By Martin Robb; et al
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Extra info for Communication, relationships and care : a reader
This pattern reoccurs at six points during the consultation, mostly in the ﬁrst half. It is as though the patient tries valiantly to be listened to on his terms but slowly gives up and retreats into the voice of medicine. The doctor uses general interjections such as ‘right’ ‘sure’ and ‘absolutely’. These might be taken as representing a habitual style of communication that is meant to indicate listening and encouraging the patient to talk, and perhaps indicative of good communication skills to the doctor.
They identiﬁed the problem arising when the doctor was trying to move the patient towards closure while the patient was trying to bring the doctor back to the stage of identifying and deﬁning the problem. Our ﬁndings suggest that the reason the patient might have felt their problem had not been sufﬁciently deﬁned was because of the exclusion of the lifeworld. [. ] The problem seems to lie with the patients with chronic, ostensibly physical conditions whose lifeworld concerns, including psychological responses to their condition, are seen as invalid and irrelevant to the 32 GIVING VOICE TO THE LIFEWORLD consultation.
In order for user involvement to ﬂourish, organisational conditions need to be 46 EXPERIENCE AND MEANING OF USER INVOLVEMENT right. These conditions then shape types of user involvement, which will differ in different settings. Therefore, the present ﬁndings suggest that involvement is not a straightforward prospect for all users, nor is it likely to be viable in every organisation. The authors argue that, to be successful, it requires adaptation not only on the part of the organisation, but also by service providers and non-involved users.