno)
  • 1. Introduction
  • 2. Theoretical background
  • 3. Materials and method
  • 3.1. The corpus and the sample
  • 3.2. Method of analysis
  • 4. Results and discussion
  • 4.1. Spanish sample
  • 4.2. Italian sample
  • 4.3. English sample
  • 4.4. Comparison of results
  • 5. Conclusion
  • References
  • Preparing the Latin anatomical nomenclature for the computer age: An overview of the revision of Terminologia Anatomica (Paul E. Neumann)
  • 1. Introduction
  • 2. Open-access publications
  • 3. Linguistically correct Latin terms
  • 4. New nomenclature rules
  • 5. Discussion
  • References
  • Part VI Epilogue
  • From the doctor’s terms to the patient’s words… and back: A journey fraught with pitfalls (Serge Quérin)
  • 1. Introduction
  • 2. Anatomical nomenclature
  • 3. Medical jargon
  • 4. Medical euphemisms
  • 5. Using the patient’s own words
  • 6. Standardizing the nomenclature of body functions and diseases for both health professionals and patients
  • 7. Words used by patients should not be misinterpreted
  • 8. Regionalisms
  • 9. Conclusion
  • References

Preface

Research at the intersection of linguistics and healthcare has demonstrated that communication is not merely a vehicle for the transmission of medical information but a fundamental component of clinical practice, patient outcomes, and patient safety. Language shapes how symptoms are described, diagnoses are conveyed, treatment decisions are negotiated, and professional knowledge is documented, translated, and taught. As healthcare systems become increasingly multilingual, technologically mediated, and patient-centered, the importance of interdisciplinary research bridging linguistic and health sciences continues to expand.

This second volume of the Semmelweis Medical Linguistics Investigations series reflects the diversity of contemporary medical linguistics by bringing together contributions from scholars working across health sciences, linguistics, and medical education. Although the chapters address diverse topics, they share a common goal: advancing our understanding of the role of language in healthcare interactions, professional practice, and the delivery of care. A unifying theme throughout the volume is the implementation of patient-centered research perspectives. Whether examining doctor–patient interaction, healthcare interpreting, medical education, documentation practices, or terminology management, the contributors emphasize the importance of communication that is accurate, accessible, culturally sensitive, and responsive to patients’ needs. In doing so, the volume contributes to ongoing efforts to improve the quality and effectiveness of healthcare through interdisciplinary research.

The volume is organized around six interconnected thematic areas. Studies of medical discourse examine interactional phenomena in clinical encounters, including agency, euphemism, metaphor, and metapragmatic communication. Contributions on language mediation explore translation, interpreting, and multilingual communication in healthcare settings. Research in languages for specific purposes (LSP) focuses on the instruction and learning of medical terminology and professional communication skills. The documentation section addresses issues of clarity, consistency, and comprehensibility in healthcare records and reports. Terminological studies investigate the development, use, and standardization of medical terminology. The volume concludes with a reflective epilogue that highlights the continuing challenges of bridging expert and lay perspectives in healthcare communication.

Agency mitigation in oncological medical interactions

Dominic Hendricks* – Wolfgang Imo**

ABSTRACT

In medical interactions, many different actors are involved in the diagnostic and therapeutic processes. This is especially relevant to oncological medical interactions. Physicians must therefore actively (though not necessarily consciously) manage different degrees of agency, and, via agency, responsibilities. While it is to be expected that physicians regularly profile themselves as the agent (and, thus, the person responsible for acting), they must also rely on other doctors, comply with guidelines, treat the patients according to the findings of medical studies, and consider the wishes of patients, who can take over agency. Languages provide their speakers with various linguistic means for the purpose of agency management. Using qualitative, interactional linguistic methods, this study demonstrates the variety of means by which physicians manage and mitigate agency—and, thus, responsibility. As this is a relatively novel area of linguistic study, one interaction from a corpus of 56 German oncological consultations was chosen for an exploratory single case study. In this interaction, the oncologist informs the patient about the adenocarcinoma diagnosis and the proposed therapy. Sixteen different patterns to present or mitigate agency are identified and the implications of these findings for future linguistic research and investigations in medical interactions are discussed.

Keywords: agency, agency mitigation, interactional linguistics, medical interactions

1. Introduction

A recurrent topic in doctor–patient interactions is the question of how to interpret the results of diagnostic findings and, consequently, which therapeutic measures to take. Behind this lies the question of who is responsible for (1) interpreting the data and (2) proposing as well as managing the therapy—in other words: to whom is the agency for all these activities attributed? On the one hand, it is to be expected that doctors themselves are the central agents, taking responsibility for medical actions. On the other hand, the oncologists, who are in charge of the general planning of the therapies, must also rely on other medical staff (e.g., radiologists and surgeons), while decisions in the German system of cancer treatment must be made by a collective body of doctors—the so-called ‘tumor board.’ Furthermore, there are often uncertainties in the planning: some necessary examinations might be pending, and, more generally, any prognoses regarding the success of therapies or the anticipated side effects are uncertain and must rely on experience, probabilities, and the latest study results.

