New gateways to dialogue in general practice Development of an illness diary to expand communication

Abstract

Objective - To present the development of a clinical communicative method based on illness diaries.

Design - Action research with qualitative evaluation of experiences leading to the clinical method.

Setting - The practice of one of the authors.

Patients - 16 patients with long-standing illness without clinical findings.

Main outcome measures - Description of the illness diary method grounded in patients' and doctor's experiences.

Results - The illness diary method includes the following approach: The patient presents his symptoms and the doctor may suggest the use of an illness diary. Together, they shape the format of the diary and identify items to be included. The patient uses the diary for home notes between consultations. The notes constitute the frame for a fresh dialogue about the complaints in the next consultation. The method has gradually been elaborated according to utilization experiences on an interactional level, leading to a more specific presentation of the method and how it can be used.

Conclusion - An illness diary and the subsequent doctor-patient interaction can be a feasible tool to expand the gateways to dialogue in general practice.

Key Words:

• general practice
• psychosomatic
• clinical method
• patient-centred method
• qualitative evaluation
• diary