Quality assurance of decision-making in conversations between professionals and non-professionals: identifying the presence of deliberative principles

Variable indicatorVariable number and nameNoYes1  Respect for possible  participationThe statement is an interruption (code 0)The statement is not an interruption (code 1)2  Implicit respect for a personNo respect: This code is reserved for speeches in which there are only negative statements towards a participant, opinions or values. The code is also used if the speaker talks in a disrespectful manner (code 0)Implicit respect: We use this code if there are no explicitly negative statements, nor any explicitly positive statements and matters directed towards a person, opinions or values (code 1)3  Explicit respect for a personNo respect (code 0)Explicit respect: This code is assigned if there is at least one explicitly positive statement about participants or matters concerning participants, opinions or values, regardless of the presence of negative statements. Participants are defined as both the person spoken to and as other persons present in the room (code 1)4  Disrespecting a personOne of the variables implicit/explicit respect is found (code 1)Neither of the variables implicit/explicit respect is found (code 0)5  Respect for last statementThe last participant's statement is ignored (code 0)The last participant's statement is included and either degraded or valued. This code is provided even when the statement is an interruption (code 1)6a Promoting mutual understanding onceInformal talk or silence (code 0)The statement promotes mutual understanding that is relevant information, relevant opinion, relevant argumentation, a relevant question, or talk about the conversation (code 1)6b Promoting mutual understanding more than onceInformal talk or silence (code 0)Either two of the same elements or more than one element defined as promoting mutual understanding (code 1)7a Expressing understanding or agreement onceThe statement does not contain understanding or agreement of the other participant(s) (code 0)The statement contains one understanding or agreement of the other participant(s), including rephrasing of statements and/or establishing a joint understanding of arguments (code 1)Helpful sentences: Yes, that's the way….Yes, that's right…Yes, that's how they see it tooYes, that's the way I see the world tooYes, then we agree on…. Then we do this….Yes, I agree to do thisI agree to valuate this argument…7b Expressing understanding or agreement more than onceThe statement does not contain understanding or agreement of the other participant(s) (code 0)The statement contains two or more understandings or agreements (code 1)8  Expressing disagreementThe statement is not an explicit disagreement (code 0)The statement expresses a disagreement (code 1)

Variable NumberCharacteristics of DeliberationOperationalization1–5Equal right to participateMCD presuppose the presence of relevant participants.Equality and no use of coercionReflected in all characteristics of deliberation, but also in the degree of respect.Measured by the following variables:Variable 1 Respect for possible participationVariable 2 Implicit respect for a personVariable 3 Explicit respect for a personVariable 4 Disrespecting a personVariable 5 Respect for last statement6–8Mutual understandingMeasured by the following variables:Variable 6a Promoting mutual understanding once Variable 6b Promoting mutual understanding more than onceVariable 7a Expressing understanding or agreement onceVariable 7b Expressing understanding or agreement more than onceVariable 8 Expressing disagreementIn addition: Equality and respect creates an atmosphere promoting mutual understanding.Open to changing one's mindPartly reflected in respect variables. Cannot be fully revealed without asking the participants.Fulfilling of validity claimReflected in inconsistency and lack of coherence, better revealed by qualitative methods.

VariablePoint-by-pointCohen's kappa1 Respect for possible participation99%0.742 Implicit respect for a person91%0.693 Explicit respect for a person93%0.734 Disrespecting a person98%0.565 Respect for last statement99%0.856a Promoting mutual understanding once90%0.656b Promoting mutual understanding more than once93%0.877a Expressing understanding or agreement once86%0.657b Expressing understanding or agreement more than once95%−0.018 Expressing disagreement100%All variables94%0.89

Appendix 1.

PersonRoleGenderProfessionalThemeResponse for possible participationImplicit respect for a personExplicit respect for a personDisrespecting a personRespect for last statementPromoting mutual understanding oncePromoting mutual understanding more than onceExpressing understanding or agreement onceExpressing understanding or agreement more than onceExpressing disagreementStatement1Patient 1MN1yynnynnnnnI usually say way too much ha ha ha, lots of chatting2Doctor 2MY1yynnyynnnnYeah we forget it [about the recorder]. Yes, Patient 1, we had an appointment for today.1Patient 1MN1yynnyynynnYeah, I was suddenly on holiday last time, so we had to change around a bit2Doctor 2MY1yynnyynnnnYeah, and we are here because we're in a weight-reduction programme and change of lifestyle and trying to get a healthier lifestyle.1Patient1MN1yynnyynynnMmm2Doctor2MY1yynnyynnnnCan you say a little about, when we started, then you were 150 kilos, what it…1Patient 1MN1nynnyyyynnYeah, that's at least what we estimated it at, well, we, like, forgot to weigh the first time, I think, that's probably what it was, yeah. I can feel it in the pants that it was something like that2Doctor 2MY1yyynyyynnnYes. Have you managed to continue? When did we have our last appointment, 30 June, have you managed to continue the good trend you showed then?1Patient 1MN1yynnyyynnnI haven't measured anything, but I've probably eaten a little more breakfast when I have been working