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|---|---|---|---|
31_14
|
Okay, um, would you mind if I talk to you, if-if I- if I gave you a little bit of information about the muscle weakness, and you tell me what you think?
|
question
|
communication behavior
|
31_16
|
Okay. The muscle weakness with this drug is very rare, uh, usually doesn't even happen, okay? Uh, if it happens it usually happens within the first month of taking the medicine, you'll notice it in terms of weakness in the arms, uh, or some muscle pain, it's not usual. If this should happen, uh, if you let the doctor or me know right away, we can get you off the medicine, it's completely reversible. It's, the muscle weakness will go away within a couple of days, right.
|
therapist_input
|
communication behavior
|
31_18
|
Now, you don't wanna let that go on for months at a time, that's when it can become serious.
|
therapist_input
|
communication behavior
|
31_20
|
But otherwise, again it's rare, and it's completely reversible if you let us know.
|
other
|
communication behavior
|
31_22
|
Okay, and, uh, so talk to me a little bit more about what the doctors told you about-about your risks of stroke or heart attack while you're ta- while you have high cholesterol.
|
question
|
communication behavior
|
31_24
|
Okay, well how important would it be for you to-to, uh, do whatever you can to reduce your risks of stroke or heart attack down the line?
|
question
|
communication behavior
|
31_26
|
Yeah, and-and one of the- certainly one of the risks of stroke is paralysis, and if you wanna be active that could be-
|
therapist_input
|
communication behavior
|
31_28
|
-really a problem.
|
therapist_input
|
communication behavior
|
31_30
|
Okay, well this medicine can really help lower your risk of having a stroke or heart attack so that five years so now when you do retire you can enjoy it without any disability, uh, what are your thoughts about that?
|
therapist_input
|
communication behavior
|
31_32
|
Sure.
|
other
|
communication behavior
|
31_34
|
Mm-hmm, yeah it would, I-I-I think that would, uh, go a long way toward reducing those risks.
|
therapist_input
|
communication behavior
|
31_36
|
Okay, um, so if so where we are right now if I understand is you're feeling more comfortable about the concern about muscle weakness?
|
reflection
|
communication behavior
|
31_38
|
Uh, you seem fairly committed to taking the medicine to reduce your risk so that you can enjoy your retirement.
|
reflection
|
communication behavior
|
31_40
|
Uh, and so at this point, you're gonna get the medication and-
|
therapist_input
|
communication behavior
|
31_42
|
Definitely, can lower your cholesterol to 50%.
|
other
|
communication behavior
|
31_44
|
So it's pretty effective.
|
therapist_input
|
communication behavior
|
31_46
|
Okay, um, and at some other point we can talk about some other things that you may be able to do including diet, changes in your eating habits, it can lower your cholesterol even more.
|
therapist_input
|
communication behavior
|
31_48
|
Okay?
|
other
|
communication behavior
|
31_50
|
All right, uh, well they have your medication ready, and, uh, if you have any questions let us know.
|
therapist_input
|
communication behavior
|
31_52
|
All right, good to meet you.
|
other
|
communication behavior
|
31_54
|
Okay.
|
other
|
communication behavior
|
33_0
|
Okay, David. So, why don't you take a rinse, and how are you feeling?
|
therapist_input
|
communication behavior
|
33_2
|
Would you like to-
|
question
|
communication behavior
|
33_4
|
-check this out? What do you think?
|
question
|
communication behavior
|
33_6
|
Yeah.
|
other
|
communication behavior
|
33_8
|
Yeah.
|
other
|
communication behavior
|
33_10
|
Yeah. No.
|
other
|
communication behavior
|
33_12
|
It went well. Good. Excellent. I did notice quite a lot of staining, actually. I'm wondering what are your thoughts about what might be related to that.
|
therapist_input
|
communication behavior
|
33_14
|
Yeah.
|
other
|
communication behavior
|
33_16
|
Any thoughts on considering quitting smoking at this time?
|
question
|
communication behavior
|
33_18
|
Okay. And it's like here I am one more person, the next- the next doctor who's saying, "You need to quit smoking, David."
|
therapist_input
|
communication behavior
|
33_20
|
Mm, and I'm sorry, that's not how I mean to come across at all.
|
therapist_input
|
communication behavior
|
33_22
|
Mm-hmm, and if it was as easy as the doctor is saying or your partner-
|
reflection
|
communication behavior
|
33_24
|
-saying-
|
reflection
|
communication behavior
|
33_26
|
-you have to quit.
|
reflection
|
communication behavior
|
33_28
|
Yeah.
