13:00-14:00 for the seminar and 14:00-16:00 for the data analysis session
Introduction: The doctor-patient relationship has acknowledged therapeutic power. Societal changes such as patient access to previously privileged health information via the internet and increasing emphasis on self-management are fundamentally altering the GP-patient relationship. Patients who ‘go online’ for health information may be reluctant to share this with their doctors. Similarly, many GPs report concerns about how best to respond when patients introduce such information in consultations. Much existing research relies on retroactive reports from patients and doctors following consultations, yet what people say they do differs from what they actually do.
Methods: Data are from multiple sources. We aim to collect 300 cases which consist of questionnaire data from patients to determine the help sought and information sources accessed prior to consultations, video-recorded consultations and semi-structured interviews with all 10 of the GPs involved in video recording consultations. We are also conducting interviews with up to 30 patients involved in the study. The questionnaires are analysed descriptively to provide contextual information. Conversation analysis is used to identify patterns of interaction and the consequences of what is said to better understand the use of the internet in consultations. The interviews with the GPs (n=10) and patients (n=30) after their consultations are being analysed thematically to illuminate the perceived barriers and facilitators to disclosing or promoting discussions of online health information in consultations.
Results: Analysis of data from consultations using conversation analysis indicates that patients can be seen to carefully select the best place in the consultation to make reference to prior use of the internet and often use phrases that minimise or downplay the internet as a source of information. Interactional difficulties occur when use of the internet is raised by patients in a place that disrupts the natural flow of the consultation. GPs use the internet in consultations to inform themselves and provide explanations to patients, provide printed information to patients and to signpost patients to information and self-help resources
Discussion: The work here provides an understanding of what is currently happening in relation to discussion, and use, of the internet in GP consultations. The findings will be used to identify strategies to aid both GPs and patients in the potentially interactionally-fraught area of discussion of the internet in consultations.
DATA SESSION
Following the seminar and after a refreshment break we are running a data session to discuss some data from the seminar in more depth. We will use conversation analysis in the session but people are welcome to come and we will explain the methodology so it will be inclusive not exclusive.
Bios
Fiona Stevenson
Reader in Medical Sociology and co-director of UCL eHealth Unit
Fiona’s research encompass a wide range of topics including eHealth, chronic illness, mental health, older people, and perceptions of the use of prescribed, over the counter, complementary and alternative therapies, as well as exercise therapy. She has a particular interest in communication in health care consultations. Fiona’s expertise lies in qualitative methods, including conversation analysis
Maureen Sequin
Maureen completed her PhD in Public Health and Policy at the London School of Hygiene and Tropical Medicine in London, United Kingdom (UK) in 2016, working within the Centre for Health and Social Change (ECOHOST) research group. Prior to commencing her PhD in 2011, she obtained an MA and BA (Hons) in Sociology, both obtained at the University of Saskatchewan, Canada. She joined University College London in the autumn of 2015, first in the Centre for Sexual Health and HIV Research, and then relocating to the Primary Care E-Health Unit within Primary Care & Population Health. Maureen possesses over a decade of research experience, broadly focused on the well-being of marginalized populations. Most prominently, her research has focused on the mental health of Georgian women internally displaced by the 2008 Russo-Georgian war. Though her primary research interests specifically lie in the area of mental health amongst refugees, Maureen has also contributed to numerous projects broadly examining access to health care amongst marginalised populations, including access to HIV testing amongst Black Africans in the UK. Methodologically, most of her research takes either a mixed-methods or qualitative approach.
Laura Hall
Laura is a research assistant on the HaRI study. Prior to joining the Department of Primary Care and Population Health in May 2017 she worked at the Warwick Clinical Trials Unit. Laura completed her PhD in Sociology at City, University of London in 2016. Her PhD explored how life history interviews she conducted with UK residents from Zimbabwe were a site for the discursive construction of subjects, places and relationships to place. Laura has also conducted research on Eritrean refugees’ journeys to the UK and the implications of the New Asylum Model and changes to legal aid to the asylum determination process.
