Taciturn Patients in Health Counseling at a Hospital: Passive Recipients or Active Participators?

Kettunen, Tarja; Poskiparta, Marita; Liimatainen, Leena; Sjögren, Auli; Karhila, Päivi

doi:10.1177/104973201129119181

Cited by 25 publications

(18 citation statements)

References 39 publications

(79 reference statements)

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“…Riva et al, 2014). But the initial behavior of patients is also related to their further participation and the progression of the encounter (Chatwin, 2008;Kettunen et al, 2001). When nurses participate in conversations outside a clinical setting (e.g.…”

Section: Organization Of Nurse-patient Interactionmentioning

confidence: 99%

Ethnomethodological studies of nurse-patient and nurse-relative interactions: A scoping review

Mayor

Bietti

2017

International Journal of Nursing Studies

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A B S T R A C TObjectives: Researchers in nursing science interested in the study of nurse-patient and nurse-relative interactions have displayed an ever increasing interest in ethnomethodology and conversation analysis. This review assesses the scope of this literature. We categorize the papers in thematic categories determined both inductively and deductively and synthesize the main findings of this literature within category. Finally we discuss the interactional determinants of the lack patient participation, the limitations of the field, and focus on implications. Design: A scoping review on nurse-patient and nurse-relative interactions. Data sources: Forty articles focusing on nurse-patient interactions and nurse-relative interactions. All the articles relied on ethnomethodology and/or conversation analysis. Review methods: A literature search has been carried out on Medline (all articles until June 2016; keywords were: nurs*.ab. and "conversation analysis"; nurs*.ab. and ethnomethodology). A similar search was performed on other platforms. The scope of the literature was identified by inductively and deductively analyzing the themes of the relevant articles. Results: Six thematic categories emerged: Organization of nurse-patient interaction (eleven articles); Organization of mediated nurse-patient interaction (seven articles); Information, explanation and advice (eight articles); Negotiation and influence asymmetry (six articles); Managing emotions in critical illness (two articles); and Interacting with patients presenting reduced interactional competences (six articles). Conclusions: Across most thematic categories it appeared that patient participation is far from ideal as interactional asymmetry was most observed in favor of nurses. When the encounters occurred at the patients' homes this pattern was reversed. Computer-mediated interactions were often reported as nonoptimal as the standardized process constrained communication and delayed patients' presentation of their ailments. Micro-analyses of interaction present a clear potential for the development of guidelines for nurse-patient interactions. Implications for practice are described.

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Section: Organization Of Nurse-patient Interactionmentioning

confidence: 99%

Ethnomethodological studies of nurse-patient and nurse-relative interactions: A scoping review

Mayor

Bietti

2017

International Journal of Nursing Studies

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“…However, some have failed to make any methodological framework explicit (Hanna et al. 1995, Kettunen et al. 2001).…”

Section: Research To Promote Understandingmentioning

confidence: 99%

“…Topics under investigation vary widely and include identifying types of nurse–patient interaction in which touch is used (Bottorff & Morse 1994); exploring patients’ taciturnity during health counselling (Kettunen et al. 2001); understanding the uncertainty experience of women living with breast cancer (Nelson 1996); and enriching the understanding of lived world of older people (Magilvy et al.…”

Section: Research To Promote Understandingmentioning

confidence: 99%

The uses of photography in clinical nursing practice and research: a literature review

Riley¹,

Manias²

2004

Journal of Advanced Nursing

113

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The most common applications of photography in nursing and related journals include photo elicitation to promote understanding in research, videorecording as a method of teaching and learning, and as a method of observation, with more creative approaches tending to be employed in health professions other than nursing. Few reports gave explanations of how researchers negotiated ethical concerns when seeking approval for studies in clinical settings, and few gave details of the processes of data analysis.

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“…Just as social conversation is constructed by all the participants, so is the medical encounter (Heritage & Maynard, 2006). Patients can be seen to utilize strategies toward clinicians, such as silence or a noncommittal response when an affirmative response is expected (Jones, 2003), hinting at issues of concern rather than stating them directly (Kettunen, Poskiparta, Liimatainen, Sjögren, & Karhila, 2001), deferring to medical judgment while at the same time using strategies to continue holding the floor (Kettunen, Poskiparta, & Gerlander, 2002), and using humor to soften the act of dissent (Mallett & Ahern, 1996). Interactions between health care professionals and patients are also influenced by the structures and systems of the health care organization itself.…”

mentioning

confidence: 99%

Strategies Used in the Pursuit of Achievability During Goal Setting in Rehabilitation

2010

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We used conversation analysis of six audio-and video-recorded goal setting meetings that were attended by patients and their respective treating team to explore and describe the interaction of participants during interdisciplinary goal setting, and to identify the strategies used to agree goals. The health care professionals involved in the six sessions included four physiotherapists, four occupational therapists, four nurses, one speech and language therapist, and one neuropsychologist. The participants included 3 patients with multiple sclerosis, 2 patients with spinal cord lesions, and 1 patient with stroke from an inpatient neurological rehabilitation unit.Detailed analysis revealed how the treating team shaped the meetings. The most notable finding was that there was rarely a straightforward translation of patient wishes into agreed-on written goals, with the treating team leading goal modification so that goals were achievable. Despite professional dominance, patients also influenced the course of the interaction, particularly when offering resistance to goals proposed by the treating team.Keywords conversation analysis; health care; health care, interprofessional perspective; health care, teamwork; rehabilitation 3 Goal setting is crucially important within rehabilitation, yet there is very little empirical evidence underlying its practice (Wade, 1999). The existing evidence base originates primarily from investigations into enhancing performance on tasks in the workplace, and the finding that specific, challenging goals can improve immediate performance (Locke & Latham, 2002). A recent systematic review of the evidence for the effectiveness of goal planning in rehabilitation lent some support to this finding . Within the rehabilitation context, goal planning is about much more than performance on a task. The process of goal setting within the overall rehabilitation plan is thought to enhance patient autonomy (Holliday, Cano, Freeman, & Playford, 2007) and interdisciplinary team work (Schut & Stam, 1994). Within the United Kingdom, patient involvement in goal setting is highly regarded at a strategic level in health care and is considered a clinical standard within the health system (Department of Health, 1997). It is generally accepted that sharing in decision making improves commitment to the decisions that are made (Gwyn & Elwyn, 1999); however, even when the will to ensure this practice is present, professionals might lack the insight needed to facilitate patients making self-determined decisions (Zoffmann, Harder, & Kirkevold, 2008). in health care, it is necessary to draw on studies utilizing detailed analyses of interaction (e.g., Robinson, 2003). By 4 looking closely at the interaction as it unfolds, it is possible to answer questions about how decisions are made between professionals and patients, and to begin to unpack the complexity and skill involved in achieving collaboration (Parry, 2004). Conversation analysis, a method for analyzing the turn-by-turn construction of meaning between ...

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Taciturn Patients in Health Counseling at a Hospital: Passive Recipients or Active Participators?

Cited by 25 publications

References 39 publications

Ethnomethodological studies of nurse-patient and nurse-relative interactions: A scoping review

Ethnomethodological studies of nurse-patient and nurse-relative interactions: A scoping review

The uses of photography in clinical nursing practice and research: a literature review

Strategies Used in the Pursuit of Achievability During Goal Setting in Rehabilitation

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