Politeness strategies in decision-making between GPs and patients

Adams, Rachel Lynette (2013). Politeness strategies in decision-making between GPs and patients. University of Birmingham. Ph.D.

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Abstract

Policy, training and research reflect the importance of patient involvement in decisions about their care. Adoption demands certain skills though, may result in conflict, or be too threatening for patients. Using an iterative process, politeness theory was used to analyse the linguistic management of these threats and challenges in videos of GP consultations.

The collaborative nature of GPs’ positive politeness had persuasive effects, whilst their negative strategies gave rise to examples of ambiguity causing confusion. Patients’ negative politeness demonstrated discomfort when presenting potentially contentious decisions whilst their use of positive politeness acted as a means of promoting cooperation. GPs used positive politeness when supporting patients’ decisions, offering reassurance and redressing damage to face, conversely disagreement was conveyed by the absence of such strategies and lack of reparative work.

Difficulties were identified in the way in which space for patient participation was created and managed, and the strategies used to convey information. The contrast in GP responses to patients’ decisions highlighted how subtle barriers to participation can be. These findings demonstrate the complexity of language and meaning and the need for a more sophisticated understanding of language use in communication skills and related training, as well as associated research.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

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