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dc.contributor.authorLian, Olaug S
dc.contributor.authorNettleton, Sarah
dc.contributor.authorGrange, Huw R.
dc.contributor.authorDowrick, Christopher
dc.date.accessioned2022-03-10T13:42:06Z
dc.date.available2022-03-10T13:42:06Z
dc.date.issued2021-10-30
dc.description.abstractObjectives: To explore interactional processes in which clinical decisions are made in situ during medical consultations, particularly the ways in which patients show agency in decision-making processes by proposing and opposing actions, and which normative dimensions and role-expectations their engagement entail.<p> Methods: Narrative analysis of verbatim transcripts of 22 naturally occurring consultations, sourced from a corpus of 212 consultations between general practitioners and patients in England. After thematically coding the whole dataset, we selected 22 consultations with particularly engaged patients for in-depth analysis.<p> Results: Patients oppose further actions more often than they propose actions, and they oppose more directly than they propose. When they explain why they propose and oppose something, they reveal their values. Patients’ role-performance changes throughout the consultations. <p>Conclusion: Assertive patients claim – and probably also achieve – most influence when they oppose actions directly and elaborate why. Patients display ambiguous role-expectations. In final concluding stages of decision-making processes, patients usually defer to GPs’ authority. Practice implications: Clinicians should be attentive to the ways in which patients want to engage in decision-making throughout the whole consultation, with awareness of normative dimensions of both process and content, and the ways in which patient’s actions are constrained by their institutional position.en_US
dc.identifier.citationLian OS, Nettleton S, Grange HR, Dowrick C. “I’m not the doctor; I’m just the patient”: Patient agency and shared decision-making in naturally occurring primary care consultations . Patient Education and Counseling. 2021en_US
dc.identifier.cristinIDFRIDAID 1949917
dc.identifier.doi10.1016/j.pec.2021.10.031
dc.identifier.issn0738-3991
dc.identifier.issn1873-5134
dc.identifier.urihttps://hdl.handle.net/10037/24375
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.journalPatient Education and Counseling
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.title“I’m not the doctor; I’m just the patient”: Patient agency and shared decision-making in naturally occurring primary care consultationsen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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