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Speaking out of turn: Implications of partner contributions for patient autonomy during prostate cancer consultations

Speaking out of turn: Implications of partner contributions for patient autonomy during prostate cancer consultations
Speaking out of turn: Implications of partner contributions for patient autonomy during prostate cancer consultations

Objective: This research examines how partners contribute to clinical consultations for people with prostate cancer. It highlights a social practice where a partner responds to talk that addresses a patient. Methods: A conversation analysis of twenty-eight prostate cancer treatment and diagnostic consultations was carried out using data collected from four clinical sites across England. Results: The analysis demonstrated that this practice was prosocial and patient enabling. Partners oriented to the patient's primary rights to take their turn as the selected next speaker, only initiating after a substantial delay from the clinician's turn-at-talk. Consequently, the partner consistently opened an opportunity space that the patient took to elaborate upon, or collaborate with the partners’ turn as they regularly took up a unified stance resisting the individualised configuration of the encounter. Conclusion: This research highlights the social and clinical utility of partners during these consultations, as they served as important, yet underutilised interactional and informational resources for clinicians and patients. Practice implications: This research indicates a need to reconsider the configuration of these consultations and sanction partners as formal participants. Absent of this, partners will continue to have to work to insert their contributions into consultations while resisting the dyadic structure of these interactions.

Autonomy, Conversation analysis, Medical communication, Partners, Prostate cancer, Turntaking
0738-3991
Stewart, Simon John
8e468a9f-617b-40df-a502-a884e025f332
Roberts, Lisa
0a937943-5246-4877-bd6b-4dcd172b5cd0
Brindle, Lucy
17158264-2a99-4786-afc0-30990240436c
Stewart, Simon John
8e468a9f-617b-40df-a502-a884e025f332
Roberts, Lisa
0a937943-5246-4877-bd6b-4dcd172b5cd0
Brindle, Lucy
17158264-2a99-4786-afc0-30990240436c

Stewart, Simon John, Roberts, Lisa and Brindle, Lucy (2023) Speaking out of turn: Implications of partner contributions for patient autonomy during prostate cancer consultations. Patient Education and Counseling, 112, [107722]. (doi:10.1016/j.pec.2023.107722).

Record type: Article

Abstract

Objective: This research examines how partners contribute to clinical consultations for people with prostate cancer. It highlights a social practice where a partner responds to talk that addresses a patient. Methods: A conversation analysis of twenty-eight prostate cancer treatment and diagnostic consultations was carried out using data collected from four clinical sites across England. Results: The analysis demonstrated that this practice was prosocial and patient enabling. Partners oriented to the patient's primary rights to take their turn as the selected next speaker, only initiating after a substantial delay from the clinician's turn-at-talk. Consequently, the partner consistently opened an opportunity space that the patient took to elaborate upon, or collaborate with the partners’ turn as they regularly took up a unified stance resisting the individualised configuration of the encounter. Conclusion: This research highlights the social and clinical utility of partners during these consultations, as they served as important, yet underutilised interactional and informational resources for clinicians and patients. Practice implications: This research indicates a need to reconsider the configuration of these consultations and sanction partners as formal participants. Absent of this, partners will continue to have to work to insert their contributions into consultations while resisting the dyadic structure of these interactions.

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Stewart Roberts Brindle Speaking Out of Turn Manuscript_author accepted version - Accepted Manuscript
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Accepted/In Press date: 30 March 2023
e-pub ahead of print date: 31 March 2023
Published date: 1 July 2023
Additional Information: Funding Information: The lead author was funded and supported by the South Coast Doctoral Training Partnership of the Economic and Social Research Council, Ref: ES/J500161/1. The Understanding Consequences Study (Chief Investigator: Brindle) was funded by TrueNTH: A collaboration between Prostate Cancer UK and Movember. The opinions expressed in this research do not necessarily reflect those of ESRC or TrueNTH.
Keywords: Autonomy, Conversation analysis, Medical communication, Partners, Prostate cancer, Turntaking

Identifiers

Local EPrints ID: 477171
URI: http://eprints.soton.ac.uk/id/eprint/477171
ISSN: 0738-3991
PURE UUID: 75a2235a-ca47-4149-9436-44b9214bd5f3
ORCID for Lisa Roberts: ORCID iD orcid.org/0000-0003-2662-6696
ORCID for Lucy Brindle: ORCID iD orcid.org/0000-0002-8933-3754

Catalogue record

Date deposited: 31 May 2023 16:38
Last modified: 17 Mar 2024 03:05

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Contributors

Author: Simon John Stewart
Author: Lisa Roberts ORCID iD
Author: Lucy Brindle ORCID iD

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