Deborah Swinglehurst
Dados Biográficos
| ID | 210646 |
|---|---|
| NOME | Deborah Swinglehurst |
| PRENOMES | Deborah |
| SOBRENOME | Swinglehurst |
| ASSINATURA | SWINGLEHURST D |
| AFILIAÇÕES | Queen Mary University of London |
| ORCID | 0000-0003-1261-9268 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 23 |
| TOTAL DE CITAÇÕES | 40 |
| TOTAL COMO AUTOR | 23 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2006 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 4 |
Choreographing Triage
This paper explores the altered landscape of primary care following the accelerated process of implementing digitally enabled triage across UK general practice in response to COVID‐19. Traditional understandings of triage are based on a static ‘pile sorting’ logic, which suggests that triage outcomes depend upon a single decision in time and space. With the introduction of remote, asynchronous and distributed decision‐making, triage needs a more …
Dementia and the disappearing subject
Dementia affects 55 million people worldwide and is a global priority as governments, health services and care providers grapple with how to provide care for people with dementia and their families. In the UK, drug treatments for dementia have been available since the early 2000s. There has been significant controversy regarding the efficacy and effectiveness of pharmaceuticals. Using framing analysis, we investigated how dementia drugs were fram…
"Living "Out of the Loop
This article is part of the special issue "Laboring from Ex-Centric Sites: Disability, Chronicity and Work" (title of SI; AWR July 2025; 46(1)) edited by Giorgio Brocco and Stefanie Mauksch. This paper examines the experiences of work and unemployment among residents of an East London borough living with multiple long-term health conditions. Through ethnographic research, we explore the psychopolitics of unemployment in an urban setting, focusing…
Addressing Polypharmacy
Background: Tackling problematic polypharmacy is a global health safety priority and is likely to require a multifaceted approach. UK health policy hinges around the potential of medication reviews, but deprescribing in medication reviews is uncommon and evidence on how to harness their potential is sparse. Methods: Storytelling Group, a design-led methodology, was used to invite experts-by-experience (‘story-creators’) to re-imagine the medicati…
‘Troubling’ medication reviews in the context of polypharmacy and ageing
Healthy ageing is a global priority. Polypharmacy (the use of 5+ medicines) amongst older people is increasing, with over one-third of adults in England, aged 80-89, prescribed at least eight medications. Although sometimes necessary, polypharmacy can be harmful; the risk of harm increases with age and number of medicines prescribed. Medication reviews are recommended as one way of reducing the potential harms of polypharmacy although evidence of…
Seeking help for atrial fibrillation
We adopt Rapley's (2008) concept of distributed decision making to explore the role of the body in people's decisions to seek medical care. We conducted in-depth interviews with patients diagnosed with atrial fibrillation (AF) who were taking long-term anticoagulants to prevent stroke. We interviewed seventeen patients recruited from English anticoagulant clinics using the biographic-narrative-interpretive method, and conducted thematic, structur…
The hidden work of general practitioners
High quality primary care is a foundational element of effective health services. Internationally, primary care physicians (general practitioners (GPs), family doctors) are experiencing significant workload pressures. How non-patient-facing work contributes to these pressures and what constitutes this work is poorly understood and often unrecognised and undervalued by patients, policy makers, and even clinicians engaged in it. This paper examines…
Multimorbidity as chronic crisis
Contemporary health services are primarily designed around single diseases. People with multimorbidity (multiple long-term health conditions) often become burdened by accumulated treatments. Through multimodal fieldwork in a socially disadvantaged London borough, we explore how people living with multimorbidity navigate conditions of 'chronic crisis', encompassing ill-health, overmedicalisation, polypharmacy and social exclusion. Participants in …
The emergence of multimorbidity as a matter of concern
Multimorbidity is considered one of the greatest emerging challenges for contemporary health care systems. However, the meaning of the term ‘multimorbidity’ is not straightforward. Despite many attempts to clarify the definition and its measurement, the concept remains elusive. Still, academic interest in the study of multimorbidity has grown exponentially in the past ten years. In this paper, we trace the emergence of multimorbidity as a ‘matter…
Weighing up the future
