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Communicating bodily changes: Physicians' ways of enabling patient understanding in gastrointestinal cancer consultations

Artikel i vetenskaplig tidskrift
Författare Febe Friberg
Eva Lidén
Cecilia Håkansson
Joakim Öhlén
Publicerad i Palliative & Supportive Care
Volym 13
Sidor 661– 671
ISSN 1478-9515
Publiceringsår 2015
Publicerad vid Centrum för personcentrerad vård vid Göteborgs universitet (GPCC)
Institutionen för vårdvetenskap och hälsa
Sidor 661– 671
Språk en
Länkar journals.cambridge.org.ezproxy.ub.g...
Ämnesord Bodily changes;
Ämneskategorier Omvårdnad

Sammanfattning

Objective: To explore how physicians communicatively enable patients' understanding of bodily changes in gastrointestinal cancer care consultations. Method: Two datasets were used. The first consisted of transcribed video-recorded palliative care consultations with three oncologists and six patients diagnosed with advanced gastrointestinal cancer, in the context of outpatient palliative care. The second dataset was audio-recorded transcriptions from diagnostic consultations with six surgeons and seven patients diagnosed with colorectal cancer, in the context of cancer surgery. An inductively driven and iterative analysis of interaction was performed, guided by Wetherell et al. (2001). Results: Two overarching communicative strategies were identified: (1) “visualizing strategies,” with the dimensions: visible strategies (visualizing with what you actually or potentially can see), sensory strategies (visualizing with what is possible to feel), and imaginative strategies; and (2) “contrasting strategies,” with the dimensions: contrasting subjective experiences and contrasting between the patient and other people. Significance of results: The visualizing and contrasting communicative strategies form parts of physicians' tacit and experience-based knowledge. The strategies employed by physicians reveal clear potentials to enable patients' understanding and sense making of bodily changes. However, these strategies need to be explicated and problematized as parts of both consultation practice and basic medical education. By means of increased awareness, physicians can more easily identify turning points in patients' levels of understanding, thereby enriching ordinary medical consultations with reflected pedagogical strategies and skills in how to dialogue in a person-centered manner.

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