Older people use healthcare services more often than other groups (Welfare, 2016), and therefore are also more often engaged in conversations about their health. This communication is important, yet older patients and patients from diverse backgrounds rate communication with health practitioners lower than younger patients (Burt, Lloyd, Campbell, Roland, & Abel, 2016; Nguyen, Barg, Armstrong, Holmes, & Hornik, 2008).
In addition, miscommunication in healthcare is common, and chances of miscommunication are higher when health practitioners (HPs) need to communicate degrees of uncertainty to their patients. When communicating about risk and certainty, HPs often use epistemic adverbs (e.g., possibly, likely etc.). Previous work revealed subtle differences between monolingual English speakers in Canada and Australia in understanding the meaning of epistemic adverbs (Segalowitz et al., 2016), however only young monolingual English speakers were studied. Here we explore whether, and how, age impacts on the semantic representation of 12 epistemic adverbs: apparently, certainly, clearly, definitely, evidently, likely, obviously, probably, possibly, presumably, reportedly, and supposedly.
To explore the possible effect of age, we compared younger (n=57; age range = [18, 50]) and older (n=31; aged 55+) monolingual speakers of Australian English. Participants performed a dissimilarity-rating task on sentence pairs presented as doctors' opinions differing only with respect to the embedded epistemic adverb (e.g., It will likely be fatal versus It will probably be fatal).
Analyses of the dissimilarity ratings, using cultural consensus analysis (factor analysis across participants), weighted-data classical-MDS, and cluster analysis, established within- and across-community consistencies and differences in the semantic mapping of risk and certainty for younger and older Australian monolingual speakers. Both groups have clustered together apparently, presumably, reportedly and supposedly; young and older Australians also added probably into a separate cluster. However, younger Australians clustered together certainly, clearly, definitely, evidently and obviously in a larger cluster, clustering likely and possibly together, while older Australians clustered certainly, likely, and possibly and placed clearly, definitely and obviously into a separate cluster. This may suggest that meanings of some epistemic adverbs such as likely and possibly may change with time. Our findings also show that adverbs of uncertainty may have more nuances in meaning than adverbs of certainty, and underscore the importance of checking for understanding when working with clients from different age groups, especially when discussing risk and uncertainty in healthcare settings.
References
Burt, J., Lloyd, C., Campbell, J., Roland, M., & Abel, G. (2016). Variations in GP-patient communication by ethnicity, age, and gender: evidence from a national primary care patient survey. British journal of general practice, 66(642), e47-e52. doi:10.3399/bjgp15X687637
Nguyen, G. T., Barg, F. K., Armstrong, K., Holmes, J. H., & Hornik, R. C. (2008). Cancer and Communication in the Health Care Setting: Experiences of Older Vietnamese Immigrants, A Qualitative Study. Journal of general internal medicine : JGIM, 23(1), 45-50. doi:10.1007/s11606-007-0455-2
Segalowitz, N. S., Doucerain, M. M., Meuter, R. F. I., Zhao, Y., Hocking, J., & Ryder, A. G. (2016). Comprehending adverbs of doubt and certainty in health communication: A multidimensional scaling approach. Frontiers in Psychology, 7(MAY), 558. doi:10.3389/fpsyg.2016.00558
