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Searching for the Patient’s Presence in Medical Case Reports

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Magdalena Zabielska

The book addresses the issue of the patient’s presence in specialist medical publications in the context of a patient-centered approach to medical practice. The author combines both quantitative and qualitative approaches in order to analyze the discourse about the patient in one of the oldest medical genres, case reports. She traces textual references to patients throughout the reports to show that their nature and frequency depend both on the structure of the genre and the context of the production of these texts. The author touches upon the topical issue that although specialist communication may seem to exclude patients, it does not mean it does not concern them. Indeed, they are written about and it appears critical how this is done.
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Chapter Five: The analysis of medical case reports

Extract

In Chapter Five, first, the examined data as well as the methods of analysis will be described and next, the results of the quantitative and qualitative analyses of the case reports will be presented and discussed. This will allow to test the following hypotheses:

(1) The abstraction from the patient results partly from the type of information conveyed in sections of case reports, but also partly from specific lexical and grammatical choices on the part of an author.

(2) Patient imaging as demonstrated in the studied case reports is in line with the premises of the biomedical model.

(3) Patient’s reactions, symptoms, biological processes and treatment he/she undergoes tend to be rendered separate from him/her.

The first hypothesis illustrates the approach adopted in the present work to studying patient imaging in the corpus as informed by John Swales’s (1990) genre analysis (cf. section 3. in Chapter One). The second hypothesis concerns medical discourse as contextualized in the biomedical model and has been formulated on the basis of the account of the evolution of the case report genre against the background of the history of medicine, which demonstrated how the changing modes of reasoning and methodologies in medicine affected the way patients were described (cf. Chapter Two). Finally, the third hypothesis was made on the basis of the literature on patient’s representation in medical discourse (cf. section 6. in Chapter Three). To test these hypotheses, the results from both quantitative and qualitative parts...

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