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Patients’ experiences of healthcare encounters in severe irritable bowel syndrome: an analysis based on narrative and feminist theory

Artikel i vetenskaplig tidskrift
Författare Ida Björkman
Magnus Simrén
Gisela Ringström
Eva Jakobsson Ung
Publicerad i Journal of Clinical Nursing
Volym 25
Nummer/häfte 19-20
Sidor 2967-2978
ISSN 1365-2702
Publiceringsår 2016
Publicerad vid Centrum för personcentrerad vård vid Göteborgs universitet (GPCC)
Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Sidor 2967-2978
Språk en
Länkar dx.doi.org/10.1111/jocn.13400
Ämnesord feminist theory, functional disorder, healthcare encounters, irritable bowel syndrome, narrative, patient experience, power relations
Ämneskategorier Klinisk medicin

Sammanfattning

Aims and objectives: This study aimed to explore patients’ experiences of healthcare encounters in severe irritable bowel syndrome. Background: Irritable bowel syndrome is a common functional disorder with symptoms such as abdominal pain and disturbed bowel habits, the cause of which is not completely known. Treatments options are limited, and healthcare encounters in irritable bowel syndrome have been described as unsatisfying and frustrating for both patients and professional healthcare providers. Furthermore, the influence of power on healthcare encounters has long been recognised, especially regarding the disadvantaged position of those suffering from functional illness which cannot be identified by commonly used tests or investigations. Methods: We interviewed 10 patients during 2014, all attending an outpatient clinic and suffering from severe irritable bowel syndrome. Relying on narrative and feminist theory, we explored how they actively negotiate professional discourse communicated to them in the clinical encounter. Results: The patients’ experiences of healthcare encounters in irritable bowel syndrome were mostly described as negative, and often induced feelings of confusion and self-doubt. Positive encounters were described as being listened to, believed and taken seriously. Narrators found it especially problematic when healthcare professionals described irritable bowel syndrome as a minor disorder with primarily stress or psychological aetiology and put the responsibility for recovery onto the patient. Patients’ actively negotiated such professional discourse by presenting a counternarrative describing their own suffering and strengths, experienced healthcare shortcomings and possible organic aetiology of irritable bowel syndrome. Conclusions: Patients suffering from severe irritable bowel syndrome described how they often felt a need to protect their positive identities in the face of trivialisation and disbelief by healthcare professionals. Relevance to clinical practice: A deepened understanding of patients’ experiences of healthcare encounters in irritable bowel syndrome could enable more helpful and supporting interventions by healthcare professionals. © 2016 John Wiley & Sons Ltd

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