The ambiguity of preparing and being prepared for a patient consultation

Authors

  • Wibeche Ingskog Oslo University Hospital
  • Wenche S. Bjorbækmo University of Oslo

DOI:

https://doi.org/10.1558/cam.32765

Keywords:

ambiguity, patient consultation, phenomenology, preparing, rare disorders, uncertainty

Abstract

This paper presents findings from a study on the ways in which counsellors working at national centres for rare disorders in Norway experience preparing, and being prepared for, a face-to-face patient consultation. The research involved semi-structured interviews with five experienced counsellors from different health professional backgrounds working at two separate centres. These interviews were then analysed with reference to the theoretical insights of phenomenologists. The excerpts chosen for this paper shed particular light on the process of preparing for a face-to-face patient consultation. Our findings underline the significance of preparing and being prepared while also drawing attention to the multifaceted, complex and ambiguous nature of the processes involved. Preparing for face-to-face consultations with patients is revealed to require approaches that are thoughtful, flexible and empathic. To be prepared for something one does not yet know is about being open to the unexpected and the unpredictable.

Author Biographies

  • Wibeche Ingskog, Oslo University Hospital

    Wibeche Ingskog, who died in March 2018, trained as a nurse before working as a counsellor at the Centre for Rare Disorders at Oslo University Hospital, Rikshospitalet. She received her Master’s of Philosophy in Health Science from the Institute of Health and Society at the University of Oslo. Her research interests included patient communication, phenomenology and counselling within the field of health science and rare disorders.

  • Wenche S. Bjorbækmo, University of Oslo

    Wenche Schrøder Bjorbækmo is a researcher in the research program FYSIOPRIM (Physiotherapy in Primary Care) at the Department of Health Science, University of Oslo, and Professor at the Department of Physiotherapy, Oslo Metropolitan University. Her research interests include phenomenology, body and movement, function as ability/disability and physiotherapy theory and practice with a special focus on knowledge expressed, developed and shared in clinical practice.

References

Arnold, Robert L. and Kathleen Egan (2004) Breaking the ‘bad’ news to patients and families: Preparing to have the conversation about end-of-life and hospice care. American Journal of Geriatric Cardiology 13 (6): 307-312. https://doi.org/10.1111/j.1076-7460.2004.03913.x

Atkinson, Paul (1995) Medical Talk and Medical Work: The Liturgy of the Clinic. London: Sage.

Berkhof, Marianne, Jolanda H. van Rijssen, Antonius J. M. Schellart, Johannes. R. Anema and Allard J. van der Beek (2011) Effective training strategies for teaching communication skills to physicians: An overview of systematic reviews. Patient Education and Counseling 84 (2): 152-162. https://doi.org/10.1016/j.pec.2010.06.010

Boycott, Kym M., Megan R. Vanstone, Dennis E. Bulman and Alex E. MacKenzie (2013) Rare-disease genetics in the era of next-generation sequencing: Discovery to translation. Nature Reviews Genetics 14 (10): 681-691. https://doi.org/10.1038/nrg3555

Browning, David M., Elaine C. Meyer, Robert D. Truog and Mildrid Z. Solomon (2007) Difficult conversations in health care: Cultivating relational learning to address the hidden curriculum. Academic Medicines 82 (9): 905-913. https://doi.org/10.1097/ACM.0b013e31812f77b9

Budych, Karolina, Thomas M. Helms and Carsten Schultz (2012) How do patients with rare diseases experience the medical encounter? Exploring role behavior and its impact on patient-physician interaction. Health Policy 105 (2-3): 154-164. https://doi.org/10.1016/j.healthpol.2012.02.018

Cohen, Julie S. and Barbara B. Biesecker (2010) Quality of life in rare genetic conditions: A systematic review of the literature. American Journal of Medical Genetics 152A (5): 1136-1156. https://doi.org/10.1002/ajmg.a.33380

