{"id":"https://openalex.org/W7225423401","doi":"https://doi.org/10.64898/2026.11.05.26367267","title":"Communication without dialogue? Framing patient\u2013professional interaction in UK institutional discourse on pregnancy loss","display_name":"Communication without dialogue? Framing patient\u2013professional interaction in UK institutional discourse on pregnancy loss","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225423401","doi":"https://doi.org/10.64898/2026.11.05.26367267"},"language":"en","primary_location":{"id":"doi:10.64898/2026.11.05.26367267","doi":"https://doi.org/10.64898/2026.11.05.26367267","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.05.26367267","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367267.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367267.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5085389578","display_name":"Louise Nuttall","orcid":"https://orcid.org/0000-0001-9891-5716","observed_orcids":["https://orcid.org/0000-0001-9891-5716"]},"institutions":[{"id":"https://openalex.org/I45129253","display_name":"University College London","ror":"https://ror.org/02jx3x895","country_code":"GB","type":"education","lineage":["https://openalex.org/I124357947","https://openalex.org/I45129253"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"Louise Nuttall","raw_affiliation_strings":["Department of English Language and Literature, University College London, Foster Court, Gower Street, London, WC1E 6BT, UK"],"raw_orcid":"https://orcid.org/0000-0001-9891-5716","affiliations":[{"raw_affiliation_string":"Department of English Language and Literature, University College London, Foster Court, Gower Street, London, WC1E 6BT, UK","institution_ids":["https://openalex.org/I45129253"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5057761186","display_name":"Beth Malory","orcid":"https://orcid.org/0000-0002-5794-4403","observed_orcids":["https://orcid.org/0000-0002-5794-4403"]},"institutions":[{"id":"https://openalex.org/I45129253","display_name":"University College London","ror":"https://ror.org/02jx3x895","country_code":"GB","type":"education","lineage":["https://openalex.org/I124357947","https://openalex.org/I45129253"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Beth Malory","raw_affiliation_strings":["Department of English Language and Literature, University College London, Foster Court, Gower Street, London, WC1E 6BT, UK"],"raw_orcid":"https://orcid.org/0000-0002-5794-4403","affiliations":[{"raw_affiliation_string":"Department of English Language and Literature, University College London, Foster Court, Gower Street, London, WC1E 6BT, UK","institution_ids":["https://openalex.org/I45129253"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5085389578"],"corresponding_institution_ids":["https://openalex.org/I45129253"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10827","display_name":"Patient-Provider Communication in Healthcare","score":0.8881999850273132,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10827","display_name":"Patient-Provider Communication in Healthcare","score":0.8881999850273132,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10366","display_name":"Discourse Analysis in Language Studies","score":0.07810000330209732,"subfield":{"id":"https://openalex.org/subfields/3310","display_name":"Linguistics and Language"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10383","display_name":"Language, Discourse, Communication Strategies","score":0.011099999770522118,"subfield":{"id":"https://openalex.org/subfields/1203","display_name":"Language and Linguistics"},"field":{"id":"https://openalex.org/fields/12","display_name":"Arts and Humanities"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/miscarriage","display_name":"miscarriage","score":0.9369999766349792},{"id":"https://openalex.org/keywords/patient-professional-communication","display_name":"patient-professional communication","score":0.9020000100135803},{"id":"https://openalex.org/keywords/institutional-discourse","display_name":"institutional discourse","score":0.7009999752044678},{"id":"https://openalex.org/keywords/medical-discourse","display_name":"medical discourse","score":0.6359999775886536},{"id":"https://openalex.org/keywords/paternalism","display_name":"paternalism","score":0.7020000219345093},{"id":"https://openalex.org/keywords/patient-agency","display_name":"patient agency","score":0.6909999847412109},{"id":"https://openalex.org/keywords/communication-breakdown","display_name":"communication