McCabe2002

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McCabe2002
BibType ARTICLE
Key McCabe2002
Author(s) Rosemarie McCabe, Christian Heath, Tom Burns, Stefan Priebe
Title Engagement of patients with psychosis in the consultation: conversation analytic study
Editor(s)
Tag(s) EMCA, Medical EMCA, Medical consultations, Psychiatry, Conversation Analysis
Publisher
Year 2002
Language
City
Month
Journal Brittish Medical Journal
Volume 325
Number
Pages 1148-1151
URL Link
DOI 10.1136/bmj.325.7373.1148
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

Objective: To investigate how doctors engage with patients with psychotic illness in routine consultations.

Design: Conversation analysis of 32 consultations between psychiatrists and patients with schizophrenia or schizoaffective disorder.

Setting: Two psychiatric outpatient clinics in east London and south west London.

Participants: 7 psychiatrists and 32 patients with schizophrenia or schizoaffective disorder.

Main outcome measure: Mutual engagement in communication during the consultation.

Results: Patients actively attempted to talk about the content of their psychotic symptoms in consultations by asking direct questions, repeating their questions and utterances, and producing these utterances in the concluding part of the consultation. In response, doctors hesitated, responded with a question rather than with an answer, and smiled or laughed (when informal carers were present), indicating that they were reluctant to engage with patients' concerns about their psychotic symptoms.

Conclusions: Patients repeatedly attempted to talk about the content of their psychotic symptoms, which was a source of noticeable interactional tension and difficulty. Addressing patients' concerns about their illness may lead to a more satisfactory outcome of the consultation and improve engagement of such patients in the health services.

Notes