Osaka Kyoiku University Researcher Information
日本語 | English
Curriculum Vitaes
Profile Information
- Affiliation
- Professor, Division of Multicultural Education, Osaka Kyoiku University
- Degree
- 修士(文学)(京都大学)博士(人間・環境学)(京都大学)
- Researcher number
- 70214947
- J-GLOBAL ID
- 200901056067926203
- researchmap Member ID
- 1000163281
- External link
Research Interests
5Research Areas
1Education
3-
Apr, 1987 - Mar, 1989
Papers
27-
Journal of General and Family Medicine, 24(2) 79-86, Dec 14, 2022 Peer-reviewed
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Research on Language and Social Interaction, 55(1) 59-78, Jan 2, 2022 Peer-reviewedLead author
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Recommending no further treatment: Gatekeeping work of generalists at a Japanese university hospitalSocial Science & Medicine, 290 113891-113891, Dec, 2021 Peer-reviewedLead authorIn medical decision-making, doctors have to take into consideration whether patients' expectations can be satisfied while appropriately allocating medical resources. This study explores how recommendations for no further treatment, or gate-closing recommendations, are resisted by patients and how doctors react to resistance in outpatient consultations at a university hospital in Japan. We show how the type of patient resistance shapes doctors' reactions. Problem-focused resistance problematizes the doctor's understanding of the patient's problem or the treatment itself without focusing on the gate-closing aspect of a recommendation, and is met with doctors' persuasion through diagnosis-based accounts. Provider-focused resistance focuses on the gate-closing aspect of a recommendation, and leads doctors to manage their dual roles as patient advocate and resource steward. Two subtypes of provider-focused resistance further shape this work differently. Unwillingness-focused resistance is met with persuasion mainly through institution-based accounts. Unavailability-focused resistance is met with a concession. Doctors systematically respond to patients' resistance in order to reach an agreement during decision-making. They take measures to reconcile their dual roles, and orient themselves toward the implicit rationale of gatekeeping, which has a moral nature.
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Social Science & Medicine, 265 113278-113278, Nov, 2020 Peer-reviewedLead author
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East Asian Pragmatics, 3(1) 91-123, Apr 17, 2018 Peer-reviewedLead authorIn medical encounters, doctors sometimes have to convey views of patients’ problems which are not in line with patients’ views and expectations. One such situation in psychiatric consultations is when the patient complains about symptoms which persist in spite of treatment, while the psychiatrist regards the patient’s condition as not serious enough to adjust treatment or has no satisfactory explanations or solutions. Based on an analysis of video-recorded psychiatric consultations in Japan, this study investigates how psychiatrists cope with such situations and shows that they steer the interaction away from the complaints using a series of moves with which they transform the reported symptoms into evidence that supports their view of the patients’ problems. It is argued that psychiatrists strike a balance between the two potentially conflicting goals of respecting patients’ epistemic authority on their symptoms and minimising inappropriate medication increases.
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Communication & medicine, 13(2) 169-184, 2016 Peer-reviewedLead authorIn spite of increasing advocacy for patients' participation in psychiatric decision-making, there has been little research on how patients actually participate in decision-making in psychiatric consultations. This study explores how patients take the initiative in decision-making over treatment in outpatient psychiatric consultations in Japan. Using the methodology of conversation analysis, we analyze 85 video-recorded ongoing consultations and find that patients select between two practices for taking the initiative in decision-making: making explicit requests for a treatment and displaying interest in a treatment without explicitly requesting it. A close inspection of transcribed interaction reveals that patients make explicit requests under the circumstances where they believe the candidate treatment is appropriate for their condition, whereas they merely display interest in a treatment when they are not certain about its appropriateness. By fitting practices to take the initiative in decision-making with the way they describe their current condition, patients are optimally managing their desire for particular treatments and the validity of their initiative actions. In conclusion, we argue that the orderly use of the two practices is one important resource for patients' participation in treatment decision-making.
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Research on Language and Social Interaction, 48(2) 230-251, Apr 3, 2015 Peer-reviewedLead author
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Sociology of Health & Illness, 37(4) 522-544, Feb 12, 2015 Peer-reviewedLead author
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Research on Language & Social Interaction, 46(3) 231-255, Jul, 2013 Peer-reviewed
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Journal of Pragmatics, 43(11) 2716-2739, Sep, 2011 Peer-reviewedLead author
Misc.
10Books and Other Publications
18Presentations
18-
International Conference on Conversation Analysis 2023, Jun 30, 2023
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17th International Pragmatics Conference, Jun 29, 2021
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The 3rd International E-Symposium on Communication in Health Care, Mar 1, 2021
Professional Memberships
4-
1998 - Present
Research Projects
17-
科学研究費助成事業 基盤研究(C), 日本学術振興会, Apr, 2022 - Mar, 2026
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Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C), Japan Society for the Promotion of Science, Apr, 2021 - Mar, 2024
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科学研究費助成事業 基盤研究(C), 日本学術振興会, Apr, 2019 - Mar, 2023
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Grants-in-Aid for Scientific Research, Japan Society for the Promotion of Science, Apr, 2018 - Mar, 2022
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Grants-in-Aid for Scientific Research Grant-in-Aid for Challenging Exploratory Research, Japan Society for the Promotion of Science, Apr, 2016 - Mar, 2019