[Believe in communication and support the patient!].
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Clinical Competence↗
Biomedical subjects
Per Stensland
Publications and source records attributed to Per Stensland.
[Approaching the locked dialogues of the body].
BACKGROUND: The objective of this project was to develop a clinical communication tool to change locked dialogues between doctor and patient in general practice consultations. The target group was patients suffering from long-standing symptoms without clinical findings. Patients were encouraged to keep an illness diary or to write personal notes on their illness as a tool for cooperating with the doctor. MATERIAL AND METHODS: The material was collected from 36 consultations with 16 patients. The qualitative evaluation aimed at giving a description and analysis of how the illness diary affected the doctor-patient dialogue in the consultation. The analysis was modified from phenomenology-based methodology. A part of the project dealt with the methodological problems of doing research on an interaction in which the general practitioner is both participant (doctor) and observer (researcher). RESULTS AND INTERPRETATION: The diary enhanced the doctor's basis for clinical decision making by giving medically relevant information from the patient and by producing more concrete information. The diary gave the doctor access to patients' insight in their own problems. The clinical dialogue modified the patient's negative internal monologues in order to search for alternate dialogues as a basis for personal coping strategies. The project demonstrated that written notes might give patient and doctor a new understanding of a previously spoken message. The writing procedure gave patients an opportunity to reflect upon their illness presentation.
Communication↗
Action research on own practice. Methodological challenges.
OBJECTIVE: Using experiences from a study on clinical communication, the objective was to clarify the methodological challenges that general practitioners are faced with when researching their own practice. DESIGN: A case study of the methodological challenges of an action research project in which the researcher is both participating observer and observing participator. The material comprised notes and transcripts from audiotapes, and was investigated with a view to highlighting experiences that might facilitate the research process. SETTING: The practice of the author. SUBJECTS: 36 consultations with 16 patients during which the illness diary method was applied. RESULTS: The challenges of the project are presented as turning-point stories, i.e. stories demonstrating relations, perspective shifts and metapositions. Perspective shifts were established by introspection through dialogues with oneself, and by relation to helpers through dialogues with patients and supervisors. Reflexivity was promoted by combining pictures from different perspectives. CONCLUSION: It is possible and sensible to study oneself in interaction. The information gained from carefully designed research in one's own practice could be an underestimated source of valuable knowledge about the personal and existential aspects of clinical medicine.
Family Practice↗