Toward a model of shared meaningful diagnosis.

Autor: Ledford CJW; Uniformed Services University of the Health Sciences, Bethesda, MD, United States. Electronic address: Christian.ledford@usuhs.edu., Seehusen DA; Augusta University, Augusta, GA, United States., Crawford PF; Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
Jazyk: angličtina
Zdroj: Patient education and counseling [Patient Educ Couns] 2021 Jan; Vol. 104 (1), pp. 143-148. Date of Electronic Publication: 2020 Jul 26.
DOI: 10.1016/j.pec.2020.07.016
Abstrakt: Objectives: The purpose was to explain the process of diabetes-related diagnosis that prompts patient action (behavior change or treatment adherence). A secondary purpose was to identify barriers/gaps that prevent those outcomes.
Methods: Using a grounded theory approach, we explored diagnosis from the patient's perspective and through the lens of the electronic health record (EHR). A thematic analysis was conducted on interview and EHR data from 28 patients, using the constant comparative method.
Results: The emerging model of shared meaningful diagnosis included four stages: stimulus to screen, medical decision making, medical information transfer, and patient sensemaking. Barriers to a meaningful diagnosis emerged in clinical documentation, clinician communication, and patient sensemaking.
Conclusions: This study expands current understanding of "diagnosis," suggesting additional stages between diagnostic labeling and disease management. The additional stages of medical information transfer and patient sensemaking are critical steps to a shared meaningful diagnosis that could enable teamwork among the patient and healthcare team.
Practice Implications: To sustain meaningful diagnosis for the patient, clinicians should document what language they used to explain the diagnosis to the patient so that subsequent clinicians can use similar language. Clinicians who work as a team should unify their approach to discussing prediabetes.
Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest.
(Published by Elsevier B.V.)
Databáze: MEDLINE
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