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The main issue explored is how patients and physicians communicate about lifestyle in the clinical encounter and what role this talk plays in terms of the outcome of the consultation. The data, collected at two primary health care centers, consist of 42 audiorecorded consultations. The analyses are based on these transcribed dialogues. Our study shows that communication about lifestyle issues is used as a source for determining what health care measures are relevant. Physicians provided a variety of types of information and explicit connections were made between lifestyle and the medical problem by physicians as well as patients. Within the process of reaching decisions on advice or treatment, two forms of interaction appeared referred to here as 'paternalism' and 'mutuality'. In general, the results show that the physicians are very cautious about making explicit medical inferences concerning specific issues of the individual's lifestyle. Key words - primary health care, general practice, doctor/patient communication, lifestyle

The problem studied concerns how patients and physicians talk about and make use of information regarding patient life style in the daily practice of primary health care. The study has been carried out at two primary health care centres in central Sweden. Transcribed dialogues between 42 patients and 12 physicians have been used as a data corpus. The analyses concern the interactional patterns in the dialogues between patient and physician, how the interlocutors address life style and for what purposes. The results show a similarity between patients and physicians with respect to the extent to which they use the discourse space. However, salient differences were found in the following way: the physicians not only introduced and closed life style topics more frequently than the patients did, they also used what is referred to as an agenda driven strategy to introduce them. The patients, on the other hand, used an interactively anchored strategy. The patients, by taking the reference in the life world and by making use of the life style topics, present and articulate their identity. The physicians subsume life style issues under a medical framing of the patients' problem and they mainly address life style in order to construe a proto-typical patient rather than an individual. Key words - primary health care, general practice, doctor/patient communication, lifestyle

This study is the first part of the project 'Lifestyle Questions in Primary Health Care'. The study aims at exploring how lifestyle enters into the health care discourse and what significance such factors are given in the clinical work. The particular problem thus concerns the extent to which lifestyle issues are brought up and attended to in the clinical encounters as well as in the medical records. The study was performed at two primary health care centres in central Sweden. The analyses are based on 42 transcribed consultations and on the medical records produced on the basis of these dialogues. The results show that lifestyle issues are given considerable attention in the primary health care encounter. Roughly one third of the discourse space is devoted to these kinds of topics, and the patients and doctors share the discourse space equally between them. There is also a high consistency between topics given space in the discussion and those that are entered into the medical records. The results also point to what could be conceived as a common discursive code between the health centres studied, indicating that there are similar communicative strategies for discussing lifestyle issues. Key words - lifestyle, primary health care, patient-doctor communication, institutional discourse