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Conversation analysis of consultations with patients who have medically unexplained symptoms

Research Project

Project/Area Number 18K02026
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 08010:Sociology-related
Research InstitutionOsaka Kyoiku University

Principal Investigator

Kushida Shuya  大阪教育大学, 教育学部, 教授 (70214947)

Project Period (FY) 2018-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2021)
Budget Amount *help
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2021: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2020: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Keywords診療 / 会話分析 / 医学的に説明のつかない症状 / 医療社会学 / コミュニケーション / 受診の正当化 / 診療場面 / 処置決定 / 門番機能 / 抵抗 / 総合診療 / 不満 / MUS / 医療
Outline of Final Research Achievements

This study has explored two aspects of interactions between patients with medically unexplained symptoms and their doctors. First, it described how patients justify their visits. Though they often complain about their previous doctors to justify their current visits, this action is risky because it might elicit a negative assessment about the patients. They manage the dilemma by cautiously choosing when to make complaints, how explicitly to do so, and whether to design their utterances as complaints or not. Second, it described how doctors manage their patients' resistance to recommendations of no further treatment at the hospital. Doctors systematically respond to patients' resistance in order to reach an agreement during decision-making. They take measures to reconcile their dual roles as patient advocate and resource steward.

Academic Significance and Societal Importance of the Research Achievements

現代医学はめざましい進歩を遂げたとはいえ、説明できない病気も依然として多い。患者の訴える症状が医学的に説明できない場合、診察室でのコミュニケーションは両者にとって困難な経験となる。本研究は、診療場面における患者と医師の実際のやりとりをビデオに録画して子細に分析することで、両者がどのような種類の困難に直面し、やりとりを前に進めるためにどんなコミュニケーション上の工夫を行っているかを明らかにした。本研究の成果は、医学教育においてより「患者中心の」コミュニケーションのあり方を教育するヒントを提供することで、医師のコミュニケーション能力の底上げに役立つだろう。

Report

(5 results)
  • 2021 Annual Research Report   Final Research Report ( PDF )
  • 2020 Research-status Report
  • 2019 Research-status Report
  • 2018 Research-status Report
  • Research Products

    (8 results)

All 2022 2021 2020 2018

All Journal Article (3 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 3 results,  Open Access: 2 results) Presentation (5 results) (of which Int'l Joint Research: 3 results,  Invited: 1 results)

  • [Journal Article] Recommending no further treatment: Gatekeeping work of generalists at a Japanese university hospital2021

    • Author(s)
      Shuya Kushida, Michie Kawashima and Tetsuya Abe
    • Journal Title

      Social Science & Medicine

      Volume: 290 Pages: 1-18

    • DOI

      10.1016/j.socscimed.2021.113891

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Why this clinic now? A context-sensitive aspect of accounting for visits2020

    • Author(s)
      Kushida, S., Kawashima, M., Abe, T.
    • Journal Title

      Social Science & Medicine

      Volume: 265 Pages: 113278-113278

    • DOI

      10.1016/j.socscimed.2020.113278

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] 先行医師への不満と受診の正当化―医学的に説明のつかない症状の事例を中心に―2020

    • Author(s)
      串田秀也・川島理恵・阿部哲也
    • Journal Title

      社会言語科学

      Volume: 22 Pages: 46-61

    • NAID

      130007831271

    • Related Report
      2019 Research-status Report
    • Peer Reviewed
  • [Presentation] 診療場面における意思決定:医師の非明示的勧めをめぐって2022

    • Author(s)
      串田秀也
    • Organizer
      第46回社会言語科学会研究大会
    • Related Report
      2021 Annual Research Report
    • Invited
  • [Presentation] Recommending no further treatment: Gatekeeping work of generalists at a Japanese university hospital2021

    • Author(s)
      Shuya Kushida, Michie Kawashima and Tetsuya Abe
    • Organizer
      The 3rd International E-Symposium on Communication in Health Care
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Recommending no further treatment: Gatekeeping work of generalists at a Japanese university hospital2021

    • Author(s)
      Shuya Kushida, Michie Kawashima, & Tetsuya Abe
    • Organizer
      The 3rd International E-Symposium on Communication in Healthcare
    • Related Report
      2020 Research-status Report
    • Int'l Joint Research
  • [Presentation] ワークショップ診療場面における「間主観性」―会話分析の視点から―2020

    • Author(s)
      串田秀也・阿部哲也・川島理恵・大石直子・佐久間博子
    • Organizer
      第44回社会言語科学会大会
    • Related Report
      2019 Research-status Report
  • [Presentation] Why this clinic now? Additional aspects of accounting for visit2018

    • Author(s)
      Shuya Kushida, Michie Kawashima, & Tetsuya Abe
    • Organizer
      International Conference of Conversation Analysis 2018
    • Related Report
      2018 Research-status Report
    • Int'l Joint Research

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Published: 2018-04-23   Modified: 2023-01-30  

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