Doctors' voices in patients' narratives: coping with emotions in storytelling.
OBJECTIVE
To understand doctors' impacts on the emotional coping of patients, their stories about encounters with doctors are used. These accounts reflect meaning-making processes and biographically contextualized experiences. We investigate how patients characterize their doctors by voicing them in their stories, thus assigning them functions in their coping process.


METHODS
394 narrated scenes with reported speech of doctors were extracted from interviews with 26 patients with type 2 diabetes and 30 with chronic pain. Constructed speech acts were investigated by means of positioning and narrative analysis, and assigned into thematic categories by a bottom-up coding procedure.


RESULTS
Patients use narratives as coping strategies when confronted with illness and their encounters with doctors by constructing them in a supportive and face-saving way. In correspondence with the variance of illness conditions, differing moral problems in dealing with doctors arise. Different evaluative stances towards the same events within interviews show that positionings are not fixed, but vary according to contexts and purposes.


CONCLUSIONS
Our narrative approach deepens the standardized and predominantly cognitive statements of questionnaires in research on doctor-patient relations by individualized emotional and biographical aspects of patients' perspective. Doctors should be trained to become aware of their impact in patients' coping processes.
Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany. lucius@psychologie.uni-freiburg.de
Gabriele
G
Lucius-Hoene
Ulrike
U
Thiele
Martina
M
Breuning
Stephanie
S
Haug
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003142:Communication; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology; D037001:Directive Counseling; D004644:Emotions; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D033262:Narration; D010146:Pain; D010465:Perception; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011594:Psychometrics; D013315:Stress, Psychological / Q000523:psychology*