Appraising Pain: Clinician-Patient Interactions in Hospital Emergency Departments

In this paper I explore the applications of appraisal analysis to one interactive context in which evaluation is critical: that of clinician-patient interactions in hospital emergency departments. The data analysed was collected by a team from the University of Technology Sydney, led by Diana Slade, as part of a three-year research project into communication in emergency departments in five Australian public hospitals. Adding appraisal analysis (Martin and White) to the SFL analysis of interaction I show how patients and clinicians use appraisal, along with other interpersonal resources, to bridge the gap between patients subjective experiences of illness and clinicians objective knowledge of it. Through appraisal, patients can rate and describe their pain. Through appraisal clinicians can elicit key evaluative information, build empathy and show respect for patients, all of which can contribute to a more compassionate and effective outcome. This paper argues that appraisal analysis adds to the SFL account of interpersonal meaning. In particular, by highlighting the evaluative colouring of ideational information that is a defining feature of emergency department interactions it helps explain how patients and clinicians make meanings collaboratively in this critical social context.