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|Title=Patient resistance towards diagnosis in primary care: Implications for concordance
 
|Title=Patient resistance towards diagnosis in primary care: Implications for concordance
 
|Tag(s)=EMCA; Medical; Medical consultations; Resistance; concordance;  conversation  analysis;  diagnosis  delivery;  doctor–patient  interaction;  primary care;
 
|Tag(s)=EMCA; Medical; Medical consultations; Resistance; concordance;  conversation  analysis;  diagnosis  delivery;  doctor–patient  interaction;  primary care;
|Key=Ijäs-Kallio-Ruusuvuori2010
+
|Key=Ijas-Kallio-Ruusuvuori2010
 
|Year=2010
 
|Year=2010
 
|Journal=Health
 
|Journal=Health
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|Number=5
 
|Number=5
 
|Pages=505–522
 
|Pages=505–522
|URL=http://hea.sagepub.com/content/14/5/505
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|URL=https://journals.sagepub.com/doi/abs/10.1177/1363459309360798
 
|DOI=10.1177/1363459309360798
 
|DOI=10.1177/1363459309360798
 
|Abstract=This article reports a conversation analytic study of patients’ resisting responses after doctors’ diagnostic statements. In these responses, patients bring forward information that confronts the doctor’s diagnostic information. We examine two turn formats — aligning and misaligning — with which patients initiate resistance displays, and describe conversational resources of resistance the patients resort to: their immediate symptoms, their past experiences with similar illness conditions, information received in past medical visits and their diagnostic expectations that have been established earlier in the consultation.Through the deployment of these resources, patients orient to the doctor’s diagnostic information as negotiable and seek to further a shared understanding with the doctor on their condition. The results are discussed with regard to concordance as a process in which patients and doctors arrive at a shared understanding on the nature of the illness and its proper treatment. Our analysis illuminates the mechanisms in interaction in and through which concordance can be realized. Thus, we suggest that concordance can be seen to encompass not only treatment discussion but also the process where participants reach agreement about the diagnosis. The data of the study consist of 16 sequences of patients’ resisting responses to diagnosis and is drawn from 86 Finnish primary care visits for upper respiratory tract infections.
 
|Abstract=This article reports a conversation analytic study of patients’ resisting responses after doctors’ diagnostic statements. In these responses, patients bring forward information that confronts the doctor’s diagnostic information. We examine two turn formats — aligning and misaligning — with which patients initiate resistance displays, and describe conversational resources of resistance the patients resort to: their immediate symptoms, their past experiences with similar illness conditions, information received in past medical visits and their diagnostic expectations that have been established earlier in the consultation.Through the deployment of these resources, patients orient to the doctor’s diagnostic information as negotiable and seek to further a shared understanding with the doctor on their condition. The results are discussed with regard to concordance as a process in which patients and doctors arrive at a shared understanding on the nature of the illness and its proper treatment. Our analysis illuminates the mechanisms in interaction in and through which concordance can be realized. Thus, we suggest that concordance can be seen to encompass not only treatment discussion but also the process where participants reach agreement about the diagnosis. The data of the study consist of 16 sequences of patients’ resisting responses to diagnosis and is drawn from 86 Finnish primary care visits for upper respiratory tract infections.
 
}}
 
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Latest revision as of 06:25, 1 September 2020

Ijas-Kallio-Ruusuvuori2010
BibType ARTICLE
Key Ijas-Kallio-Ruusuvuori2010
Author(s) Taru Ijäs-Kallio, Johanna Ruusuvuori
Title Patient resistance towards diagnosis in primary care: Implications for concordance
Editor(s)
Tag(s) EMCA, Medical, Medical consultations, Resistance, concordance, conversation analysis, diagnosis delivery, doctor–patient interaction, primary care
Publisher
Year 2010
Language
City
Month
Journal Health
Volume 14
Number 5
Pages 505–522
URL Link
DOI 10.1177/1363459309360798
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

This article reports a conversation analytic study of patients’ resisting responses after doctors’ diagnostic statements. In these responses, patients bring forward information that confronts the doctor’s diagnostic information. We examine two turn formats — aligning and misaligning — with which patients initiate resistance displays, and describe conversational resources of resistance the patients resort to: their immediate symptoms, their past experiences with similar illness conditions, information received in past medical visits and their diagnostic expectations that have been established earlier in the consultation.Through the deployment of these resources, patients orient to the doctor’s diagnostic information as negotiable and seek to further a shared understanding with the doctor on their condition. The results are discussed with regard to concordance as a process in which patients and doctors arrive at a shared understanding on the nature of the illness and its proper treatment. Our analysis illuminates the mechanisms in interaction in and through which concordance can be realized. Thus, we suggest that concordance can be seen to encompass not only treatment discussion but also the process where participants reach agreement about the diagnosis. The data of the study consist of 16 sequences of patients’ resisting responses to diagnosis and is drawn from 86 Finnish primary care visits for upper respiratory tract infections.

Notes