Attending to child agency in paediatric palliative care consultations: Adults’ use of tag questions directed to the child

Abstract

Children's agency in their own lives is increasingly recognised as important, including within paediatric health care. The issue of acknowledging child agency is complex in the context of paediatric palliative care, where children have serious and complex conditions that often impact their ability to verbally communicate with others. This study explores how clinicians and parents/guardians direct talk towards a child patient when they are present in a consultation. Conversation analysis methods were used to examine 74 video‐recorded paediatric palliative care consultations. Detailed turn‐by‐turn examination of the recorded consultations identified the recurrent use of a practice described by linguists as a ‘tag question’, which follows some statement (e.g. ‘he loves that, don't ya’). Both clinicians and parents/guardians often directed these tag questions towards the child patient. Analysis demonstrated how these tag questions: (1) validated the child's epistemic authority over what was being said and (2) made a child's response a possible, but not necessary, next action. The findings are discussed in relation to the sociology of child agency and how this agency is acknowledged and displayed within and through social interaction. This research provides direct evidence of children's competence as informants about their own symptoms. (PsycInfo Database Record (c) 2022 APA, all rights reserved)School of Early Childhood and Inclusive Education, Queensland University of Technology, Brisbane City, QLD, Australia. Other Publishers: Blackwell Publishing. Release Date: 20220609. Publication Type: Journal (0100), Peer Reviewed Journal (0110). Format Covered: Electronic. Document Type: Journal Article. Language: EnglishMajor Descriptor: Clinicians; Competence; Discourse Analysis; Palliative Care; Pediatrics. Minor Descriptor: Epistemology; Love; Sociology. Classification: Health & Mental Health Services (3370). Population: Human (10); Male (30); Female (40); Inpatient (50). Location: Australia. Age Group: Childhood (birth-12 yrs) (100); Neonatal (birth-1 mo) (120); Infancy (2-23 mo) (140); Preschool Age (2-5 yrs) (160); School Age (6-12 yrs) (180); Adolescence (13-17 yrs) (200); Adulthood (18 yrs & older) (300); Young Adulthood (18-29 yrs) (320). Methodology: Empirical Study; Quantitative Study. References Available: Y. Page Count: 20. Issue Publication Date: Mar, 2022. Publication History: Accepted Date: Jan 7, 2022; First Submitted Date: May 26, 2021. Copyright Statement: Published by John Wiley & Sons Ltd. on behalf of Foundation for SHIL (SHIL). This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. The Authors—Sociology of Health & Illness. 2022.Sponsor: Australian Research Council, Australia. Grant: DP180101941. Recipients: No recipient indicated <br />