The English National Child Measurement Programme (NCMP) is a nationally mandated public health programme. It provides data for child excess weight indicators in the Public Health Outcomes Framework, part of the government’s approach to reducing childhood obesity. Drawing on a meta-ethnographic synthesis of household members’ experiences of the programme, we conceptualise the NCMP as a ‘technique of futuring’ to generate new insights into how it (…
Supporting Inclusion and Participation for People Living With Dementia
Dementia researchers have persuasively argued for using flexible and creative methods with people with dementia, to ensure their historically marginalised voices are now heard. This article builds on that work, using examples from a study of medicines practices of people with dementia and their informal carers. We have two aims: firstly, we show the ways in which two methods - linguistic ethnography and diary-interview method - can support the in…
Keeping in balance on the multimorbidity tightrope
Primary care management of patients with multimorbidity in the UK is underpinned by clinical guidelines, quality standards and measurable targets which govern practices of risk management and disease control. There is concern that standardised approaches may not always be appropriate for older patients living with multimorbidity. Using a narrative approach, we elicited the voices of older people living with multiple conditions in order to rethink…
Digital Consumer Health
In this paper, we explore what may happen when people who are ostensibly “well” bring data from digital self-tracking technologies to medical consultations. On the basis of a fictional case narrative, we explore how multiple “voices”, in a Bakhtinian sense of the term, inscribed in the self-tracking devices are activated, negotiated, evaluated and re-imagined in the context of care. The digital metrics “speak” precision, objectivity and urgency i…
Self-Management in Older Pakistanis Living With Multimorbidity in East London
In this article, we explore how older British Pakistani people experience multimorbidity (defined as the coexistence of two or more medical conditions) and engage with self-management within the context of their life histories and relationships. We conducted biographical narrative interviews in Urdu and/or English with 15 first-generation Pakistani migrants living with multimorbidity, at their homes in East London. Our analysis showed that the tr…
Framing obesity in public discourse
Adherence and the Moral Construction of the Self
In this article, we examine illness narratives to illuminate the discursive work that patients undertake to construct themselves as “good” and adherent. Biographical narrative interviews were undertaken with 17 patients receiving anticoagulation for stroke prevention in atrial fibrillation, from five English hospitals (May 2016–June 2017). Through pluralistic narrative analysis, we highlight the discursive tensions narrators face when sharing acc…
The NHS visitor and migrant cost recovery programme – a threat to health
Since the introduction of the CRP there has been a significant delay for TB treatment among non-UK born patients. Further research exploring the effect of policies restricting access to healthcare for migrants is urgently needed if we wish to eliminate TB nationally
Liminality in practice
Contemporary health challenges (e.g., diabetes, climate change, antimicrobial resistance) are underpinned by complex interrelationships between behavioural, cultural, social, environmental and biological processes. Current experimental systems are only partially relevant to the problems they investigate, but aspirations to embed interdisciplinary working and community engagement into life scientists’ work in response to this partiality have prove…
Displays of authority in the clinical consultation
The introduction of computers into general practice settings has profoundly changed the dynamics of the clinical consultation. Previous research exploring the impact of the computer (in what has been termed the 'triadic' consultation) has shown that computer use and communication between doctor and patient are intricately coordinated and inseparable. Swinglehurst et al. have recently been critical of the ongoing tendency within health communicati…
Choose and Book
In 2004, the English Department of Health introduced a technology (Choose and Book) designed to help general practitioners and patients book hospital outpatient appointments. It was anticipated that remote booking would become standard practice once technical challenges were overcome. But despite political pressure and financial incentives, Choose and Book remained unpopular and was generally used reluctantly if at all. Policymakers framed this a…
Tensions and Paradoxes in Electronic Patient Record Research
