Olaug S. Lian
Professor in medical sociology and leader of the Medical Humanities research group at UiT. She has worked in various academic positions for three decades, the last 10 years as full professor. Her research relates to cultural aspects of health and illness, illness experiences, clinical interaction, and medical uncertainty. Exhibiting the clinical relevance of studies informed by social science theories and perspectives is a key feature of her research.
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Clinical interaction in context: a narrative exploration of 212 naturally occurring GP consultations.
Clinical interaction in context is a research project dealing with the interaction between patients and doctors in clinical consultations, with a focus on patient centred care and shared decision-making. Through various sub-studies, we explore the moment-to-moment unfolding of naturally occurring clinical consultations between patients and general practitioners (GPs). Although our empirical exploration focuses on in situ consultations between patients and GPs as they unfold, we situate their interaction in the sociocultural context in which it is embedded and explore their negotiations in relation to their institutionalised positions and roles. The study is based on 212 naturally occurring GP consultations in England, sourced from the One in a Million data archive in the UK. Consultations involve musculoskeletal, psychological, digestive, cardiovascular, neurological, endocrine/metabolic and general conditions. By exploring complete naturally occurring consultations with a heterogenous sample of patients, we capture the interactional dynamics of negotiations in relation to a wide range of consultation aspects and clinical conditions. Contextualising these negotiations enables us to see how the actions of both patients and GPs are constrained by their different institutionalised positions. Through data-grounded semantic coding of all 212 consultations in NVivo, we are able to relate single cases to the wider dataset. While analysing the data, we combine qualitative thematic analysis and narrative analysis, but our main analytical approach is qualitative interpretive narrative analysis. In line with this methodology, we analyse the consultations as narratives, and explore complete consultation transcripts in relation to what was uttered (content), how it was uttered (form), and by whom (speaker). By focusing on the interactional dynamics; quoting long extracts; analysing components in light of the whole, and attending to sequentiality, we respect the integrity of the narrative. The project is structured around three main overlapping subthemes: (1) risk and uncertainty, (2) modes of interaction, and (3) patient agency. Read more on separate webpage here.
Most recent publication from the project:
Lian OS, Nettleton S, Grange H and Dowrick C. (2023) ‘My cousin said to me ...’ Patients’ use of 3rd-party references to facilitate shared decision-making during naturally occurring primary care consultations. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine. https://journals.sagepub.com/doi/10.1177/13634593231188489
Lian OS, Nettleton S, Grange H and Dowrick C (2023) ‘I’d best take out life insurance, then.’ Conceptualisations of risk and uncertainty in primary care consultations, and implications for shared decision-making. Health, Risk & Society 25(5-6): 234-251. https://doi.org/10.1080/13698575.2023.2197780
Lian OS, Nettleton S, Grange H and Dowrick C (2023) "It feels like my metabolism has shut down". Negotiating interactional roles and epistemic positions in a primary care consultation. Health Expectations 26(1): 366-375. https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.13666
Lian OS, Nettleton S, Grange H and Dowrick C (2022) “I’m not the doctor; I’m just the patient”: Patient agency and shared decision-making in naturally occurring primary care consultations. Patient Education and Counceling 105(7): 1996-2004. https://doi.org/10.1016/j.pec.2021.10.031
Lian OS, Nettleton S, Wifstad Å and Dowrick C (2021) Negotiating Uncertainty in Clinical Encounters: A Narrative Exploration of Naturally Occurring Primary Care Consultations. Social Science & Medicine 291 (114467). https://doi.org/10.1016/j.socscimed.2021.114467
Lian OS, Nettleton S, Wifstad Å and Dowrick C (2021) Modes of Interaction in Naturally Occurring Medical Encounters with General Practitioners: The ´One in a Million´ Study. Qualitative Health Research 31(6): 1129-1143. https://doi.org/10.1177/1049732321993790
Complete list of research interests:
- Clinical interaction and shared decision-making
- Uncertainty and risk
- Medical uncertainty
- Illness narratives
- Contested Chronic Conditions: experiential perspectives
- Sociology of diagnosis
- Social constructions of health and illness
- Cultural, historical and gendered perspectives on medical knowledge and practice
- Medicalisation as a modern phenomena
- Qualitative research and narrative theory
- The role of theory in qualitative research
- Photography and visual research
Member of research group
Member of project
Professor in medical sociology
Dr. Polit. 1999 (sociology)
Cand. Polit. 1993 (sociology and philosophy)
Current academic roles
- Professor in medical sociology, Department of Community Medicine, University of Tromsø (since 2013)
- Research advisor (20%) at the University hospital of Northern Norway (since 2003)
- Member of International advisory board, Sociology of health & illness
- Reviewer for 16 journals: Sociology of health & illness, Social Science & Medicine, SSM - Qualitative Research in Health, Qualitative Health Research, Social theory & health, Patient education and counselling, Scandinavian journal of public health, British Journal of Social Psychology, Journal of Psychosomatic Research, BMC Health Services Research, BMC Family Practice, Medical Humanities, Sosiologisk tidsskrift, Tidsskrift for samfunnsforskning, Tidsskrift for Den norske legeforening and Michael.
