Objective: This study addresses, for the first time, the effectiveness of receptionists handling incoming calls from patients to access General Practice services. Methods: It is a large-scale qualitative study of three services in the UK. Using conversation analysis, we identified the issue of 'patient burden', which we defined based on the trouble patients display pursuing service. We quantified instances of 'patient burden' using a coding scheme. Results: We demonstrate how 'patient burden' unfolds in two phases of the telephone calls: (i) following an initial rejection of a patient's request; and (ii) following a receptionist's initiation of call closing. Our quantitative analysis shows that the three GP services differ in the frequency of 'patient burden' and reveals a correlation between the proportion of 'patient burden' and independent national satisfaction scores for these surgeries. Conclusion: Unlike post-hoc surveys, our analysis of live calls identifies the communicative practices which may constitute patient (dis)satisfaction. Practice Implications: Through establishing what receptionists handle well or less well in encounters with patients, we propose ways of improving such encounters through training or other forms of intervention.
Loneliness is framed as an enduring problem for carers of all ages, including older carers; however, there is little examination of older men’s experiences of caring, loneliness and social isolation. Based on interviews with 25 men (aged 68–92 years), we discuss findings from a study of older male carers’ experiences of loneliness in England. Within their accounts, loneliness is framed as a future, rather than present, problem as caring provides a time-limited buffer to loneliness while concurrently increasing social isolation. Further, the findings shed light on how male carers seek and benefit from carers’ support groups while also maintaining autonomy.
This article examines how practitioners engage with parents who have been referred to parenting programmes. Engaging parents is an important component of child welfare work so that parents can benefit from interventions and outcomes for children can be improved. However, our knowledge of engagement is still developing and research in the field is frequently based on self-reported data. This study used Conversation Analysis to examine direct recordings of initial telephone conversations between parenting practitioners and parents following their referral to the service. Results revealed that in the majority of calls, practitioners focused on the primary task of making arrangements for the service, but in a minority of calls, practitioners departed from the usual progress of the call to ask parents about the difficulties they were facing. When they did so, practitioners committed themselves to substantial additional work listening to the parent and extending the length of the call. However, they also pursued different actions to engage the parent with the service that were built up incrementally in the talk. By examining three particular features of practitioners' talk during these sequences, the article considers how a practice phenomenon such as engagement may be purposefully worked up moment by moment.
Background
Acute respiratory tract infections (RTI) in children are a common reason for antibiotic prescribing. Clinicians’ prescribing decisions are influenced by perceived parental expectations for antibiotics, however there is evidence that parents actually prefer to avoid antibiotics. This study aimed to investigate the influence of parent-clinician communication on antibiotic prescribing for RTI in children in England.
Methods
A mixed methods analysis of videoed primary care consultations for children (under 12 years) with acute cough and RTI. Consultations were video-recorded in six general practices in southern England, selected for socio-economic diversity. 56 recordings were transcribed in detail and a subset of recordings and transcripts used to develop a comprehensive interaction-based coding scheme. The scheme was used to examine communication practices between parents and clinicians and how these related to antibiotic or non-antibiotic treatment strategies.
Results
Parents’ communication rarely implied an expectation for antibiotics, some explicitly offering a possible viral diagnosis. Clinicians mostly gave, or implied, a viral diagnosis and mainly recommended non-antibiotic treatment strategies. In the minority of cases where parents’ communication behaviours implied they may be seeking antibiotic treatment, antibiotics were not usually prescribed. Where clinicians did prescribe antibiotics, they voiced concern about symptoms or signs, including chest pain, discoloured phlegm, prolonged fever, abnormal chest sounds, or pink /bulging ear drums.
Conclusions
We found little evidence of a relationship between parents’ communication behaviours and antibiotic prescribing. Rather, where antibiotics were prescribed, this was associated with clinicians’ expressed concerns regarding symptoms and signs.
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