Examining patient participation in medical consultations: A combined quantitative and qualitative approach

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Abstract
This study used a combination of quantitative and qualitative analytic approaches to examine the nature of patient participation in medical consultations. The hospital clinic interviews of 101 rheumatology outpatients were analysed using the Verbal Response Mode coding scheme. Patient participation was, in general, low throughout the consultation. In addition, high patient participation was significantly correlated with low satisfaction-with-treatment scores. Qualitative analysis of transcripts from high and low participation patients showed that increased patient participation often reflected distress, dissatisfaction with prior care, and was more common with diagnostic uncertainty on the part of the doctor. Low participation reflected low emotion content and more diagnostic certainty. The results are discussed in terms of the inconsistent and methodological difficulties in examining patient participation in the medical interview.