How General Practitioners Raise Psychosocial Concerns as a Potential Cause of Medically Unexplained Symptoms: A Conversation Analysis

Stortenbeker, Inge; Stommel, Wyke; Hartman, Tim olde; Dulmen, Sandra van; Das, Enny

doi:10.1080/10410236.2020.1864888

Cited by 7 publications

(4 citation statements)

References 57 publications

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“…We do see some similarities in the psychiatric literature regarding spiritual dimensions (Glas, 2021 ) and in the research on explanations that are used by doctors during consultations on MUS (Ring et al, 2005 ). Some authors focus on the psychosocial dimension of the disease (Stortenbeker et al, 2022 ). However, many patients feel offended by the association of their ailment with psychosomatic disorders.…”

Section: Discussionmentioning

confidence: 99%

A Dutch Study of Remarkable Recoveries After Prayer: How to Deal with Uncertainties of Explanation

et al. 2023

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This article addresses cases of remarkable recoveries related to healing after prayer. We sought to investigate how people who experienced remarkable recoveries re-construct and give meaning to these experiences, and examine the role that epistemic frameworks available to them, play in this process. Basing ourselves on horizontal epistemology and using grounded theory, we conducted this qualitative empirical research in the Netherlands in 2016–2021. It draws on 14 in-depth interviews. These 14 cases were selected from a group of 27 cases, which were evaluated by a medical assessment team at the Amsterdam University Medical Centre. Each of the participants had experienced a remarkable recovery during or after prayer. The analysis of the interviews, which is based on the grounded theory approach, resulted in three overarching themes, placing possible explanations of the recoveries within (1) the medical discourse, (2) biographical discourse, and (3) a discourse of spiritual and religious transformation. Juxtaposition of these explanatory frameworks provides a way to understand better the transformative experience that underlies remarkable recoveries. Uncertainty regarding an explanation is a component of knowing and can facilitate a dialogue between various domains of knowledge.

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Section: Discussionmentioning

confidence: 99%

A Dutch Study of Remarkable Recoveries After Prayer: How to Deal with Uncertainties of Explanation

et al. 2023

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“…Conversation Analysis (CA) is well-established as a method for examining naturally occurring interactions between doctors and patients ( Barnes, 2019 ; Drew et al., 2001 ), including examining how sensitive topics are discussed ( Silverman & Peräkylä, 1990 ; Weijts et al, 1993 ). CA examinations of talking about sensitive matters have already found that clinicians use specific strategies, including mentioning matters in preliminary discussions ( Stortenbeker et al., 2021 ), and that patients use humour to manage talk about delicate issues ( Beach & Prickett, 2017 ). Examining how patients respond, and if they demonstrate alignment or passive resistance in the conversation ( Heritage & Sefi, 1992 ; Steensig, 2019 ), can highlight which strategies tend to work well.…”

Section: Introductionmentioning

confidence: 99%

Talking delicately: Providing opportunistic weight loss advice to people living with obesity

Tremblett

Webb

Ziébland

et al. 2022

SSM - Qualitative Research in Health

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“…The existing discourse and conversation analytic literature that have been referred to above [i.e. 46,47,49,[50][51][52][53][54][55]57…”

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confidence: 99%

Patient Values in Patient-Provider Communication about Participation in Early Phase Clinical Cancer Trials: a Qualitative Analysis before and after Implementation of an Online Value Clarification Tool Intervention

Lent¹,

Ham²,

Jonge³

et al. 2023

Preprint

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Background Patients with advanced cancer who have no standard treatment options anymore can sometimes decide to participate in early phase clinical trials (i.e. experimental treatments with uncertain outcomes). Shared decision-making models consider discussing patient values essential, but such communication is often limited in this context and may require new interventions. Correspondingly, the OnVaCT intervention was previously developed consisting of a preparatory online value clarification tool (OnVaCT) for patients and communication training for oncologists. This study aimed to qualitatively explore which and how patient values are discussed (in context with each other) between patients and oncologists during consultations about potential early phase clinical trial participation before and after implementation of the OnVaCT intervention. Methods This study had a between-subjects design: pre-test patients received usual care, while post-test patients additionally received the OnVaCT. Oncologists participated in the communication training between study phases. Patients’ initial consultation on potential early phase clinical trial participation was recorded and transcribed verbatim. Applying a directed approach, two independent coders analysed the transcripts using an initial codebook based on previous studies. Steps of continuous evaluation and revision were repeated until data saturation was reached. Results Data saturation was reached after 32 patient-oncologist consultations (i.e. 17 pre-test and 15 post-test). These revealed the values hope, perseverance, quality or quantity of life, risk tolerance, trust in the healthcare system/professionals, autonomy, social adherence, altruism, corporeality, accepting one’s fate, and humanity. Pre-test patients mostly expressed values shortly and spontaneously, e.g. while responding to information. Oncologists acknowledged the importance of patient values, but generally only described ‘opposite’ examples why some accept and others decline trial participation, without asking further questions. In the post-test, many oncologists referred to the OnVaCT and/or asked probing questions, while patients used longer phrases connecting multiple values. Conclusions While all values could be recognized in both study phases, our analysis has pointed to the different patterns surrounding patient values in communication on potential early phase clinical trial participation before and after implementation of the OnVaCT intervention. This study thereby suggests that the OnVaCT intervention may support patients and oncologists in discussing their values. Trial registration Netherlands Trial Registry: NL7335, registered on July 17, 2018

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How General Practitioners Raise Psychosocial Concerns as a Potential Cause of Medically Unexplained Symptoms: A Conversation Analysis

Cited by 7 publications

References 57 publications

A Dutch Study of Remarkable Recoveries After Prayer: How to Deal with Uncertainties of Explanation

A Dutch Study of Remarkable Recoveries After Prayer: How to Deal with Uncertainties of Explanation

Talking delicately: Providing opportunistic weight loss advice to people living with obesity

Patient Values in Patient-Provider Communication about Participation in Early Phase Clinical Cancer Trials: a Qualitative Analysis before and after Implementation of an Online Value Clarification Tool Intervention

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