Difference between revisions of "Monzoni-et-al2011"

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|Title=Are  there  interactional  reasons  why  doctors  may find  it  hard  to  tell  patients  that their  physical  symptoms  may  have  emotional  causes?  A  conversation  analytic
 
|Title=Are  there  interactional  reasons  why  doctors  may find  it  hard  to  tell  patients  that their  physical  symptoms  may  have  emotional  causes?  A  conversation  analytic
 
study  in  neurology  outpatients
 
study  in  neurology  outpatients
|Tag(s)=EMCA; Medical consultations; Emotion;  
+
|Tag(s)=EMCA; Medical consultations; Emotion;
 
|Key=Monzoni-et-al2011
 
|Key=Monzoni-et-al2011
 
|Year=2011
 
|Year=2011
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|Volume=85
 
|Volume=85
 
|Pages=189–200
 
|Pages=189–200
 +
|Abstract=Objective:  This  qualitative  study  analyses  patients’  conversational  behaviours  to  explore  whether  there are  interactional  factors  that  could  explain  why  doctors  find  clinical  encounters  in  which  the  diagnosis  of functional  symptoms  (physical  symptoms  with  presumed  emotional  causes)  is  explained  and psychological  treatment  offered  particularly  challenging.
 +
Methods:  Twenty  out-patient  consultations  between  neurologists  and  patients  with  functional symptoms  were  recorded  and  analysed  using  Conversation  Analysis.  Patients’  communication  behaviour was  characterised  by  pervasive  interactional  resistance.  Instances  of  resistance  were  identified  and counted.
 +
Results:  Interactional  resistance  was  especially  evident  when  the  aetiology  of  symptoms  and  treatment recommendations  were  discussed.  Resistance  was  expressed  overtly  (through  disagreements, challenges,  rejections)  or  more  passively  (through  moves  such  as  lack  of  engagement  with  the interaction,  silences  or  the  use  of  minimal  responses).
 +
Conclusion:  This  study  provides  objective  evidence  that  doctors  face  interactional  challenges  when  they try  to  explain  that  symptoms  are  medically  unexplained  and  suggest  psychological  treatment.
 +
Practice  implications:  Doctors  may  try  to  avoid  provoking  patients’  overt  resistance  because  they perceive  it  as  unpleasant.  However,  the  display  of  overt  resistance  enables  them  to  deal  explicitly  with the  grounds  on  which  patients  reject  their  explanations  and  recommendations,  and  to  address  patients’
 +
particular concerns.
 
}}
 
}}

Revision as of 03:58, 19 August 2018

Monzoni-et-al2011
BibType ARTICLE
Key Monzoni-et-al2011
Author(s) Chiara M. Monzoni, Roderick Duncan, Richard Grünewald, Markus Reuber
Title Are there interactional reasons why doctors may find it hard to tell patients that their physical symptoms may have emotional causes? A conversation analytic

study in neurology outpatients

Editor(s)
Tag(s) EMCA, Medical consultations, Emotion
Publisher
Year 2011
Language
City
Month
Journal Patient Education and Counseling
Volume 85
Number
Pages 189–200
URL
DOI
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

Objective: This qualitative study analyses patients’ conversational behaviours to explore whether there are interactional factors that could explain why doctors find clinical encounters in which the diagnosis of functional symptoms (physical symptoms with presumed emotional causes) is explained and psychological treatment offered particularly challenging. Methods: Twenty out-patient consultations between neurologists and patients with functional symptoms were recorded and analysed using Conversation Analysis. Patients’ communication behaviour was characterised by pervasive interactional resistance. Instances of resistance were identified and counted. Results: Interactional resistance was especially evident when the aetiology of symptoms and treatment recommendations were discussed. Resistance was expressed overtly (through disagreements, challenges, rejections) or more passively (through moves such as lack of engagement with the interaction, silences or the use of minimal responses). Conclusion: This study provides objective evidence that doctors face interactional challenges when they try to explain that symptoms are medically unexplained and suggest psychological treatment. Practice implications: Doctors may try to avoid provoking patients’ overt resistance because they perceive it as unpleasant. However, the display of overt resistance enables them to deal explicitly with the grounds on which patients reject their explanations and recommendations, and to address patients’ particular concerns.

Notes