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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

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journal contribution
posted on 01.03.2021, 08:59 by Laura Jenkins, Ruth Parry, Marco Pino
As the main symptom in palliative care, pain requires careful assessment. Repeating patient answers is one recommended communication technique for helping convey to patients that they have been heard, and to encourage them to say more. We examined 23 episodes where experienced doctors repeat patients' answers with mirrored rhythm and downward-final intonation, captured in pain assessments video-recorded in 37 consultations in a large UK hospice. Using conversation analysis, our aim was to determine whether or not the repeats invite additional talk, and if so, how they do so. Our findings reveal 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 confirmation or disconfirmation. The patients in our data sometimes—but not always—respond to the repeat with confirmation or further talk. We conclude that repeating patient answers with mirrored rhythm and downward-final intonation provides a no-obligation opportunity for patient-led confirmation, disconfirmation, or expansion of pain descriptions, particularly when the pain matter is new, revised, or has been problematic to report.

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

VoR (Version of Record)

Rights holder

© The Authors

Publisher statement

This is an Open Access Article. It is published by Oxford University Press under the Creative Commons Attribution 4.0 International Licence (CC BY 4.0). Full details of this licence are available at: https://creativecommons.org/licenses/by/4.0/

Acceptance date

05/11/2020

Publication date

2021-02-22

Copyright date

2021

ISSN

0142-6001

eISSN

1477-450X

Language

en

Depositor

Dr Laura Jenkins. Deposit date: 6 November 2020

Licence

Exports