title: Exploration of communicative patterns of consultations in palliative cancer care.
abstract: Building on the research conducted on institutional communication, and the analysis of actual communication taking place in clinical settings, this study describes and highlights features of palliative care consultations and focuses on the distribution of discursive space (i.e., share of words, lengths of turns), occurring topics and conversational frames. Six consultations between physicians, patients and significant others were videotaped and all participants took part in audio-taped interviews. The recordings were transcribed and analysed in regard to expectations of, the discursive space of, and topics addressed in the consultations. The distribution of the discursive space was unequal; the physicians had the greatest share of words and length of turns in all six consultations, and they mostly initiated discussion of medical issues connected to examinations and treatment, while only patients initiated the topic of the patient's future. During the consultations, institutional framing tended to dominate over client framing. There was found to be room for further study of the structure and content of palliative care consultations with emphasis on how the voice of the patient can manifest itself within the framework of the medical agenda of the consultation and its significance for palliative cancer team work.
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, P.O. Box 457, SE-405 30 Gothenburg, Sweden. joakim.ohlen@gu.se
authors.forename: Joakim
authors.initials: J
authors.lastname: Ohlén
authors.forename: Linnéa Carling
authors.initials: LC
authors.lastname: Elofsson
authors.forename: Lars-Christer
authors.initials: LC
authors.lastname: Hydén
authors.forename: Febe
authors.initials: F
authors.lastname: Friberg
mesh_terms: D000368:Aged; D003142:Communication; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control / Q000523:psychology*; D015404:Nursing Methodology Research; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D010353:Patient Education as Topic; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D012930:Social Dominance; D011795:Surveys and Questionnaires; D013548:Sweden; D014743:Videotape Recording