Patient meaning refers to what their illness or symptom signifies personally, beyond the practical consequences. It encompasses emotional responses, mental and psychological impact, beliefs, fears, guilt, and how the patient interprets their condition in the context of their life. While Impact looks at what the illness does, Meaning explores what the illness means to the patient.

Understanding Meaning helps uncover hidden distress or psychosocial burden.

Guides empathetic, patient-centred communication and management.

Prevents misinterpretation: what looks minor medically may carry major personal significance.

Provides context for patient decisions, adherence, and coping strategies..

Allow silence; patients often reveal meaning in pauses or after prompts.

Avoid jumping straight to medical explanations; focus on personal significance first.

Recognise overlap with Impact, but maintain a separate line of inquiry into emotional and personal interpretation.

Use insights from Meaning to guide empathy, reassurance, and shared planning.

1. Use open-ended prompts:

“How has having this affected you emotionally?”

“What worries or concerns come up for you most often?”

“What does this mean to you in your day-to-day life?”

2. Explore feelings and beliefs:

Listen for statements reflecting fear, guilt, or personal interpretation.

Encourage reflection without judgment:

“I hear this is really worrying for you. Can you tell me a bit more about that?”

3. Look for subtle cues:

Emotional tone, pauses, sighs, or body language may indicate deeper meaning.

Pay attention to recurring themes in the patient’s narrative.

4. Summarise and validate:

Reflect what you’ve heard to show understanding and encourage elaboration:

“It sounds like this situation has been weighing heavily on you and affecting your confidence. Is that right?”

Find the IMP: Quick Reference Toolkit

Patient priorities are the issues or problems the patient feels need addressing first. Unlike expectations, they aren’t simply what the patient wants from the consultation, nor are they a checklist of outcomes. Priorities are revealed through conversation, often subtly, as patients indicate which concerns dominate their thoughts or which problems interfere most with their life.

Helps tailor management to what the patient perceives as most urgent or important.

Prevents clinicians from over-focusing on medical or procedural concerns while neglecting what truly matters to the patient.

Supports shared decision-making and rapport, by showing the patient their perspective has been understood.

Be patient; priorities often emerge gradually.

Don’t over-interpret; confirm your understanding with the patient.

Combine attention to verbal, emotional, and non-verbal cues.

Recognise that priorities may shift over time or with new information.

1. Listen for cues:

Note which issues the patient mentions first or returns to repeatedly.

Observe emotional emphasis, hesitation, or body language.

2. Use reflective prompts:

“It sounds like [issue] has been weighing on you a lot…”

“I hear that [problem] is really affecting your day-to-day life…”

Avoid directly asking “What’s your priority?” — instead, let it emerge through the conversation.

3. Link to context:

Explore how different problems affect work, relationships, or daily routines.

Ask questions like:

“How has this been affecting your day-to-day life?”

“Which of these issues has been most difficult to manage recently?”

4. Summarise and confirm:

Reflect back what you’ve heard and check if it aligns with the patient’s concerns:

“So it seems that [issue] is the main thing worrying you right now. Is that right?”

Find the IMP: Quick Reference Toolkit