Explaining Illness

Explaining illness is an area of inquiry that concerns the use of informatory and explanatory discourse, coupled with linguistic and visual communicative strategies, to design messages for the purposes of aiding patients' understanding of the anatomical, physiological, biological, and process factors affecting their health. Some scholars suggest that an illness explanation should describe the health-related problem, its cause, and the effects of the medical condition, followed by the procedures, tests, and the medications involved. Research indicates that patients find, as essential, that illness explanations address the cause, effects, treatment and process, side effects, and expectations of treatment.

Researchers suggest that several core factors can hinder the illness explanation process. Specifically, among the most prominent and frequent barriers are (1) differentiating between foundational and needed meanings of terms from associated term meanings, (2) trouble with the visualization of unseen, unfamiliar, or complex phenomena, and (3) ideas that are perceived as counterintuitive by patients.

Theorists and researchers have discussed three types of explanations to address these obstacles. Elucidating explanations are suggested to ameliorate the first obstacle. Specifically, these explanations aid in patients' understanding of a concept's [Page 473]key, foundational meaning in contrast to any other meanings that may be associated with the concept. As such, sound elucidating explanations contain a definition that includes (1) detail of each of the concept's critical features, (2) a host of varied exemplars, (3) a discussion of instances that are frequently assumed to be examples, but are not, and (4) occasions to practice delineating between nonexamples from examples.

Quasi-scientific explanations are helpful to offset the second obstacle. This type of explanation aids patients in visualizing multifarious or complex structures and processes by helping patients to perform in the same manner as do topic authorities when they ponder about their specialized area of knowledge. Quality quasi-scientific explanations aid patients in (1) selecting relevant aspects of complex material, (2) organizing that information into a coherent account of how or why something works, and (3) integrating newly learned information with already understood notions.

In addressing the third obstacle, transformative explanations assist patients in comprehending phenomena or notions that are counterintuitive or that patients consider implausible—ideas that are extremely difficult to comprehend. A foundational factor in patients' difficulty with understanding ideas that are counterintuitive or implausible is their lay theories concerning illness. Transformative explanations help patients elucidate the nature of their lay theories, the strengths and weakness of these theories, and the premises of a new, more accurate theory. Specifically, transformative explanations assist patients to recognize the flaws in their lay theories by having them (1) state the lay theory, and then (2) articulate how a more accepted theory or notion better explains the health-related issue. An overarching premise concerning any illness explanation is that the quality of the information embedded in the explanation is more important, preferred, and effective in meeting the communicative goal than is the quantity of information.

A German Navy doctor explains an X-ray to a Guyanan patient at a Continuing Promise medical site in New Amsterdam, Guyana, October 19, 2010. Strategies for communicating illness explanations use both linguistic and visual means.

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