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Qualitative Health Research
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Taciturn Patients in Health Counseling at a Hospital: Passive Recipients or Active Participators?

Tarja Kettunen

Department of Sport and Health Sciences, University of Jyväskylä, Finland.

Marita Poskiparta

Department of Sport and Health Sciences, University of Jyväskylä, Finland.

Leena Liimatainen

School of Health and Social Care, JAMK Services, Jyväskylä, Finland.

Auli Sjögren

School of Social Work and Health, Mikkeli Polytecnic, Finland.

Päivi Karhila

Department of Sport and Health Sciences, University of Jyväskylä, Finland.

This study explored patients’ taciturnity as observed on videotape during hospital health counseling situations with a nurse. Health counseling sessions, 38 in number, were videotaped, transcribed verbatim, and analyzed by using an adaptation of conversation analysis. The data analysis included information on 18 selected patients who spoke little and did not introduce new topics, but rather supported the discussion on the theme chosen by the nurse. When we examined nurses’ and patients’ speech word by word, we discovered four participation frames that produced taciturnity: in the hands of professionals, compliant, guilty, and polite. These could fluctuate during interaction. The findings indicate that there is a need for a more extensive description of taciturn, or silent, patients. What has been interpreted as passivity in the literature can be interpreted more constructively. This insight can be useful for developing health counseling practice in hospitals.

Qualitative Health Research, Vol. 11, No. 3, 399-422 (2001)
DOI: 10.1177/104973201129119181


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