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

LaKrista Morton, Alison Elliott, Jennifer Cleland, Vincent Deary, Christopher Burton

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)224-230
Number of pages7
JournalPatient Education and Counseling
Volume100
Issue number2
Early online date17 Aug 2016
DOIs
Publication statusPublished - Feb 2017
Externally publishedYes

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General Practitioners
Medically Unexplained Symptoms
Referral and Consultation
Research

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Morton, LaKrista ; Elliott, Alison ; Cleland, Jennifer ; Deary, Vincent ; Burton, Christopher. / A taxonomy of explanations in a general practitioner clinic for patients with persistent "medically unexplained" physical symptoms. In: Patient Education and Counseling. 2017 ; Vol. 100, No. 2. pp. 224-230.
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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; Burton, Christopher.

In: Patient Education and Counseling, Vol. 100, No. 2, 02.2017, p. 224-230.

Research output: Contribution to journalArticle

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AU - Morton, LaKrista

AU - Elliott, Alison

AU - Cleland, Jennifer

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AU - Burton, Christopher

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PY - 2017/2

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N2 - 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.

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