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Table 6 Excerpt 5. Turn-taking challenging local management of the interaction

From: Shared decision making in chronic kidney disease: a qualitative study of the impact of communication practices on treatment decisions for older patients

Turn

Speaker

Talk

Turn-taking activity

283.

Doc7:

Are you getting any—have—have—have you checked the blood pressure between the fourth of November when you last saw me and today? Have you checked it in between with anyone?

Doctor asks question (q) 1

284.

CKD-P22:

No.

[to carer] Ah, yes, didn’t I go to [unclear]?

Patient (Pt) answers q1 but then revises answer by asking carer q2

285.

CKD-P22’s carer:

Did they check your blood pressure when you were out there?

Instead of answering q2, asks q3

286.

CKD-P22:

I think so. You wouldn’t know out there. Well, I had to go there for something. What …

Responds to carer’s q3 but also begins to ask new q4

287.

CKD-P22’s carer:

Scripts wasn’t it?

Answers q4

288.

CKD-P22:

Scripts, yeah. He would have checked it surely. It’s the first thing they do, isn’t it?

Agrees with answer to q4, offers delayed answer to q1, asks q5

289.

Doc7:

I’d like to believe that that’s the first thing they do.

Responds to q5

290.

CKD-P22’s carer:

Not always, yeah.

Comments on Doctor’s response to q5

291.

Doc7:

Um, what we might need to do is restart you on one of the blood pressure tablets again […]

Dr returns to the issue that initiated the question sequence: the need to better control pt’s blood pressure