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Offering patients choices: A pilot study of interactions in the seizure clinic

Toerien, M., Shaw, R., Duncan, R. and Reuber, M. (2011) Offering patients choices: A pilot study of interactions in the seizure clinic. Epilepsy & Behavior, 20 (2). pp. 312-320. ISSN 1525-5050


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Using conversation analysis (CA), we studied conversations between one United Kingdom-based epilepsy specialist and 13 patients with seizures in whom there was uncertainty about the diagnosis and for whom different treatment and investigational options were being considered. In line with recent communication guidance, the specialist offered some form of choice to all patients: in eight cases, a course of action was proposed, to be accepted or rejected, and in the remaining five, a "menu" of options was offered. Even when presenting a menu, the specialist sometimes conveyed his own preferences in how he described the options, and in some cases the menu was used for reasons other than offering choice (e.g., to address patient resistance). Close linguistic and, interactional analysis of clinical encounters can show why doctors may feel they are offering choices when patients report that the decision was clinician dominated. (C) 2010 Elsevier Inc. All rights reserved.

Item Type: Article
Copyright, Publisher and Additional Information: © 2011 Elsevier. This is an author produced version of a paper subsequently published in Epilepsy & Behavior. Uploaded in accordance with the publisher's self-archiving policy.
Keywords: Conversation analysis; Epilepsy; Nonepileptic seizures; Decision making; Patient choice; Patient participation
Institution: The University of Sheffield
Academic Units: The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine (Sheffield) > Division of Genomic Medicine (Sheffield) > Academic Neurology Unit (Sheffield)
Depositing User: Miss Anthea Tucker
Date Deposited: 08 Apr 2011 10:34
Last Modified: 08 Feb 2013 17:31
Published Version: http://dx.doi.org/10.1016/j.yebeh.2010.11.004
Status: Published
Publisher: Elsevier
Refereed: Yes
Identification Number: 10.1016/j.yebeh.2010.11.004
URI: http://eprints.whiterose.ac.uk/id/eprint/42937

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