Skip to main content
SpringerLink
Log in
Book cover

Analysing Health Communication pp 19–48Cite as

Palgrave Macmillan

Conversation Analysis: Questioning Patients About Prior Self-Treatment

  • Chapter
  • First Online:

Abstract

Conversation Analysis (CA hereafter) is a method for analysing communication whose foundations lie in the work of sociologists Harvey Sacks, Emanuel Schegloff and Gail Jefferson. A CA approach offers both theory and method. Its theoretical concern is with identifying and characterising the ‘machinery’ (Sacks 1984: 27) underlying talk and social relations. Its methodological principles involve making and working with recordings of conversations—‘details of actual occurrences’—rather than using interview methods or direct observation where researchers have ‘an active and ongoing part in soliciting reports’ or are present and taking notes ‘as the observed activity unfolds’ (Potter and Shaw 2018: 189). In CA, talk is therefore treated as the topic rather than an ‘unanalysed and unexplicated methodological resource’, for research (Jefferson and Lee 1980: iii). Recordings are transcribed in preparation for analysis using standard conventions developed by Jefferson (2004) that require close attention to both what was said and how it was said.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Antaki, C. (2011). Six kinds of applied conversation analysis. In C. Antaki (Ed.), Applied conversation analysis: Intervention and change in institutional talk (pp. 1–14). Basingstoke: Palgrave Macmillan.

    Chapter  Google Scholar 

  • Atkinson, J. M., & Heritage, J. (Eds.). (1984). Structures of social action: Studies in conversation analysis. Cambridge: Cambridge University Press.

    Google Scholar 

  • Barnes, R.K. (2017). One in a million: A study of primary care consultations. Dataset. https://doi.org/10.5523/bris.l3sq4s0w66ln1x20sye7s47wv.

  • Barnes, R. K. (2018). Preliminaries to treatment recommendations in UK primary care: A vehicle for shared decision-making? Health Communication, 33(11), 1366–1376.

    Article  Google Scholar 

  • Barnes, R. K. (2019). Conversation analysis of communication in medical care: Description and beyond. Research on Language and Social Interaction, 52(3), 300–315.

    Article  Google Scholar 

  • Boyd, E., & Heritage, J. (2006). Taking the patient’s medical history: Questioning during comprehensive history taking. In J. Heritage & D. W. Maynard (Eds.), Communication in medical care: Interactions between primary care physicians and patients (pp. 151–184). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Cassell, E. (1985). Talking with patients: Vol. II clinical technique. Cambridge, MA: MIT Press.

    Google Scholar 

  • Cmejrková, S., & Prevignano, C. L. (2003). A discussion with Emanuel a. Schegloff. In G. Raymond, G. H. Lerner, & J. Heritage (Eds.), Enabling human conduct: Studies of talk-in-interaction in honor of Emanuel a. Schegloff (pp. 15–54). Amsterdam/Philadelphia: John Benjamins.

    Google Scholar 

  • Drew, P. (1992). Contested evidence in courtroom cross-examination: The case of a trial for rape. In P. Drew & J. Heritage (Eds.), Talk at work (pp. 470–520). Cambridge: Cambridge University Press.

    Google Scholar 

  • Drew, P. (2006). Misalignments in “after-hours” calls to a British GP’s practice: A study in telephone medicine. In J. Heritage & D. W. Maynard (Eds.), Communication in medical care: Interactions between primary care physicians and patients (pp. 416–444). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Drew, P., & Heritage, J. (Eds.). (1992). Talk at work. Cambridge: Cambridge University Press.

    Google Scholar 

  • Edwards, D., & Stokoe, E. (2007). Self-help in calls for help with problem neighbours. Research on Language and Social Interaction, 40(1), 9–32.

    Article  Google Scholar 

  • Garfinkel, H. (1967). Studies in ethnomethodology. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Gill, V. T., & Roberts, F. (2013). Conversation analysis in medicine. In J. Sidnell & T. Stivers (Eds.), The handbook of conversation analysis (pp. 575–592). Chichester: John Wiley and Sons Ltd.

    Google Scholar 

  • Goffman, E. (1953). Communication conduct in an island community. Unpublished PhD dissertation. Chicago: Department of Sociology, University of Chicago.

