How do patients become certain of their future? -The meaning of sickness as seen in medical consultations for cardiovascular disease and Kampo medicine

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It has been more than 10 years since evidence-based medicine was introduced into Japan. Evidence is currently employed to establish guidelines for diseases and medical policy because evidence is judged to give us the most certain information about reality. However, it is unclear how patients become certain either about their treatment or about how they understand their disease. This study aims to clarify this issue by using participants'observations of medical consultations for cardiovascular disease and Kampo medicine - a traditional Japanese system of medicine - together with interviews with patients and doctors. As a result,it is found that a patient's certainty is not derived from evidence but is based instead on narratives constructed through a patient's dialogue with their doctor and the physical sensations that they feel every day. Furthermore, this certainty is fluid and is continually being reconstructed in and through the patient's everyday life.