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Qualitative Health Research
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Negotiation in Type 2 Diabetes Counseling: From Problem Recognition to Mutual Acceptance During Lifestyle Counseling

Päivi Karhila

University of Jyväskylä Department of Health Sciences, Finland

Tarja Kettunen

University of Jyväskylä Department of Health Sciences, Finland

Marita Poskiparta

University of Jyväskylä Department of Health Sciences, Finland

Leena Liimatainen

Jyväskylä Polytechnic School of Health and Social Care, Jyväskylä, Finland

Negotiation, an essential communication activity in lifestyle counseling, has rarely been studied at the micro level of interaction. Furthermore, the evidence for interpersonal negotiation to occur in counseling practice is inconclusive. In this study, the authors describe how negotiation focused on lifestyle changes was produced in nurse-patient interaction. The research data, 73 videotaped diabetes counseling situations, were analyzed using conversation analysis. The process of negotiation consisted of recognizing the problems in the patients' health behavior, offering proposals as solutions to the problems, and reaching an agreement on them. Negotiation had characteristics similar to those mentioned in the literature, but there were also prominent inadequacies. The authors suggest that nurses might need to become more aware of their counseling practices in routine situations through conscious effort for self-evaluation. In addition, further research would be required to demonstrate the effectiveness of negotiation for facilitating changes in patients' health behavior.

Key Words: negotiation • type 2 diabetes • lifestyle counseling • nurse-patient interaction • conversation analysis

Qualitative Health Research, Vol. 13, No. 9, 1205-1224 (2003)
DOI: 10.1177/1049732303257153
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