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患者的抗拒作为一种资源:糖尿病会诊中的潜在障碍

Patient resistance as a resource: candidate obstacles in diabetes consultations.

作者信息

Barton Josh, Dew Kevin, Dowell Anthony, Sheridan Nicolette, Kenealy Timothy, Macdonald Lindsay, Docherty Barbara, Tester Rachel, Raphael Debbie, Gray Lesley, Stubbe Maria

机构信息

School of Social and Cultural Studies, Victoria University of Wellington.

Department of Primary Health Care and General Practice, University of Otago.

出版信息

Sociol Health Illn. 2016 Sep;38(7):1151-66. doi: 10.1111/1467-9566.12447. Epub 2016 Jun 4.

Abstract

This study uses conversation analysis to explore 'candidate obstacles', a practice observed in sequences of patient resistance to lifestyle advice within health professional consultations. This article presents illustrative analyses of selected data excerpts drawn from audio-visual recordings of 116 tracked consultations between health professionals and 34 patients newly diagnosed with type 2 diabetes mellitus in New Zealand. The analysis shows that in consultations where health promotion activities are central, patient resistance can provide space for patients to identify obstacles to their compliance with lifestyle advice. Identifying candidate obstacles provides opportunities for health professionals to align advice with concerns of patients and potentially improve patient outcomes.

摘要

本研究运用会话分析方法,探究“潜在障碍”,这是在医疗专业人员会诊过程中患者对生活方式建议产生抵触的一系列行为中观察到的一种现象。本文展示了对从116次跟踪会诊的视听记录中选取的数据片段的分析,这些会诊发生在新西兰的医疗专业人员与34名新诊断出2型糖尿病的患者之间。分析表明,在以健康促进活动为核心的会诊中,患者的抵触情绪可为患者提供空间,使其能够识别自身遵守生活方式建议的障碍。识别潜在障碍为医疗专业人员提供了机会,使其能使建议与患者的担忧相契合,并有可能改善患者的治疗效果。

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