Medical explanations and lay conceptions of disease and illness in doctor–patient interaction

Nordby, Halvor

doi:10.1007/s11017-008-9080-2

Cited by 18 publications

(22 citation statements)

References 14 publications

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“…Patients typically think of themselves as consumers of technical medical terms in the sense that they normally defer to health professionals' explanations of meaning. It is at the same time well documented that patients tend to think they are entitled to understand lay health terms like 'sickness' and 'illness' in ways that do not necessarily correspond to health professionals' understanding [24].…”

Section: The Medical Consultation Process From Social Psychologymentioning

confidence: 99%

Psychology of doctor-patient relationship in general medicine

Turabián¹

2019

Arch Community Med Public Health

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The transcendence of psychological factors of the doctor-patient relationship is given by the fact of its infl uence on results and quality of medical care, improvement in compliance, satisfaction and recall of physician information, and plays a fundamental role in the medical care process: the skills Listening and communication are fundamental parts to make the diagnosis and treatment. Some of these positive consequences arise from the fact that relationships are linked to emotions which have a physiological substrate. The different psychological behaviors of the patient and the doctor (such as verbal and nonverbal communication, affective behavior, beliefs, empathy, listening), symptom perception, shared decision, negotiation, information, persuasion, etc., give different types of relationship. In doctor-patient relationship there is a modality of psychotherapy, where the treatment is based on that relationship, in which the general practitioner and the patient work together to improve psychopathological conditions through the focus on the therapeutic relationship, which brings consequences on thoughts, emotions, and behaviors. The therapeutic function of the doctor-patient relationship can be understood in analogy to dialysis, in which the patient experience of illness passes through the clinician's compassionate equanimity for affective detoxifi cation and cognitive clarifi cation. Also, the work of the general practitioner can be understood as a psycho-physiological doctor-patient relationship process through which the doctor and the patient can infl uence the health of the other. Doctor-patient relationship evaluation has to be carried out jointly by both, doctor and patient, on the effect that both are achieving with that relationship. "The disease is like removing the soil where a tree is planted: the roots are exposed, and you can see how deep and strong they are." Virginia Woolf (1882-1941; English writer).

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Section: The Medical Consultation Process From Social Psychologymentioning

confidence: 99%

Psychology of doctor-patient relationship in general medicine

Turabián¹

2019

Arch Community Med Public Health

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“…According to the theory of implicit conceptions, such deference to patient's meaning can be sufficient for concept communication. As shown above, all that matters is that nurses and patients defer to the same norms of meaning -the source of these norms is not important (Wright, 1984;Nordby, 2008). Consider for example the following case: 2 A nurse is talking to a patient who uses lay health terms such as 'pain', 'ill' and 'sick' to describe his experiences of illness.…”

Section: Practical Implicationsmentioning

confidence: 99%

The meaning of illness in nursing practice: a philosophical model of communication and concept possession

Nordby

2016

Nursing Philosophy

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It is fundamental assumption in nursing theory that it is important for nurses to understand how patients experience states of ill health. This assumption is often related to aims of empathic understanding, but normative principles of social interpretation can have an important action-guiding role whenever nurses seek to understand patients' subjective horizons on the basis of active or passive expressions of meaning. The aim of this article is to present a philosophical theory of concept possession and to argue that it can shed light on how nurses should seek to understand patients' subjective perspectives on the meaning of illness. The two basic ideas in the theory are that patients' beliefs and thoughts about their experiences involve concepts and that concepts can be communicated on the basis of shared implicit conceptions of what they mean. These conditions of understanding have a striking application: nurse-patient communication is limited by many contextual factors, but it is often possible for nurses to detect shared implicit conceptions of the meaning of concepts of disease and illness. Furthermore, by acting as sympathetic linguistic experts and creating an atmosphere for dialogue, nurses can make patients feel comfortable about deferring to medical explanations of meaning that can constitute a communicative platform. The last part of the article uses a number of cases studies to show how these implications can be implemented as conceptual tools for securing meaningful communication about illness experiences in patient dialogue.

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“…Other researchers study what we call patients in health policy [41], mental health [42], and particularly obstetrics [43]. Finally, health care professional language is itself a subject of much study, inasmuch as it relates to patient comprehension of the language and its impact on the patient receiving it (Nordby provides an excellent summary [44]). Researchers consider seman-tic gaps in the meaning of ''asthma'' [45], ''life expectancy'' [46], ''gift'' (in the context of organ donation) [47], ''back pain'' [48], ''black'' and ''white'' (in the context of moral values) [49], and ''euthanasia'' and ''assisted suicide'' [50].…”

Section: Patient Language: Medical and Nursing Literaturementioning

confidence: 99%