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Professionals’ embodied orientations towards patients in discharge-planning meetings and their impact on patient participation


Keel, Sara; Schoeb, Veronika (2016). Professionals’ embodied orientations towards patients in discharge-planning meetings and their impact on patient participation. Communication & Medicine, 13(1):115-134.

Abstract

To enhance the patient’s involvement, clinical guidelines on rehabilitation require the patient’s participation in the entire rehabilitation process, including discharge planning (DP). However, very little is known about how this institutional demand is actually dealt with in everyday clinical practice. Adopting a conversation analytic (CA) approach, our paper tackles the matter by looking at interdisciplinary entry meetings (IEMs) at a rehabilitation clinic in German-speaking Switzerland. Our study is based on audio-visual recordings of 11 IEMs, whose central aim is to formulate patients’ rehabilitation goals and to plan their discharge. The paper offers a detailed analysis of the embodied practices through which healthcare professionals seek to involve patients in the IEMs, and also investigates patients’ responses. Our analysis shows that, although carefully elaborated, the professionals’ practices do not elicit more than reactive patient participation. The paper argues that this is due to (1) the practices’ temporal positioning within the overall activity structure of the meeting – they are deployed when no important decision is at stake, projecting minimal patient participation on the phases in which decisions are taken – and (2) the actions the practices project on the next turn: confirmation, acknowledgement or ratification of what has previously been proposed by professionals.

Abstract

To enhance the patient’s involvement, clinical guidelines on rehabilitation require the patient’s participation in the entire rehabilitation process, including discharge planning (DP). However, very little is known about how this institutional demand is actually dealt with in everyday clinical practice. Adopting a conversation analytic (CA) approach, our paper tackles the matter by looking at interdisciplinary entry meetings (IEMs) at a rehabilitation clinic in German-speaking Switzerland. Our study is based on audio-visual recordings of 11 IEMs, whose central aim is to formulate patients’ rehabilitation goals and to plan their discharge. The paper offers a detailed analysis of the embodied practices through which healthcare professionals seek to involve patients in the IEMs, and also investigates patients’ responses. Our analysis shows that, although carefully elaborated, the professionals’ practices do not elicit more than reactive patient participation. The paper argues that this is due to (1) the practices’ temporal positioning within the overall activity structure of the meeting – they are deployed when no important decision is at stake, projecting minimal patient participation on the phases in which decisions are taken – and (2) the actions the practices project on the next turn: confirmation, acknowledgement or ratification of what has previously been proposed by professionals.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:06 Faculty of Arts > Institute of Education
Dewey Decimal Classification:370 Education
Scopus Subject Areas:Health Sciences > Public Health, Environmental and Occupational Health
Uncontrolled Keywords:Conversation analysis, discharge planning, interdisciplinary meetings, rehabilitation, patient participation, professionals’ embodied orientation
Language:English
Date:2016
Deposited On:30 May 2024 12:18
Last Modified:13 Jun 2024 14:44
Publisher:Equinox Publishing
ISSN:1612-1783
OA Status:Closed
Publisher DOI:https://doi.org/10.1558/cam.21624
PubMed ID:29958347
Project Information:
  • : FunderSNSF
  • : Grant ID134835
  • : Project TitleDischarge planning in rehabilitation centers: what about patient participation?
  • : FunderResearch Funds of the University of Applied Sciences and Arts, Western Switzerland, HES-SO (RéSAR)
  • : Grant ID
  • : Project Title
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