|
other
|
communication behavior
|
33_30
|
Yeah.
|
other
|
communication behavior
|
33_32
|
Yeah. And what's been your past experience with smoking? Tell me-- Can you tell me a little bit about kind of how the role it plays in your life, how long you've smoked?
|
question
|
communication behavior
|
33_34
|
Mm-hmm.
|
other
|
communication behavior
|
33_36
|
Mm-hmm.
|
other
|
communication behavior
|
33_38
|
It sounds like almost you've tried a lot of things that are out there and it's not something that you're—
|
reflection
|
communication behavior
|
33_40
|
Yeah, yeah.
|
other
|
communication behavior
|
33_42
|
Yeah.
|
other
|
communication behavior
|
33_44
|
Mm-hmm.
|
other
|
communication behavior
|
33_46
|
Mm-hmm.
|
other
|
communication behavior
|
33_48
|
Yeah. And it really is your choice. You're absolutely right-
|
therapist_input
|
communication behavior
|
33_50
|
-that nobody has the right to tell you what to do. Um, can I ask? If you were to-- Uh, if there was to be a situation where you decided, "I must quit," what-what would that situation be?
|
question
|
communication behavior
|
33_52
|
Mm-hmm.
|
other
|
communication behavior
|
33_54
|
Right.
|
other
|
communication behavior
|
33_56
|
Mm-hmm.
|
other
|
communication behavior
|
33_58
|
So, this is something that you-you-
|
reflection
|
communication behavior
|
33_60
|
-pretty much see yourself doing for-
|
reflection
|
communication behavior
|
33_62
|
Yeah. Okay. Well, I really appreciate you being willing to even talk about it. And I get that right now, this is not something that you wanna pursue. Would it be okay if I brought it up in our next visit? 'Cause I-I know that you've said you don't want a lecture, but on the other hand, I am- I am concerned.
|
therapist_input
|
communication behavior
|
33_64
|
As long as I don't talk too much?
|
reflection
|
communication behavior
|
33_66
|
Okay. [chuckles]
|
other
|
communication behavior
|
33_68
|
Hmm.
|
other
|
communication behavior
|
33_70
|
[chuckles] You're glad to keep him as a doctor?
|
reflection
|
communication behavior
|
33_72
|
Yeah. Well, and, David, honestly, wherever you're at, we'll work with it.
|
therapist_input
|
communication behavior
|
33_74
|
Um, and so thanks for- thanks for taking a couple of minutes and talking about smoking.
|
therapist_input
|
communication behavior
|
33_76
|
Okay.
|
other
|
communication behavior
|
34_0
|
Thank you for coming in to see me today, Nina. I'm looking forward to getting to know you a little bit and hearing a little bit about you and what brought you in here today.
|
other
|
communication behavior
|
34_2
|
Okay. He's thinking you were a little irresponsible.
|
reflection
|
communication behavior
|
34_4
|
And you're feeling kind of concerned about that.
|
reflection
|
communication behavior
|
34_6
|
Okay. So, you're concerned about the consequences, and you really care about your baby, and you want to give your baby the best start you can.
|
reflection
|
communication behavior
|
34_8
|
And you're wondering a little bit about this time that we're going to spend together.
|
reflection
|
communication behavior
|
34_10
|
So here you are today and, um, you're sharing that you have been drinking alcohol throughout your pregnancy.
|
reflection
|
communication behavior
|
34_12
|
Okay.
|
other
|
communication behavior
|
34_14
|
Mm-hmm. So, there's this external pressure coming from the people you care about to sort of stay in the scene.
|
reflection
|
communication behavior
|
34_16
|
Kind of feels like You're between two worlds. In one world, you're preparing to be a mother and bring a baby into this world, and this other world is the world that you've been in for a while where you're kind of having a good time and-
|
reflection
|
communication behavior
|
34_18
|
-drinking and your friends are-
|
other
|
communication behavior
|
34_20
|
Okay. So, this party-time world's- are you feeling like this is something you want to move out of and move into that mom world? Or does it feel like I want to hang out there still too?
|
question
|
communication behavior
|
34_22
|
So, for you, you're feeling like once the baby comes and actually in your arms, then things are going to change, but right now, while you're pregnant, you're thinking, "I can kind of hang out in both worlds a little bit," but part of you may be thinking maybe that's not the case. It's time to go to the mom world maybe.
|
reflection
|
communication behavior
|
34_24
|
Okay. So, you've got a lot of concerns about what's happened to- up until this point, as far as your drinking. What do you know about, um, drinking alcohol throughout pregnancy?
