Asymmetrical Roles and Conflicting Expectations in Institutional Talk: An Analysis of Verbal Autopsy

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Pubblicato in:3L, Language, Linguistics, Literature vol. 31, no. 1 (2025), p. 65
Autore principale: Doroja-Cadiente, Glenda
Altri autori: Gustilo, Leah
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Universiti Kebangsaan Malaysia
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LEADER 00000nab a2200000uu 4500
001 3185291872
003 UK-CbPIL
022 |a 0128-5157 
024 7 |a 10.17576/3L-2025-3101-05  |2 doi 
035 |a 3185291872 
045 2 |b d20250101  |b d20250331 
100 1 |a Doroja-Cadiente, Glenda  |u College of Education Leyte Normal University, Philippines 
245 1 |a Asymmetrical Roles and Conflicting Expectations in Institutional Talk: An Analysis of Verbal Autopsy 
260 |b Universiti Kebangsaan Malaysia  |c 2025 
513 |a Journal Article 
520 3 |a This study addresses the research gap in doctor-death informant interactions within verbal autopsy (VA) contexts, examining these interactions as unequal encounters through institutional interaction research. The study aims to analyse the content, structure, and function of question-and-answer exchanges in VA interviews, explore conflicting frames, and identify opposing discursive strategies. It connects microanalysis to the broader sociocultural context, viewing VA as a regulatory practice reflecting local health unit procedures. Data were collected from 64 death informants and two rural municipal health physicians in Northern Leyte, Philippines. Interviews were conducted using WHO's Standardised Verbal Autopsy guide, and the interactions were transcribed and analysed for topic, question type, question-answer sequence, and alignment with institutional roles. The study reveals that doctors, as institutional authorities, control the interaction, with informants recognising this asymmetry through honorifics and apologies. Conflicting frames of expectations between doctors' objective questioning and informants' subjective responses lead to interactional struggles. These struggles are exacerbated by the informants' emotional instability, potentially compromising the reliability of death reports. The overwhelming VA process challenges doctors' decision-making capabilities, leading to the imposition of institutional authority. The study highlights the need for VA training that considers the psycho-socio-cultural contexts of informants to improve the quality of health information systems. Understanding interactional barriers and implementing research-based communication strategies can enhance doctor-informant relationships and institutional protocols. Policymakers might better address the need for context-sensitive VA training. Future research could explore variations in death reporting across different regions and the psychological experiences of doctors and informants. 
653 |a Interviews 
653 |a Autopsies 
653 |a Apologies 
653 |a Discourse strategies 
653 |a Social factors 
653 |a Sociocultural factors 
653 |a Honorifics 
653 |a Physicians 
653 |a Question answer sequences 
653 |a Interpersonal communication 
653 |a Respondents 
653 |a Cultural factors 
653 |a Reliability 
653 |a Death & dying 
653 |a Autopsy 
653 |a Health status 
653 |a Policy making 
653 |a Information systems 
653 |a Communication strategies 
653 |a Frame analysis 
653 |a Health information 
653 |a Emotional instability 
653 |a Expectations 
653 |a Training 
653 |a Subjectivity 
653 |a Mental health services 
653 |a Decision making 
653 |a Medical decision making 
653 |a Imposition 
653 |a Information technology 
653 |a Information sources 
653 |a Research 
653 |a Health 
653 |a Communication research 
700 1 |a Gustilo, Leah  |u De La Salle University, Philippines 
773 0 |t 3L, Language, Linguistics, Literature  |g vol. 31, no. 1 (2025), p. 65 
786 0 |d ProQuest  |t East & South Asia Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3185291872/abstract/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3185291872/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch