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dc.contributor.authorSheaff, Rod
dc.contributor.authorHalliday, J
dc.contributor.authorByng, Richard
dc.contributor.authorØvretveit, J
dc.contributor.authorExworthy, M
dc.contributor.authorPeckham, S
dc.contributor.authorAsthana, Sheena
dc.date.accessioned2017-05-15T10:25:55Z
dc.date.available2017-05-15T10:25:55Z
dc.date.issued2017-07-31
dc.identifier.issn0141-9889
dc.identifier.issn1467-9566
dc.identifier.urihttp://hdl.handle.net/10026.1/9244
dc.description.abstract

<jats:title>Abstract</jats:title><jats:p>For older people with multiple chronic co‐morbidities, strategies to coordinate care depend heavily on information exchange. We analyse the information‐sharing difficulties arising from differences between patients’ oral narratives and medical sense‐making; and whether a modified form of ‘narrative medicine’ might mitigate them. We systematically compared 66 general practice patients’ own narratives of their health problems and care with the contents of their clinical records. Data were collected in England during 2012–13. Patients’ narratives differed from the accounts in their medical record, especially the summary, regarding mobility, falls, mental health, physical frailty and its consequences for accessing care. Parts of patients’ viewpoints were never formally encoded, parts were lost when clinicians de‐coded it, parts supplemented, and sometimes the whole narrative was re‐framed. These discrepancies appeared to restrict the patient record's utility even for <jats:styled-content style="fixed-case">GP</jats:styled-content>s for the purposes of risk stratification, case management, knowing what other care‐givers were doing, and coordinating care. The findings suggest combining the encoding/decoding theory of communication with inter‐subjectivity and intentionality theories as sequential, complementary elements of an explanation of how patients communicate with clinicians. A revised form of narrative medicine might mitigate the discursive gap and its consequences for care coordination.</jats:p>

dc.format.extent1019-1034
dc.format.mediumPrint-Electronic
dc.languageen
dc.language.isoen
dc.publisherWiley
dc.subjectcare coordination
dc.subjectinformational continuity of care
dc.subjectgeneral practice
dc.subjectEngland
dc.subjectelectronic patient record
dc.subjectpatient discourse
dc.subjectnarrative medicine
dc.titleBridging the discursive gap between lay and medical discourse in care coordination
dc.typejournal-article
dc.typeJournal Article
plymouth.author-urlhttps://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000410766100003&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008
plymouth.issue7
plymouth.volume39
plymouth.publication-statusAccepted
plymouth.journalSociology of Health and Illness
dc.identifier.doi10.1111/1467-9566.12553
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA20 Social Work and Social Policy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/FoH - Community and Primary Care
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CCT&PS
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
plymouth.organisational-group/Plymouth/Users by role/Researchers in ResearchFish submission
dc.publisher.placeEngland
dcterms.dateAccepted2016-12-07
dc.identifier.eissn1467-9566
dc.rights.embargoperiodNo embargo
rioxxterms.versionofrecord10.1111/1467-9566.12553
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2017-07-31
rioxxterms.typeJournal Article/Review
plymouth.oa-locationhttp://onlinelibrary.wiley.com/doi/10.1111/1467-9566.12553/full


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