Ijas-Kallio2010

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Ijas-Kallio2010
BibType ARTICLE
Key Ijas-Kallio2010
Author(s) Taru Ijäs-Kallio, Johanna Ruusuvuori, Anssi Peräkylä
Title Patient involvement in problem presentation and diagnosis delivery in primary care
Editor(s)
Tag(s) EMCA, Medical EMCA, Conversation Analysis, Doctor-patient interaction, Problem Presentation, Diagnosis, Primary care, Patient Participation
Publisher
Year 2010
Language English
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Journal Communication & Medicine
Volume 7
Number 2
Pages 131–141
URL Link
DOI 10.1558/cam.v7i2.131
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Abstract

This article reports a conversation analytic study of primary care physicians’ orientations to different types of patients’ problem presentation. Four types of problem presentation are examined: 1) symptoms only, 2) candidate diagnosis, 3) diagnosis implicative symptom description, and 4) candidate diagnosis as background information. The analysis shows that both in receiving the problem presentation at the beginning of the visit and in delivering a diagnosis later on, doctors address the patients’ presentations which involved or implied a candidate diagnosis. In contrast, following a symptoms-only type of problem presentation such references predominantly are not made. The study suggests that patients’ problem presentation has a crucial role in shaping the doctor’s communication patterns also in the phases of consultation in which the patient’s active participation is of lesser significance, such as the diagnostic phase. The findings are discussed in relation to the question of patient participation in the medical consultation. The data consist of 86 video-recorded Finnish primary care consultations for upper respiratory tract infection including both child and adult patients.

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