[Chronic somatic illness--illness diaries written at home give possibilities for communication about the body].
The article presents the development and qualitative evaluation of a clinical communicative method based on illness diaries used in consultations with patients suffering from long-standing illness without clinical findings. The article is based on action research in the authors' own practice. Data were collected from 36 consultations with 16 patients where the illness diary method was applied. Analysis followed a procedure modified from phenomenologically based methodology. The method has gradually been elaborated according to utilization experiences on an interactional level, leading to a more specific presentation of the method and its use. Communicative strategies arising from illness diary utilization could be summarized as: using illness diaries as medical documentation; getting access to the patient's insight; exploring internal dialogues and locked voices; and adding meaning to a spoken message through writing. When the framework of conversation is changed through illness diary utilization towards one or more of these four levels of communication, the patient may become a more equal consultation partner. Illness diaries can provide clinically relevant information and may emphasize the patient's input and significance in medical dialogues on long-standing symptoms without clinical findings.
Stensland
P
P
Seksjon for allmennmedisin, Universitetet i Bergen.
Malterud
K
K
D000293:Adolescent; D000328:Adult; D002648:Child; D003142:Communication; D004282:Documentation; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010817:Physician-Patient Relations; D011602:Psychophysiologic Disorders / Q000503:physiopathology / Q000523:psychology; D012017:Referral and Consultation