Connor, Ulla, Marta Anton, Elizabeth Goering, Kathryn Lauten, Amir Hayat, Paris Roach and Stephanie Balunda (2012) Listening to patients’ voices: Linguistic indicators related to diabetes self-management. Communication & Medicine 9 (1): 1-12. https://doi.org/10.1558/cam.v9i1.1

Dastur, Françoise (2000) Phenomenology of the event: Waiting and surprise. Hypatia 15 (4): 178-233. https://doi.org/10.1111/j.1527-2001.2000.tb00360.x

de Haes, Hanneke and Jozien Bensing (2009) Endpoints in medical communication research, proposing a framework of functions and outcomes. Patient Education and Counseling 74 (3): 287-294. https://doi.org/10.1016/j.pec.2008.12.006

Depraz, Natalie (2010) Phenomenology of surprise. In Thomas Nenon and Philip Blosser (eds) Advancing Phenomenology: Essays in Honor of Lester Embree, 223-233. New York: Springer. https://doi.org/10.1007/978-90-481-9286-1_14

Deveugele, Myriam (2015) Communication training: Skills and beyond. Patient Education and Counseling 98 (10): 1287-1291. https://doi.org/10.1016/j.pec.2015.08.011

Dodge, John A., Tamara Chigladze, Jean Donadieu, Zachi Grossman, Feliciano Ramos, Angelo Serlicorni, Liesbeth Siderius, Constantinos J Stefanidis, Velibor Tasic, Arunas Valiulis and Jola Wierzba (2011) The importance of rare diseases: From the gene to society. Archives of Disease in Childhood 96 (9): 791-792. https://doi.org/10.1136/adc.2010.193664

Fioretti, Chiara and Andrea Smorti (2014) Improving doctor-patient communication through an autobiographical narrative theory. Communication & Medicine 11 (3): 275-284. https://doi.org/10.1558/cam.v11i3.20369

Garrino, Lorenza, Elisa Picco, Ivana Finiguerra, Daniela Rossi, Paola Simone and Dario Roccatello (2015) Living with and treating rare diseases: Experiences of patients and professional health care providers. Qualitative Health Research 25 (5): 636-631. https://doi.org/10.1177/1049732315570116

Griffin, Simon J., Ann-Louise Kinmonth, Marijcke W. Veltman, Susan Gillard, Julie Grant and Moira Stewart (2004) Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: A systematic review of trials. Annals of Family Medicine 2 (6): 595-608. https://doi.org/10.1370/afm.142

Grut, Lisbet and Marit H. Kvam (2013) Facing ignorance: People with rare disorders and their experiences with public health and welfare services. Scandinavian Journal of Disability Research 15 (1): 20-32. https://doi.org/10.1080/15017419.2011.645870

Haffner, Marlene E., Janet Whitley and Marie Moses (2002) Two decades of orphan product development. Nature Reviews Drug Discovery 1 (1): 821-825. https://doi.org/10.1038/nrd919

Hagen, Kari and Grethe Hummelvoll (2015) Practical videoconference training: Experience from a Norwegian resource centre for rare disorders. Communication & Medicine 12 (2-3): 199-209. https://doi.org/10.1558/cam.16690

Harrison, Mark E. and Anne Walling (2010) What do we know about giving bad news? A review. Clinical Pediatrics 49 (7): 619-626. https://doi.org/10.1177/0009922810361380

helsenorge.no (2016) Kvalitetssikret helseinformasjon; Hva er en sjelden diagnose? [Quality-Assured Health Information: What constitutes a rare disorder?] Retrieved from: https://helsenorge.no/sjeldne-diagnoser/hva-er-en-sjelden-diagnose

Huyard, Caroline (2009) What, if anything, is specific about having a rare disorder? Patients’ judgements on being ill and being rare. Health Expectations 12 (4): 361-370. https://doi.org/10.1111/j.1369-7625.2009.00552.x

Maguire, Peter and Carolyn Pitceathly (2002) Key communication skills and how to acquire them. British Medical Journal 325 (7366): 697. https://doi.org/10.1136/bmj.325.7366.697

Maiella, Sylvie, Ana Rath, Céline Angin, Florence Mousson and Odile Kremp (2013) Orphanet and its consortium: Where to find expert-validated information on rare diseases / Orphanet et son réseau : où trouver une information validée sur les maladies rares. Revue Neurologique 169 (1): 3-8. https://doi.org/10.1016/S0035-3787(13)70052-3

Merleau-Ponty, Maurice (1964) [1960] Signs. Chicago: Northwestern University Press.