Context: The extensive research literature on electronic patient records (EPRs) presents challenges to systematic reviewers because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches. Methods: Using the meta‐narrative method and searching beyond the Medline‐indexed literature, this review used “conflicting” findings to address higher‐order questions about how researchers had di…
Using the online environment in assessment for learning
The development of e-learning has opened up new opportunities for innovation in assessment practices in higher education. This descriptive case study draws upon staff and student experiences of teaching and learning on a web-based Masters programme in primary health care to explore how specific features of the online environment can be exploited to promote assessment as part of learning. It begins by identifying different ways of conceptualising …
Video-reflexive Ethnography in health research and healthcare improvement
Video-reflexive Ethnography in health research and healthcare improvement: theory and application." Health Sociology Review, 28(3), pp. 339–340
Choose and Book
In 2004, the English Department of Health introduced a technology (Choose and Book) designed to help general practitioners and patients book hospital outpatient appointments. It was anticipated that remote booking would become standard practice once technical challenges were overcome. But despite political pressure and financial incentives, Choose and Book remained unpopular and was generally used reluctantly if at all. Policymakers framed this a…
Supporting Inclusion and Participation for People Living With Dementia
Dementia researchers have persuasively argued for using flexible and creative methods with people with dementia, to ensure their historically marginalised voices are now heard. This article builds on that work, using examples from a study of medicines practices of people with dementia and their informal carers. We have two aims: firstly, we show the ways in which two methods - linguistic ethnography and diary-interview method - can support the in…
Keeping in balance on the multimorbidity tightrope
Primary care management of patients with multimorbidity in the UK is underpinned by clinical guidelines, quality standards and measurable targets which govern practices of risk management and disease control. There is concern that standardised approaches may not always be appropriate for older patients living with multimorbidity. Using a narrative approach, we elicited the voices of older people living with multiple conditions in order to rethink…
Framing obesity in public discourse
Displays of authority in the clinical consultation
The introduction of computers into general practice settings has profoundly changed the dynamics of the clinical consultation. Previous research exploring the impact of the computer (in what has been termed the 'triadic' consultation) has shown that computer use and communication between doctor and patient are intricately coordinated and inseparable. Swinglehurst et al. have recently been critical of the ongoing tendency within health communicati…
Multimorbidity as chronic crisis
Contemporary health services are primarily designed around single diseases. People with multimorbidity (multiple long-term health conditions) often become burdened by accumulated treatments. Through multimodal fieldwork in a socially disadvantaged London borough, we explore how people living with multimorbidity navigate conditions of 'chronic crisis', encompassing ill-health, overmedicalisation, polypharmacy and social exclusion. Participants in …
Video-reflexive Ethnography in health research and healthcare improvement
Video-reflexive Ethnography in health research and healthcare improvement: theory and application." Health Sociology Review, 28(3), pp. 339–340
The hidden work of general practitioners
High quality primary care is a foundational element of effective health services. Internationally, primary care physicians (general practitioners (GPs), family doctors) are experiencing significant workload pressures. How non-patient-facing work contributes to these pressures and what constitutes this work is poorly understood and often unrecognised and undervalued by patients, policy makers, and even clinicians engaged in it. This paper examines…
Using the online environment in assessment for learning
The development of e-learning has opened up new opportunities for innovation in assessment practices in higher education. This descriptive case study draws upon staff and student experiences of teaching and learning on a web-based Masters programme in primary health care to explore how specific features of the online environment can be exploited to promote assessment as part of learning. It begins by identifying different ways of conceptualising …
Tensions and Paradoxes in Electronic Patient Record Research
Context: The extensive research literature on electronic patient records (EPRs) presents challenges to systematic reviewers because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches. Methods: Using the meta‐narrative method and searching beyond the Medline‐indexed literature, this review used “conflicting” findings to address higher‐order questions about how researchers had di…
