How companions speak on patients' behalf without undermining their autonomy: Findings from a conversation analytic study of palliative care consultations.

Companions are individuals who support patients and attend health-care appointments with them. Several studies characterised companions' participation in broad terms, glossing over the details of how they time and design their actions, and how patients and health-care practitioners (HCPs) respond to them. This article aims to examine these aspects in detail by using conversation analysis, focusing on actions whereby companions speak on patients' behalf-mentioning delicate aspects of patients' experience (specifically, by alluding to patients' thoughts or feelings about dying).

Communicating with patients and families about illness progression and end of life: a review of studies using direct observation of clinical practice.

Background: There is growing recognition that a diverse range of healthcare professionals need competence in palliative approaches to care. Effective communication is a core component of such practice. This article informs evidence-based communication about illness progression and end of life through a rapid review of studies that directly observe how experienced clinicians manage such discussions.

A survey of ambulance clinicians' perceptions of recording and communicating patient information electronically.

Objective: Ambulance services are evolving from use of paper-based recording of patient information to electronic platforms and the impact of this change has yet to be fully explored. The aim of this study is to explore how the introduction of a system permitting electronic information capture and its subsequent sharing were perceived by the ambulance clinicians using it.

Methods: An online questionnaire was designed based upon the technology acceptance model and distributed throughout one ambulance service in the south east of England.

Addressing possible problems with patients' expectations, plans and decisions for the future: One strategy used by experienced clinicians in advance care planning conversations.

Objective: Giving terminally ill people opportunities to participate in advance care planning involves tensions between: endorsing and supporting patients' expectations, plans and decisions, and addressing how realistic these are. The latter risks exerting undue pressure to change plans; undermining autonomy; jeopardising therapeutic relationships. Our objective is to describe how experienced hospice doctors raise potential/actual problems with patients' expectations, plans or decisions.

Communication practices that encourage and constrain shared decision making in health-care encounters: Systematic review of conversation analytic research.

Background: Shared decision making (SDM) is generally treated as good practice in health-care interactions. Conversation analytic research has yielded detailed findings about decision making in health-care encounters.

Objective: To map decision making communication practices relevant to health-care outcomes in face-to-face interactions yielded by prior conversation analyses, and to examine their function in relation to SDM.

Healthcare professionals' assertions and women's responses during labour: A conversation analytic study of data from One born every minute.

Objective: Communication during labour is consequential for women's experience yet analyses of situated labour-ward interaction are rare. This study demonstrates the value of explicating the interactional practices used to initiate 'decisions' during labour.

Methods: Interactions between 26 labouring women, their birth partners and HCPs were transcribed from the British television programme, One Born Every Minute.

Engaging Terminally Ill Patients in End of Life Talk: How Experienced Palliative Medicine Doctors Navigate the Dilemma of Promoting Discussions about Dying.

Objective: To examine how palliative medicine doctors engage patients in end-of-life (hereon, EoL) talk. To examine whether the practice of "eliciting and responding to cues", which has been widely advocated in the EoL care literature, promotes EoL talk.

Design: Conversation analysis of video- and audio-recorded consultations.

How to communicate with patients about future illness progression and end of life: a systematic review.

Background: Conversation and discourse analytic research has yielded important evidence about skills needed for effective, sensitive communication with patients about illness progression and end of life.

Objectives: To: ▸ Locate and synthesise observational evidence about how people communicate about sensitive future matters; ▸ Inform practice and policy on how to provide opportunities for talk about these matters; ▸ Identify evidence gaps.

Design: Systematic review of conversation/discourse analytic studies of recorded interactions in English, using a bespoke appraisal approach and aggregative synthesis.

Systematically reviewing and synthesizing evidence from conversation analytic and related discursive research to inform healthcare communication practice and policy: an illustrated guide.

Background: Healthcare delivery is largely accomplished in and through conversations between people, and healthcare quality and effectiveness depend enormously upon the communication practices employed within these conversations. An important body of evidence about these practices has been generated by conversation analysis and related discourse analytic approaches, but there has been very little systematic reviewing of this evidence.

Methods: We developed an approach to reviewing evidence from conversation analytic and related discursive research through the following procedures: • reviewing existing systematic review methods and our own prior experience of applying these • clarifying distinctive features of conversation analytic and related discursive work which must be taken into account when reviewing • holding discussions within a review advisory team that included members with expertise in healthcare research, conversation analytic research, and systematic reviewing • attempting and then refining procedures through conducting an actual review which examined evidence about how people talk about difficult future issues including illness progression and dying

Results: We produced a step-by-step guide which we describe here in terms of eight stages, and which we illustrate from our 'Review of Future Talk'.

The evidence on how to best treat sunburn in children: a common treatment dilemma.

While many have suggested that prevention is key regarding sun over exposure, individuals (including children) still frequently experience sunburn. The Skin Cancer Foundation (2008) reported that 42% of individuals polled endured at least one sunburn per year. Furthermore, the Centers for Disease Control and Prevention (CDC) reports indicate that the incidence of sunburn rose from 31.