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Related Experiment Videos

Knowledge structures in illness narratives: development and reliability of a coding scheme.

Lara Stern1, Laurence J Kirmayer

  • 1McGill University. lara.stern@mail.mcgill.ca

Transcultural Psychiatry
|June 3, 2004
PubMed
Summary

Patients use diverse knowledge structures, not just explanatory models, to describe their illnesses. This study identified prototypes, chain complexes, and explanatory accounts in illness narratives, offering new analytical tools.

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Area of Science:

  • Medical Anthropology
  • Sociology of Health and Illness
  • Qualitative Research Methods

Background:

  • Illness narratives are crucial for understanding patient perspectives.
  • Existing research primarily focuses on explanatory models of illness.
  • Patients may employ various knowledge structures beyond explanatory models to articulate their experiences.

Purpose of the Study:

  • To operationalize and code three distinct knowledge structures: prototypes, chain complexes, and explanatory accounts.
  • To analyze the presence and reliability of these structures in patient illness narratives.
  • To provide a framework for investigating the role of knowledge structures in shaping illness conceptions.

Main Methods:

  • Development of operational definitions and a coding manual for prototypes, chain complexes, and explanatory accounts.

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  • Application of the coding manual to a sample of illness narratives from an urban community help-seeking study.
  • Reliability testing of the identification of the three knowledge structures within the narratives.

    • Main Results:

    • All three defined knowledge structures (prototypes, chain complexes, explanatory accounts) were reliably identified in the analyzed illness narratives.
    • Demonstrated the feasibility of using the developed coding system to analyze patient-generated illness descriptions.
    • Highlighted the presence of diverse cognitive frameworks in how individuals conceptualize and communicate their symptoms.

    Conclusions:

    • Illness narratives are constructed using multiple types of knowledge schemas, not solely explanatory models.
    • The developed methodology offers a reliable approach to analyzing these diverse knowledge structures in patient accounts.
    • This research opens avenues for further investigation into how different knowledge structures influence illness perception and help-seeking behaviors.