title: Interactional difficulties as a resource for patient participation in prenatal screening consultations in Hong Kong.
abstract: OBJECTIVE
  In this paper, we examine the interactional means by which non-native English speaking patients in Hong Kong participate in prenatal screening sessions.
  
  
  METHODS
  Using interactional sociolinguistics as the theoretical framework, we apply the concept of contextualization cues to illustrate that patients indicate their participation in the consultation through verbal and non-verbal modes.
  
  
  RESULTS
  We find that non-native English speaking patients participate: (1) by displaying the interactional difficulties they are encountering and (2) by coordinating their displays of interactional difficulties with the activities of the healthcare provider.
  
  
  CONCLUSIONS
  We conclude that the notion of patient participation must be expanded to take into account non-native speaking contexts; in particular, that collaborative displays of knowledge (or lack thereof) must be included as part of the definition of patient participation. While verbal contributions represent an important mode of participation in consultations, patients also participate by contextualizing their lack of understanding, which then can serve as a resource to healthcare providers in pursuing meaningful consultations.
  
  
  CONCLUSIONS
  Our analysis illustrates how health care professionals' awareness of the modes of patient participation and what these modes may signal in non-native consultations can help to establish what the patient knows in the consultation.
authors: School of English, University of Hong Kong, Hong Kong. makang@hku.hk
authors: M Agnes
authors: MA
authors: Kang
authors: Olga A
authors: OA
authors: Zayts
mesh_terms: D003142:Communication; D032882:Comprehension; D003299:Cooperative Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006723:Hong Kong; D006801:Humans; D007802:Language; D010358:Patient Participation; D010817:Physician-Patient Relations; D011247:Pregnancy; D011296:Prenatal Diagnosis