Patient involvement in problem presentation and diagnosis delivery in primary care

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http://hdl.handle.net/10138/29637

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Ijäs-Kallio , T , Ruusuvuori , J E & Peräkylä , A 2010 , ' Patient involvement in problem presentation and diagnosis delivery in primary care ' , Communication & Medicine , vol. 7 , no. 2 , pp. 131-141 .

Title: Patient involvement in problem presentation and diagnosis delivery in primary care
Author: Ijäs-Kallio, Taru; Ruusuvuori, Johanna Elisabeth; Peräkylä, Anssi
Contributor: University of Helsinki, Helsinki Collegium for Advanced Studies
Date: 2010
Number of pages: 11
Belongs to series: Communication & Medicine
ISSN: 1612-1783
URI: http://hdl.handle.net/10138/29637
Abstract: This article reports a conversation analytic study of primary care physicians’ orientations to different types of patients’ problem presentation. Four types of problem presentation are examined: 1) symptoms only, 2) candidate diagnosis, 3) diagnosis implicative symptom description, and 4) candidate diagnosis as background information. The analysis shows that both in receiving the problem presentation at the beginning of the visit and in delivering a diagnosis later on, doctors address the patients’ presentations which involved or implied a candidate diagnosis. In contrast, following a symptoms-only type of problem presentation such references predominantly are not made. The study suggests that patients’ problem presentation has a crucial role in shaping the doctor’s communication patterns also in the phases of consultation in which the patient’s active participation is of lesser significance, such as the diagnostic phase. The findings are discussed in relation to the question of patient participation in the medical consultation. The data consist of 86 video-recorded Finnish primary care consultations for upper respiratory tract infection including both child and adult patients.
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