Conversation analysis of consultations with patients who have medically unexplained symptoms
Project/Area Number |
18K02026
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Research Category |
Grant-in-Aid for Scientific Research (C)
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Allocation Type | Multi-year Fund |
Section | 一般 |
Review Section |
Basic Section 08010:Sociology-related
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Research Institution | Osaka 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.
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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。
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Report
(5 results)
Research Products
(8 results)