A taxonomy of explanations in a general practitioner clinic for patients with persistent “medically unexplained” physical symptoms

Morton, LaKrista, Elliott, Alison, Cleland, Jennifer, Deary, Vincent and Burton, Christopher (2017) A taxonomy of explanations in a general practitioner clinic for patients with persistent “medically unexplained” physical symptoms. Patient Education and Counseling, 100 (2). pp. 224-230. ISSN 0738-3991

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Official URL: http://dx.doi.org/10.1016/j.pec.2016.08.015

Abstract

Objective - To develop a taxonomy of explanations for patients with persistent physical symptoms.

Methods - We analysed doctors’ explanations from two studies of a moderately-intensive consultation intervention for patients with multiple, often “medically-unexplained,” physical symptoms. We used a constant comparative method to develop a taxonomy which was then applied to all verbatim explanations.

Results - We analysed 138 explanations provided by five general practitioners to 38 patients. The taxonomy comprised explanation types and explanation components. Three explanation types described the overall structure of the explanations: Rational Adaptive, Automatic Adaptive, and Complex. These differed in terms of who or what was given agency within the explanation. Three explanation components described the content of the explanation: Facts – generic statements about normal or dysfunctional processes; Causes – person-specific statements about proximal or distal causes for symptoms; Mechanisms – processes by which symptoms arise or persist in the individual. Most explanations conformed to one type and contained several components.

Conclusions - This novel taxonomy for classifying clinical explanations permits detailed classification of explanation types and content. Explanation types appear to carry different implications of agency.

Practice implications - The taxonomy is suitable for examining explanations and developing prototype explanatory scripts in both training and research settings.

Item Type: Article
Uncontrolled Keywords: Medically unexplained symptoms; Somatoform disorders; Explanation; Reassurance; Primary care
Subjects: B900 Others in Subjects allied to Medicine
C800 Psychology
Department: Faculties > Health and Life Sciences > Psychology
Depositing User: Becky Skoyles
Date Deposited: 23 Dec 2016 15:03
Last Modified: 15 Nov 2017 09:45
URI: http://nrl.northumbria.ac.uk/id/eprint/28962

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