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.
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.
| Original language | English |
|---|---|
| Pages (from-to) | 224–230 |
| Number of pages | 7 |
| Journal | Patient Education and Counseling |
| Volume | 100 |
| Issue number | 2 |
| Early online date | 17 Aug 2016 |
| DOIs | |
| Publication status | Published - 1 Feb 2017 |
Bibliographical note
MSS1 and MSS2 were supported by grants from the Chief Scientist Office of the Scottish Government (references CZG/2/412 and CZH/4/945). We are grateful to the general practitioners and patients who participated in these studies.Keywords
- medically unexplained symptoms
- somatoform disorders
- explanation
- reassurance
- primary care