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Patient participation and learning in medical consultations about congenital heart defects
Stockholm University, Faculty of Humanities, Department of Swedish Language and Multilingualism, Scandinavian Languages.
Stockholm University, Faculty of Humanities, Department of Swedish Language and Multilingualism, Scandinavian Languages.ORCID iD: 0000-0002-5618-9573
2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 7, article id e0220136Article in journal (Refereed) Published
Abstract [en]

In this article, patient activity in 8 audio recorded specialist consultations on fetal cardiology is investigated in order to explore how, why and when patients tend to participate in encounters in which the doctor dominates the interaction. The overall question is: How can the participation of patients in the consultations be connected to the development of higher levels of health literacy, i.e. to interactive literacy and to critical literacy? Patient participation is here understood as interactive action and is analyzed in terms of different interactive moves, which are related to different recurring topics. Despite the highly standardized format of the consultations, there is a large variation between the patients’ participation: between 0.7 and 2.8 moves per minute. The patients participate most during the topics ‘Prevalence’ and ‘Consultations’ and least during the topic ‘The normal heart’. Although most of the patients' moves are responses to what the doctor says, they remarkably often pose questions and use so called rejoinders. By posing questions, they take control of the information flow and sometimes even change the topics. By using rejoinders, they analyze the problems involved in the discussion e.g. by asking for clarifications or confirmation. Patients with a low over-all participation rate also use fewer moves that indicate higher literacy levels. The qualitative analysis problematizes the idea of a simple scale from basic literacy to critical literacy. Moves that indicate basic literacy skills are interactively important for the learning activity, led by the doctor. However, patients who mainly support the doctor’s initiatives don’t take the opportunity to influence the flow of information in ways that might favor their health literacy development.

Place, publisher, year, edition, pages
2019. Vol. 14, no 7, article id e0220136
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Research subject
Scandinavian Languages
Identifiers
URN: urn:nbn:se:su:diva-171090DOI: 10.1371/journal.pone.0220136ISI: 000482335700057OAI: oai:DiVA.org:su-171090DiVA, id: diva2:1339217
Projects
Hälsolitteracitet och kunskapsbyggande i informationssamhället
Funder
Swedish Research Council, 2014-1959Available from: 2019-07-26 Created: 2019-07-26 Last updated: 2019-09-16Bibliographically approved

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CiteExportLink to record
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  • apa
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