Engagement of patients with psychosis in the consultation: conversation analytic study.

OBJECTIVE: To investigate how doctors engage with patients with psychotic illness in routine consultations. DESIGN: Conversation analysis of 32 consultations between psychiatrists and patients with schizophrenia or schizoaffective disorder. SETTING: Two psychiatric outpatient clinics in east London...

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Main Authors: McCabe, R, Heath, C, Burns, T, Priebe, S
Format: Journal article
Language:English
Published: 2002
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author McCabe, R
Heath, C
Burns, T
Priebe, S
author_facet McCabe, R
Heath, C
Burns, T
Priebe, S
author_sort McCabe, R
collection OXFORD
description OBJECTIVE: To investigate how doctors engage with patients with psychotic illness in routine consultations. DESIGN: Conversation analysis of 32 consultations between psychiatrists and patients with schizophrenia or schizoaffective disorder. SETTING: Two psychiatric outpatient clinics in east London and south west London. PARTICIPANTS: 7 psychiatrists and 32 patients with schizophrenia or schizoaffective disorder. MAIN OUTCOME MEASURE: Mutual engagement in communication during the consultation. RESULTS: Patients actively attempted to talk about the content of their psychotic symptoms in consultations by asking direct questions, repeating their questions and utterances, and producing these utterances in the concluding part of the consultation. In response, doctors hesitated, responded with a question rather than with an answer, and smiled or laughed (when informal carers were present), indicating that they were reluctant to engage with patients' concerns about their psychotic symptoms. CONCLUSIONS: Patients repeatedly attempted to talk about the content of their psychotic symptoms, which was a source of noticeable interactional tension and difficulty. Addressing patients' concerns about their illness may lead to a more satisfactory outcome of the consultation and improve engagement of such patients in the health services.
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spelling oxford-uuid:4cb2f95d-1c63-4148-900a-0771c14b36f32022-03-26T15:50:59ZEngagement of patients with psychosis in the consultation: conversation analytic study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4cb2f95d-1c63-4148-900a-0771c14b36f3EnglishSymplectic Elements at Oxford2002McCabe, RHeath, CBurns, TPriebe, SOBJECTIVE: To investigate how doctors engage with patients with psychotic illness in routine consultations. DESIGN: Conversation analysis of 32 consultations between psychiatrists and patients with schizophrenia or schizoaffective disorder. SETTING: Two psychiatric outpatient clinics in east London and south west London. PARTICIPANTS: 7 psychiatrists and 32 patients with schizophrenia or schizoaffective disorder. MAIN OUTCOME MEASURE: Mutual engagement in communication during the consultation. RESULTS: Patients actively attempted to talk about the content of their psychotic symptoms in consultations by asking direct questions, repeating their questions and utterances, and producing these utterances in the concluding part of the consultation. In response, doctors hesitated, responded with a question rather than with an answer, and smiled or laughed (when informal carers were present), indicating that they were reluctant to engage with patients' concerns about their psychotic symptoms. CONCLUSIONS: Patients repeatedly attempted to talk about the content of their psychotic symptoms, which was a source of noticeable interactional tension and difficulty. Addressing patients' concerns about their illness may lead to a more satisfactory outcome of the consultation and improve engagement of such patients in the health services.
spellingShingle McCabe, R
Heath, C
Burns, T
Priebe, S
Engagement of patients with psychosis in the consultation: conversation analytic study.
title Engagement of patients with psychosis in the consultation: conversation analytic study.
title_full Engagement of patients with psychosis in the consultation: conversation analytic study.
title_fullStr Engagement of patients with psychosis in the consultation: conversation analytic study.
title_full_unstemmed Engagement of patients with psychosis in the consultation: conversation analytic study.
title_short Engagement of patients with psychosis in the consultation: conversation analytic study.
title_sort engagement of patients with psychosis in the consultation conversation analytic study
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AT heathc engagementofpatientswithpsychosisintheconsultationconversationanalyticstudy
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AT priebes engagementofpatientswithpsychosisintheconsultationconversationanalyticstudy