Displays of authority in the clinical consultation
The introduction of computers into general practice settings has profoundly changed the dynamics of the clinical consultation. Previous research exploring the impact of the computer (in what has been termed the 'triadic' consultation) has shown that computer use and communication between doctor and patient are intricately coordinated and inseparable. Swinglehurst et al. have recently been critical of the ongoing tendency within health communicati…
Choose and Book
In 2004, the English Department of Health introduced a technology (Choose and Book) designed to help general practitioners and patients book hospital outpatient appointments. It was anticipated that remote booking would become standard practice once technical challenges were overcome. But despite political pressure and financial incentives, Choose and Book remained unpopular and was generally used reluctantly if at all. Policymakers framed this a…
Liminality in practice
Contemporary health challenges (e.g., diabetes, climate change, antimicrobial resistance) are underpinned by complex interrelationships between behavioural, cultural, social, environmental and biological processes. Current experimental systems are only partially relevant to the problems they investigate, but aspirations to embed interdisciplinary working and community engagement into life scientists’ work in response to this partiality have prove…
Adherence and the Moral Construction of the Self
In this article, we examine illness narratives to illuminate the discursive work that patients undertake to construct themselves as “good” and adherent. Biographical narrative interviews were undertaken with 17 patients receiving anticoagulation for stroke prevention in atrial fibrillation, from five English hospitals (May 2016–June 2017). Through pluralistic narrative analysis, we highlight the discursive tensions narrators face when sharing acc…
The NHS visitor and migrant cost recovery programme – a threat to health
Since the introduction of the CRP there has been a significant delay for TB treatment among non-UK born patients. Further research exploring the effect of policies restricting access to healthcare for migrants is urgently needed if we wish to eliminate TB nationally
Digital Consumer Health
In this paper, we explore what may happen when people who are ostensibly “well” bring data from digital self-tracking technologies to medical consultations. On the basis of a fictional case narrative, we explore how multiple “voices”, in a Bakhtinian sense of the term, inscribed in the self-tracking devices are activated, negotiated, evaluated and re-imagined in the context of care. The digital metrics “speak” precision, objectivity and urgency i…
Self-Management in Older Pakistanis Living With Multimorbidity in East London
In this article, we explore how older British Pakistani people experience multimorbidity (defined as the coexistence of two or more medical conditions) and engage with self-management within the context of their life histories and relationships. We conducted biographical narrative interviews in Urdu and/or English with 15 first-generation Pakistani migrants living with multimorbidity, at their homes in East London. Our analysis showed that the tr…
Framing obesity in public discourse
Keeping in balance on the multimorbidity tightrope
Primary care management of patients with multimorbidity in the UK is underpinned by clinical guidelines, quality standards and measurable targets which govern practices of risk management and disease control. There is concern that standardised approaches may not always be appropriate for older patients living with multimorbidity. Using a narrative approach, we elicited the voices of older people living with multiple conditions in order to rethink…
The emergence of multimorbidity as a matter of concern
Multimorbidity is considered one of the greatest emerging challenges for contemporary health care systems. However, the meaning of the term ‘multimorbidity’ is not straightforward. Despite many attempts to clarify the definition and its measurement, the concept remains elusive. Still, academic interest in the study of multimorbidity has grown exponentially in the past ten years. In this paper, we trace the emergence of multimorbidity as a ‘matter…
Weighing up the future
The English National Child Measurement Programme (NCMP) is a nationally mandated public health programme. It provides data for child excess weight indicators in the Public Health Outcomes Framework, part of the government’s approach to reducing childhood obesity. Drawing on a meta-ethnographic synthesis of household members’ experiences of the programme, we conceptualise the NCMP as a ‘technique of futuring’ to generate new insights into how it (…
