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The interactional management of patients' physical incompetence: a conversation analytic study of physiotherapy interactions

journal contribution
posted on 24.04.2018 by Ruth Parry
Patients’ physical incompetence is a feature of many clinical interactions; the challenges it presents are not only technical but also interactional. This paper examines how interpretations and interactional consequences of physical incompetence are dealt with during stroke physiotherapy. A conversation analytic approach was used to examine video-recorded treatment sessions. Analysis demonstrated that managing physical incompetence forms an important element of the organisation of these interactions. Through their conduct, patients and therapists limit and counter its various negative implications, including those which attribute it to failure of a patient’s efforts, co-operation and personal competence, and failure of therapy. Understanding orientations to incompetence and their influence upon interactions provides some explanations, or ‘good reasons’, for certain features of clinical interactions that have attracted criticism. Analysis also shows how management of incompetence is grounded in the clinician’s authority and contributes to its maintenance. In the face of failures of physical competence, participants collaboratively and continually work to portray patients as deserving of treatment rather than sanction, and to convey that despite evident difficulties, the therapeutic process is a cooperative and successful endeavour. The paper examines how these meanings are addressed and accomplished through interaction.

Funding

This work formed part of a study funded by the National Health Service Executive, Trent Region, UK.

History

School

  • Social Sciences

Department

  • Communication, Media, Social and Policy Studies

Published in

Sociology of Health and Illness

Volume

26

Issue

7

Pages

976 - 1007

Citation

PARRY, R., 2004. The interactional management of patients' physical incompetence: a conversation analytic study of physiotherapy interactions. Sociology of Health and Illness, 26 (7), pp.976-1007.

Publisher

Blackwell Publishing © Blackwell Publishing Ltd and the Foundation for the Sociology of Health and Illness

Version

VoR (Version of Record)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Publication date

2004

Notes

This paper is closed access.

ISSN

0141-9889

eISSN

1467-9566

Language

en

Exports