Previous academic positions
- Various academic positions at University of Tromsø from 1993 to 2004 (PhD fellow/post. doc./researcher/)
- Associate professor at University of Tromsø 2004 - 2013
- Editor Sosiologisk tidsskrift [Journal of sociology] in 2014
- Visiting scholar, Department of sociology, University of York, from March to May 2012.
- Research manager (20%), The Health Service Research Program of the Norwegian Research Council (2008-2010)
- Member of several committees working to elaborate a new curriculum for medical studies at University of Tromsø (from 2006 to 2011)
- Visiting scholar, Czech Association for Health Services Research, Prague, The Czech Republic (3 months during 2005)
- Visiting scholar, Health Services Management Centre, University of Birmingham, UK (12 months during 2000 and 2001)
- Member of expert panel on social inequalities in health appointed by The Norwegian Directorate of Health (2005-2013)
- Researcher at University of Oslo, Department of health sciences, 10% (2018-2021)
Research grants as project manager
- Quality, accessibility and coordination of health care in Norway for people with chronic illnesses - seen from the users’ point of view, research project (1/2011 – 12/2014), Norwegian Research Council, grant no. 212987 (5 mill. Norwegian crowns).
- Pasienterfaringer i allmennlegetjenesten før og etter fastlegeordningen, research project, (10/2002 – 12/2003), Norwegian Research Council, grant no. 151318/330.
- When health becomes commodified, post. doc. project (07/1999 – 06/2002), Norwegian Research Council, grant no. 129173/330.
- Convergence or divergence? Reforming primary care in Norway and United Kingdom, research project (07.2000 – 07/2001), Norwegian Research Council, grant no. 137351/300.
- Nyere helsepolitiske reformer - fordelingsvirkninger og normative problemstillinger, PhD-project (02/1995 – 03/1999), Norwegian Research Council, grant no. 108243/330.
Invited speeches and paper presentations (selection, since 2012)
- (Co-)construction of illness narratives in medical encounters characterised by uncertainty (with Christopher Dowrick, Sarah Nettleton and Åge Wifstad), SymPCa conference, Sheffield UK, 27. September 2019.
- Contextualising health narratives as situated action. CANCUL seminar University of Oslo, 28. October 2019.
- Sosio-logiske helseulikheter i breddeformat. Invitert foredrag, Vinterseminaret, Norsk Sosiologforening, Storefjell 1.2.2019.
- Biomedical hegemony: a critical perspective on the cultural imperialism of modern biomedical perspectives on human life. Paper presentation at The 6th Euroacademia Global Forum of Critical Studies - Asking Big Questions Again, Lucca, Italy, 23-25 November 2017.
- Gendered perspectives on contested chronic conditions. Invited speaker at the conference ”Embodying the gender regime: health, illness and dis-ease across the life course”, University of Liverpool UK, 22 September 2017.
- ”I do not really belong out there anymore.” Sense of being and belonging among people with medically unexplained long-term fatigue. Paper presented at the 12th ESA conference, Prague, Czech Republic, 28 August 2015.
- “United we stand.” The discursive framing of online negotiations of ME in a virtual symbolic community. Speech given at the ESRC seminar series on the sociology of diagnosis, University of York, 27. January 2014.
- Negotiating medically unexplained seizures (PNES) in clinical encounters. Paper presented at the 67.th BSA Annual Conference 2014 in Leeds, England, 23. April 2014 (with Catherine Robson).
- Kvalitet på helsetjenester til ME-syke: et brukerperspektiv. Regional nettverkskonferanse CFS/ME, Helse Nord, Tromsø 13. november 2014.
- Medical constructions of exhausted women – today and yesterday. Paper presented at the 66.th BSA Annual Conference 2013 in London, England, 5. April 2013.
- Negotiating ME in Norwegian Virtual Symbolic Communities. Paper presented at the BSA Medical Sociology Group Annual Conference, York 12. September 2013 (with Sarah Nettleton)
- Illness without disease – a challenge to the paradigm of modern medicine. Paper presented at the 14th biennal congress of ESHMS in Hannover, Germany, 31. August 2012.
- Illness without disease – a challenge to the paradigm of modern medicine. Paper presented at the 26th conference of the Nordic sociological association, Reykjavik, Island, 18. August 2012.
Publications: see Cristin