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Untimely illness: When diagnosis does not match age‐related expectations

BACKGROUND: We explore the concept of “untimely diagnosis,” where the onset of a long‐term condition occurs at a life stage which does not conform to traditional expectations, focusing on two conditions (asthma and arthritis) typically associated with a particular life stage (childhood and older adu...

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Autores principales: Kirkpatrick, Susan, Locock, Louise, Farre, Albert, Ryan, Sara, Salisbury, Helen, McDonagh, Janet E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117493/
https://www.ncbi.nlm.nih.gov/pubmed/29424066
http://dx.doi.org/10.1111/hex.12669
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author Kirkpatrick, Susan
Locock, Louise
Farre, Albert
Ryan, Sara
Salisbury, Helen
McDonagh, Janet E.
author_facet Kirkpatrick, Susan
Locock, Louise
Farre, Albert
Ryan, Sara
Salisbury, Helen
McDonagh, Janet E.
author_sort Kirkpatrick, Susan
collection PubMed
description BACKGROUND: We explore the concept of “untimely diagnosis,” where the onset of a long‐term condition occurs at a life stage which does not conform to traditional expectations, focusing on two conditions (asthma and arthritis) typically associated with a particular life stage (childhood and older adulthood, respectively). Previous literature has focused on the meaning of chronic illness in terms of life history, and the biographical lens has been used in various ways to make sense of the experience. Less attention has been paid to the condition onset when it seems dissonant with chronological age. METHODS: Secondary analysis of two qualitative data sets (total 58 interviews) exploring the experiences of people with adult‐onset asthma and young people diagnosed with arthritis. Data from the original interview transcripts relating to diagnosis and symptom recognition were re‐analysed using a “candidacy” framework to examine how age and diagnosis intersect. RESULTS: People did not always assert their candidacy for either condition because of pre‐conceived expectations around age. Similarly, health professionals sometimes failed to recognize patients’ candidacy, instead pursuing “age‐plausible” possibilities. In some cases, participants were proactive in suggesting a diagnosis to the health professional where diagnosis was delayed. CONCLUSION: The diagnosis of adult‐onset asthma, and arthritis in young people, may be regarded as “untimely.” We suggest that being diagnosed with what is perceived to be a “childhood” condition in adulthood, or “an older person's” condition in childhood, may be viewed as a “biographical paradox” and an “untimely breach” to the expected order.
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spelling pubmed-61174932018-09-05 Untimely illness: When diagnosis does not match age‐related expectations Kirkpatrick, Susan Locock, Louise Farre, Albert Ryan, Sara Salisbury, Helen McDonagh, Janet E. Health Expect Original Research Papers BACKGROUND: We explore the concept of “untimely diagnosis,” where the onset of a long‐term condition occurs at a life stage which does not conform to traditional expectations, focusing on two conditions (asthma and arthritis) typically associated with a particular life stage (childhood and older adulthood, respectively). Previous literature has focused on the meaning of chronic illness in terms of life history, and the biographical lens has been used in various ways to make sense of the experience. Less attention has been paid to the condition onset when it seems dissonant with chronological age. METHODS: Secondary analysis of two qualitative data sets (total 58 interviews) exploring the experiences of people with adult‐onset asthma and young people diagnosed with arthritis. Data from the original interview transcripts relating to diagnosis and symptom recognition were re‐analysed using a “candidacy” framework to examine how age and diagnosis intersect. RESULTS: People did not always assert their candidacy for either condition because of pre‐conceived expectations around age. Similarly, health professionals sometimes failed to recognize patients’ candidacy, instead pursuing “age‐plausible” possibilities. In some cases, participants were proactive in suggesting a diagnosis to the health professional where diagnosis was delayed. CONCLUSION: The diagnosis of adult‐onset asthma, and arthritis in young people, may be regarded as “untimely.” We suggest that being diagnosed with what is perceived to be a “childhood” condition in adulthood, or “an older person's” condition in childhood, may be viewed as a “biographical paradox” and an “untimely breach” to the expected order. John Wiley and Sons Inc. 2018-02-09 2018-08 /pmc/articles/PMC6117493/ /pubmed/29424066 http://dx.doi.org/10.1111/hex.12669 Text en © 2018 The Authors Health Expectations published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research Papers
Kirkpatrick, Susan
Locock, Louise
Farre, Albert
Ryan, Sara
Salisbury, Helen
McDonagh, Janet E.
Untimely illness: When diagnosis does not match age‐related expectations
title Untimely illness: When diagnosis does not match age‐related expectations
title_full Untimely illness: When diagnosis does not match age‐related expectations
title_fullStr Untimely illness: When diagnosis does not match age‐related expectations
title_full_unstemmed Untimely illness: When diagnosis does not match age‐related expectations
title_short Untimely illness: When diagnosis does not match age‐related expectations
title_sort untimely illness: when diagnosis does not match age‐related expectations
topic Original Research Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117493/
https://www.ncbi.nlm.nih.gov/pubmed/29424066
http://dx.doi.org/10.1111/hex.12669
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