Difference between revisions of "Niedel-etal2012"

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Niedel-etal2012
BibType ARTICLE
Key Niedel-etal2012
Author(s) Selaine Niedel, Michael Traynor, Martin McKee, Margaret Grey
Title Parallel vigilance: Parents’ dual focus following diagnosis of Type 1 diabetes mellitus in their young child
Editor(s)
Tag(s) EMCA, Medical, chronic illness, conversation analysis, parallel vigilance, parent–clinician communication, Type 1 diabetes consultation
Publisher
Year 2012
Language
City
Month
Journal Health
Volume 17
Number 3
Pages 246 –265
URL
DOI 10.1177/1363459312451180
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

There is consensus that enabling patient self-care and expertise leads to better management of chronic illness. Clinicians are being encouraged to manage clinical encounters in ways that promote these outcomes rather than perpetuate hierarchical relationships. This article describes one part of a larger study of 55 outpatient consultations conducted within 14 months of the diagnosis of Type 1 diabetes mellitus in young children. Participants were parents and the specialist doctors, nurses, dieticians and social workers who oversee the child’s secondary care. Consultations were audio-recorded and transcribed. Our analysis draws on aspects of conversation analysis (CA) to investigate how parents’ talk enacts a growing confidence in the management of their child’s disease in the face of questioning from professionals. Analysis reveals how this talk distinguishes a duality of focus that combines the normal watchfulness exhibited by all parents as they protect their children, with an additional intense, parallel watchfulness for signs of potentially serious manifestations of diabetes. We term this phenomenon parallel vigilance and illustrate its development using five representative extracts from consultations. The concept of parallel vigilance extends the chronic illness literature and informs our understanding of a process that contributes to parents’ developing expertise and provides new and important insights into the way in which parents conceptualize and implement their evolving role in the care of their child. Moreover, parallel vigilance serves as an enabler of parental contributions to the specialist consultation.

Notes