Conversation analysis and discourse analysis research and conventional qualitative methods research
must include collection and fine-grained analysis of audio and/or video recording of actual interpersonal communication episodes
Condition or domain being studied
Chronic illness, old age and frailty, life-limiting illness.
These being conditions where addressing sensitive future matters is relevant to healthcare consultations, provision, decision-making and planning for the future.
People whose consultations are conducted in English.
The intervention: Provision of opportunity to address sensitive future matters including death, dying and planning for end of life in the context of healthcare consultations
For the purpose of this review we define talk about sensitive future matters as talk where there is reference to states, events and/or actions:
1) In the domain of individual persons (rather than, e.g. the Earth’s climate).
2) That span those that are uncertain to certain.
3) That may or will happen in relation to individual persons and are - in the given context - negative or potentially negative.
4) That may or will happen after the current interactional episode.
5) That includes talk about feelings and responses to the future matters, and/or actions in relation to future matters.
6) That is not exclusively focused on feelings and future actions in relation to currently existing troubles.
1) Published in peer reviewed journals or published books.
2) Analysis reliant on audio or video-recorded naturalistic data.
3) English language data.
4) Transcripts of data include talk about sensitive future matters (as defined above) AND analysis. includes explicit attention to practices through which sensitive future topics are addressed.
5) Study setting either formal institutional and/or informal setting.
1) Based on audio or video recordings but primary analytic approach is quantitative survey using standardised a priori coding system.
2) Large group interactions, e.g. classrooms.
3) Unpublished manuscripts and postgraduate theses.
The documented practice(s) provide(s) service providers or users with opportunities to raise, address and/or pursue talk about sensitive future matters, including death, dying and planning for end of life care
Data extraction, (selection and coding)
Selecting - two researchers pilot database and specialist source searches.
One researcher conducts definitive searches.
One researcher screens on titles and abstracts.
Any uncertain cases: inclusion resolved by (1) obtain abstract and where necessary full paper (2) two researchers read and discuss to reach consensus re inclusion.
Final iterative checking of inclusion during data extraction completion.
Custom designed data extraction proforma.
Copies of all relevant data extracts (i.e. transcripts) from each included paper.
Two researchers involved in designing and testing data extraction forms.
Two researchers independently tested data extraction forms on 3 purposively selected studies.
Discrepancies and uncertainties resolved through discussion between the two researchers and consultation with other members of team (Drew and Toerien) where needed.
Risk of bias (quality) assessment
Risk of bias per se is difficult to apply to the form of evidence we are working with.
We use 'strength of evidence' and record the multiple parameters:
Size of data collection (number of recorded interactions, number of hours of data, number of specific episodes collected).
Number of data extracts appearing in the publication.
Whether any participants in interactions are simulated (e.g. simulated patients).
Number of sites in which data recorded.
Number of participants noted to use the practice(s).
Only single turns examined, or sequence.
Only semantic content of talk, or prosodic, grammatical, pragmatic, aspects.
Examination of sequential environment.
Examination of turn and/or sequence design.
Examination of interactional effects/consequences.
Examination of deviant cases.
Analytic claims supported by direct quote from or references to the data.
Use of established analytic findings as tools in analysis.
Practice documented in other settings (English data).
Documented in other settings (non-English data).
Strategy for data synthesis
Descriptive narrative synthesis combined with techniques of realist evaluation (Pawson et al).
Analysis of subgroups or subsets
Invited conference presentations:
July 2011: preliminary findings presented at 9th Interdisciplinary conference on Communication, Medicine and Ethics (COMET), Nottingham UK.
November 2011: Death and Emotions: An International Symposium on Human Mortality University of Helsinki Centre for Advanced Studies
Peer reviewed abstract also submitted to European Association for Palliative Care conference 2012.
Detailed report available within collected resources on Sue Ryder Care Centre for Study of Supportive, Palliative and End of Life Care website.
Submit report of findings to clinical journal (target BMJ) and report of methods to medical sociology journal (target Social Science and Medicine)
Dissemination to policy makers:
Drawing on Professor Seymour's associates: provide short report for National End of Life programme, and Dying Matters Coalition
Other planned dissemination:
Practitioner Research network seminar, Sue Ryder Care Centre for the Study of Supportive, Palliative, and End of Life Care
European Association for Palliative Care conference Trondheim 2012
Contact details for further information
Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care
This is an unusual review given that the main body of work included derives from sociological and linguistic research. It is a novel piece of work aiming to make available to clinicians and educators some of the rich evidence currently 'buried' in linguistic, interactional and sociological research publications.
Stage of review
Date of registration in PROSPERO
13 October 2011
Date of publication of this revision
03 December 2013
Details of final report/publication(s)
R H Parry and V Land (2013) Systematically reviewing and synthesizing evidence from conversation analytic and related discursive research to inform healthcare communication practice and policy: an illustrated guide , BMC Med Res Methodol.;13:69. doi: 10.1186/1471-2288-13-69. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674894/pdf/1471-2288-13-69.pdf
Abstract reporting findings:
R Parry, V Land, J Seymour (2012) Communicating with Patients about their Feelings and Preferences for the Future in Palliative Care: A Systematic Review of Evidence from Social Science and Linguistics
Abstracts of the 7th World Research Congress of the European Association for Palliative Care (EAPC)
Palliat Med 26: 539. DOI: 10.1177/0269216312446391
Formal screening of search results against eligibility criteria
Risk of bias (quality) assessment
PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites.