Puheenaiheiden esittely ja jatkaminen lääkärin vastaanotolla

• Liisa Raevaara

Avainsanat: keskusteluntutkimus, kysymys

Abstrakti

Initiating and following up topics in doctor-patient interaction (englanti)

3/1996 (100)

Liisa Raevaara (kotus.fi)

INITIATING AND FOLLOWING UP TOPICS IN DOCTOR-PATIENT INTERACTION

Research on doctor-patient interaction has paid attention to the fact that medical interviews are mainly based on questions asked by the doctor and the patient's responses to these questions. As the one doing the asking, the doctor can initiate new topics of discussion and control the kinds of topics that are discussed in the interaction; the potential for patients to initiate new topics is restricted. Research to date has focused mainly on topic construction in these interviews: researchers have looked at whether it is the doctor or the patient who initiates a new topic, what kinds of topics are introduced and to what extent the doctor interrupts, ignores or follows up a topic introduced by the patient.

This article looks at how topics are introduced and followed up in a medical interview from the point of view of the ongoing activity - in terms of both the global structure of the interview and locally defined activity sequences. Talk - whether it is the doctor's or the patient's - is given a different meaning and provokes a different response depending on the kind of activity sequence in which it occurs. This article analyses doctor-patient interaction as a process that is collaboratively constructed and investigates the status and role of both doctor and patient in terms of the ongoing activity. There is also some discussion of cut-and-dried classifications of activity types as being either doctor-centred or patient-centred. The data is from videotapes of medical interviews recorded at a Finnish medical centre. The research method used in the analysis of the data is ethnomethodological conversation analysis.