Hidden dimensions: the analysis of interaction in nurse-patient encounters.

BACKGROUND It is well established that the success of much healthcare provision is strongly linked to the quality of interaction that occurs between healthcare professionals and patients. Nurse-led consultations are becoming ever more common in primary care, and patient satisfaction with this type of clinical encounter is reportedly high. While many fields of health care have been the subject of detailed interactional and socio-linguistic analysis, nurse-patient encounters are currently under-represented. OBJECTIVE This article will outline how one particular socio-linguistic approach - conversation analysis (CA) - can be applied to the investigation of nurse-led consultations. It will illustrate how the unique perspective that this method offers can reveal aspects of behaviour that would otherwise be inaccessible, and discusses the practical implications that a greater understanding of these behaviours can have for improving quality of care. STRATEGY The CA method is illustrated through the presentation and analysis of data collected as part of a recent study into nurse/patient interaction in a specialist wound dressing clinic. The sequential and treatment-related consequences of a simple interactional misalignment during the initial stages of a consultation are explored, and used to demonstrate how such misalignments can impact on treatment processes.