Show simple item record

dc.contributor.authorØstbye, Silje Vagli
dc.contributor.authorWang, Catharina Elisabeth Arfwedson
dc.contributor.authorGranheim, Ida Pauline Høilo
dc.contributor.authorKristensen, Kjersti Elisabeth
dc.contributor.authorRisør, Mette Bech
dc.date.accessioned2018-09-26T11:44:09Z
dc.date.available2018-09-26T11:44:09Z
dc.date.issued2018-09-24
dc.description.abstract<p><i>Background</i>: Early adolescence is considered a critical period for the development of chronic and recurrent medically unexplained symptoms (MUS), and referrals and system-initiated patient trajectories often lead to an excess of examinations and hospitalizations in the cross-section between mental and somatic specialist care for this group of patients. Dimensions of the relationship and communication between clinician and patient are shown in primary care studies to be decisive for subsequent illness pathways, often creating adverse effects, but knowledge on clinical communication in specialist care is still scarce.</p> <p><i>Methods</i>: This study explores communicative challenges specific to clinical encounters between health professionals and adolescent patients in specialist care, as presented through interviews and focus group data with highly experienced specialists working in adolescent and child services at a Norwegian university hospital.</p> <p><i>Results</i>: The results are presented in a conceptual model describing the epistemological and methodological paradoxes inherent in the clinical uncertainty of MUS. Within these paradoxes, the professionals try to solve the dilemmas by being creative in their communication strategies; applying metaphors and other rhetorical devices to explain complex ideas; creating clinical prototypes as a way to explain symptoms and guide them in clinical action; relying on principles from patient-centered care involving empathy; and trying to balance expertise and humility.</p> <p><i>Conclusion</i>: The challenges in communication arise as a result of opposing discourses on biomedicine, family, health and adolescence that create dilemmas in everyday clinical work. By moving away from a positivist and biomedical framework towards an interpretive paradigm, where culturally derived and historically situated interpretations are used to understand the social life-world of the patient, one can create a more humane health service in accordance with ideals of patient-centered care.</p>en_US
dc.identifier.citationØstbye, S.V., Wang, C.E.A., Granheim, I.P.H., Kristensen, K.E. & Risør, M.B. (2018). Epistemological and methodological paradoxes: secondary care specialists and their challenges working with adolescents with medically unexplained symptoms. International Journal of Mental Health Systems, 12(52). https://doi.org/10.1186/s13033-018-0232-0en_US
dc.identifier.cristinIDFRIDAID 1613575
dc.identifier.doidoi.org/10.1186/s13033-018-0232-0
dc.identifier.issn1752-4458
dc.identifier.urihttps://hdl.handle.net/10037/13869
dc.language.isoengen_US
dc.publisherBMCen_US
dc.relation.ispartofØstbye, S.V. (2020). Terrains of Uncertainty. Communicative Challenges of Medically Unexplained Illness in Youth. (Doctoral thesis). <a href=https://hdl.handle.net/10037/19204>https://hdl.handle.net/10037/19204</a>
dc.relation.journalInternational Journal of Mental Health Systems
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Samfunnsvitenskap: 200::Psykologi: 260en_US
dc.subjectVDP::Social science: 200::Psychology: 260en_US
dc.subjectAdolescentsen_US
dc.subjectMedically unexplained symptomsen_US
dc.subjectCommunicationen_US
dc.subjectClinical encountersen_US
dc.subjectSpecialist careen_US
dc.titleEpistemological and methodological paradoxes: secondary care specialists and their challenges working with adolescents with medically unexplained symptomsen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


File(s) in this item

Thumbnail

This item appears in the following collection(s)

Show simple item record