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Combining patient talk about internet use during primary care consultations with retrospective accounts. A qualitative analysis of interactional and interview data

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Stevenson, Fiona A., Seguin, Maureen, Leydon-Hudson, Geraldine, Barnes, Rebecca, Ziebland, Sue, Pope, Catherine, Murray, Elizabeth and Atherton, Helen (2021) Combining patient talk about internet use during primary care consultations with retrospective accounts. A qualitative analysis of interactional and interview data. Social Science & Medicine, 272 . 113703. doi:10.1016/j.socscimed.2021.113703 ISSN 0277-9536.

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Official URL: https://doi.org/10.1016/j.socscimed.2021.113703

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Abstract

Despite widespread acknowledgement of internet use for information about health, patients report not disclosing use of online health information in consultations. This paper compares patients' reported use of the internet with matched video recordings of consultations. The concepts of doctorability and epistemics are employed to consider similarities and differences between patients’ reports in interviews and actions in the consultation. Data are drawn from the Harnessing Resources from the Internet study conducted in the UK. The data set consists of 281 video-recorded general practice consultations, with pre-consultation questionnaires completed by all patients, interviews with all 10 participating doctors and 28 selected patients. We focus on the 28 patient interviews and associated consultation recordings. A conversation analytic (CA) approach is used to systematically inspect both the interview and consultation data. In interviews patients presented use of the internet as associated with appropriate self-management and help-seeking. In consultations patients skilfully translated what they had found on the internet in order to provide grounds for the actions they sought. We conclude that patients translate and utilise what they have found on the internet to assert the doctorability of their presenting problems. Furthermore, patients design their talk in both interviews and consultations to accord with their understanding of the epistemic rights of both doctors and patients. Patients search the internet so they are informed about their medical problem, however they carefully manage disclosure of information to avoid disrupting the smooth running of medical interactions.

Item Type: Journal Article
Subjects: P Language and Literature > P Philology. Linguistics
R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
T Technology > TK Electrical engineering. Electronics Nuclear engineering
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Telecommunication in medicine -- Great Britain, Internet in medicine -- Great Britain, Internet users -- Patients, Primary health care -- Great Britain, Physician and patient -- Great Britain, Medical consultation -- Great Britain, Conversation analysis -- Research, Qualitative research -- Great Britain
Journal or Publication Title: Social Science & Medicine
Publisher: Elsevier
ISSN: 0277-9536
Official Date: March 2021
Dates:
DateEvent
March 2021Published
23 January 2021Available
11 January 2020Accepted
Volume: 272
Article Number: 113703
DOI: 10.1016/j.socscimed.2021.113703
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 13 January 2021
Date of first compliant Open Access: 9 February 2021
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
284NIHR School for Primary Care Researchhttp://dx.doi.org/10.13039/501100013374
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