Kairotic and chronological knowing: diabetes logbooks in-and-out of the hospital

Publication Date05 February 2018
Date05 February 2018
AuthorEnrico Maria Piras
SubjectLibrary & information science,Librarianship/library management,Library technology,Information behaviour & retrieval,Metadata,Information & knowledge management,Information & communications technology,Internet
Kairotic and chronological
knowing: diabetes logbooks
in-and-out of the hospital
Enrico Maria Piras
Center for Information and Communication Technology,
Fondazione Bruno Kessler, Trento, Italy and
Universita degli Studi di Verona, Verona, Italy
Purpose The paper reflects on the role of knowledge artefacts in the patient-provider relationship across
the organisational boundaries of the clinical setting. Drawing on the analysis of the diabetes logbook,
the purpose of this paper is to illustrate the role of knowledge artefacts in a fragmented system of knowledge
through the study of two distinct practices: logbook compilingand consultation in the surgery.
Design/methodology/approach The theoretical framework of analysis is rooted in the tradition of
practice-based studies which envisions knowledge as the emerging, precarious and socially constructed
product of being involved in a practice. The paper follows a designed qualitative research, conducting
semi-structured interviews, participant observation and artefact analysis.
Findings The knowledge artefacts support different and partially irreducible forms of knowledge.
Knowing-in-practice is accomplished by means of different activities which contribute to the reshaping of the
knowledge artefact itself. The analysis of the knowledge artefact-in-usereveals that different actors
(doctors and patients) adopt two different perspectives when investigating the chronic condition. Clinicians
are interested in a chronological representation of patient data while patients and families are interested in
making sense of specific situations, adopting a kairotic perspective (Kairos: the right moment) that
emphasises the instant in which something significant for someone happens.
Originality/value The analysis of the knowledge artefacts-in-use has a twofold outcome. On one hand,
it illustrates the mutual shaping of knowing, artefacts and practices. On the other hand, it shows how
knowledge artefact can become pivotal resources in a fragmented system of knowledge.
Keywords Knowing-in-practice, Qualitative analysis, Practice-based studies, Artefact analysis,
Knowledge artefact, Type 1 diabetes
Paper type Research paper
1. Introduction
The role of artefacts to support knowledge-related processes has a longstanding tradition in
several academic debates. The interest of the scientific communities goes hand in hand with the
societal demand to create, improve and transfer knowledge. The idea that knowledge can be
captured and encapsulated into artefacts, however, has attracted criticism from socially oriented
scholarly traditions. A knowledge artefactis an expression whose meaning depends on what
connotation is attributed to the word knowledge. As noted by Cabitza and Locoro (2014),
roughly speaking, we can identify two poles of a continuum arealisticandaprocessual
perspective, where the former considers knowledge as the representation of a piece of reality,
while the latter focusses on knowing that emerges in situated interactions (Turnbull, 2003).
These conflicting visions and their inherent tensions are of special significance in the
healthcare sector, where there is a longstanding debate regarding what should be
considered legitimate knowledge. Since evidence-based medicine has been established as a
dominant paradigm, personal experience has lost currency. Despite some criticism
(Greenhalgh et al., 2014), we can say that what is considered legitimate knowledge is the
result of systematic meta-reviews or randomised controlled trials being condensed into
Data Technologies and
Vol. 52 No. 1, 2018
pp. 148-162
© Emerald PublishingLimited
DOI 10.1108/DTA-03-2017-0018
Received 13 March 2017
Revised 26 June 2017
Accepted 19 July 2017
The current issue and full text archive of this journal is available on Emerald Insight at:
This work was supported by Department of Health and Social Politics of the Autonomous Province of
Trento, Italy (TreC Project).

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