breakdown","score":0.47999998927116394},{"id":"https://openalex.org/keywords/maternity-care","display_name":"obstetric care","score":0.6620000004768372},{"id":"https://openalex.org/keywords/speech-acts","display_name":"speech acts","score":0.6660000085830688},{"id":"https://openalex.org/keywords/passive-voice","display_name":"passive voice","score":0.5619999766349792},{"id":"https://openalex.org/keywords/bidirectional-communication","display_name":"two-way communication","score":0.5680000185966492}],"concepts":[{"id":"https://openalex.org/C2679804","wikidata":"https://www.wikidata.org/wiki/Q58434","display_name":"Paternalism","level":2,"score":0.7113000154495239},{"id":"https://openalex.org/C169087156","wikidata":"https://www.wikidata.org/wiki/Q2131593","display_name":"Framing (construction)","level":2,"score":0.5475999712944031},{"id":"https://openalex.org/C84389358","wikidata":"https://www.wikidata.org/wiki/Q1129466","display_name":"Discourse analysis","level":2,"score":0.5236999988555908},{"id":"https://openalex.org/C2777742833","wikidata":"https://www.wikidata.org/wiki/Q1964083","display_name":"Reciprocal","level":2,"score":0.5202999711036682},{"id":"https://openalex.org/C2779234561","wikidata":"https://www.wikidata.org/wiki/Q11995","display_name":"Pregnancy","level":2,"score":0.4733999967575073},{"id":"https://openalex.org/C77805123","wikidata":"https://www.wikidata.org/wiki/Q161272","display_name":"Social psychology","level":1,"score":0.4440000057220459},{"id":"https://openalex.org/C108170787","wikidata":"https://www.wikidata.org/wiki/Q3951828","display_name":"Agency (philosophy)","level":2,"score":0.4368000030517578},{"id":"https://openalex.org/C160798450","wikidata":"https://www.wikidata.org/wiki/Q4230870","display_name":"Concordance","level":2,"score":0.4020000100135803},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.3880999982357025},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.3880000114440918},{"id":"https://openalex.org/C2780829048","wikidata":"https://www.wikidata.org/wiki/Q1624720","display_name":"Conversation analysis","level":3,"score":0.38089999556541443},{"id":"https://openalex.org/C2778080475","wikidata":"https://www.wikidata.org/wiki/Q4353774","display_name":"Health communication","level":2,"score":0.37439998984336853},{"id":"https://openalex.org/C2778551981","wikidata":"https://www.wikidata.org/wiki/Q36224","display_name":"Pronoun","level":2,"score":0.3628000020980835},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.3479999899864197},{"id":"https://openalex.org/C14224292","wikidata":"https://www.wikidata.org/wiki/Q13600188","display_name":"Conceptual framework","level":2,"score":0.3391000032424927},{"id":"https://openalex.org/C2780572471","wikidata":"https://www.wikidata.org/wiki/Q18206027","display_name":"Clinical Ethics","level":2,"score":0.31520000100135803},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.30559998750686646},{"id":"https://openalex.org/C3019806175","wikidata":"https://www.wikidata.org/wiki/Q11974939","display_name":"Health professionals","level":3,"score":0.2793999910354614},{"id":"https://openalex.org/C2779030433","wikidata":"https://www.wikidata.org/wiki/Q1789511","display_name":"Critical discourse analysis","level":4,"score":0.26829999685287476},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.260699987411499},{"id":"https://openalex.org/C121242521","wikidata":"https://www.wikidata.org/wiki/Q1427574","display_name":"Philosophy of medicine","level":3,"score":0.2605000138282776},{"id":"https://openalex.org/C2780233690","wikidata":"https://www.wikidata.org/wiki/Q535347","display_name":"Transparency (behavior)","level":2,"score":0.2581999897956848}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.11.05.26367267","doi":"https://doi.org/10.64898/2026.11.05.26367267","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.05.26367267","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367267.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.11.05.26367267","doi":"https://doi.org/10.64898/2026.11.05.26367267","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.05.26367267","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367267.