    Google Scholar 

  • Heritage, J. (1984). Garfinkel and ethnomethodology. Cambridge: Polity Press.

    Google Scholar 

  • Heritage, J. (2009). Negotiating the legitimacy of medical problems: A multi-phase concern for patients and physicians. In D. Brashers & D. Goldsmith (Eds.), Communicating to manage health and illness (pp. 147–164). New York: Routledge.

    Google Scholar 

  • Heritage, J. (2010). Questioning in medicine. In A. Freed & S. Ehrlich (Eds.), Why do you ask?’: The function of questions in institutional discourse (pp. 42–68). New York: Oxford University Press.

    Google Scholar 

  • Heritage, J. (2013). Foreword. In W. Beach (Ed.), Handbook of patient-provider interactions: raising and responding to concerns about life, illness and disease (pp. xi–xii). New York, NY: Hampton Press Inc.

    Google Scholar 

  • Heritage, J., & Clayman, S. (2010). Talk in action: Interactions, identities and institutions. Chichester: John Wiley and Sons.

    Book  Google Scholar 

  • Heritage, J., & Maynard, D. W. (2006). Communication in medical care: Interactions between primary care physicians and patients. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Heritage, J., & Robinson, J. D. (2006). Accounting for the visit. In J. Heritage & D. W. Maynard (Eds.), Communication in medical care: Interactions between primary care physicians and patients (pp. 48–85). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Heritage, J., Robinson, J. D., Elliott, M. N., Beckett, M., & Wilkes, M. (2007). Reducing patients’ unmet concerns in primary care: the difference one word can make. Journal of General Internal Medicine, 22(10), 1429–1433.

    Google Scholar 

  • Jefferson, G. (1980). On “trouble-premonitory” response to inquiry. Sociological Inquiry, 50(3–4), 153–185.

    Article  Google Scholar 

  • Jefferson, G. (2004). Glossary of transcript symbols with an introduction. In G. H. Lerner (Ed.), Conversation Analysis: Studies from the First Generation. Amsterdam (pp. 13–31). Philadelphia: John Benjamins.

    Chapter  Google Scholar 

  • Jefferson, G., & Lee, J.R.E. (1980). On the sequential organization of troubles-talk in ordinary conversation. End of grant report to the Social Science Research Council on the analysis of conversations in which ‘troubles’ and ‘anxieties’ are expressed. (Ref. HR 4802).

    Google Scholar 

  • Jepson, M., Salisbury, C., Ridd, M., Metcalfe, C., Garside, L., & Barnes, R. K. (2017). The “One in a Million” study: Creating a database of UK primary care consultations. British Journal of General Practice, 67, e345–e351.

    Article  Google Scholar 

  • Kendrick, K., & Torreira, F. (2015). The timing and construction of preference: A quantitative study. Discourse Processes, 52(4), 255–289.

    Article  Google Scholar 

  • Laurier, E., & Philo, C. (2006). Natural problems of naturalistic video data. In H. Knoblauch, B. Schnettler, J. Raab, & H.-G. Soeffner (Eds.), Video-analysis methodology and methods: Qualitative audiovisual data analysis in sociology (pp. 183–192). Berlin: Peter Lang.

    Google Scholar 

  • Lerner, G. H. (2004). Introduction. In G. H. Lerner (Ed.), Conversation analysis: Studies from the first generation (pp. 1–12). Amsterdam/Philadelphia: John Benjamins.

    Chapter  Google Scholar 

  • Levinson, S. C. (1983). Pragmatics. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Leydon, G. M., & Barnes, R. K. (2020). Conversation analysis. In C. Pope & N. Mays (Eds.), Qualitative research in health care (4th ed., pp. 135–150). Oxford: Wiley Blackwell.

    Chapter  Google Scholar 

  • Lindström, A. (1997). Designing social actions: Grammar, prosody and interaction in Swedish conversation. Unpublished doctoral dissertation. Department of Sociology, University of California Los Angeles.

    Google Scholar 

  • Mishler, E. (1984). The discourse of medicine: Dialectics of medical interviews. Norwood, NJ: Ablex.

