NEW GATEWAYS TO DIALOGUE IN GENERAL-PRACTICE - DEVELOPMENT OF AN ILLNESS DIARY TO EXPAND COMMUNICATION

Objective -To present the development of a clinical communicative meth od based on illness diaries. Design -Action research with qualitative evaluation of experiences leading to the clinical method. Setting -The practice of one of the authors. Patients -16 patients with long-stand ing illness without clinical findings. Main outcome measures -Descript ion of the illness diary method grounded in patients' and doctor's exp eriences. Results -The illness diary method includes the following app roach: The patient presents his symptoms and the doctor may suggest th e use of an illness diary. Together, they shape the format of the diar y and identify items to be included. The patient uses the diary for ho me notes between consultations. The notes constitute the frame for a f resh dialogue about the complaints in the nest consultation. The metho d has gradually been elaborated according to utilization experiences o n an interactional level, leading to a more specific presentation of t he method and how it can be used. Conclusion -An illness diary and the subsequent doctor-patient interaction can be a feasible tool to expan d the gateways to dialogue in general practice.