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Providing opportunities for patients to say more about their pain without overtly asking: a conversation analysis of doctors repeating patient answers in palliative care pain assessment

journal contribution
posted on 09.11.2020, 11:13 by Laura Jenkins, Ruth Parry, Marco Pino
Background: As the main symptom in palliative care, pain requires careful assessment. Repeating patient answers is one recommended communication technique for enabling patients to feel heard, and to encourage them to say more.
Aim: To examine doctor-repeats of patient answers to determine whether or not the repeats invite additional talk, and if so, how they do so.
Method: Conversation analysis of 23 episodes where experienced doctors repeat a patient’s answer with downward-final intonation, captured in pain assessments video-recorded in 37 consultations in a large UK hospice.
Results: There are lexical and prosodic features of doctors’ repeated pain answers that signal completion of the sequence. At the same time, because the patient has greater (epistemic) access to their own pain, a repeat can also invite (dis)confirmation. The patients in our data sometimes (15/23) – but not always - respond to the repeat with confirmation or further talk.
Conclusion: Repeating patient answers with mirrored rhythm and downward-final intonation provides a no-obligation opportunity for patient-led (dis)confirmation/expansion of pain descriptions, particularly when the pain matter is new, revised, or has been problematic to accomplish.

Funding

This work was supported by a Research Development Fund grant from the University of Nottingham’s Centre for Advanced Studies; the Health Foundation [grant number RU33/GIFTS 7210]; the National Institute for Health Research Career Development Fellowship award [grant number CDF-2014-07-046]; and the National Institute for Health Research (NIHR).

History

School

  • Social Sciences and Humanities

Department

  • Communication and Media

Published in

Applied Linguistics

Publisher

Oxford University Press

Version

AM (Accepted Manuscript)

Publisher statement

This is a pre-copyedited, author-produced version of an article accepted for publication in Applied Linguistics following peer review. The version of record [insert complete citation information here] is available online at: xxxxxxx [insert URL and DOI of the article on the OUP website].

Acceptance date

05/11/2020

ISSN

0142-6001

eISSN

1477-450X

Language

en

Depositor

Dr Laura Jenkins. Deposit date: 6 November 2020

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