‘I Have to Explain to him’: How Companions Broker Mutual Understanding Between Patients with Intellectual Disabilities and Health Care Practitioners in Primary Care

Deborah Chinn*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

People with intellectual disabilities (ID) experience marked health inequalities. This is attributable, at least in part, to suboptimal healthcare communication with health care practitioners (HCPs) whereby patients with ID and HCPs struggle to understand each other. Companions who attend healthcare appointments with patients with ID can support the communicative exchange between patient and HCP, but their involvement can have unintended consequences. This article uses Conversation Analysis (CA) to analyse video-recorded data from primary care health checks involving 24 patients with ID. This method shows that companions use their linguistic and experiential resources to intervene as ‘brokers’ to address real or potential threats to mutual understanding between patients with ID and HCPs. Their interventions can fill in the gaps in knowledge and understanding of the other parties, but also run the risk of deskilling the others in the interaction, by relieving them of the obligation to address communication breakdown directly themselves.

Original languageEnglish
Pages (from-to)1215-1229
Number of pages15
JournalQualitative Health Research
Volume32
Issue number8-9
Early online date18 Apr 2022
DOIs
Publication statusPublished - Jul 2022

Keywords

  • conversation analysis
  • doctor-patient communication
  • intellectual disabilities
  • primary health care

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