Co-construction of illness narratives in medical encounters
Research type
Research Study
Full title
Co-construction of illness narratives in medical encounters: a qualitative secondary data analysis of the One in a Million study.
IRAS ID
232578
Contact name
Sarah Nettleton
Contact email
Sponsor organisation
University of York
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
The objective of the proposed research is to explore if and if so how illness narratives are co-constructed within consultations between doctors and patients. The study will analyse consultation recordings and verbatim transcripts of doctor patient interactions from the One-in-a-Million archive in the UK. The One-in-a-Million study comprises an archived data base of primary care medical consultations held at Bristol University (ethically approved by Central Bristol NHS REC, REF:14/SW/0112). The data collection was funded by the NIHR School for Primary Care Research (Ref: 208) to create a database of video-recorded consultations, transcripts and linked data that could be shared for future research and secondary data analysis.
Consultations will be selected from the database on the following conditions: musculo-skeletal, psychological, digestive, cardiovascular, general and unspecified, neurological and endocrine/metabolic and nutritional - to allow for a comparison across health and illness concerns.
Qualitative interpretive inductive thematic analysis will be used to explore these naturally occurring clinical consultations. In practice the analytic procedures will involve: observing and interpreting the archived consultations; identifying factor facilitating constructive interactions; categorising; and identifying optimum conditions for successful clinical encounters.
This will then enable the team to identify the processes involved in the co-construction of illness narratives, which is the main aim of the study. This includes several aspects: constructing a diagnosis, etiological explanations and treatment options. Our study design is based on a sociological perspective, meaning that we seek to understand doctor-patient interactions within the wider socio-cultural contexts that permeate clinical consultations. The findings of the research will contribute to our understandings of processes of shared decision-making, satisfaction and dissatisfaction with consultations for both doctors and patients and enhance the scope for developing person-centred care.
The proposed study is exploratory and the analysis will be used to inform research applications for funding to carrying out more detailed research.
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
18/WM/0008
Date of REC Opinion
9 Jan 2018
REC opinion
Favourable Opinion