Saskia Briede

Chapter 1 16 Multiple perspectives From the start of our research we recognized the value of integrating perspectives. This was enhanced by adding a specialist in communication and linguistics to our medical research team. This enabled us not only to juxtapose patient and physician viewpoints (as both were research subjects in our studies), but to also foster a rich, interdisciplinary dialogue among our team members. This collaborative effort, combining the clinical knowledge of physicians with the language expertise of a communication specialist, often revealed interesting insights when interpreting identical data sets. Additionally, the strong educational background of our team members allowed us to incorporate educational considerations into the development of training and interpretation of results. By merging quantitative with qualitative research methods, such as semi-structured interviews and conversation analysis, this thesis represents the convergence of these diverse viewpoints. Intermezzos In this thesis, we provide three Intermezzos that serve as an intermission in the main parts. In these Intermezzos the physicians’ perspective will be discussed. A student’s final research project provided us various interviews. The insight gained by this small interview study were highly recognizable and connected the results from our other studies. This resulted in Intermezzos like in opera: short and lighter parts that connect the major sections of the work. Objectives of this thesis: This thesis explores how care decision conversations can be improved. Specifically, it examines the effect of physician training and patient education in different settings: the outpatient clinic and emergency department. Besides, it provides insight in how care decision conversations are currently conducted and patients’ and physicians’ perspectives on care decisions. These results together learn us how best to prepare patients and physicians to talk about care decisions.

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