|
question
|
communication behavior
|
34_26
|
So, you were thinking because your-your friends weren't pressuring you to stop drinking, that-that it must be okay.
|
reflection
|
communication behavior
|
34_28
|
And then there's this other part of you that's- was thinking maybe it's not okay.
|
reflection
|
communication behavior
|
34_30
|
So, your gut is telling you what? Tell me about that.
|
question
|
communication behavior
|
34_32
|
And you really wanna do what's best for your babe. And kind of wondering, um, how to move forward from here, is that where you wanna, you know, kind of focus in on, or what are your thoughts about giving up drinking altogether?
|
question
|
communication behavior
|
34_34
|
So, you kind of have this identity, dual identity going on. I wanna be that person, yet, that person-
|
reflection
|
communication behavior
|
34_36
|
Mm. So, embraces this life of the picket fence and the, you know, the little house and having the baby in this-
|
reflection
|
communication behavior
|
34_38
|
So, you don't wanna be that- that- that woman that's just sort of living in this house with the baby carriage, and at the same time, that world's kind of saying it's behind you.
|
reflection
|
communication behavior
|
34_40
|
You care about them.
|
reflection
|
communication behavior
|
34_42
|
It's just the scene that they're-they're still in because their life maybe hasn't taken that change that your life has made. And so now, you're here and you're not sure. You want the baby, but you're not sure about the suburbs and the picket fence thing. You're not sure—
|
reflection
|
communication behavior
|
34_44
|
You don't want that.
|
reflection
|
communication behavior
|
34_46
|
You want this baby.
|
reflection
|
communication behavior
|
34_48
|
And you wanna be, um, take care of your baby as the baby's growing.
|
reflection
|
communication behavior
|
34_50
|
You don't wanna let your baby down.
|
reflection
|
communication behavior
|
34_52
|
And at the same time, it's hard to let go of the past, but on the other hand, you're thinking, "I don't have a choice. I've got to look this way." Is that kind of what it feels like?
|
reflection
|
communication behavior
|
34_54
|
Nina, I'm wondering, what's your hope for the future? When you think about where you are today, um, what do you hope for when you look ahead?
|
question
|
communication behavior
|
34_56
|
You put your heart there that the baby is really- it was almost kind of like a sign for you that was saying, "This baby is giving you a kind of a new chance at life, or giving you a plan B," and you guys both get to decide what plan B is gonna look like.
|
reflection
|
communication behavior
|
34_58
|
While this baby's growing in you and you think of all the opportunities that could come out of this, there's a part of you that says, "I'm still that same girl that was drinking and partying," and-and maybe not living the life you wanted to live.
|
reflection
|
communication behavior
|
34_60
|
While this baby feels like this is your second chance, you're wondering, "Do I deserve that second chance?" And then this other part of you that says, "Why not? It's here and I wanna go for it."
|
reflection
|
communication behavior
|
34_62
|
Mm-hmm. You got a lot of people around you that are kind of pulling it down, and it's kind of taking you back to the old life. And the baby is a constant reminder that there’s this new life ahead.
|
reflection
|
communication behavior
|
34_64
|
When you think about, you know, embracing this new life, and taking that different path, turning away from path A and moving into path B, how confident are you that you can take path B and be successful in raising this baby, and letting go with the drinking and the life that you were in-in path A?
|
question
|
communication behavior
|
34_66
|
Mm-hmm. Tell me more about that, what makes you say, "I have to take that path"? What makes you feel like you need that?
|
question
|
communication behavior
|
34_68
|
This part of you that says, "I don't have an option to-to-to make this life better," it's wondering, "Do I have the confidence to be able to make that life a reality?" What do you think you need to increase your confidence that you can do this?
|
question
|
communication behavior
|
34_70
|
So you're thinking that, um, once your friends see you with the baby in your arms that they too will see that there's a different path for them too?
|
question
|
communication behavior
|
34_72
|
Mm, kind of feel like you're pulled between two worlds there.
|
reflection
|
communication behavior
|
34_74
|
It's not easy to be in that world and also having that constant reminder that the baby is coming and this baby is saying, "I want this better life," and you want to give the baby a better life too. Who can support you, do you think when-when you look around who's in your circle right now, who do you think can support you in moving towards path B?
|
question
|
communication behavior
|
34_76
|
And your parents are a support for you and support you from giving up the drinking, the alcohol use, that's something that they would support-
|
reflection
|
communication behavior
|
34_78
|
Okay.
|
other
|
communication behavior
|
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