    Google Scholar 

  • NHS England. (2018). Over-the-counter guidance for CCGs. Retrieved from https://www.england.nhs.uk/wp-content/uploads/2018/03/otc-guidance-for-ccgs.pdf.

  • Parsons, T. (1951). The social system. London: Routledge & Kegan Paul.

    Google Scholar 

  • Penner, L. A., Orom, H., Albrecht, T. L., Franks, M. M., Foster, T. S., & Ruckdeschel, J. C. (2007). Camera-related behaviors during video recorded medical interactions. Journal of Nonverbal Behaviour, 31, 99–117.

    Article  Google Scholar 

  • Pomerantz, A., & Heritage, J. (2013). Preference. In J. Sidnell & T. Stivers (Eds.), The handbook of conversation analysis (pp. 210–228). Chichester: John Wiley and Sons Ltd.

    Google Scholar 

  • Potter, J., & Shaw, C. (2018). The virtues of naturalistic data. In E. Flick (Ed.), The sage handbook of qualitative data collection (pp. 182–199). London: Sage.

    Chapter  Google Scholar 

  • Raymond, G. (2003). Grammar and social organization: Yes/no interrogatives and the structure of responding. American Sociological Review, 68(6), 939–967.

    Article  Google Scholar 

  • Sacks, H. Harvey sacks papers, 1955–1980. UCLA Library Special Collections. Charles E. Young Research Library. Retrieved from https://oac.cdlib.org/findaid/ark:/13030/tf8s2009gs/.

  • Sacks, H. (1966). The search for help: No one to turn to. PhD dissertation, University of California, Berkeley.

    Google Scholar 

  • Sacks, H. (1972). An initial investigation of the usability of conversational data for doing sociology. In D. Sudnow (Ed.), Studies in social interaction (pp. 31–74). New York: Free Press.

    Google Scholar 

  • Sacks, H. (1984). Notes on methodology. In J. Heritage & J. M. Atkinson (Eds.), Structures of social action: Studies in conversation analysis (pp. 2–27). Cambridge: Cambridge University Press.

    Google Scholar 

  • Sacks, H. (1987). On the preferences for agreement and contiguity in sequences in conversation. In G. Button & J. R. E. Lee (Eds.), Talk and social organisation (pp. 54–69). Clevedon: Multilingual Matters.

    Google Scholar 

  • Sacks, H. (1992a). Harvey Sacks: Lectures on conversation (Vol. 2 vols). Oxford: Blackwell.

    Google Scholar 

  • Sacks, H. (1992b). ‘Lecture 3’. In: Harvey Sacks: Lectures on conversation. Volume 1, part II, fall 1965. Oxford: Blackwell.

    Google Scholar 

  • Schegloff, E. A. (1967). The first five seconds: The order of conversational openings. PhD dissertation, University of California, Berkeley.

    Google Scholar 

  • Schegloff, E. A. (1968). Sequencing in conversational openings’. American Anthropologist, 70(6), 1075–1095.

    Article  Google Scholar 

  • Schegloff, E. A. (1996). Turn organization: One intersection of grammar and interaction. In Elinor Ochs, Emanuel A. Schegloff & Sandra A. Thompson (Eds.), Interaction and grammar (pp. 52–133). Cambridge: Cambridge University Press.

    Google Scholar 

  • Sidnell, J. (2010). Conversation analysis: An introduction. Chichester: John Wiley and Sons Ltd.

    Google Scholar 

  • Sidnell, J. (2013). Basic conversation analytic methods. In J. Sidnell & T. Stivers (Eds.), The handbook of conversation analysis (pp. 77–99). Chichester: John Wiley and Sons Ltd..

    Google Scholar 

  • Steensig, J., & Drew, P. (2008). Introduction: Questioning and affiliation/disaffiliation in interaction. Discourse Studies, 10(1), 5–15.

    Article  Google Scholar 

  • Stevenson, F. A., Barry, C. A., Britten, N., Barber, N., & Bradley, C. P. (2000). Doctor-patient communication about drugs: The evidence for shared decision-making. Social Science & Medicine, 50(6), 829–840.

