Offering patients choices: A pilot study of interactions in the seizure clinic

Abstract Using conversation analysis (CA), we studied conversations between one United Kingdom-based epilepsy specialist and 13 patients with seizures in whom there was uncertainty about the diagnosis and for whom different treatment and investigational options were being considered. In line with re...

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Bibliographic Details
Published inEpilepsy & behavior Vol. 20; no. 2; pp. 312 - 320
Main Authors Toerien, Merran, Shaw, Rebecca, Duncan, Roderick, Reuber, Markus
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.02.2011
Subjects
Choice Behavior - physiology
Conversation analysis
Decision making
Epilepsy
Female
Humans
Male
Neurology
Nonepileptic seizures
Patient choice
Patient participation
Patient Satisfaction
Pilot Projects
Seizures - diagnosis
Seizures - physiopathology
Time Factors
Nonepileptic seizures
Patient choice
Conversation analysis
Decision making
Epilepsy
Patient participation
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Summary:Abstract Using conversation analysis (CA), we studied conversations between one United Kingdom-based epilepsy specialist and 13 patients with seizures in whom there was uncertainty about the diagnosis and for whom different treatment and investigational options were being considered. In line with recent communication guidance, the specialist offered some form of choice to all patients: in eight cases, a course of action was proposed, to be accepted or rejected, and in the remaining five, a “menu” of options was offered. Even when presenting a menu, the specialist sometimes conveyed his own preferences in how he described the options, and in some cases the menu was used for reasons other than offering choice (e.g., to address patient resistance). Close linguistic and interactional analysis of clinical encounters can show why doctors may feel they are offering choices when patients report that the decision was clinician dominated.
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ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2010.11.004