Using patients’ lay knowledge to guide the treatment of vitamin D deficiency : Perceptions and experiences of general practitioners and patients

Alhajri, Lamia and Limmer, Mark and Holland, Paula (2023) Using patients’ lay knowledge to guide the treatment of vitamin D deficiency : Perceptions and experiences of general practitioners and patients. PhD thesis, Lancaster University.

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Abstract

The worldwide prevalence of vitamin D deficiency is high despite all efforts and availability of effective treatment options. Literature unraveled the existance of a relationship between patients’ behaviour, their social, environmental and cultural contexts and vitamin D deficiency. Hence, heightening the visibility of patients’ contexts through lay knowledge could help provide more sensible medical advice. Thus, this thesis aims to: a) explore how patients’ contexts affect their experiences with vitamin D b) explore the current practice regarding vitamin-D medical consultation in terms of utilising lay knowledge for customisation purposes, c) explore the perceptions of participants regarding the use of lay knowledge to customise and contextualise medical advice. To achieve the objectives, a qualitative methodology was adopted, where general practitioners and patients were recruited purposely and interviewed using semi-structured interviews. Braun and Clarke’s (2019) thematic analysis was then used to analyse the data. Participants reported on a number of contextual factors that might have affected their experience including: motherhood, culture and religion, weather and indoor lifestyle, urbanisation and immigration, work-family demands, autonomy and more. These factors were found to be complex, subjective, dynamic, interactive and in certain instances hidden. Although the majority of participants valued the use of lay knowledge to contextualise medical advice, the current practice says otherwise, which could be due to the conflict between technical and lay knowledge. Combining lay knowledge with the socio-ecological model helped unravel holistic and hidden experiences, deep meanings, ideologies, values and beliefs. These are important to consider during the vitamin D-related medical consultation to render the medical advice more sensible, and accordingly heighten compliance. Hence, civic intelligence, which entails combining lay with technical knowledge is the way forward, and should govern the medical consultation for vitamin D deficiency. Yet more efforts are needed to adopt it and overcome the identified barriers.