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Challenging the Biopsychosocial Model in a Chronic Constipation Clinic

Wainwright, M.; Russell, A.; Yiannakou, Y.

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Y. Yiannakou


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.


Wainwright, M., Russell, A., & Yiannakou, Y. (2011). Challenging the Biopsychosocial Model in a Chronic Constipation Clinic. Qualitative Health Research, 21(12), 1643-1657.

Journal Article Type Article
Publication Date Dec 1, 2011
Deposit Date Oct 24, 2011
Publicly Available Date Sep 7, 2012
Journal Qualitative Health Research
Print ISSN 1049-7323
Electronic ISSN 1552-7557
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 21
Issue 12
Pages 1643-1657
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


Accepted Journal Article (212 Kb)

Copyright 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:

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