The ‘management’ of degrees of agency therefore constitutes one of the routine tasks of doctors. In German, there are grammatical means of what Hennig & Niemann (2013) called Deagentivierungsmuster ‘de-agentivization patterns’ with which to mitigate or even hide the agent of an action. However, most of the (few) analyses of Deagentivization (Hennig & Niemann, 2013; von Polenz, 1981) or “agent defocusing” (Giacalone Ramat & Sansò, 2007; Myhill, 1997; Sansò, 2006) have focused on academic writing. Almost none were concerned with spoken language—a rare exception being the study of De Cock & Kluge (2016), who analyzed the “pragmatic effect of agent defocusing and/or agent extension” as a central condition for non-prototypical uses of the personal pronouns we and you. As a systematic analysis of agency mitigation in medical interactions is still lacking, this paper will present a first overview of structures and functions of different patterns of agency management in German oncological interactions.

2. Agency, the agent, and agent mitigation

Early analyses of the expression of agentivity are based on Fillmore’s (1968, p. 25) case grammar, where he defines the agentive case as “the case of the typically animate perceived instigator of the action identified by the verb.” Following these initial thoughts, Dowty (1991, p. 572; as before in Lakoff, 1977) proposed the concept of an “agent proto role,” whereby the agent is characterized by the ability of (i) perception, (ii) intentional action, (iii) active change of an external state or event, and (iv) movement. This means that the typical agent is a living entity and usually a human being, although, less prototypically, machines or institutions can be ascribed these properties in certain contexts, too. Despite efforts to establish the concept of the agent in linguistics, there is still no standard, universally accepted definition. A useful working definition comes from Duranti (2005, p. 453), who combines linguistic and sociological perspectives, making it well-suited for analyzing agency management in interactions. Duranti defines agency as “the property of those entities (i) that have some degree of control over their own behavior, (ii) whose actions in the world affect other entities’ (and sometimes their own), and (iii) whose actions are the object of evaluation (e.g., in terms of their responsibility for a given outcome)” (Duranti, 2005, p. 453). The concept of intentionality, which lies behind this property of entities, is defined in a broad sense as “the property of an entity of being directed toward or being about something,” not “the conscious planning of a given act (or sequence of acts) by someone” (Duranti, 2005, p. 453). The focus therefore is not on the ascription of intentions, but on the potential for acting and affecting people or things—which applies to every human being. Accordingly, the analytical perspective is refocused on the analysis of the verbalized actions of ‘possible agents.’1 Duranti (2005, p. 454) identifies “performance” and “encoding” as the two key dimensions through which agency manifests in language use: agency is enacted through performance and verbalized through encoding. This distinction has notably been adapted by Deppermann (2015) and Lucius-Hoene (2012) as they analyze how narrators present themselves and others as agents with different degrees of agency.

Languages offer different ways of highlighting or downplaying degrees of agency, the latter being called the “mitigation of agency” (Duranti, 2005, p. 466) or “agent-defocusing” (Giacalone Ramat & Sansò, 2007, p. 98; Myhill, 1997, p. 802). This allows for different perspectivizations of situations and roles of the participants (Duranti, 2005, p. 460).

While some agency-mitigating strategies have received attention in linguistic research, what is lacking is a systematic overview of (1) which grammatical constructions exist in a given language to mitigate agency, (2) what the different functions of these constructions are, and (3) how frequent they are in contrast to agent-expressing constructions.

Details

Pages
290
Publication Year
2026
ISBN (PDF)
9783631918821
ISBN (ePUB)
9783631918838
ISBN (Hardcover)
9783631918814
DOI
10.3726/b24022
Open Access
CC-BY
Language
English
Publication date
2026 (November)
Keywords
medical linguistics healthcare communication medical terminology LSP genre analysis discourse analysis medical translation medical interpreting patient-centered communciation metaphor in medicine medical documentation intercultural healthcare
Published
Berlin, Bruxelles, Chennai, Lausanne, New York, Oxford, 2026. 290 pp., 8 fig. col., 11 fig. b/w, 30 tables.
Product Safety
Peter Lang Group AG

Biographical notes

Dániel Mány (Volume editor) Katalin Fogarasi (Volume editor)

Dániel Mány is Assistant Professor and Vice-Director for Research and Innovation at the Institute of Languages for Specific Purposes, Semmelweis University (Budapest). Katalin Fogarasi is Associate Professor and Director of the Institute of Languages for Specific Purposes, Semmelweis University.

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Title: Implementation of Patient-Centered Research Trends