Speech practices that facilitate patient participation in health counselling - A way to empowerment?

Abstract

Objective This study described nurse-patient communication during health counselling and focused on the linguistic realisations of empowering speech practices that emphasised patient participation. It aimed at a description of nurses' speech practices that facilitated the inclusion of patients' perspectives and preferences and encouraged patients to express themselves.

Design and setting Thirty-eight videotaped nurse-patient health- counselling sessions that were conducted in a hospital were transcribed verbatim.

Method The analysis of the videotaped data was based on the adaptation of Conversation Analysis (CA) and was carried out on a turn-by-turn basis.

Results The research material revealed that affective questions and tentative speech, together with continuers, facilitated active participation by patients. Thus, patients were free to discuss their ideas, concerns, experiences, and knowledge with nurses. The findings indicated that nurses were able to establish collaboration and involve patients in their own frame of reference.

Conclusion The results emphasised partnership and reciprocal conversation, with nurses' social and emotional skills at the heart of the ' encounter. The findings may advance professional understanding of patient-centred empowering practice, which has until now remained at a conceptual level. The results may be useful for developing health counselling and for designing training programmes for nurses.