title: Content and distribution of discursive space in consultations between patients with atrial fibrillation and healthcare professionals.
abstract: OBJECTIVE
  To describe (i) the topics participants talk about, (ii) the use of discursive space in consultations between patients with atrial fibrillation (AF) and their nurses and physicians, and (iii) the frequencies of the ways the patients, nurses and physicians introduce the topics.
  
  
  METHODS
  Data were collected from 23 videotaped consultations concerning patients with AF as well as physicians and nurses, respectively. To obtain a description of topics discussed, the transcripts were analysed using content analysis. The patterns of dominance for the respective topic and participant were explored from the framework of analysis that treats dominance.
  
  
  RESULTS
  Four topics were used by both nurses and physicians in the consultations. These were 'pathophysiology', 'diagnostic procedures', 'treatment' and 'activity'. In the nurse-patient consultation an additional topic, 'routines related to the physician's responsibilities', emerged. With respect to the number of words and turns, the distribution of the discourse space was almost equal between the nurses and patients and unequal between the physicians and patients. The healthcare professionals initiated the topics more frequently compared to the patients, whereby the medical approach recommended in the guidelines for AF could be recognized. The patients were the dominating initiators in the topic 'activity', which refers to the adaptation of activities in daily life in relation to the AF.
  
  
  CONCLUSIONS
  The medical-driven agenda dominates over the patient-driven agenda in consultations between healthcare professional and patients with AF. The patients initiated the conversations when discussing living with AF and were more talkative during conversations in nurse consultations.
authors.affiliation: Department of Nursing Science, School of Health Sciences, Jönköping University, Sweden. eleni.siouta@hhj.hj.se
authors.forename: Eleni
authors.initials: E
authors.lastname: Siouta
authors.forename: Anders
authors.initials: A
authors.lastname: Broström
authors.forename: Berith
authors.initials: B
authors.lastname: Hedberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000628:therapy*; D001291:Attitude of Health Personnel; D003142:Communication; D016208:Databases, Factual; D005260:Female; D006282:Health Personnel / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D010348:Patient Care Team / Q000458:organization & administration*; D010817:Physician-Patient Relations; D011369:Professional-Patient Relations; D011786:Quality Control; D012017:Referral and Consultation / Q000592:standards* / Q000639:trends; D011795:Surveys and Questionnaires; D013548:Sweden; D014743:Videotape Recording