Supporting Inclusion and Participation for People Living With Dementia
Dementia researchers have persuasively argued for using flexible and creative methods with people with dementia, to ensure their historically marginalised voices are now heard. This article builds on that work, using examples from a study of medicines practices of people with dementia and their informal carers. We have two aims: firstly, we show the ways in which two methods - linguistic ethnography and diary-interview method - can support the in…
Addressing Polypharmacy
Background: Tackling problematic polypharmacy is a global health safety priority and is likely to require a multifaceted approach. UK health policy hinges around the potential of medication reviews, but deprescribing in medication reviews is uncommon and evidence on how to harness their potential is sparse. Methods: Storytelling Group, a design-led methodology, was used to invite experts-by-experience (‘story-creators’) to re-imagine the medicati…
‘Troubling’ medication reviews in the context of polypharmacy and ageing
Healthy ageing is a global priority. Polypharmacy (the use of 5+ medicines) amongst older people is increasing, with over one-third of adults in England, aged 80-89, prescribed at least eight medications. Although sometimes necessary, polypharmacy can be harmful; the risk of harm increases with age and number of medicines prescribed. Medication reviews are recommended as one way of reducing the potential harms of polypharmacy although evidence of…
Video-reflexive Ethnography in health research and healthcare improvement
Video-reflexive Ethnography in health research and healthcare improvement: theory and application." Health Sociology Review, 28(3), pp. 339–340
Seeking help for atrial fibrillation
We adopt Rapley's (2008) concept of distributed decision making to explore the role of the body in people's decisions to seek medical care. We conducted in-depth interviews with patients diagnosed with atrial fibrillation (AF) who were taking long-term anticoagulants to prevent stroke. We interviewed seventeen patients recruited from English anticoagulant clinics using the biographic-narrative-interpretive method, and conducted thematic, structur…
The hidden work of general practitioners
High quality primary care is a foundational element of effective health services. Internationally, primary care physicians (general practitioners (GPs), family doctors) are experiencing significant workload pressures. How non-patient-facing work contributes to these pressures and what constitutes this work is poorly understood and often unrecognised and undervalued by patients, policy makers, and even clinicians engaged in it. This paper examines…
Multimorbidity as chronic crisis
Contemporary health services are primarily designed around single diseases. People with multimorbidity (multiple long-term health conditions) often become burdened by accumulated treatments. Through multimodal fieldwork in a socially disadvantaged London borough, we explore how people living with multimorbidity navigate conditions of 'chronic crisis', encompassing ill-health, overmedicalisation, polypharmacy and social exclusion. Participants in …
Dementia and the disappearing subject
Dementia affects 55 million people worldwide and is a global priority as governments, health services and care providers grapple with how to provide care for people with dementia and their families. In the UK, drug treatments for dementia have been available since the early 2000s. There has been significant controversy regarding the efficacy and effectiveness of pharmaceuticals. Using framing analysis, we investigated how dementia drugs were fram…
"Living "Out of the Loop
This article is part of the special issue "Laboring from Ex-Centric Sites: Disability, Chronicity and Work" (title of SI; AWR July 2025; 46(1)) edited by Giorgio Brocco and Stefanie Mauksch. This paper examines the experiences of work and unemployment among residents of an East London borough living with multiple long-term health conditions. Through ethnographic research, we explore the psychopolitics of unemployment in an urban setting, focusing…
Choreographing Triage
This paper explores the altered landscape of primary care following the accelerated process of implementing digitally enabled triage across UK general practice in response to COVID‐19. Traditional understandings of triage are based on a static ‘pile sorting’ logic, which suggests that triage outcomes depend upon a single decision in time and space. With the introduction of remote, asynchronous and distributed decision‐making, triage needs a more …
Sociology (16 obras) · Psychology (14 obras) · Medicine (13 obras) · Political science (10 obras) · Social science (8 obras) · Chronic Disease Management Strategies (6 obras) · Ethnography (6 obras) · Social Psychology (6 obras) · Epistemology (5 obras) · Health care (5 obras)