The first visit in oncology is an institutional event (Drew and Heritage, 1992), highly complex both for the doctor and the patient. The paper presents a study on a corpus of first oncological visits and it examines the distinctive stages of this event. The data corpus is consti-tuted by 36 videorecordings of oncological visits, conducted by two senior oncologists in two different hospitals in Rome. The study is conducted within the Conversation Analytic perspec-tive (Schegloff, 2007), particularly applied to the medical context (Heritage and Maynard, 2006). Relying on discursive and multimodal markers, 8 stages have been identified, of differ-ent lenght and degree of complexity, along which the visit unfolds: Opening, History taking, Cancer problem presentation, Stadiation, Treatment recommendation, Prescriptions and Clos-ing. The qualitative analyses show how patients and companions (when present) orient to these boundaries and to relevant transitions between stages, thus cooperating with the doctor in the accomplishment of the specific agenda of the visit. Implications of the study are dis-cussed for the study and understanding of the forms of participation and empowerment strate-gies available to patients to cope with the communicative complexity of the encounter with the oncologist and with the potential anxiety accompanying this event.
Keywords: Doctor-patient communication, first oncological visit, stages, patient’s participa-tion, companion, Conversation Analysis.
Marilena Fatigante, Cristina Zucchermaglio, Francesca Alby, Mariacristina Nutricato, The structure of the first oncological visit: A conversation analytic study in "PSICOLOGIA DELLA SALUTE" 1/2021, pp. 53-77, DOI:10.3280/PDS2021-001005