Sequences of talk about emotional concerns in follow-up consultations with adolescent childhood cancer survivors

- A gradual build-up of emotional expression.
- A task-focused pattern was most often upheld in talk about emotional concerns.
- Doctors' responses and the elaboration of the emotional concerns (work-up) varied.
- Topic shifts were often abrupt.

ObjectiveTo explore practices regarding communication about emotional concerns in follow-up consultations with adolescent cancer survivors and pediatrician.MethodSeven video-taped follow-up consultations with adolescent survivors which contained many examples of emotional cues and concern were analyzed according to principles of conversation analysis.ResultsDuring talk about emotional concerns, a task-focused asymmetric pattern of pediatrician questions and patient responses was most often upheld. In a number of cases a gradual build-up of emotional expression from a weak hint to a more explicit expression of emotional concern was observed, often facilitated by the pediatricians. Most often work-up was relatively brief, sometimes with a brief positive reappraisal, but more comprehensive elaboration was also seen. Topic shifts were often abrupt.ConclusionPediatricians and patients used some of the same conventions as in everyday conversation during emotional talk in medical encounters. We observed shifts between informal talk and a typical task-focused mode. Conscious attention to such shifts and to the sequential nature of emotional talk could be helpful for doctors in designing their responses to patients' emotional concerns.Practice implicationsOur findings may contribute to insight in how clinicians respond to emotional concerns in follow-up consultations and have implications for communication skills training.