Seize the moment!

Using the methodology of conversation analysis, this study focuses on patients’ disclosures of psychosocial problems during moments of suspended interaction, i.e. when the doctor is otherwise engaged. Contrary to most activities in the medical encounter, these disclosures are initiated by patients themselves. However, they are placed and designed so as not to require the doctor to respond, but rather to minimise the imposition on the doctor. Uptake, therefore, is not guaranteed. The placement of such disclosures exactly during suspended interaction displays a patient orientation to not derailing the progressivity of the consultation towards its end goal of treatment, an orientation also found by other interactional studies and shown to be related to low patient participation. The independent contribution of this study is that it enhances our understanding of the hitherto unexplored interactional barriers to the

本研究采用会话分析（conversation analysis）方法，聚焦于患者在互动暂停时刻（即医生无暇顾及的时段）披露心理社会问题的情况。与医疗接触中的大多数活动不同，这些披露由患者主动发起。然而，其发生时机与设计方式并不要求医生回应，而是旨在最大限度减少对医生的打扰，因此医生的回应（uptake）无法得到保证。此类披露恰好发生在互动暂停期间，体现了患者不愿干扰诊疗朝向治疗这一最终目标推进的倾向——这种倾向也为其他互动研究证实，并被证明与患者参与度低相关。本研究的独立贡献在于，它加深了我们对迄今为止尚未被探索的互动障碍的理解，这些障碍