Approaching the locked dialogues of the body: Communicating symptoms through illness diaries

Abstract

Objective - To describe and analyse communication following the use of an illness diary method in consultations with patients suffering from longstanding illness without clinical findings. Design - Action research in own practice with qualitative formative evaluation of material provided by the use of the diary method. Analysis followed a procedure modified from phenomenologically-based methodology. Setting - The practice of the main author. Subjects - 36 consultations with 16 patients where the illness diary method was applied. Result - Communication following illness diary utilisation could be summarised as: 1) illness diaries as medical documentation, 2) making access to the insight of the patient, 3) exploring internal dialogues and locked voices, and 4) adding meaning to a spoken message through writing (creative distance). By changing the frames of conversation through illness diary utilisation towards one or more of these four levels of communication, the patient may become a more equal consultation partner. Conclusion - Illness diaries can provide clinically relevant information and may emphasise the patient's input and significance in medical dialogues on longstanding symptoms without clinical findings.