Marit Nygård Halvorsen (OsloMet)

All Nordic countries have implemented guidelines recommending that midwives ask all pregnant women about violence. Sweden was the first to do so in 2008 and Denmark the last in 2024. In Norway the guidelines were introduced in 2014, based on the assumption that adding another question would have minimal impact on the midwives’ workloads (Hjemdal & Engnes, 2009). However, research suggest that midwives find the task challenging (Henriksen et al., 2017). Building on qualitative interview studies, this project addresses a research gap by exploring what happens turn-by-turn during these conversations in real-life consultations. Using Conversation Analysis (CA), 35 video-recorded antenatal care consultations were collected, and 21 instances where violence was discussed was analysed. The data includes consultations from 35 pregnant women and 8 midwives, mostly from the first or second antenatal visit, where Norwegian midwives are expected to ask about violence. The analysis explores how midwives design and formulate questions about violence, and the consequences this may have for the pregnant woman’s possibilities to respond.

Keywords: Antenatal care, conversation analysis, question-design, violence, sensitive topics, interactional delicacy

Henriksen, L., Garnweidner-Holme, L. M., Thorsteinsen, K. K., & Lukasse, M. (2017). ‘It is a difficult topic’ – a qualitative study of midwives ́ experiences with routine antenatal enquiry for intimate partner violence. BMC Pregnancy and Childbirth, 17(1), 165.

Hjemdal, O.K. and Engnes, K. (2009) Å spørre om vold ved svangerskapskontroll: Rapport fra et forsøksprosjekt i fire kommuner. (Rapport 1/2009).

Pain management is an essential part of cancer care, and therefore it is frequently monitored and adjusted in cancer consultations. Safe and effective use of pain medication, particularly opioids, requires patient education so that risks and side-effects can be controlled. We analyse video-recorded oncology and palliative care consultations with chronically ill cancer patients with conversation analysis, and study how pain medication is discussed.

Our data is longitudinal, and shows that correct type, dosage and timing of pain medication is a recurring and problematic topic in cancer consultations. Chronically ill patients need pain medication for the rest of their life with increasing intensity. This creates practical problems: tolerance, side-effects and risks increase, whereas the effectiveness of the medication may decrease. Furthermore, even when the use of opioids is well justified, it is stigmatizing and can be contrary to patient’s values.

The patients are instructed to adjust their medication within limits to acquire accurate pain control. Nevertheless, our data shows that in spite of previously given instructions, there are recurrent problems and misunderstandings regarding the use of medication, which make relevant repeated instructions on how to control the pain in a safe and effective way.

We describe a specific practice in interaction in which problems come up, are elaborated and further instructions are given - namely, discussion about the patient’s daily agenda. It can be initiated by the doctor or by the patients themselves, and it is a key practice in and through doctors recognize need for advice regarding pain management.

Personalized health information, such as health records and test results, is increasingly communicated directly to patients through digital portals, bypassing quality checks and translations by general practitioners. This direct availability places new demands on practitioners' writing of health information.
The aim of this project is to examine the production and understanding of texts for patient portals.
Research question: How does the direct publication of health information texts in patient portals affect both healthcare professionals' writing practices and patients' ability to read and interpret the information?
The project employs a multi-method approach, including interviews, workshops, and document analysis from a corpus of 250 test results.
Preliminary analysis of the interviews and workshop data reveals a gap between what healthcare practitioners and patient representatives consider understandable texts, particularly regarding text structure and the use of phrases and terms. While healthcare professionals emphasize the importance of correct terminology, including acronyms and detailed explanations, patients highlight that the average health literacy level of citizen-patients is equivalent to a 10th-grade school level (15 years). Therefore, basic terms such as "hormone" and "thyroid gland" should be explained within the textual context in which they are introduced.
These insights suggest that patient portals should present text material with a recognizable structure and common terms, quality ensured by patient representatives. When medical terms are necessary, they should be explained in a way that is relevant to the patient. For healthcare professionals, this is challenging, and even more so for language models and chatbots that don't know the patient.

Background and Aim:
Young people increasingly rely on the internet for health information but often lack the skills to assess its quality. Although they are digital natives, many have low health literacy and seek guidance from adults. To provide trustworthy information, the Norwegian government launched ung.no in 2003, a website for youth aged 13–20, featuring an anonymous Q&A service. This study explored how adolescents use the Q&A service to build oral health literacy.

The results are a part of #Care4YoungTeeth<3, funded by the Research Council of Norway.

Methods:
All dentist-answered questions submitted to the Q&A service over three years were collected. A sample of 756 questions was qualitatively analysed using the four health literacy dimensions: finding, processing, evaluating and using health information.

Results:
Adolescents seem to use the Q&A service as a decision-making aid. Their questions often reflect a desire for confirmation or clarification of previously found information. Many demonstrate good oral health literacy, showing awareness of symptoms, the need for reliable sources and when to seek professional help. However, they also reveal uncertainty in evaluating different actions, and typically ask about the consequences of various options and request help in identifying the best choice—or alternatives that fit their preferences. In some cases, they seek ways to maintain harmful habits, e.g., asking how to drink acidic beverages with less dental harm.

Conclusion:
Adolescents seem to use the Q&A service to support decisions and confirm their understanding, thereby building oral health literacy, but this does not necessarily lead to healthier choices.