Details

Autor(en) / Beteiligte

• Antaki, Charles
• Chinn, Deborah

Titel

Companions' dilemma of intervention when they mediate between patients with intellectual disabilities and health staff

Ist Teil von

• Patient education and counseling, 2019-11, Vol.102 (11), p.2024-2030

Ort / Verlag

Ireland: Elsevier B.V

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• •The first study of interactions between medical practitioner, patient with intellectual disability and their companion.•Companions may intervene when the practitioner asks the patient a question.•We find a gradient of companions' intervention from low to high entitlement.•The low end of the gradient respects the patient's knowledge of their own body and habits.•The high end of the gradient bypasses the patient and answers on their behalf. We analyse, for the first time, how companions intervene in the answers that an adult patient with intellectual disabilities gives to their medical practitioner in primary care. Video records of 25 health-check consultations in a large multi-ethnic city in the UK were analysed with the qualitative methods of Conversation Analysis. We found that companions' interventions in patients' answers fell along a gradient of low to high entitlement, from mere hinting to outright direct take-over. Companions have to manage the dilemma of displaying information which is the proper domain of the patient: encroachment on the patient's epistemic rights versus the needs of the medical practitioner. Practitioners may need to check the patients themselves when their companions intervene at the most assertive end of the gradient of help.