Sequences of talk about emotional concerns in follow-up consultations with adolescent childhood cancer survivors.
OBJECTIVE
To explore practices regarding communication about emotional concerns in follow-up consultations with adolescent cancer survivors and pediatrician.


METHODS
Seven video-taped follow-up consultations with adolescent survivors which contained many examples of emotional cues and concern were analyzed according to principles of conversation analysis.


RESULTS
During talk about emotional concerns, a task-focused asymmetric pattern of pediatrician questions and patient responses was most often upheld. In a number of cases a gradual build-up of emotional expression from a weak hint to a more explicit expression of emotional concern was observed, often facilitated by the pediatricians. Most often work-up was relatively brief, sometimes with a brief positive reappraisal, but more comprehensive elaboration was also seen. Topic shifts were often abrupt.


CONCLUSIONS
Pediatricians and patients used some of the same conventions as in everyday conversation during emotional talk in medical encounters. We observed shifts between informal talk and a typical task-focused mode. Conscious attention to such shifts and to the sequential nature of emotional talk could be helpful for doctors in designing their responses to patients' emotional concerns.


CONCLUSIONS
Our findings may contribute to insight in how clinicians respond to emotional concerns in follow-up consultations and have implications for communication skills training.
Department of Behavioural Sciences in Medicine, University of Oslo, Norway. Electronic address: anneli.mellblom@medisin.uio.no.
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Mellblom
Department of Behavioural Sciences in Medicine, University of Oslo, Norway; Department of Paediatric Medicine, Women and Children's Unit, Oslo University Hospital, Rikshospitalet, Norway.
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Korsvold
Department of Paediatric Medicine, Women and Children's Unit, Oslo University Hospital, Rikshospitalet, Norway.
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Ruud
Department of Behavioural Sciences in Medicine, University of Oslo, Norway.
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Lie
Department of Behavioural Sciences in Medicine, University of Oslo, Norway; National Resource Centre for Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet, Norway.
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Loge
Department of Behavioural Sciences in Medicine, University of Oslo, Norway.
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Finset
D000293:Adolescent; D001007:Anxiety / Q000523:psychology; D003142:Communication; D003463:Cues; D004644:Emotions; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D009633:Nonverbal Communication; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D012017:Referral and Consultation; D017741:Survivors / Q000523:psychology*; D014743:Videotape Recording
Adolescent; Childhood cancer; Communication; Conversation analysis; Emotional concerns