2024 Fiscal Year Final Research Report

Elucidating the Process of Shared Decision-Making Using Conversation Analysis

Research Project

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Project/Area Number	21K10369
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 58010:Medical management and medical sociology-related
Research Institution	Saitama Medical University (2023-2024) Gunma University (2021-2022)
Principal Investigator	Takizawa Makiko 埼玉医科大学, 医学部, 教授 (70613090)
Co-Investigator(Kenkyū-buntansha)	中島和江大阪大学, 医学部附属病院, 教授 (00324781) 調憲群馬大学, 大学院医学系研究科, 教授 (70264025) 野口怜群馬大学, 医学部附属病院, 助教 (50828861) 安部猛福島県立医科大学, 公私立大学の部局等, 教授 (80621375) 小松康宏群馬大学, 大学院医学系研究科, 教授 (60195849) 渡辺亮群馬大学, 大学院医学系研究科, 助教 (60738847) 田中和美群馬大学, 大学院医学系研究科, 教授 (30526843) 大石裕子群馬大学, 医学部附属病院, 助教 (90846924) 石井範洋群馬大学, 大学院医学系研究科, 助教 (00711508)
Project Period (FY)	2021-04-01 – 2025-03-31
Keywords	インフォームドコンセント / 会話分析 / 自然言語処理
Outline of Final Research Achievements	This study aimed to explore how consensus is built between physicians and patients during informed consent (IC) by analyzing pre-existing audio recordings of their conversations. A total of 42 recordings were analyzed to examine the number of utterances, length of pauses between turns, explanation of medical terminology, and consistency with written consent documents. The findings suggest that appropriate pauses in the conversation ensuring sufficient time before or after physician explanations were associated with increased patient participation. Open-ended questions also tended to encourage greater patient speech. However, these tendencies did not reach statistical significance. The study highlights the potential importance of conversational dynamics, including the use of open-ended questions and the conscious allowance of pauses, in facilitating patient understanding and engagement in the IC process.
Free Research Field	医療の質・安全学
Academic Significance and Societal Importance of the Research Achievements	本研究は、インフォームド・コンセントにおける医師と患者の対話を実録データに基づき分析し、合意形成を促す要因（適切な「間」やオープンクエスチョン）を明らかにした。これにより、患者中心の医療実践の質向上に資するとともに、医療コミュニケーション研究に実証的知見を提供する点で社会的・学術的意義を有する。