Interaction Practices of Physicians, Patients and their Relatives in Palliative Care
| Author: | Lindtner, Heide |
| Abstract: | |
| Unlike curative care, palliative care is unable to cure, but rather aims to substantially increase the quality of life of terminally-ill patients. In order to do this, one of its main tasks is to determine and attend to psychological, social and spiritual issues of both patients and their relatives. Consequently, personal, intensive talk to physicians (and their way of talking) plays a key role in this context. Nevertheless, hardly any conversation analytic research in the field of either communication in clinical palliative care or interactions between physicians and relatives of terminally-ill patients exists to the present day. Longitudinal studies of entire discourses are also missing (cf. Heritage/Maynard 2006, Nowak 2007). A dissertation at the University of Heidelberg investigates, for the first time, audio data of complete interaction discourses between physicians, patients and their relatives recorded at a palliative care unit. In this study, constitutive characteristics of verbal interaction (Kallmeyer 2005) are applied as methodogical guidelines and at the same time assessed in regard to their methodological applicability (Deppermann 2001). Based on interactions between hospital staff physicians and patients and/or relatives in ten cases, the different interaction types of this interaction discourse (i.e. admission/ counselling/ ward round / discharging interviews) are systematically detected and differentiated with regard to activity patterns and distribution of interaction activity burdens. In terms of sequence organisation, actual moments of misunderstanding and clashing as well as potential “teachable moments” (resp. their felicity conditions) are closely examined: Interaction practices of identity and relationship constitution as well as negotiation of interactive relevant understanding are instructive at this. Two case studies will expatiate on this and highlight the significance of these interaction practices with regard to teachable moments. |
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