My postdoctoral research uses Conversation Analysis to examine how professionals in the Emergency Department talk to patients about thoughts and attempts of suicide and self-harm. In addition, working with video-recorded consultations, patient and carer interviews, and focus groups with mental health professionals, our team aims to develop brief communications-based interventions for Emergency Department personnel.
My dissertation examines how doctors and patients talk about lifestyle in high-income white communities and low-income communities of colour. I analyse instances in which a physician uncovers evidence of, or a patient or family member discloses, a medically problematic health behaviour such as non-adherence to medications, smoking or lack of exercise. Findings are relevant from a methodological and theoretical standpoint, as well as for health services and behavioural medicine audiences. For example, I demonstrate that patients are most likely to accept and engage with a doctor’s advice to change diet or exercise habits if that advice is framed as a treatment recommendation for a chronic condition – regardless of the severity of the chronic condition. I show that patients distinguish between a physician’s deontic authority to establish a treatment plan versus establish a wellness regimen.
In parallel line of research, I am exploring the relevance of the social interactional context in which physicians introduce the topic of chronic illness management. Preliminary analysis indicates that the context in which this topic is introduced has a significant impact on patient engagement and varies across communities. For instance, I find that patients overwhelmingly do not engage with discussions of chronic illness management when they are initiated at the opening of the consultation by the physician; yet, this is done in 61% of consultations that service low-income communities of colour in these data.