Diagnostic communication in the memory clinic: a conversation analytic perspective

Area of Science:

• Medical Communication
• Conversation Analysis
• Dementia Care

Background:

• Debate exists on how to disclose dementia diagnoses to patients.
• Early dementia diagnosis is recognized as crucial for care.
• Limited research explores the verbal communication of dementia diagnoses.

Purpose of the Study:

• To analyze how dementia diagnostic information is verbally communicated in British memory clinics.
• To interrogate the assumption that explicit terminology is essential for effective dementia diagnosis delivery.
• To examine the role of conversation analysis in understanding diagnostic communication.

Main Methods:

• Video recordings of 29 patient and accompanying person appointments in a UK memory clinic.
• Conversation analytic approach to study diagnostic delivery segments.
• Analysis of talk where clinicians evaluate patient conditions.

Main Results:

• Sensitive and responsive diagnostic communication is not dependent on specific word choices.
• The complexity of dementia diagnosis, particularly in early stages, is reflected in clinical conversations.
• Diagnostic talk involves intricate interactional work between clinicians, patients, and carers.

Conclusions:

• Dementia diagnostic information is communicated to minimize catastrophic reactions and respect patient insight.
• Communication strategies align with intersubjective norms for sensitive medical disclosures.
• The delivery and receipt of dementia diagnoses are influenced by interactional sensitivity.