Using health mind maps to capture patient's explanatory models of illness
Buitron De la Vega, Pablo Andres
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BACKGROUND: Management of chronic diseases has become one of the major challenges for the health care community. Most of disease management relies on patient’s self-management, influenced in part by their illness perspectives or explanatory models of illness (EMI). Unfortunately, assessing patient’s EMI and using this information to engage patients in chronic illness self-management continues to be a challenge. This is due to time constraints, ambiguity in the design of EMI assessments, lack of motivation, and low health literacy. This study used ‘mind mapping’, a graphic representation of ideas, to develop a process that captures EMI. We will refer to this process as “Health Mind Mapping” (HMM). We explored patient’s experiences using HMM and potential uses of this tool during their care. METHODS: 20 adult (>18 years old) English and Spanish patients with uncontrolled (HbA1c >7%) type 2 diabetes were recruited from a primary care clinic. Participants developed their health mind maps with the guide of a facilitator. Each participant also completed a semi-structured interview in which patients were asked about their experience with HMM. The HMM process and qualitative interviews were video and audio recorded. Transcriptions were analyzed using grounded thematic analysis to identify how patients perceived and were impacted by the process. RESULTS: Two domains regarding the HMM process were identified: patient’s perceptions of the process itself and patient’s reports of potential uses of HMM. Three main themes related to the process itself emerged: 1) Helps to develop insight about self and illness; 2) Catalyst for taking actions to improve their illness; 3) Opportunity to actively share illness. Four main themes related to potential uses of HMM were identified: 1) Communicating their illness to others in their social network; 2) Communicating with their providers; 3) Share to help others with diabetes; 4) Use to encourage ongoing engagement in diabetes self-care. CONCLUSIONS: HMM helped patients to develop new insight about their illness and represented a catalyst for taking control of their illness. Additional research is needed to determine how to use HMM to facilitate patient communication and better engage patients in collaborative goal setting to improve self-care in chronic illness.