Temporal and spatial disruption: exploring illness behaviours and help seeking among vulnerable patients with Chronic Obstructive Pulmonary Disease (COPD)
|Dates:||13 December 2011|
|Times:||14:00 - 15:00|
|What is it:||Seminar|
Health Sciences Group-Primary Care present 'Temporal and spatial disruption: exploring illness behaviours and help seeking among vulnerable patients with Chronic Obstructive Pulmonary Disease (COPD)'
Speaker: Dr. Peter Coventry
Hospital admission and readmission for acute exacerbations are common events in the natural history of chronic obstructive pulmonary disease, and are associated with significant decrements in physical and mental health, poor prognosis and reduced survival. In the English National Health Service patients at high risk of hospital readmission are referred to nurse led early discharge schemes (EDS) which provide out of hospital care. EDS operate at the interface between secondary and primary care and are designed to support patients make the transition from hospital to self-care in the home. However, whilst EDS are safe and cost-effective they do not reduce the risk of readmission. A recently completed prospective cohort study showed that patients with depressive symptoms and living in rented or sheltered accommodation were more likely to be readmitted, despite being referred to EDS. This presentation builds on this finding by using in-depth interviews to explore the psychosocial, embodied and material dimensions of help seeking and other illness behaviours among a sub-sample of vulnerable COPD patients drawn from the cohort study. Major themes centred on notions of biographical disruption (and reconstruction) in the presence of threats to self-identity during and after acute episodes such as hospital readmissions. Additionally, biographical flow or continuity were salient among some patients who had avoided hospital readmissions – their illness narratives were characteristic of stories about adjustment and coping. The theoretical flexibility of this biographical mode of analysis is further tested by examining how illness behaviours associated with COPD are temporally and spatially patterned. In doing so this analysis challenges overly reflexive and cognitive modes of biographical analysis by bringing to the fore the embodied and emotional experiences of living with COPD, highlighting how these experiences are played out over time and space. Additionally, this study serves as a theoretical and empirical counterpoint to the predominance of health psychological models that seek to predict illness behaviours through the lens of social cognition and social learning theories.
Travel and Contact Information
Seminar Room 2, 5th Floor