Using conversation analytic methods to assess fidelity to a talk-based healthcare intervention for frequently attending patients

Publication date: Available online 11 April 2018 Source:Social Science & Medicine Author(s): Rebecca K. Barnes, Marcus Jepson, Clare Thomas, Sue Jackson, Chris Metcalfe, David Kessler, Helen Cramer The study aim was to assess implementation fidelity (i.e., adherence) to a talk-based primary care intervention using Conversation Analytic (CA) methods. The context was a UK feasibility trial where General Practitioners (GPs) were trained to use “BATHE” ( B ackground, A ffect, T rouble, H andling, E mpathy) – a technique to screen for psychosocial issues during consultations – with frequently attending patients. 35 GPs received BATHE training between July–October 2015. 15 GPs across six practices self-selected to record a sample of their consultations with study patients at three and six months. 31 consultations were recorded. 21/26 patients in four intervention practices gave permission for analysis. The recordings were transcribed and initially coded for the presence or absence of the five BATHE components. CA methods were applied to assess delivery, focusing on position and composition of each component, and patients’ responses. Initial coding showed most of the BATHE components to be present in most contacts. However the CA analysis revealed unplanned deviations in position and adaptations in composition. Frequently the intervention was initiated too early in the consultation, and the BATHE questions misunderstood by patients as pertaining to t...
Source: Social Science and Medicine - Category: Psychiatry & Psychology Source Type: research