RHP&EO is the electronic journal of the International Union for Health Promotion and Education

Life Style Discourse in Primary Health Care. -- Talking about smoking and drinking---

Ullabeth Si/tterlund Larsson, RN, Dipl Nurse Ed, BSc, PhD (a, b), Marita Johanson, RN, Dipl Nurse Ed, PhD(a), Roger Siiljo, PhD(a) and Kurt Svardsudd, MD, PhD(b)

Department of Communication Studies, Linkoping University, Linkoping (a), Department of Advanced Nursing Education, Goteburg University Co) and Clinical Epidemiology Unit, Department of Family Medicine. University Hospital, Uppsala University, Uppsala (c) Sweden.

Purpose-- The present study addresses the issue of how life style habits, notably smoking and drinking, are discussed in health care. Data from two different primary health care centres in Sweden are reported. The results are also compared with a previous study carried out by the same researchers. in the context of an internal medicine outpatient clinic

Methods-- The data consist of authentic consultations which have: been audio-taped, transcribed and analysed. Participants -- 42 patients and 12 physicians were involved in this study.

Results-- Smoking and drinking habits were brought up in 45 per cent of the consultations in primary health care. The communication patters with respect to who asked the questions and how the questions were asked were analogous to the previous study. The physician controlled 'the floor' and kept the discussion within the 'voice of medicine'. In this respect, talk about smoking was integrated into 'the biomedical voice'. On the other hand, physicians' arguments related to alcohol use seem to be grounded in a set of normative assumptions of a general moral nature. The data also illustrate how physicians display 'professional cautiousness' when talking about these life style habits. The questions on smoking were direct, while the questions on alcohol were indirectly asked. Compared to the earlier study, communication about smoking and drinking was more extensive and more in-depth in primary health care.

Discussion-- The results will be discussed in the presentation

Key words: Patient-physician communication, life style habits, smoking, drinking, primary health care

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