Diagnosis Between Chaos and Control
Affect and Hospital Clinicians' and Older Adult Patients' Narratives of Urinary Tract Infections
Bibliographic Data
| ID | 13075799 |
|---|---|
| Authors | Paula Saukko (0000-0001-7614-0091, Loughborough University, corresponding author), Emily K Rousham (0000-0001-5654-9279, Loughborough University) |
| Year | 2020 |
| Volume | 5 |
| Pages | 57-57 |
| Publication date | 2020-08-12 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Sociology (JOURNAL) |
| Journal identifiers | ISSN: 2297-7775 • E-ISSN: 2297-7775 |
| Publisher | Frontiers Media (PUBLISHER • CH) |
| DOI | 10.3389/fsoc.2020.00057 |
| PMID | 33869463 |
| OpenAlex | W3048450412 |
| Language | EN |
| References cited | 37 |
Research has observed that older adults are frequently overdiagnosed with urinary tract infection (UTI) and unnecessarily prescribed antibiotics in hospitals. In this article we explore the overlooked affective dimension of experiences of diagnosis and prescribing. Drawing on interviews with doctors, nurses and older adult patients ( n = 41) on UTI diagnosis in two UK hospitals and Arthur Frank's work on illness narratives we identified two affective ways of experiencing diagnosis. Some clinicians and older adult patients articulated chaos narratives about being overwhelmed by contradictory evidence and events, doubting the repeated UTI diagnoses and courses of antibiotics but being unable to do anything about their concerns. Other clinicians and patients articulated control narratives about UTIs being frequently diagnosed and antibiotics prescribed to restore patients' health, echoing certainty and security, even if the processes described typically did not follow current guidance. We contend that analyzing the affective dimension offers conceptual insights that push forward sociological discussions on diagnosis as reflective or dogmatic in the context of the contradiction between acute care and chronic illnesses of old age. Our findings contribute practical ideas of why overdiagnosis and overprescribing happen in hospitals and complicate notions of patients pressuring for antibiotics. We also present methodological suggestions for analyzing how participants tell about their experiences in order to explore the typically not directly spoken affective dimension that influences thoughts and actions about diagnosis
Affect (linguistics · Context (archaeology · Health care · Medical diagnosis · Narrative · Overdiagnosis · Pathology · Psychiatry · Empathy and Medical Education · Historical Psychiatry and Medical Practices · Medicine · Mental Health and Psychiatry · Psychology · Internal Medicine
The Evolution of Medical Uncertainty
Core affect and the psychological construction of emotion.
The Wounded Storyteller
Narrative Analysis in Psychological Research
The Affect Theory Reader
The Autonomy of Affect
Cultures of resistance? A Bourdieusian analysis of doctors' antibiotic prescribing
Trends in the Turn to Affect
Diagnosis and nosology in primary care
Nurses as Antibiotic Brokers
Struggles Over Antibiotics
Training for certainty
Evidence-Based Medicine, Clinical Uncertainty, and Learning to Doctor
The Constant Comparative Method of Qualitative Analysis
Theory Construction in Qualitative Research
Beyond guidelines
| Highly cited | No |
|---|