Structures of District Nurse - Patient Interaction

Research output: ThesisDoctoral Thesis (monograph)


This dissertation is about social interaction between Swedish district nurses and patients when they meet to perform such routine things as to measure blood pressures or give injections. Conversation analytic methodology is used to explicate interactional structures and to understand how they come about; (i) how tests and treatments are achieved; (ii) how concerns are introduced; (iii) how test results are talked about; and (iv) how advice is given and responded to. These interactional structures are also related to the institutional contexts to which nurses and patients are oriented when they interact. Thus, a more traditional ethnographic approach is used as a complement to conversation analytic methodology.

Data consists of ethnographic material, primarily nurses’ textbooks, interviews with nurses, and observations of nurses’ meetings with patients. Data also consists of 64 audio and video recordings of encounters between 17 nurses and 58 patients. 32 of these recordings have been transcribed and analyzed in detail.

District nurse-patient interactions occur in rather straightforward ways. This interpretation is strengthened by comparisons between these interactions and interactions in other institutional settings (between health visitors and first-time mothers, HIV counselors and clients, doctors and patients). The main reason for the straightforwardnesses is found in the nature of district nurses’ work: They meet patients in order to perform tests and treatments, which are unproblematic manual activities. The verbal activities that are generated during these meetings tend to become rather straightforward.


  • Vesa Leppänen
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Sociology (excluding Social Work, Social Psychology and Social Anthropology)


  • primary care, patient, social interaction, conversation analysis, ethnomethodology, ethnographic method, district nurse, Care and help to handicapped, video analysis
Original languageEnglish
Awarding Institution
Supervisors/Assistant supervisor
  • [unknown], [unknown], Supervisor, External person
Award date1998 Sep 28
  • Department of Sociology, Lund University
Print ISBNs91-89078-44-6
Publication statusPublished - 1998
Publication categoryResearch

Bibliographic note

Defence details Date: 1998-09-28 Time: 10:15 Place: Carolinasalen, Kungshuset External reviewer(s) Name: Silverman, David Title: Professor Affiliation: Goldsmiths' College, University of London ---