The Explanatory Model in healthcare is used as a way to understand how patients view their conditions and their expectations surrounding a cure. In the Explanatory Model, providers uses open questions to uncover the patient’s experience, ascribed meaning and behavior regarding an illness episode.
This model can provide insight into cultural, social, psychological and environmental factors affecting the patient. It can help the provider predict how receptive a patient will be to health information, diagnosis and treatment.
This model can help providers:
- uncover cultural differences that may cause problems for clinical management
- identify what sort of patient education is needed and most appropriate
- clarify potential patient/provider conflicts related to different values and beliefs
When interviewing a patient, providers must hold a genuine attitude of interest in the patient’s point of view. The purpose is to gather information. The provider should be non-judgmental and not contradict the patient, which may lead the patient to shut down and stop speaking. Patients who feel ridiculed about their beliefs may withhold information or not return for follow-up care.
The provider can use the information gained with this model to negotiate with the patient a treatment plan that is mutually satisfactory and most likely to be followed.
Sample questions include:
- How would you describe the problem?
- What do you think is causing your problem?
- Why do you think it started when it did?
- How does your sickness affect to you?
- What are the chief problems your sickness has caused for you?
- How severe is your sickness? Will it have a long or short course?
- What do you fear most about your sickness?
- How are you treating your sickness now?
- What type of treatment do you think you should receive?
- What are the most important results you hope to get from treatment?
(adapted from Klienman 1980)