Difference between revisions of "Zhao-Ma2020"

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Latest revision as of 11:55, 11 June 2020

Zhao-Ma2020
BibType ARTICLE
Key Zhao-Ma2020
Author(s) Chunjuan Zhao, Wen Ma
Title Patient resistance towards clinicians’ diagnostic test-taking advice and its management in Chinese outpatient clinic interaction
Editor(s)
Tag(s) EMCA, China, Diagnostic tests, Decision making, Advice, Patient resistance
Publisher
Year 2020
Language English
City
Month
Journal Social Science & Medicine
Volume 258
Number 113041
Pages
URL Link
DOI https://doi.org/10.1016/j.socscimed.2020.113041
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

Performing diagnostic tests is a fundamental information-gathering activity in diagnostic process. However, little attention has been paid to the interactional process where a diagnostic test is advised and received, especially in Chinese medical settings. Decision making over prescribing diagnostic tests consists of clinicians' advice and patients' acceptance or resistance/rejection. Drawing on audio-recordings of clinician-patient encounters in Chinese outpatient clinics as data and conversation analysis as a method, we discuss how patient resistance to clinicians' diagnostic test-taking advice is displayed and managed over sequences of interaction. Two types of advice deliveries have been identified: advice either with no diagnostic utterances or with indeterminate diagnostic utterances. We find that patients demonstrate their resistance towards the former type of advice in two ways: questioning clinicians’ decisions and proposing an alternative plan. Displaying resistance to the latter type of advice, patients have been found to recurrently resort to one way: proffering additional information about personal experience. Confronted with resistance, clinicians generally proceed to justify decisions by either asserting their epistemic primacy in determining a test or lowering certainty in the original speculative diagnosis. Towards persistent resistance, clinicians mainly employ two techniques to impose acceptance onto patients: repeating the initial advice and terminating forcefully current sequence. This study adds to a growing body of research on resistance in medical settings and contributes to our understanding of the decision making over medical investigations in Chinese outpatient clinic interaction.

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