‘No problem’ advice during occupational health examinations


  • Elina Weiste Finnish Institute of Occupational Health
  • Timo Leino Finnish Institute of Occupational Health
  • Jaana Laitinen Finnish Institute of Occupational Health




advice giving, client problem, client resistance, institutional conversation analysis, occupational health examination


In many countries, occupational health examinations are considered to have a central role in ensuring that employees’ health and work ability are maintained or enhanced. In contemporary Finland, the institutional goal of these examinations is to construct a health plan based on the client’s own aims, and in this paper we analyse how occupational health nurses and clients in Finland negotiate what is considered to be a problem. The data consist of 10 video-recorded occupational health examination encounters, analysed by means of conversation analysis. Our analysis focuses on ‘no problem’ advice, in which the advice giving is initiated in the absence of a problem-indicative response. The client’s ‘no problem’ response was typically followed by the nurse upgrading the problem that she had identified and giving a general reminder of a possible problem. The clients resisted not so much the content of the advice, but the act of advising itself. In a few cases, the client’s ‘no problem’ response was followed by a turn in which the nurse contested the client’s knowledge and offered advice that was tailored to the client’s situation. The client acknowledged the advice as new information. Our findings indicate that regardless of client-centred ideals, the interaction in occupational health examinations is largely led by nurses, who set up the agenda and raise issues that they consider to be problems for their clients.

Author Biographies

Elina Weiste, Finnish Institute of Occupational Health

Elina Weiste is a Doctor of Social Sciences whose expertise is in conversation analysis and healthcare communication. She has studied clinician–client interaction in different types of rehabilitational, therapeutic and counselling settings.

Timo Leino, Finnish Institute of Occupational Health

Timo Leino is a Doctor of Medical Sciences and an Adjunct Professor in Occupational Health Services. His study interests are the quality and effectiveness of occupational health services, good occupational health practices, health promotion, disability management and ICT-based solutions in occupational health practices and education.

Jaana Laitinen, Finnish Institute of Occupational Health

Jaana Laitinen, Adjunct Professor, specialises in health promotion in workplaces. She has planned, executed and led several health-promotion projects that have used counselling to promote lifestyle changes and enhance work ability among different target groups.


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How to Cite

Weiste, E., Leino, T., & Laitinen, J. (2021). ‘No problem’ advice during occupational health examinations. Communication and Medicine, 16(3), 280–291. https://doi.org/10.1558/cam.37849