When patients present serious health conditions as unlikely: managing potentially conflicting issues and constraints

Pomerantz, Anita; Gill, Virginia Teas; Denvir, Paul

doi:10.1017/cbo9780511611216.007

Cited by 12 publications

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“…By showing her attentiveness to the possibility that the recent heat could be causing the problem, and by exposing its logical inconsistency (that is, her feet never swelled in previous summers), the patient not only moves to potentially block that avenue of inquiry, she suggests that other diagnostic avenues are more relevant. At the same time, she displays her ability to consider (and weigh the evidence for) a relatively ordinary cause rather than automatically assuming that the swelling represents serious illness (see Pomerantz et al 2007).…”

Section: Discussionmentioning

confidence: 99%

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Pre-emptive resistance: patients’ participation in diagnostic sense-making activities

Gill

Pomerantz

Denvir

2010

Sociology of Health &Amp; Illness

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In medical clinic visits, patients do more than convey information about their symptoms and problems so doctors can diagnose and treat them. Patients may also show how they have made sense of their health problems and may press doctors to interpret their problems in certain ways. Using conversation analysis, we analyse a practice patients use early in the medical visit to show that relatively benign or commonplace interpretations of their symptoms are implausible. In this practice, which we term pre-emptive resistance, patients raise candidate explanations for their symptoms and then report circumstances that undermine these explanations. By raising candidate explanations on their own and providing evidence against them, patients call for doctors to restrict the range of diagnostic hypotheses they might otherwise consider. However, the practice does not compel doctors to transparently indicate whether they will do so. Patients also display their ability to recognise and weigh the evidence for common, easily remedied causes of their symptoms. By presenting evidence against them, they show doctors the relevance of more serious diagnostic interpretations without pressing for them outright.

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Section: Discussionmentioning

confidence: 99%

“…3 3 See (Pomerantz et al 2007) for an investigation of how patients show that more serious conditions are unlikely. …”

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confidence: 99%

Pre-emptive resistance: patients’ participation in diagnostic sense-making activities

Gill

Pomerantz

Denvir

2010

Sociology of Health &Amp; Illness

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“…Discourse-analysis research on the complaint stage of medical consultations has led to important findings and implications. In the complaint stage, physicians often let patients talk for longer periods of time than usual and use cooperative strategies in consulting narratives (Chatwin, 2006;Pomerantz, Gill, & Denvir, 2007). Similarly, ten Have (1989) found that in the complaint stage, consultation takes longer than in other stages because both patient and health practitioner can extend their talk beyond what is technically necessary for accurate diagnosis.…”

Section: Pain-assessment Interviewmentioning

confidence: 99%

Do Nurses Use Discourse Markers Differently when Using Their Second Language as Opposed to Their First while Interviewing Patients?

Han

Segalowitz

Khalil

et al. 2020

The Canadian Modern Language Review

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Les auteurs se demandent si l’utilisation de marqueurs discursifs change, dans les interactions des infirmières avec les patients, en fonction de l’usage qu’elles font de leur langue maternelle (L1) ou de leur langue seconde (L2). Les marqueurs sont analysés à titre de marqueurs de maintien du tour de parole, indiquant la « prise en compte » et de marqueurs de transition dans le discours, indiquant un changement de sujet ou de locuteur dans la conversation. Ces deux catégories de marqueurs diffèrent sur le plan du degré de gestion du discours et du contrôle interactionnel. Seize infirmières mènent auprès d’un patient de L1 anglaise et d’un patient de L1 française un entretien visant l’évaluation de la douleur, entretien dans lequel les infirmières utilisent leur propre L1 dans un cas et leur propre L2, moins bien maîtrisée, dans l’autre. Les résultats de l’étude ne permettent pas de confirmer la première hypothèse, selon laquelle les infirmières devraient normalement utiliser les marqueurs discursifs plus fréquemment en L1 qu’en L2. Ils confirment toutefois la seconde hypothèse, selon laquelle les infirmières devraient utiliser les marqueurs de changement de sujet moins fréquemment en L2 qu’en L1, comparativement à leur usage (de base) des marqueurs de maintien du tour de parole. Les constatations des auteurs, en particulier l’attestation de la seconde hypothèse, pourraient avoir des répercussions sur le développement de la formation en L2 des professionnels de la santé.

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“…These dual goals can be conflicting and may pose a communicative challenge. Health communication research has explored clinicians’ role as gatekeepers to rights involved with being ill and patients’ claims that their problems are worthy of medical consideration . A less studied area is how participants, in interaction, manage potentially limiting aspects of the diagnosis on patients’ everyday lives.…”

Section: Introductionmentioning

confidence: 99%

Balancing task focus and relationship building: asking sleepy patients about traffic risk in treatment initiation consultations

Iversen

Broström

Ulander

2017

Scandinavian Caring Sciences

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To clarify the difference between their two potentially conflicting roles, nurses need to refer to existing laws and official guidelines when they raise the issue of risk in treatment initiation consultations. Nurses should also ask risk assessment questions in a problem-oriented communicative environment. Traffic risk assessment is sensitive yet important, as obstructive sleep apnoea is a highly prevalent problem causing excessive sleepiness. It is essential to acknowledge nurses' double roles with regard to coaching continuous positive airway pressure treatment and assessing traffic risk.

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When patients present serious health conditions as unlikely: managing potentially conflicting issues and constraints

Cited by 12 publications

References 0 publications

Pre-emptive resistance: patients’ participation in diagnostic sense-making activities

Pre-emptive resistance: patients’ participation in diagnostic sense-making activities

Do Nurses Use Discourse Markers Differently when Using Their Second Language as Opposed to Their First while Interviewing Patients?

Balancing task focus and relationship building: asking sleepy patients about traffic risk in treatment initiation consultations

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