Evid Based Nurs 5:30 doi:10.1136/ebn.5.1.30
  • Qualitative

Patient taciturnity in health counselling was understood in terms of 4 participation frames

 QUESTION: How do taciturn (silent) patients communicate during hospital counselling sessions?


Qualitative study using an adaptation of conversation analysis to analyse data.


A hospital in Finland.


38 patients (age range 18–70 y, 63% women) and 19 nurses who participated in 38 nurse–patient health counselling sessions in 7 different wards.


Genuine patient counselling sessions related to admission, discharge, preoperative issues, and patient illness were followed up with individual interviews. Videotapes were transcribed verbatim, including stammering, and supplemented with information about periods of silence, overlapping speech, intonation, and some non-verbal communication. The tapes and transcripts were analysed using conversation analysis to examine how “turns” were taken with regard to the other participant's speech and the implications each turn had for the next.

Main findings

The findings focused on 18 patients who were identified as taciturn or silent. They spoke little about themselves, did not introduce new topics, and supported the manner and theme of discussion chosen by nurses. 4 participation frames that produced taciturnity were identified. …

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