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Knowledge mobilisation: an ethnographic study of the influence of lay mindlines on eczema self-management in primary care in the UK
  1. Fiona Cowdell1,2
  1. 1 Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
  2. 2 Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
  1. Correspondence to Professor Fiona Cowdell; fiona.cowdell{at}


Objective To investigate the way in which mindlines, ‘collectively reinforced, internalised tacit guidelines’, are constructed among lay people with eczema in primary care.

Design Ethnographic study.

Setting Observation in one general practice in the UK and interviews across central England.

Participants In observation, patients in the participating general practice regardless of presenting complaint and in interviews, people with eczema or parents of children with eczema (n=16).

Results Observation of over 250 hours and interview data were combined and analysed using an ethnographic approach through the lenses of mindlines and self-management. Four themes were identified: doctor knows best; not worth bothering the doctor; I need to manage this myself; and how I know what to do. Themes were set within the context of four broad typologies of lay people’s approach to self-management: content to self-manage; content to accept practitioner management; self-managing by default; and those referred to secondary care.

Conclusions This study is the first to examine how lay eczema mindlines are developed and to recognise typologies of people with different need for, and receptiveness to, information. Lay eczema mindlines are constructed in many ways. The outstanding challenge is to find strategies to revise or modify these mindlines by adding reliable and useful knowledge and by erasing outdated or inaccurate information.

  • eczema
  • ethnography
  • knowledge mobilisation
  • mindlines
  • primary care

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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  • Contributors FC is the sole contributor to this paper.

  • Funding This report is independent research arising from a Knowledge Mobilisation Research Fellowship, Professor Fiona Cowdell, KMRF-2015-04-004, supported by the National Institute for Health Research.

  • Disclaimer The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, Health Education England or the Department of Health.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The study was approved by a University Ethics Committee and HRA Yorkshire & The Humber – Leeds West Research Ethics Committee (ref no:16/YH/0252).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The datasets generated and/or analysed during the current study are not publicly available as they are not designed to be reanalysed by others but are available from the corresponding author on reasonable request.

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