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Challenging the biopsychosocial model in a chronic constipation clinic.

Wainwright, Megan and Russell, Andrew and Yiannakou, Yan (2011) 'Challenging the biopsychosocial model in a chronic constipation clinic.', Qualitative health research., 21 (12). pp. 1643-1657.


In this article we discuss the results of an ethnographic study of professionals’ and patients’ experiences within a specialist constipation clinic in England. Chronic constipation tends to be poorly understood and inadequately treated. Eleven patients were followed through their illness trajectory during a 5-month fieldwork period, involving 21 home interviews, clinic-based interviews, participant observation, and a focus group. Professionals were likewise observed and interviewed. The clinic could be broadly described as biopsychosocial in its approach. However, professionals expressed uncertainty about how best to provide biopsychosocial care and suggested that some patients were not “open” to psychosocial therapies or to discussing psychosocial aspects of their disease. Patients’ concerns were with being taken seriously, receiving treatment, and narrating intersections of life events, emotional well-being, and the bowels. We situate these findings within the discourse of “functional” disorders and discuss why implementing a biopsychosocial approach is problematic in this case.

Item Type:Article
Keywords:Anthropology, Ethnography, Health care professionals, Health care, Users’ experiences, Illness and disease, Chronic, Narrative inquiry, Observation, Participant, Pain, Chronic, Relationships, Health care, Sensitive topics
Full text:(AM) Accepted Manuscript
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Publisher statement:The final definitive version of this article has been published in the Journal Qualitative health research 21/12, 2011 © SAGE Publications Ltd by SAGE Publications Ltd at the Qualitative health research page: on SAGE Journals Online:
Date accepted:No date available
Date deposited:07 September 2012
Date of first online publication:December 2011
Date first made open access:No date available

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