'So just to go through the options…': patient choice in the telephone delivery of the NHS Improving Access to Psychological Therapies services.
Doctor-patient communication/interaction
Mental health services
Patient-centredness
Psychotherapy
Shared decision-making
Telemedicine
Journal
Sociology of health & illness
ISSN: 1467-9566
Titre abrégé: Sociol Health Illn
Pays: England
ID NLM: 8205036
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
29
01
2020
revised:
06
08
2020
accepted:
06
08
2020
pubmed:
23
9
2020
medline:
27
10
2021
entrez:
22
9
2020
Statut:
ppublish
Résumé
This article considers patient choice in mental healthcare services, specifically the ways that choice is enabled or constrained in patient-practitioner spoken interaction. Using the method of conversation analysis (CA), we examine the language used by practitioners when presenting treatment delivery options to patients entering the NHS Improving Access to Psychological Therapies (IAPT) service. Analysis of 66 recordings of telephone-delivered IAPT assessment sessions revealed three patterns through which choice of treatment delivery mode was presented to patients: presenting a single delivery mode; incrementally presenting alternative delivery modes, in response to patient resistance; and parallel presentation of multiple delivery mode options. We show that a distinction should be made between (i) a choice to accept or reject the offer of a single option and (ii) a choice that is a selection from a range of options. We show that the three patterns identified are ordered in terms of patient-centredness and shared decision-making. Our findings contribute to sociological work on healthcare interactions that has identified variability in, and variable consequences for, the ways that patients and practitioners negotiate choice and shared decision-making. Findings are discussed in relation to tensions between the political ideology of patient choice and practical service delivery constraints.
Identifiants
pubmed: 32959917
doi: 10.1111/1467-9566.13182
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3-19Subventions
Organisme : Department of Health
ID : RP-PG-1016-20010
Pays : United Kingdom
Informations de copyright
© 2020 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL (SHIL).
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