The literature suggests that the patient-perspective approach (i.e., eliciting and responding to patients' perspectives, including beliefs, preferences, values, and attitudes) to patient-centered care (PCC) is not a reliable predictor of positive outcomes; however, little is known about why the patient-perspective approach does not necessarily lead to positive outcomes. By using discourse analysis to examine 44 segments of oncologist-patient interactions, we found that providers' use of patient-perspective contextualization can affect the quality of care through (a) constructing the meanings of patient conditions, (b) controlling interpreting frames for patient conditions, and (c) manipulating patient preferences through strategic information sharing. We concluded that providers' use of patient-perspective contextualization is an insufficient indicator of PCC because these discursive strategies can be used to control and manipulate patient preferences and perspectives. At times, providers' patient-perspective contextualization can silence patients' voice and appear discriminatory.

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Social change often is positioned as the gradual acceptance of one set of dominant ideas over another. Ambivalence and indifference, however, also play an important role in the development of social change. Participants in this study discussed their use of common holiday greeting rituals and their reasons for using one greeting over another. Through constant comparative analysis, it was revealed that practicing American Christians undesirably challenge social change, desirably support it, see it as inevitable and therefore regard it with ambivalence, or see social change as irrelevant and meet it with indifference. Importantly, the way individuals experience social change has direct and observable implications on patterns of talk, thus affecting the nature of social change over time.A common misconception held by the American public is that the US is moving down a path of complete secularization because Christianity, representing the once prevailing set of ideals, is in the decline. While a decrease in religious attendance might be occurring in Western Europe, other global trends suggest that religion still ''enters prominently into the public sphere,'' especially in the US

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