Exploring risk, resistance and closing talk in chronic diabetes routine consultations

Qualitative research is widely recognised as making a valuable contribution to healthcare practice and policy. One area of study that has noticeably relied on qualitative research is doctor-patient communication, due to the fact that practitioner-patient interaction is inherently dependent on talk. One methodology that has proven very useful in order to analyse practitioner-patient interaction is Conversation Analysis (CA). Little seems to have been done in terms of analysing practitioner-patient talk within chronic routine consultations. Routine consultations are especially important in the treatment of long-term conditions such as type 2 diabetes. This study analyses the talk between type 2 diabetic patients and a practice nurse during their routine consultations. The study will address four main points. Firstly, it will determine the differences between diabetic chronic routine consultations and acute primary care visits. Secondly, based on these differences, it will address the closing phase of these visits. Thirdly, it will establish how communication of risk takes place during these consultations and lastly it will demonstrate how disagreement takes place during these visits. Analysing these elements within chronic routine consultations can potentially inform best practice when it comes to closing a visit, communicating risk and identifying patient disagreement. The analysis and presentation of significant differences between chronic and acute visits could have an effect on patients presenting new concerns and in turn could affect their long-term care.