title: Facilitating narrative medical discussions of type 1 diabetes with computer visualizations and photography.
abstract: OBJECTIVE
  Patient-centered approaches to medicine suggest the need for physicians to become more aware of concerns and needs expressed in patient narratives. However, patients and physicians have different goals and discourse styles during consultations. We attempt to bridge these differences by providing patients with ways to collect, visualize, and describe behavioral and biomedical data.
  
  
  METHODS
  We describe an intervention where individuals with type 1 diabetes photograph health-related behaviors. These images and blood glucose records are displayed in computer visualizations and used during patient-physician interviews.
  
  
  RESULTS
  Qualitative analyses of interview data with patients who photographed their lives suggest the range of difficulties associated with diabetes self-management. The visualizations helped them articulate concerns about stress, peer relations, and unhealthy routines.
  
  
  CONCLUSIONS
  Interventions that combine biomedical and biopsychosocial data during patient-physician consultations may be beneficial for patients, helping them reflect on correlations between behaviors and health. Physicians are provided with contextual evidence to better understand patient issues around diabetes management.
  
  
  CONCLUSIONS
  We suggest that this and similar interventions could be used as an occasional diagnostic to help patients articulate stories of their health-related practices. Annotated archives of photographs and glucose data may also be useful tools for sharing diabetes experiences with newly diagnosed patients.
authors.affiliation: Colleges of Information Sciences & Technology and Education, The Pennsylvania State University, University Park, PA 16802, USA. bsmith@ist.psu.edu
authors.forename: Brian K
authors.initials: BK
authors.lastname: Smith
authors.forename: Jeana
authors.initials: J
authors.lastname: Frost
authors.forename: Meltem
authors.initials: M
authors.lastname: Albayrak
authors.forename: Rajneesh
authors.initials: R
authors.lastname: Sudhakar
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001294:Attitude to Health; D015190:Blood Glucose Self-Monitoring; D003142:Communication; D017281:Cost of Illness; D003625:Data Collection; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D033262:Narration; D010353:Patient Education as Topic; D018802:Patient-Centered Care; D010781:Photography / Q000458:organization & administration; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000458:organization & administration