• Scand J Prim Health Care · Jan 2008

    Diagnostic interaction: the patient as a source of knowledge?

    • Merete Undeland and Kirsti Malterud.
    • Department of Neurology, Buskerud Hospital Trust, Drammen, Norway. merete.undeland@sb-hf.no
    • Scand J Prim Health Care. 2008 Jan 1; 26 (4): 222227222-7.

    ObjectiveTo explore diagnostic interaction to understand more about why some problems appear medically unexplained.DesignA qualitative discourse analysis case study.SettingEncounters between women patients and general practitioners in primary healthcare.SubjectsMicroanalysis of two audiotaped consultations without a clear-cut diagnosis and opposing levels of mutuality between doctor and patient.Main Outcome MeasuresDescriptions of linguistic patterns in diagnostic interaction.ResultsTwo patterns were identified demonstrating how different ways of speech acts contribute or obstruct diagnostic interaction and common ground for understanding. To invite or reject the patient into/from the diagnostic process, and to recognize or stereotype the patient may impose on how illness stories are perceived as medically unexplained.ConclusionMaking sense of illness can be enhanced by inviting and recognizing the patient's story.

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