Difference between revisions of "PinoDoehringParry2021"

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(Created page with "{{BibEntry |BibType=ARTICLE |Author(s)=Marco Pino; Ann Doehring; Ruth Parry |Title=Practitioners’ Dilemmas and Strategies in Decision-making Conversations Where Patients and...")
 
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|URL=https://repository.lboro.ac.uk/articles/journal_contribution/Practitioners_dilemmas_and_strategies_in_decision-making_conversations_where_patients_and_companions_take_divergent_positions_on_a_healthcare_measure_An_observational_study_using_conversation_analysis/12833999
 
|URL=https://repository.lboro.ac.uk/articles/journal_contribution/Practitioners_dilemmas_and_strategies_in_decision-making_conversations_where_patients_and_companions_take_divergent_positions_on_a_healthcare_measure_An_observational_study_using_conversation_analysis/12833999
 
|DOI=10.1080/10410236.2020.1813952
 
|DOI=10.1080/10410236.2020.1813952
|Abstract=The presence of companions adds complexity to healthcare interactions. Few studies have characterized
+
|Abstract=The presence of companions adds complexity to healthcare interactions. Few studies have characterized challenges arising when interactions involve healthcare professionals (HCPs), patients, and companions, or how those challenges are managed. Using conversation analysis, we examined recorded episodes where patients and companions adopt divergent positions on healthcare measures (e.g., walking aids, homecare, medications). We found nine such episodes within a dataset of 37 palliative care consultations with 37 patients, their companions, and ten healthcare practitioners (HCPs) – doctors, physiotherapists and occupational therapists. Palliative care is one of several healthcare domains where companions substantially contribute to care, consultations, and decision making. We propose that, when patients and companions adopt divergent positions, HCPs face a dilemma of affiliation’ wherein taking a position on the healthcare measure (e.g., recommending it) entails siding with one party, against the other. By examining what happens in the face of patient-companion divergence, we characterize HCPs’ strategies and substantiate our proposal that these reflect an underlying dilemma. We show that: HCPs do not immediately take a position on the healthcare measure after patient-companion divergence emerges; and when HCPs take a position later in the consultation, they do so without ostensibly siding with the party who previously supported the healthcare measure. Further, once an HCP takes a position, the party who supports the measure can treat the HCP as an ally. We offer insights and propose implications for: palliative care; the interactional complexities of healthcare decision-making; and consultations in which companions participate.
challenges arising when interactions involve healthcare professionals (HCPs), patients, and companions,
 
or how those challenges are managed. Using conversation analysis, we examined recorded episodes
 
where patients and companions adopt divergent positions on healthcare measures (e.g., walking aids,
 
homecare, medications). We found nine such episodes within a dataset of 37 palliative care consultations
 
with 37 patients, their companions, and ten healthcare practitioners (HCPs) – doctors, physiotherapists
 
and occupational therapists. Palliative care is one of several healthcare domains where companions
 
substantially contribute to care, consultations, and decision making. We propose that, when patients
 
and companions adopt divergent positions, HCPs face a ‘dilemma of affiliation’ wherein taking a position
 
on the healthcare measure (e.g., recommending it) entails siding with one party, against the other. By
 
examining what happens in the face of patient-companion divergence, we characterize HCPs’ strategies
 
and substantiate our proposal that these reflect an underlying dilemma. We show that: HCPs do not
 
immediately take a position on the healthcare measure after patient-companion divergence emerges; and
 
when HCPs take a position later in the consultation, they do so without ostensibly siding with the party
 
who previously supported the healthcare measure. Further, once an HCP takes a position, the party who
 
supports the measure can treat the HCP as an ally. We offer insights and propose implications for:
 
palliative care; the interactional complexities of healthcare decision-making; and consultations in which
 
companions participate.
 
 
}}
 
}}

Revision as of 08:42, 22 September 2020

PinoDoehringParry2021
BibType ARTICLE
Key PinoDoehringParry2020
Author(s) Marco Pino, Ann Doehring, Ruth Parry
Title Practitioners’ Dilemmas and Strategies in Decision-making Conversations Where Patients and Companions Take Divergent Positions on a Healthcare Measure: An Observational Study Using Conversation Analysis
Editor(s)
Tag(s) EMCA
Publisher
Year 2020
Language English
City
Month
Journal Health Communication
Volume
Number
Pages
URL Link
DOI 10.1080/10410236.2020.1813952
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

The presence of companions adds complexity to healthcare interactions. Few studies have characterized challenges arising when interactions involve healthcare professionals (HCPs), patients, and companions, or how those challenges are managed. Using conversation analysis, we examined recorded episodes where patients and companions adopt divergent positions on healthcare measures (e.g., walking aids, homecare, medications). We found nine such episodes within a dataset of 37 palliative care consultations with 37 patients, their companions, and ten healthcare practitioners (HCPs) – doctors, physiotherapists and occupational therapists. Palliative care is one of several healthcare domains where companions substantially contribute to care, consultations, and decision making. We propose that, when patients and companions adopt divergent positions, HCPs face a dilemma of affiliation’ wherein taking a position on the healthcare measure (e.g., recommending it) entails siding with one party, against the other. By examining what happens in the face of patient-companion divergence, we characterize HCPs’ strategies and substantiate our proposal that these reflect an underlying dilemma. We show that: HCPs do not immediately take a position on the healthcare measure after patient-companion divergence emerges; and when HCPs take a position later in the consultation, they do so without ostensibly siding with the party who previously supported the healthcare measure. Further, once an HCP takes a position, the party who supports the measure can treat the HCP as an ally. We offer insights and propose implications for: palliative care; the interactional complexities of healthcare decision-making; and consultations in which companions participate.

Notes