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

Susan Kirkpatrick, Louise Locock, Albert Farre, Sara Ryan, Helen Salisbury, Janet McDonagh

Research output: Contribution to journalArticle

4 Citations (Scopus)
3 Downloads (Pure)

Abstract

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 datasets (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 recognise 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.
Original languageEnglish
Pages (from-to)730-740
Number of pages11
JournalHealth Expectations
Volume21
Issue number4
Early online date9 Feb 2018
DOIs
Publication statusPublished - Aug 2018

Fingerprint

Arthritis
Asthma
Interviews
Delayed Diagnosis
Health
Lenses
Chronic Disease
Datasets

Keywords

  • adult onset asthma
  • young people with arthritis
  • diagnosis
  • age related expectations
  • chronic illness
  • age and diagnosis
  • candidacy
  • diagnostic delay

Cite this

Kirkpatrick, S., Locock, L., Farre, A., Ryan, S., Salisbury, H., & McDonagh, J. (2018). Untimely illness: When diagnosis does not match age-related expectations. Health Expectations, 21(4), 730-740. https://doi.org/10.1111/hex.12669

Untimely illness : When diagnosis does not match age-related expectations. / Kirkpatrick, Susan; Locock, Louise; Farre, Albert ; Ryan, Sara; Salisbury, Helen ; McDonagh, Janet.

In: Health Expectations, Vol. 21, No. 4, 08.2018, p. 730-740.

Research output: Contribution to journalArticle

Kirkpatrick, S, Locock, L, Farre, A, Ryan, S, Salisbury, H & McDonagh, J 2018, 'Untimely illness: When diagnosis does not match age-related expectations' Health Expectations, vol. 21, no. 4, pp. 730-740. https://doi.org/10.1111/hex.12669
Kirkpatrick, Susan ; Locock, Louise ; Farre, Albert ; Ryan, Sara ; Salisbury, Helen ; McDonagh, Janet. / Untimely illness : When diagnosis does not match age-related expectations. In: Health Expectations. 2018 ; Vol. 21, No. 4. pp. 730-740.
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abstract = "BackgroundWe 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. MethodsSecondary analysis of two qualitative datasets (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. ResultsPeople did not always assert their candidacy for either condition because of pre-conceived expectations around age. Similarly, health professionals sometimes failed to recognise 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 ConclusionThe 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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N2 - BackgroundWe 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. MethodsSecondary analysis of two qualitative datasets (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. ResultsPeople did not always assert their candidacy for either condition because of pre-conceived expectations around age. Similarly, health professionals sometimes failed to recognise 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 ConclusionThe 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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