Difference between revisions of "Tarber-etal2016"

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|Author(s)=Christel Tarber; Lisbeth Frostholm; Emma Rehfeld
 
|Author(s)=Christel Tarber; Lisbeth Frostholm; Emma Rehfeld
 
|Title=Talking at cross purposes: Negotiation of the sick role with a MUS patient as a real time social process
 
|Title=Talking at cross purposes: Negotiation of the sick role with a MUS patient as a real time social process
 
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|Tag(s)=EMCA; Medical; Medical EMCA
|Tag(s)=EMCA; Medical;  
 
 
|Key=Tarber-etal2016
 
|Key=Tarber-etal2016
 
|Year=2016
 
|Year=2016
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|URL=http://ojs.statsbiblioteket.dk/index.php/sygdomogsamfund/article/view/18843
 
|URL=http://ojs.statsbiblioteket.dk/index.php/sygdomogsamfund/article/view/18843
 
|Abstract=Medically unexplained symptoms (MUS) challenge our perception of illness. As a consequence, a MUS-patient’s legitimised entry into the sick role, as defined by Parsons, poses a problem for physicians and patients alike. The encounter between patients with MUS and physicians therefore can be frustrating for both parties. The present study is a single case analysis of such an encounter in primary care. Using the microanalytical method of conversation analysis, this study aims to provide a contextualised description of both the patient’s and the physician’s different orientations to the purpose of the encounter. This approach locates the source of the frustration in the participants’ incompatible interactional projects. The patient is oriented towards the emotional and life world aspects of her situation. She is pursuing recognition, not only of the destructive effect that the symptoms have on all aspects of her life, but also of herself as a morally sound person. The physician, on the contrary, is oriented towards avoiding to psychologise the patient and keeping the focus on reaching an agreement about future clinical action. The physician uses ancillary questions to refocus the emotionally loaded contributions from the patient and maintain structured progression. Consequently, physician and patient are talking at cross purposes, and it is argued that this is a structurally facilitated pitfall of the conventional format of primary care visits that physicians are trained to adhere to.
 
|Abstract=Medically unexplained symptoms (MUS) challenge our perception of illness. As a consequence, a MUS-patient’s legitimised entry into the sick role, as defined by Parsons, poses a problem for physicians and patients alike. The encounter between patients with MUS and physicians therefore can be frustrating for both parties. The present study is a single case analysis of such an encounter in primary care. Using the microanalytical method of conversation analysis, this study aims to provide a contextualised description of both the patient’s and the physician’s different orientations to the purpose of the encounter. This approach locates the source of the frustration in the participants’ incompatible interactional projects. The patient is oriented towards the emotional and life world aspects of her situation. She is pursuing recognition, not only of the destructive effect that the symptoms have on all aspects of her life, but also of herself as a morally sound person. The physician, on the contrary, is oriented towards avoiding to psychologise the patient and keeping the focus on reaching an agreement about future clinical action. The physician uses ancillary questions to refocus the emotionally loaded contributions from the patient and maintain structured progression. Consequently, physician and patient are talking at cross purposes, and it is argued that this is a structurally facilitated pitfall of the conventional format of primary care visits that physicians are trained to adhere to.
 
 
}}
 
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Latest revision as of 05:51, 6 September 2018

Tarber-etal2016
BibType ARTICLE
Key Tarber-etal2016
Author(s) Christel Tarber, Lisbeth Frostholm, Emma Rehfeld
Title Talking at cross purposes: Negotiation of the sick role with a MUS patient as a real time social process
Editor(s)
Tag(s) EMCA, Medical, Medical EMCA
Publisher
Year 2016
Language
City
Month
Journal Tidsskrift for Forskning i Sygdom og Samfund
Volume 13
Number 24
Pages
URL Link
DOI
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

Medically unexplained symptoms (MUS) challenge our perception of illness. As a consequence, a MUS-patient’s legitimised entry into the sick role, as defined by Parsons, poses a problem for physicians and patients alike. The encounter between patients with MUS and physicians therefore can be frustrating for both parties. The present study is a single case analysis of such an encounter in primary care. Using the microanalytical method of conversation analysis, this study aims to provide a contextualised description of both the patient’s and the physician’s different orientations to the purpose of the encounter. This approach locates the source of the frustration in the participants’ incompatible interactional projects. The patient is oriented towards the emotional and life world aspects of her situation. She is pursuing recognition, not only of the destructive effect that the symptoms have on all aspects of her life, but also of herself as a morally sound person. The physician, on the contrary, is oriented towards avoiding to psychologise the patient and keeping the focus on reaching an agreement about future clinical action. The physician uses ancillary questions to refocus the emotionally loaded contributions from the patient and maintain structured progression. Consequently, physician and patient are talking at cross purposes, and it is argued that this is a structurally facilitated pitfall of the conventional format of primary care visits that physicians are trained to adhere to.

Notes