Dew et al - Health Sociology Review - Ascertaining patients understandings accepted version.pdf (8.73 MB)

Ascertaining patients’ understandings of their condition: a conversation analysis of contradictory norms in cancer specialist consultations

Download (8.73 MB)
journal contribution
posted on 22.07.2020 by Kevin Dew, J Barton, J Stairmand, D Sarfati, L Signal
© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group. Patient-centred care requires patients to be active participants in decision-making in consultations. Decision-making participation requires patients to understand their condition and to be able to convey their health literacy to medical specialists they encounter. Based on conversation analysis of 18 audio-recorded consultations between cancer patients and a range of cancer care specialists, this article analyses the ways cancer specialists attempt to ascertain their patient’s understanding of their disease. Cancer specialists routinely enquire about their patient’s understanding. In doing so, they phrase enquiries in different ways, resulting in different patient responses. How questions are phrased can require patients to deal with contradictory norms in the consultation, such as the patient being competent but not assuming medical expertise, and potentially hinder patient participation. Alternatively, questions can allow patients to draw on their own experience and so facilitate greater patient involvement. Questions aimed directly at the patient’s medical understanding result in minimal or negative responses. In contrast, questions directed at what the patient has been told or has experienced, elicit longer and more in-depth responses from the patient. This analysis illuminates the co-construction of cancer specialist consultations and suggests simple ways in which patient involvement in the consultation can be facilitated.

History

Preferred citation

Dew, K., Barton, J., Stairmand, J., Sarfati, D. & Signal, L. (2019). Ascertaining patients’ understandings of their condition: a conversation analysis of contradictory norms in cancer specialist consultations. Health Sociology Review, 28(3), 229-244. https://doi.org/10.1080/14461242.2019.1633945

Journal title

Health Sociology Review

Volume

28

Issue

3

Publication date

02/09/2019

Pagination

229-244

Publisher

Informa UK Limited

Publication status

Published

Online publication date

29/07/2019

ISSN

1446-1242

eISSN

1839-3551

Language

en

Exports

Logo branding

Categories

Exports