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‘You don't get told anything, they don't do anything and nothing changes’. Medicine as a resource and constraint in progressive ataxia

Bibliographic Data

ID19506965
AuthorsGavin Daker‐white (0000-0002-3538-8805, Health Sciences Research Group – Methodology The University of Manchester Manchester UK, corresponding author), Helen Kingston (Department of Clinical Genetics St. Mary's Hospital Central Manchester University Hospitals NHS Foundation Trust Manchester UK), Katherine Payne (0000-0002-3938-4350, Health Sciences Research Group – Health Economics The University of Manchester Manchester UK), Julie Greenfield (0000-0003-2876-4849, Ataxia UK London UK), John Ealing (Department of Neurology Salford Royal NHS Foundation Trust Salford UK), Caroline Sanders (0000-0002-0539-928X, Health Sciences Research Group – Primary Care The University of Manchester Manchester UK)
Year2015
Volume18
Issue2
Pages177-187
Publication date2015-04-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hex.12016
PMID23094806
OpenAlexW2132434556
LanguageEN
Citations received2
References cited19

BACKGROUND: Progressive ataxias are neurological disorders affecting balance, co-ordination of movement and speech. OBJECTIVE: A qualitative study was undertaken to discover patients' experiences of ataxia and its symptoms. PARTICIPANTS: Thirty-eight people with ataxia recruited from patient support groups and two hospital outpatients departments. DESIGN: Cross-sectional qualitative study with thematic analysis. RESULTS: These accounts highlight the limits of medicine in the context of a rare, incurable and disabling disorder, and the embodied uncertainties brought by slowly progressive diseases that lie at the boundaries of mainstream medical knowledge. The existential crises faced by people with ataxia are seemingly magnified by sometimes idiopathic aetiologies and the limited number of inherited conditions identifiable by the available genetic tests. Interviewees were drawn into a medical system that was focused mainly on the diagnosis process, with widely varying results. However, when asked, most had rather valued the provision of disability aids and physical therapies. Only one informant reported overcoming the myriad uncertainties of progressive ataxia, and their account supported the notion of 'biographical repair' in chronic illness. CONCLUSIONS: Clinical uncertainties in ataxia constrained people's attempts to deal with their condition. The construction of the proactive, informed, medical consumer who is assumed to be a partner in care is problematic in the context of a rare and difficult-to-diagnose disease for which there is usually no cure. Service providers should be mindful of the need to manage patient expectations in relation to diagnosis and cure. More focus might usefully be placed on the provision of physical therapies and disability aids

Ataxia · Blame · Mainstream · Psychiatry · Psychotherapist · Qualitative research · Sociology · Thematic analysis · Genetic Neurodegenerative Diseases · Medicine · Mental Health and Psychiatry · Neurology and Historical Studies · Psychology

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Unique citing works2
Citations per year0,22
Citation span2017 - 2022 (6)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 2

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