    Article  Google Scholar 

  • Stevenson, F. A., Britten, N., Barry, C. A., Bradley, C. P., & Barber, N. (2003). Self-treatment and its discussion in medical consultations: How is medical pluralism managed in practice? Social Science & Medicine, 57(3), 513–527.

    Article  Google Scholar 

  • Stivers, T. (2007). Prescribing under pressure: Parent-physician conversations and antibiotics. New York: Oxford University Press.

    Book  Google Scholar 

  • Stivers, T. (2008). Stance, alignment and affiliation during story telling: When nodding is a token of preliminary affiliation. Research on Language and Social Interaction, 41, 29–55.

    Article  Google Scholar 

  • Stivers, T. (2015). Coding social interaction: A heretical approach in conversation analysis? Research on Language and Social Interaction, 48(1), 1–19.

    Article  Google Scholar 

  • Stivers, T. (2019). How we manage social relationships through answers to questions: The case of interjections. Discourse Processes, 56(3), 191–209.

    Article  Google Scholar 

  • Stivers, T., & Hayashi, M. (2010). Transformative answers: One way to resist a question’s constraints. Language in Society, 39(1), 1–25.

    Article  Google Scholar 

  • Stivers, T., Heritage, J., Barnes, R. K., McCabe, R., Thompson, L., & Toerien, M. (2018). Treatment recommendations as actions. Health Communication, 33(11), 1335–1344.

    Article  Google Scholar 

  • Themessyl-Huber, M., Humphris, G., Dowell, J., Macgillivray, S., Rushmer, R., & Williams, B. (2008). Audio-visual recording of patient–GP consultations for research purposes: A literature review on recruiting rates and strategies. Patient Education and Counseling, 71, 157–168.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK

    Rebecca K. Barnes

  2. Department of Primary Care and Population Health, University College London, London, UK

    Iris Z. van der Scheer

Authors
  1. Rebecca K. Barnes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Iris Z. van der Scheer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rebecca K. Barnes .

Editor information

Editors and Affiliations

  1. Department of Linguistics and English Language, Lancaster University, Lancaster, UK

    Gavin Brookes

  2. School of English, University of Nottingham, Nottingham, UK

    Daniel Hunt

Appendix: Key to Transcription Notation

Appendix: Key to Transcription Notation

The notation symbols that are used in the extracts in this chapter are based on the system developed by Gail Jefferson (2004).

word_

An underscore indicates a ‘flat’ turn final intonation

word_

An underscore indicates a ‘flat’ intonation

word,

A comma indicates a brief rising intonation

word?

A question mark indicates a rising intonation

(.)

Just noticeable untimed pause

(0.3), (2.6)

Examples of timed pauses, in tenths of seconds

word [word]

[word]

Square brackets aligned across adjacent lines denote the start and end of overlapping talk

.hh hh

Hearable in-breath (note the preceding full stop) and out-breath respectively

w(h)ord

The (h) shows that the word has aspiration, possibly hearable as laughter or crying, bubbling within it

wor-

A dash shows a sharp cut-off

wo::rd

Colons show that the speaker has stretched the preceding sound

↑word ↓word

Up and down arrows indicate a marked pitch shift

( )

Unclear talk

word=

=word

The equals sign shows that there is no discernible pause between two speakers or, if put between two words, within a single speaker’s turn, shows that they run together

word, WORD

Underlined sounds are louder, capitals louder still

°word°

Material between ‘degree signs’ is delivered more quietly than surrounding speech

>word word<

<word word>

Inward pointing signs show hearably faster delivery, outward pointing signs show slower delivery than surrounding speech

((typing))

Transcriber’s comments or attempt to represent something hard, or impossible, to write phonetically

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Barnes, R.K., van der Scheer, I.Z. (2021). Conversation Analysis: Questioning Patients About Prior Self-Treatment. In: Brookes, G., Hunt, D. (eds) Analysing Health Communication. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-68184-5_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-68184-5_2

  • Published:

  • Publisher Name: Palgrave Macmillan, Cham

  • Print ISBN: 978-3-030-68183-8

  • Online ISBN: 978-3-030-68184-5

  • eBook Packages: Social SciencesSocial Sciences (R0)

Publish with us

Policies and ethics

Search

Navigation