Healing Traditions: Alternative Medicine and the Health Professions

By Bonnie Blair O’Connor | Go to book overview

Eliciting the Patient’s
Explanatory Model

The wording of questions will vary with the characteristics of the patient, the problem, and the setting, but we suggest the following set of questions to elicit the patient explanatory model. Patients may often hesitate to disclose their models to doctors. Clinicians need to be persistent in order to show patients that their ideas are of genuine interest and importance for clinical management.

Explanatory Model
1. What do you think caused your problem?
2. Why do you think it started when it did?
3. What do you think your sickness does to you?

How does it work?

4. How severe is your sickness?

Will it have a long or a short course?

5. What kind of treatment do you think you should receive?

Several other questions will elicit the patient’s therapeutic goals and the psychosocial and cultural meaning of his illness, if these issues have not already been incorporated into his answers:

Goals
6. What are the most important results you hope to receive from this treatment?
7. What are the chief problems your sickness has caused for you?
8. What do you fear most about your sickness?

Quoted and adapted from Kleinman, Eisenberg, and Good. “Culture, Illness, and
Care: Clinical Lessons from Anthropologic and Cross-Cultural Research.” Annals of
Internal Medicine
88:251–258, 1978, p. 256. Used by permission.

-207-

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