Authority and Accountability: The Delivery of Diagnosis in Primary Health Care

Peräkylä, Anssi

doi:10.2307/2787032

Cited by 303 publications

(216 citation statements)

References 17 publications

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“…Patients are capable of translating differences in seizure manifestations into lexical distinctions, and may resist the use of certain labels or actively encourage the doctor to apply particular labels to their experiences. Despite suggestions in early labelling theory (Hagan 1973, Mercer 1973, labelling is therefore not a one-way process from doctor to patient, but a complex, interactional negotiation with doctors and patients as participants with equal stakes (Maynard 1992, Gill and Maynard 1995, Peräkylä 1998. …”

Section: Discussionmentioning

confidence: 99%

Seizure, Fit or Attack? The Use of Diagnostic Labels by Patients with Epileptic or Non-epileptic Seizures

Plug

Sharrack

Reuber

2009

Applied Linguistics

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We present an analysis of the use of diagnostic labels such as seizure, attack, fit and blackout by patients who experience seizures. While previous research on patients' preferences for diagnostic terminology has relied on questionnaires, we assess patients' own preferences and their responses to a doctor's use of different labels through the qualitative and quantitative analysis of doctor-patient interactions in a realistic clinical setting. We also examine whether two subgroups of patients -those with epileptic seizures and those with (psychogenic) nonepileptic seizures -show different behaviours in this respect. Our findings suggest firstly that patients make fine lexical distinctions between the various diagnostic labels they use to describe their seizure experiences; secondly, that patients play an active role in the development and application of labels for their medical complaint; and thirdly, that attention to patients' lexical choices and interactive use or avoidance of labels can be relevant for the differential diagnosis of seizures.

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Section: Discussionmentioning

confidence: 99%

Seizure, Fit or Attack? The Use of Diagnostic Labels by Patients with Epileptic or Non-epileptic Seizures

Plug

Sharrack

Reuber

2009

Applied Linguistics

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“…As summarized in earlier work on these types of data (Stivers, 2002a, b), CA examines the social actions that interactants accomplish in and through interaction focusing on sequences of interaction (e.g., the delivery and reception of advice in British health visitors' interactions with first time mothers (Heritage & Sefi, 1992), the delivery and receipt of diagnoses (Heath, 1992;Pera¨kyla¨, 1998), and the delivery and reception of bad news (Maynard, 2003) rather than restricting analyses to isolated sentences or phrases (for a full discussion see Schegloff, in press). …”

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confidence: 99%

Non-antibiotic treatment recommendations: delivery formats and implications for parent resistance

Stivers

2005

Social Science & Medicine

147

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This study draws on a database of 570 community-based acute pediatric encounters in the USA and uses conversation analysis as a methodology to identify two formats physicians use to recommend non-antibiotic treatment in acute pediatric care (using a subset of 309 cases): recommendations for particular treatment (e.g., ''I'm gonna give her some cough medicine.'') and recommendations against particular treatment (e.g., ''She doesn't need any antibiotics.''). The findings are that the presentation of a specific affirmative recommendation for treatment is less likely to engender parent resistance to a non-antibiotic treatment recommendation than a recommendation against particular treatment even if the physician later offers a recommendation for particular treatment. It is suggested that physicians who provide a specific positive treatment recommendation followed by a negative recommendation are most likely to attain parent alignment and acceptance when recommending a non-antibiotic treatment for a viral upper respiratory illness. r

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“…af tegn på lidelsen. Men sådanne beskrivelser tages typisk i brug når der under undersøgelsen enten forekommer smalltalk som forskyder muligheden for at laegen kan levere diagnosen umiddelbart efter, eller når diagnosen meget klart modstrider patientens erklaerede forventning om en bestemt lidelse (Peräkylä 1998). Ingen af delene er naturligvis på spil i eksempel (2).…”

Section: Samtalerunclassified

“…Én af dem er beskrevet ovenfor. Peräkylä (1998) viser at overgangen fra undersøgelse til diagnose kan vaere kort: laegen kigger lidt ind i øret, laener sig tilbage i stolen og siger "du fejler ikke noget". Alligevel er sammenhaengen mellem laegens to handlinger betydningsfuld for hvordan patienter opfatter diagnosen.…”

Section: Spor 3: Multimodale Analyserunclassified

Konversationsanalyse af læge-patient-samtaler. Status, overblik og muligheder

Nielsen¹

2010

NyS

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Authority and Accountability: The Delivery of Diagnosis in Primary Health Care

Cited by 303 publications

References 17 publications

Seizure, Fit or Attack? The Use of Diagnostic Labels by Patients with Epileptic or Non-epileptic Seizures

Seizure, Fit or Attack? The Use of Diagnostic Labels by Patients with Epileptic or Non-epileptic Seizures

Non-antibiotic treatment recommendations: delivery formats and implications for parent resistance

Konversationsanalyse af læge-patient-samtaler. Status, overblik og muligheder

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