Multi-party interactions comprising healthcare professionals, patients, and their partners during consultations for localised prostate cancer

Abstract

People with localised prostate cancer regularly attend their clinical consultations with their partner or spouse. Using conversation analysis, this thesis examined a corpus of twenty-eight treatment and diagnostic consultations comprising a patient, their partner, and a healthcare professional. This thesis addresses the overarching research question, how are co-present romantic partners involved in the conversation during clinical consultations for people with low to intermediate risk localised prostate cancer? Across this corpus, partners were almost entirely unaddressed by healthcare professionals, as they were explicitly invited to contribute for just 3% of their turns-at-talk. Sequential misalignments were evident where couples expressed preferences relating to treatment choices. These misalignments led to couples silencing themselves in service of conflict avoidance. The analysis also illustrated how discussions relating to the sexual impact of prostate cancer were communicated in a manner that minimised opportunity space for patient and partner contributions. Moreover, these discussions erased the relational impact through exclusive focus on individual, male sexual and reproductive function. This thesis identifies the structure of these consultations as dyadic, thus inhibiting opportunity space for partners to contribute. It argues that this structure is underpinned by the enactment of Kantian liberal autonomy. Accordingly, it proposes a shift away from the individualised interpretation of autonomy, towards an understanding of the patient and their autonomy as inherently relational.

More information

Identifiers

ORCID for Simon, John Stewart: orcid.org/0000-0002-9026-2981

ORCID for Lucy Brindle: orcid.org/0000-0002-8933-3754

Catalogue record

Export record