Arthur Kleinman’s Eight Questions

The 2020 Canadian Clinical Practice Guidelines for Adult Obesity stress the importance of patient-centred care and ensuring that we understand the patient’s story.

In this context, it may be a good idea to consider presenting the patient with Arthur Kleinman’s eight questions. These questions evolved from Kleinman’s work as a medical anthropologist working across a range of ethnic populations and are particularly helpful in approaching patients of other cultures – but nut not just those.

  • What do you call your problem? What name do you give it?
  • What do you think has caused it?
  • Why did it start when it did?
  • What does your sickness do to your body? How does it work inside you?
  • How severe is it? Will it get better soon or take longer?
  • What do you fear most about your sickness?
  • What are the chief problems your sickness has caused for you (personally, family, work, etc.)?
  • What kind of treatment do you think you should receive? What are the most important results you hope to receive from the treatment?

The answers to these questions – which the patient can formulate ahead of the clinical encounter – can provide important insights and form the basis of an explanatory model towards understanding the patient’s interpretation of their disease state and their health beliefs including their worldview, culture, social context, and spirituality.

For more on Arthur Kleinman and his Explanatory Model click here

Berlin, D