How technology shapes advice: professional–parent interaction in a digital pediatric treatment

Abstract

IntroductionTechnology-enabled treatments (TET) have emerged in pediatric care as an effective solution for early and intensive intervention. There is a lack of research in the field of digitalized health care on the interaction between professionals and parents on which these treatments are based, and at the same time too little is known about the impact of remoteness and technology on interaction in the field of health communication.MethodWe use a conversation analytical approach to examine the interaction between occupational therapists and parents in one such treatment on a micro level, with a focus on advice-giving and the role of professional and parental authorities in this.ResultsOur analyses show that professionals in TET work together with the parents of children in treatment to achieve children's rehabilitation goals. In advice-giving in TET, the professionals interactionally downgrade their epistemic and deontic authority, orienting toward the imposition on parents inherent to advice and orienting toward parental authority.DiscussionBy describing three different patterns of the interactional unfolding of advice-giving, we provide insights into how professionals carefully initiate and return to advice and show how this activity is shaped by the technology used for the interaction. Our study offers a better understanding of how paramedical professionals practice their profession given remoteness and technology and what TET entails interactionally in terms of advice-giving.

Communication in Telehealth: A State-of-the-Art Literature Review of Conversation-Analytic Research

“…One study investigates a distinct form of healthcare where parents submit videos of their child to the clinician and where they discuss these videos with a pediatric occupational therapist over text (Dalmaijer et al, 2023 ). This allows parents to show not only how their child is progressing, but also how they implement the clinician’s advice.…”

“…Not even (a)synchronicity is a distinguishing feature. As Dalmaijer et al ( 2023 ) show, healthcare can involve multiple modalities interchangeably, videos submitted by patients and text in response by paramedics. Clinical disciplines like dermatology are using photos or videos submitted asynchronously by patients in combination with synchronous video or telephone (Wang et al, 2022 ).…”

“…Healthcare services are increasingly hybrid, with patients seeing their clinician in-person for specific types of encounters (e.g., acute care) and remotely for others (e.g., follow-up). Furthermore, polymedia service models in which patients, for example, submit e-consultations (text), photos or videos to their healthcare provider, which they then discuss in the consultation or through text exchange (as, for example, in Dalmaijer et al, 2023 ) are increasingly common. For CA to be relevant for clinical practice, we need to conduct research on these more prevalent forms of mediated interaction and on emerging forms of hybrid and polymedia care.…”