# Dialogued into being: Constructing knowledge about hand osteoarthritis from a polyphony of voices in healthcare encounters

## TL;DR

This study explores how knowledge about hand osteoarthritis is created and shared during doctor-patient conversations.

## Contribution

It reveals how multiple voices co-construct knowledge in clinical encounters, including dominant and peripheral perspectives.

## Key findings

- Health professionals often dominate the conversation in shaping knowledge about hand OA.
- Patients contribute their own understanding of the condition in chronic healthcare dialogues.
- Knowledge is sometimes co-constructed in hybrid roles when patients and professionals share experiences.

## Abstract

Multiple knowledge sources inform healthcare. In healthcare encounters, patients and health professionals’ ideas intersect to understand illness and disease. Exploring what is thought of as legitimate knowledge, and where those reflections come from is central to the process of improving and developing healthcare. Within this context, we aim to explore how knowledge about hand osteoarthritis (OA) is constructed and negotiated in clinical consultations.

The article is based on interviews with 21 patients and 14 health professionals in combination with observation in 16 clinical consultations. Reflexive thematic analysis was used to interpret the data.

We generated four themes from codes to tell an interpretive story about how hand OA meaning-making is “talked into being” in patient-provider encounters: from the dominant voice of health professionals, from patients as knowers in the chronic healthcare dialogue, from health professionals and patients constructing knowledge together and from the construction of knowledge in hybrid positions when patients are health professionals and health professionals have hand OA.

New knowledge about hand OA is co-constructed in the situated context of the clinical encounter through a polyphony of voices—some of which are dominant, while others occupy the periphery—within and between the interactants in dialgue.