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225423401.pdf","grobid_xml":"https://content.openalex.org/works/W7225423401.grobid-xml"},"referenced_works_count":30,"referenced_works":["https://openalex.org/W565539210","https://openalex.org/W1969776198","https://openalex.org/W1995295431","https://openalex.org/W1996345898","https://openalex.org/W2001442493","https://openalex.org/W2032816933","https://openalex.org/W2102437672","https://openalex.org/W2133518763","https://openalex.org/W2244626821","https://openalex.org/W2305122361","https://openalex.org/W2498641003","https://openalex.org/W2521711156","https://openalex.org/W2563284245","https://openalex.org/W2973353015","https://openalex.org/W3034514532","https://openalex.org/W3088411831","https://openalex.org/W3135469463","https://openalex.org/W3161113501","https://openalex.org/W4233713573","https://openalex.org/W4238951193","https://openalex.org/W4248308225","https://openalex.org/W4280498667","https://openalex.org/W4320305207","https://openalex.org/W4377823844","https://openalex.org/W4415075290","https://openalex.org/W4415389562","https://openalex.org/W4415525633","https://openalex.org/W4416703364","https://openalex.org/W7116895578","https://openalex.org/W7127405347"],"related_works":["https://openalex.org/W4409623248","https://openalex.org/W2915067910","https://openalex.org/W4320305207","https://openalex.org/W598223689","https://openalex.org/W3010038066","https://openalex.org/W6944149653","https://openalex.org/W4385715489","https://openalex.org/W2898825464","https://openalex.org/W2971401119","https://openalex.org/W1522445117"],"abstract_inverted_index":{"Abstract":[0],"Communication":[1],"failures":[2],"are":[3],"repeatedly":[4],"implicated":[5],"in":[6,11,15,29,55,146,164],"harmful":[7],"experiences":[8],"and":[9,48,73,83,90,101,118,133,142,181,188,229],"outcomes":[10],"pregnancy":[12,61,238],"care,":[13],"especially":[14],"contexts":[16],"of":[17,36,157,202,215,236],"loss,":[18],"yet":[19],"little":[20],"is":[21,27,46,53],"known":[22],"about":[23,60],"how":[24,49],"communication":[25,45,185,197],"itself":[26],"represented":[28],"the":[30,41,200],"institutional":[31],"texts":[32,66],"that":[33,151,192],"shape":[34],"expectations":[35],"care.":[37,239],"This":[38],"study":[39],"examines":[40],"extent":[42],"to":[43,226],"which":[44],"discussed,":[47],"patient-healthcare":[50],"professional":[51,112,134],"interaction":[52,103],"framed,":[54],"publicly":[56],"accessible":[57],"UK":[58,193],"discourse":[59,170,195],"loss.":[62],"Two":[63],"corpora":[64],"comprising":[65],"from":[67],"seven":[68],"medical":[69,98,126,194],"organisations":[70],"(120,383":[71],"words)":[72,77],"eight":[74],"charities":[75],"(224,481":[76],"were":[78,93,104,120],"divided":[79],"into":[80],"healthcare":[81],"professional-facing":[82],"patient-facing":[84],"sub-corpora.":[85],"Frequency,":[86],"semantic":[87],"keyness,":[88],"keyword":[89],"concordance":[91],"analyses":[92],"conducted":[94],"using":[95],"Wmatrix7.":[96],"In":[97],"discourse,":[99],"language":[100,227],"communicative":[102,216],"underrepresented,":[105],"while":[106],"speech":[107],"acts":[108],"associated":[109],"with":[110,123],"unidirectional":[111],"activities":[113],"such":[114],"as":[115,155,186,199,207,233],"advising,":[116],"recommending":[117],"referring":[119],"overrepresented.":[121],"Compared":[122],"charity":[124],"texts,":[125],"outputs":[127],"foregrounded":[128,173],"clinical":[129,209],"evidence,":[130],"policy,":[131],"risk":[132],"knowledge.":[135],"Characteristic":[136],"forms":[137],"including":[138],"\u201cconfirmed\u201d,":[139],"\u201cadvised\u201d,":[140],"\u201crecommended\u201d":[141],"\u201coffered\u201d":[143],"frequently":[144],"occurred":[145],"passive":[147],"or":[148,167],"agentless":[149],"constructions":[150],"positioned":[152],"patients":[153],"principally":[154],"recipients":[156],"information;":[158],"patient":[159,182],"agency":[160],"was":[161],"most":[162],"visible":[163],"\u201creporting\u201d":[165],"symptoms":[166],"concerns.":[168],"Charity":[169],"more":[171],"often":[172],"talking,":[174],"listening,":[175,222],"feelings,":[176],"preferences,":[177,228],"wording,":[178],"lived":[179],"experience,":[180],"knowledge;":[183],"representing":[184],"active":[187],"bidirectional.":[189],"We":[190],"argue":[191],"constructs":[196],"primarily":[198],"transmission":[201],"authorised":[203],"knowledge":[204],"rather":[205],"than":[206],"relational":[208],"practice,":[210],"reinforcing":[211],"a":[212],"paternalistic":[213],"distribution":[214],"agency.":[217],"Medical":[218],"institutions":[219],"should":[220],"embed":[221],"reciprocal":[223],"dialogue,":[224],"sensitivity":[225],"checks":[230],"on":[231],"understanding":[232],"core":[234],"standards":[235],"safe":[237]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-07T00:00:00"}
