Silence is golden

doi:10.1016/j.pec.2016.08.025

Patient Education and Counseling

Volume 99, Issue 10, October 2016, Pages 1545-1546

https://doi.org/10.1016/j.pec.2016.08.025 Get rights and content

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Cited by (1)

Exploratory study of language paediatricians use to promote adherence to long-term controller medication in children with asthma
2020, Allergologia et Immunopathologia
Citation Excerpt :
An appropriately timed request for explicit agreement to follow the proposed treatment plan may thus increase the likelihood of the treatment plan being followed by the patient.8,15 The strengths of this study include the setting of a clinic in which high treatment adherence has been documented and the use of conversation analysis, a qualitative research strategy aimed at identifying verbal and nonverbal communication strategies which can be used to improve the efficacy of consultations.17,39,40 This study was set up to explore the communication strategies used by the paediatricians who were previously shown to be successful in helping their patients adhere to long-term daily controller therapy.27
Although patient centred communication is associated with patients’ daily medication adherence, the exact communication phenomena promoting high treatment adherence remain elusive.
We used conversation analysis of videotaped follow-up consultations of seven outpatients (4–13 years of age) with chronic asthma and their caregivers, consulting two paediatric respiratory physicians in a practice in which high treatment adherence has been documented, to explore the language paediatricians use to promote their patients’ adherence to daily controller medication.
Starting the consultation with the patient’s (and caregivers’) agenda commonly resulted in presentation of issues new to the physician. Information was mostly provided in response to patient/caregiver questions, prompting the delivery of specific information tailored to the patient’s and caregivers’ needs. Although patients and caregivers showed resistance in response to unsolicited information and advice, they always accepted the doctor’s explicit request for agreement with proposed treatment. The doctor’s description of favourable treatment results in most patients prompted caregivers’ willingness to accept treatment proposals.
Paediatricians with a documented success in achieving adherence to controller medication in their patients with asthma tend to start consultations with the patient’s agenda, provide information in response to questions, offer reassurance on overall treatment effectiveness, and seek explicit agreement with a treatment proposal.

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From the EditorSilence is golden

Soc. Sci. Med.

Patient Educ. Couns.

Everyone and no one to turn to: intellectual roots and contexts for conversation analysis

Turn design

From the Editor
Silence is golden