‘I knew before I was told’: Breaches, cues and clues in the diagnostic assemblage.

Louise Locock; Sarah Nettleton; Susan  Kirkpatrick; Sara Ryan; Sue Ziebland

doi:doi:10.1016/j.socscimed.2016.02.037

‘I knew before I was told’: Breaches, cues and clues in the diagnostic assemblage.

Louise Locock, Sarah Nettleton, Susan Kirkpatrick , Sara Ryan, Sue Ziebland

Sociology

Research output: Contribution to journal › Article › peer-review

Abstract

Diagnosis can be both a ‘diagnostic moment’, but also a process over time. This paper uses secondary analysis of narrative interviews on ovarian cancer, antenatal screening and motor neurone disease to explore how people relate assembling procedural, spatial and interactional evidence before the formal diagnostic moment. We offer the idea of a diagnostic assemblage to capture the ways in which individuals connect to and re-order signs and events that come to be associated with their bodies. Building on the empirical work of Poole and Lyne (2000) in the field of breast cancer diagnosis, we identify how patients describe being alerted to their diagnosis, either through ‘clues’ they report picking up (often inadvertently) or through ‘cues’, perceived as a more intentional prompt given by a health professional, or an organisational process. For patients, these clues frequently represent a breach in the expected order of their encounter with healthcare. Even seemingly mundane episodes or behaviours take on meanings which health professionals may not themselves anticipate. Our findings speak to an emergent body of work demonstrating that experiences of formal healthcare during the lead-up to diagnosis shape patients' expectations, degree of trust in professionals, and even health outcomes.

Original language	English
Pages (from-to)	85-92
Journal	Social Science & Medicine
Volume	154
Early online date	28 Feb 2016
DOIs	https://doi.org/doi:10.1016/j.socscimed.2016.02.037
Publication status	Published - 28 Apr 2016

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doi:10.1016/j.socscimed.2016.02.037

http://www.sciencedirect.com/science/article/pii/S0277953616300922

Cite this

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title = "{\textquoteleft}I knew before I was told{\textquoteright}: Breaches, cues and clues in the diagnostic assemblage.",

abstract = "Diagnosis can be both a {\textquoteleft}diagnostic moment{\textquoteright}, but also a process over time. This paper uses secondary analysis of narrative interviews on ovarian cancer, antenatal screening and motor neurone disease to explore how people relate assembling procedural, spatial and interactional evidence before the formal diagnostic moment. We offer the idea of a diagnostic assemblage to capture the ways in which individuals connect to and re-order signs and events that come to be associated with their bodies. Building on the empirical work of Poole and Lyne (2000) in the field of breast cancer diagnosis, we identify how patients describe being alerted to their diagnosis, either through {\textquoteleft}clues{\textquoteright} they report picking up (often inadvertently) or through {\textquoteleft}cues{\textquoteright}, perceived as a more intentional prompt given by a health professional, or an organisational process. For patients, these clues frequently represent a breach in the expected order of their encounter with healthcare. Even seemingly mundane episodes or behaviours take on meanings which health professionals may not themselves anticipate. Our findings speak to an emergent body of work demonstrating that experiences of formal healthcare during the lead-up to diagnosis shape patients' expectations, degree of trust in professionals, and even health outcomes.",

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