{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T21:01:17Z","timestamp":1785445277270,"version":"3.56.0"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Inquiry"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Older adults' experiences of primary care are shaped not only by service capacity but by the language and routines through which access and care are organised. Using a qualitative Critical Discourse Studies (CDS) approach informed by the bioethics of vulnerability, we analysed interviews and focus groups with 12 community\u2010dwelling older adults living alone in southern Spain. Critical Discourse Analysis (CDA) linked micro\u2010level talk to meso\u2010level scripts and macro\u2010rationales. Participants portrayed appointment systems and digital channels as gatekeeping devices that shifted agency to family \u2018brokers\u2019, with telephone and app\u2010based booking often producing situational\u2014or, after repeated failures, pathogenic\u2014vulnerability. In consultations, haste, technical jargon and the \u2018doctor\u2013patient\u2013computer\u2019 triad curtailed understanding; age\u2010based commonplaces (e.g., \u2018what do you expect at your age\u2019) legitimised truncated responses; discontinuity with physicians contrasted with nurse\u2010led clarity and vigilance. Emotional sequelae included strategic silence and reduced help\u2010seeking. We argue that vulnerability here is produced rather than intrinsic and can be mitigated via human\u2010assisted booking parity, plain\u2010language and teach\u2010back as safety practices, continuity\u2010by\u2010design, and explicit de\u2010ageing of triage and policy scripts. Communicative justice emerges as a core condition for equitable care in later life.<\/jats:p>","DOI":"10.1111\/nin.70089","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:04:42Z","timestamp":1772985882000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Communicative Justice in Later Life: A Critical Discourse Study and Bioethics\u2010of\u2010Vulnerability Analysis of Older Adults' Primary Care in Spain"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1515-2210","authenticated-orcid":false,"given":"Pablo","family":"Mart\u00ednez\u2010Angulo","sequence":"first","affiliation":[{"name":"Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing University of C\u00f3rdoba (UCO) C\u00f3rdoba Spain"},{"name":"Maimonides Institute for Biomedical Research of C\u00f3rdoba (IMIBIC), Reina Sof\u00eda University Hospital C\u00f3rdoba University C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Mill\u00e1n\u2010Eslava","sequence":"additional","affiliation":[{"name":"Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing University of C\u00f3rdoba (UCO) C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2018.10.006"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2014.11.024"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.37955"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X712289"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12232454"},{"issue":"3","key":"e_1_2_13_7_1","first-page":"1","article-title":"Spain: Health System Review","volume":"26","author":"Bernal\u2010Delgado E.","year":"2024","journal-title":"Health Systems in Transition"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0220857"},{"key":"e_1_2_13_9_1","unstructured":"Consejo General de la Psicolog\u00eda de Espa\u00f1a (INFOCOP).2024. \u201cEl 40% de espa\u00f1oles espera entre 1 y 3 meses para tener cita con un especialista en salud mental [40% of Spaniards Wait Between 1 and 3 Months for an Appointment With a Mental Health Specialist].\u201d Press release.https:\/\/www.infocop.es\/el-40-de-espanoles-espera-entre-1-y-3-meses-para-tener-cita-con-un-especialista-en-salud-mental."},{"key":"e_1_2_13_10_1","unstructured":"Defensor del Pueblo.2024. \u201cInforme Anual 2023 [Annual Report 2023].\u201d Press release.https:\/\/www.defensordelpueblo.es\/wp-content\/uploads\/2024\/03\/Defensor-del-Pueblo_Informe-anual-2023.pdf."},{"key":"e_1_2_13_11_1","unstructured":"Defensor del Pueblo Andaluz.2024. \u201cInforme anual 2023 [Annual Report 2023].\u201d Press release.https:\/\/www.defensordelpuebloandaluz.es\/sites\/default\/files\/informe-anual-2024\/informe\/balance-del-defensor.php."},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-03131-2"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781315739342-3"},{"key":"e_1_2_13_14_1","volume-title":"Digital Economy and Society Statistics\u2014Households and Individuals","author":"Eurostat","year":"2024"},{"key":"e_1_2_13_15_1","volume-title":"Language and Power","author":"Fairclough N.","year":"2015"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/20552076221120724"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep14040295"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/20552076241282247"},{"key":"e_1_2_13_19_1","unstructured":"Instituto Nacional de Estad\u00edstica (INE).2024a. \u201cPadr\u00f3n municipal: Poblaci\u00f3n por municipios [Municipal Register: Population 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