Table 2

Coding scheme for categorising utterances of nurse practitioners and GPs.

Code wordDefinitionExamples
Gathering information
 GATHERSYMDesigned to generate information about current symptoms‘Have you actually been sick or do you just feel sick?’
 GATHERHISTDesigned to generate information about past history of illness or treatment, family experience of illness and possible causative factors that might have a bearing on the current illness‘You don't get asthma or anything do you?’
Physical examination
 EXPLAINPHYSExplanations of the purpose or reasoning behind the physical examination, or of the physical procedures this involves‘But if I listen to your chest first - just to make sure your asthma is fine.’
 MANIPULATEGetting the patient to move their body in a way that facilitates the physical examination‘Can you stand up — put your foot on the floor for me. Stand up and move it.’
 APPEARANCEComments on the visual appearance of the patient‘Oh dear, it's quite swollen, isn't it?’
Naming and explaining disease
 DIAGNaming of the condition or delivery of diagnostic evaluation‘This is a contact dermatitis of some sort.’
 EXPLAINDISExplanations of cause of the problem‘I'm pretty convinced it's your work boots that are doing it.’
 PROGRESSIONThe likely course that the condition will take‘I would expect that, you know, within 3 or 4 days for that to be gone completely.’
Social/emotional/patient centred
 ANYQUESTIONSAsking if there are any further issues the patient wants to raise‘Is there anything you want to ask about?’
 CHITCHATGeneral small talk about holidays etc.‘Mind you, it's muggy out there, isn't it?’
 HUMOURMoments where jokes are told or laughter is recorded by the transcribers‘My [weighing] scales are very friendly don't worry, they are very, very nice.’
 MOTHERESEDesigned to put children at their ease 13‘Alright — I'll show you something — see? Teddy bear.’
 PRAISEPraise or support for a patients apparently sensible approach to things‘No, that's right, you were right to do that.’
 SYMPATHYExpressions of sympathy‘Poor little thing, aren't you? It can make you feel quite miserable and ill.’
 SOCIALDiscussion of impact of the condition on patients ability to carry out work OR school role‘Well there's no need to miss school really, is there?’
 TREATMENTPROPProposing a treatment and/or explaining how it works‘I would, you know, just try symptomatic treatments, so drink plenty, take either paracetamol or gargle with soluble aspirin, sleep and rest as much as possible.’
 HOWTOTREATExplanations of how to apply/carry out a treatment‘Put it in water and it dissolves and then what you can do is to try and gargle it and then that will take some of the pain out of that tonsil.’
 COSTOFTREATDiscussions of financial cost of treatment‘Well it doesn't cost much at the chemist.’
 SIDEFFECTSChecking for the potential of treatment to cause side effects, or any other discussion of side effects of treatments‘Just take them at night they can make you drowsy, so do be careful if you're driving or if you're out.’
 ARRANGEArranging for the signing of a prescription by another party, or their approval of a treatment plan‘I'll run down and get these prescriptions signed.’