Functional Phases and Patterns of Dialogue Sequence in Nurse-Patient Conversation about Medication

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Effective communication is an essential aspect of nursing care. This qualitative study was performed to analyze nurse-patient conversations about medication. The nurse-patient dialogue was collected by video tape recording during the nurse's duty time in an internal medicine ward. One hundred seventy-eight episodes were extracted from the conversation. Using conversational analysis, the functional phases and patterns of dialogue sequence pertaining to medication were analyzed. Conversations about medication were very brief dialogues, so 68.8% of the dialogue had a duration of less than 20 seconds. However, it was a systematic and comprehensive dialogue which had structures and sequential dialogue patterns. Four functional phases were explored: greeting, identifying the patient, medicating, finishing. The medicating phase was essential, in which the nurse gave the drug to the patient and provided information initiated by the nurse simultaneously. The patterns of the dialogue sequence represented were the nurse provided information first, and then, patients responded to the nurse as accepting, rejecting, raising an objection, or asking again later. As the results of this study show, a nurse's role is important as an educator. For effective conversation about medication, the development of an educational program should be considered, which includes knowledge about medication and communication skills.