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Symptomization and triggering processes: Ovarian cancer patients' narratives on pre-diagnostic sensation experiences and the initiation of healthcare seeking

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Listed:
  • Brandner, Susanne
  • Müller-Nordhorn, Jacqueline
  • Stritter, Wiebke
  • Fotopoulou, Christina
  • Sehouli, Jalid
  • Holmberg, Christine

Abstract

Ovarian cancer is a malignant entity typically diagnosed in advanced stages, with concomitant poor prognosis. Delayed healthcare seeking is commonly explained by the ‘vague’ character of the disease's symptoms combined with a lack of awareness among patients. However, research on the social contexts of ovarian cancer patients' pre-diagnostic illness experiences and healthcare seeking is scarce. To explore these topics, we initiated a qualitative interview study guided by the principles of grounded theory and based on interviews with 42 ovarian cancer patients. The study was conducted in Germany from September 2011 to February 2013. Our analysis illustrates how, in the narratives, the interviewees struggled to balance specific bodily sensations with aspects of their life-worlds prior to consulting a biomedical professional. We propose a three-phase model to capture these experiences and demonstrate how the developments of pre-diagnostic sensations were catalysed by the dynamic and complex interplay of the sensations with a variety of individual and socio-cultural factors. To conceptualize these interplays, we introduce the analytical notion of a triggering process, and we elaborate on the different ways in which such a process conditioned the transformation of a sensation into a symptom and decisions to seek healthcare. We finally discuss our findings both in relation to current research on sensations, symptoms and healthcare seeking and in their relevance for understanding diagnostic delays in ovarian cancer.

Suggested Citation

  • Brandner, Susanne & Müller-Nordhorn, Jacqueline & Stritter, Wiebke & Fotopoulou, Christina & Sehouli, Jalid & Holmberg, Christine, 2014. "Symptomization and triggering processes: Ovarian cancer patients' narratives on pre-diagnostic sensation experiences and the initiation of healthcare seeking," Social Science & Medicine, Elsevier, vol. 119(C), pages 123-130.
    • Handle: RePEc:eee:socmed:v:119:y:2014:i:c:p:123-130
    DOI: 10.1016/j.socscimed.2014.08.022
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    References listed on IDEAS

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    1. Andersen, Rikke Sand & Paarup, Bjarke & Vedsted, Peter & Bro, Flemming & Soendergaard, Jens, 2010. "'Containment' as an analytical framework for understanding patient delay: A qualitative study of cancer patients' symptom interpretation processes," Social Science & Medicine, Elsevier, vol. 71(2), pages 378-385, July.
    2. van Wijk, Cécile M. T. Gijsbers & