The interactive work of narrative elicitation in person‐centred care: Analysis of phone conversations between health care professionals and patients with common mental disorders
Abstract Introduction Narratives play a central part in person‐centred care (PCC) as a communicative means of attending to patients' experiences. The present study sets out to explore what activities are performed and what challenges participants face in the interactive process of narrative eli...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | Health Expectations |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/hex.13440 |
| _version_ | 1811340236973670400 |
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| author | Matilda Cederberg Andreas Fors Lilas Ali Anneli Goulding Åsa Mäkitalo |
| author_facet | Matilda Cederberg Andreas Fors Lilas Ali Anneli Goulding Åsa Mäkitalo |
| author_sort | Matilda Cederberg |
| collection | DOAJ |
| description | Abstract Introduction Narratives play a central part in person‐centred care (PCC) as a communicative means of attending to patients' experiences. The present study sets out to explore what activities are performed and what challenges participants face in the interactive process of narrative elicitation, carried through in patient‐professional communication in a remote intervention based on PCC. Methods Data were gathered from a randomized controlled trial (RCT) in a Swedish city where health care professionals (HCPs) conducted remote PCC for patients on sick leave due to common mental disorders. A sample of eleven audio‐recorded phone conversations between HCPs and patients enroled in the RCT were collected and subjected to conversation analysis. Results Three interactive patterns in narrative elicitation were identified: Completed narrative sequences driven by the patient, question‐driven narrative sequences guided by the HCP, and narrative sequences driven as a collaborative project between the patient and the HCP. In the question‐driven narrative sequences, communication was problematic for both participants and they did not accomplish a narrative. In the other two patterns, narratives were accomplished but through various collaborative processes. Conclusion This study provides insight into what challenges narrative elicitation may bring in the context of a remote PCC intervention and what interactive work patients and HCP need to engage in. Importantly, it also highlights tensions in the ethics of PCC and its operationalization, if the pursuit of a narrative is not properly balanced against the respect for patients' integrity and personal preferences. Our findings also show that narrative elicitation may represent an interactive process in PCC in which illness narratives are jointly produced, negotiated and transformed. Patient or Public Contribution Stakeholders, including patient representatives, were involved in the design of the main study (the RCT). They have been involved in discussions on research questions and dissemination throughout the study period. They have not been involved in conducting the present study. |
| first_indexed | 2024-04-13T18:39:03Z |
| format | Article |
| id | doaj.art-7eabcc5e9b464be99ce50895521f09ff |
| institution | Directory Open Access Journal |
| issn | 1369-6513 1369-7625 |
| language | English |
| last_indexed | 2024-04-13T18:39:03Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Expectations |
| spelling | doaj.art-7eabcc5e9b464be99ce50895521f09ff2022-12-22T02:34:47ZengWileyHealth Expectations1369-65131369-76252022-06-0125397198310.1111/hex.13440The interactive work of narrative elicitation in person‐centred care: Analysis of phone conversations between health care professionals and patients with common mental disordersMatilda Cederberg0Andreas Fors1Lilas Ali2Anneli Goulding3Åsa Mäkitalo4Institute of Health and Care Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg SwedenInstitute of Health and Care Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg SwedenInstitute of Health and Care Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg SwedenRegion Västra Götaland, Psychosis Clinic Sahlgrenska University Hospital Gothenburg SwedenDepartment of Education University of Oslo Oslo NorwayAbstract Introduction Narratives play a central part in person‐centred care (PCC) as a communicative means of attending to patients' experiences. The present study sets out to explore what activities are performed and what challenges participants face in the interactive process of narrative elicitation, carried through in patient‐professional communication in a remote intervention based on PCC. Methods Data were gathered from a randomized controlled trial (RCT) in a Swedish city where health care professionals (HCPs) conducted remote PCC for patients on sick leave due to common mental disorders. A sample of eleven audio‐recorded phone conversations between HCPs and patients enroled in the RCT were collected and subjected to conversation analysis. Results Three interactive patterns in narrative elicitation were identified: Completed narrative sequences driven by the patient, question‐driven narrative sequences guided by the HCP, and narrative sequences driven as a collaborative project between the patient and the HCP. In the question‐driven narrative sequences, communication was problematic for both participants and they did not accomplish a narrative. In the other two patterns, narratives were accomplished but through various collaborative processes. Conclusion This study provides insight into what challenges narrative elicitation may bring in the context of a remote PCC intervention and what interactive work patients and HCP need to engage in. Importantly, it also highlights tensions in the ethics of PCC and its operationalization, if the pursuit of a narrative is not properly balanced against the respect for patients' integrity and personal preferences. Our findings also show that narrative elicitation may represent an interactive process in PCC in which illness narratives are jointly produced, negotiated and transformed. Patient or Public Contribution Stakeholders, including patient representatives, were involved in the design of the main study (the RCT). They have been involved in discussions on research questions and dissemination throughout the study period. They have not been involved in conducting the present study.https://doi.org/10.1111/hex.13440narrativespatient‐centred carepatient‐provider communicationperson‐centred carestorytelling |
| spellingShingle | Matilda Cederberg Andreas Fors Lilas Ali Anneli Goulding Åsa Mäkitalo The interactive work of narrative elicitation in person‐centred care: Analysis of phone conversations between health care professionals and patients with common mental disorders Health Expectations narratives patient‐centred care patient‐provider communication person‐centred care storytelling |
| title | The interactive work of narrative elicitation in person‐centred care: Analysis of phone conversations between health care professionals and patients with common mental disorders |
| title_full | The interactive work of narrative elicitation in person‐centred care: Analysis of phone conversations between health care professionals and patients with common mental disorders |
| title_fullStr | The interactive work of narrative elicitation in person‐centred care: Analysis of phone conversations between health care professionals and patients with common mental disorders |
| title_full_unstemmed | The interactive work of narrative elicitation in person‐centred care: Analysis of phone conversations between health care professionals and patients with common mental disorders |
| title_short | The interactive work of narrative elicitation in person‐centred care: Analysis of phone conversations between health care professionals and patients with common mental disorders |
| title_sort | interactive work of narrative elicitation in person centred care analysis of phone conversations between health care professionals and patients with common mental disorders |
| topic | narratives patient‐centred care patient‐provider communication person‐centred care storytelling |
| url | https://doi.org/10.1111/hex.13440 |
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