Merleau-Ponty, Maurice (1968) [1964] The Visible and the Invisible: Followed by Working Notes. Chicago, IL: Northwestern University Press.

Merleau-Ponty, Maurice (2012) [1945] Phenomenology of Perception. London: Routledge. https://doi.org/10.4324/9780203720714

Pestoff, Rebecka, Charlotta Ingvoldstad and Heather Skirton (2016) Genetic counsellors in Sweden: Their role and added values in clinical setting. European Journal of Human Genetics 24 (3): 350-355. https://doi.org/10.1038/ejhg.2015.110

Rao, Jaya K., Lynda A. Anderson, Thomas. S Inui and Richard M. Frankel (2007) Communication interventions make a difference in conversations between physicians and patients: A systematic review of the evidence. Medical Care 45 (4): 340-349. https://doi.org/10.1097/01.mlr.0000254516.04961.d5

Salmon, Peter and Bridget Young (2011) Creativity in clinical communication: From communication skills to skilled communication. Medical Education 45 (3): 217-226. https://doi.org/10.1111/j.1365-2923.2010.03801.x

Sarangi, Srikant and Angus Clark (2002) Zones of expertise and the management of uncertainty in genetics risk communication. Research on Language and Social Interaction 35 (2): 139-171. https://doi.org/10.1207/S15327973RLSI3502_2

Slatman, Jenny (2011) [2008] Our Strange Body: Philosophical Reflections on Identity and Medical Interventions. Amsterdam: Amsterdam University Press.

Stone-Goldman, Judy (2013) Make it work: Handling a hard conversation. ASHA Leader 18 (6): 26-27. https://doi.org/10.1044/leader.MIW.18062013.26

Teutsch, Carol (2003) Patient-doctor communication. The Medical Clinics of North America 87 (5): 1115-1145. https://doi.org/10.1016/S0025-7125(03)00066-X

Van Manen, Max (2014) Phenomenology of Practice: Meaning-Giving Methods in Phenomenological Research and Writing. Walnut Creek, CA: Left Coast Press.

Van Manen, Max (2017) Phenomenology in its original sense. Qualitative Health Research 27 (6): 810-825. https://doi.org/10.1177/1049732317699381

von der Lippe, Charlotte, Jan C. Frich, Anna Harris and Kari N. Solbraekke (2017) Treatment of hemophilia: A qualitative study of mothers’ perspectives. Pediatric Blood & Cancer 64 (1): 121-127. https://doi.org/10.1002/pbc.26167

von der Lippe, Charlotte, Plata S. Diesen and Kristin B. Feragen (2017) Living with a rare disorder: A systematic review of the qualitative literature. Molecular Genetics & Genomic Medicine 5 (6): 758-773. https://doi.org/10.1002/mgg3.315 https://doi.org/10.1002/mgg3.315

Zolnierek, Kelly B. and M. Robin DiMatteo (2009) Physician communication and patient adherence to treatment: A meta-analysis. Medical Care 47 (8): 826-834. https://doi.org/10.1097/MLR.0b013e31819a5acc

Published

2020-05-15

Issue

Section

Articles

How to Cite

Ingskog, W., & Bjorbækmo, W. S. (2020). The ambiguity of preparing and being prepared for a patient consultation. Communication and Medicine, 15(3), 282-292. https://doi.org/10.1558/cam.32765

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>