Multimodal analysis of caregiver/patient interaction in the intensive care unit

Through a real-life observational study, the project aims to explain the conditions for handling pragmatic disorders in the context of intensive care unit. In order to ultimately improve interactional conditions in this emergency situation (i.e., where the life prognosis is at stake), the goal will be to project the requirements for efficient communication and to clarify the operational conditions for implementing tools designed to compensate for communicative impediments (intubation, tetraparesis). The research will be conducted from an ethnomethodological perspective. On the basis of an ecological interactional corpus constituted for the study, we will study the modalities of coordination and synchronization of verbal acts with the plurisemiotic context.

Keywords: care interaction, linguistic analysis, multimodality, communicative disability, medical resuscitation

Scientific background

An essential human function, communication is both a complex and fragile dimension of care. The deprivation of ordinary language resources for communication is a source of frustration, dehumanization, depersonalization, loss of self-esteem and stress for the patient, and accentuates the difficulty of the stay, described by many patients as a traumatic memory. In the context of intensive care unit, communication is required in a complex situation where the patient's vital prognosis is at stake. The intubated patient's expression is impacted by the endotracheal intubation tube; some patients are also deprived of gestures (resuscitation tetraparesis, muscle wasting, oedema, etc.).
Finally, because of their pathology or the treatments they undergo, patients may present comprehension disorders that can impair understanding.

Augmentative and alternative communication (AAC) tools are said to improve communication. However, their efficiency depends on a detailed assessment of individual needs, and on considering the contextual limits to individualization. In a pilot study, the Intensive Care Unit at Tours University Hospital experimented with the use of dedicated tablets with eye tracker to assess their potential benefits for communication. In addition to their opportunistic and minimal mobilization in many cases, implementation came up against the reticence of nursing staff, who judged the use of such tools to be pointless or were put off by the time required to get accustomed.

Objectives and methodology

The aim of the research project is to clarify the conditions for the handling of pragmatic disorders in an intensive care setting. The research will establish the communicative needs of caregivers and patients in a difficult situation, by observing and analyzing the coordination and synchronization of verbal acts with the plurisemiotic context: what communicative functions are observed? How do participants express their impairment or specific need?

With a view to ultimately improving interactional conditions in the resuscitation context, the aim is to project the requirements for efficient communication (Freeman-Sanderson et al. 2024 ; Bohart et al. 2024 ) and to clarify the operational conditions for implementing communication aids: which communicative functions are most impaired by context-specific equipment? Which compensatory strategies are observed in interactions? What pragmatic functions can be supported by the use of an AAC-type technological tool? How do users appropriate compensatory tools?

The study will be based on an ethnomethodological approach and, in particular, interactional linguistics, which aims to explore the functioning of communicative events by questioning the relationship between language resources, their sequential environments and the actions performed by participants (Couper-Kuhlen and Selting 2017 ; Mondada 2008 ). The analysis incorporates a heuristic approach whose orientation is primarily qualitative and follows the principles of descriptive empiricism. The empirical data consists of complete captures of interactions to be carried out in the Intensive Care Unit (CHU Tours), which will be transcribed and analyzed. The data will be ecological, in the sense that they “would have taken place even in the absence of the researcher, and have not been elicited or orchestrated by him or her with a view to their recording” (Mondada ibid. 884). The project is leading to the creation of a reference video corpus for future research into innovative communication tools.

The project is a winner of the Loire-Valley-Health 2025 call for projects, with funding for 3 years, including a doctoral grant and equipment. The thesis will be directed by Katja Ploog (LLL CNRS UMR 7270, Université d'Orléans) and co-supervised by Laetitia Bodet-Contentin (CHU de Tours; INSERM U1246 SPHERE).

Profile requirements
- Initial training in language sciences
- Skills in tool linguistics and/or multimodal analysis
- Experience in field research
- Excellent writing skills in French
- Very good English language skills
- Autonomy in work organization
- Good interpersonal skills
- Mobility (Tours/Orléans and international)

Selection process

Candidates will be evaluated by the Humanité & Langues Doctoral School of the Universities of Orléans and Tours, in accordance with the requirements of the AAP Loire-Valley-Health and EU recommendations.

Applications should be sent by e-mail to [email protected] and should include:

- a detailed academic CV with copies of diplomas and academic records
- a motivational letter
- proof of relevant experiences mentioned in the CV
- contact details of any referees to be contacted by the jury.

The deadline for applications is March 14, 2025.

Applications will be evaluated by the thesis directors and the doctoral school. Shortlisted candidates will be auditioned between March 24 and April 4. The ranking is established at the end of the audition process.

Beginning of contract: October 1, 2025.

Linguistic Field(s): Anthropological Linguistics
Applied Linguistics
Discourse Analysis

Subject Language(s): French (fra)

Language Family(ies): Gallo-Romance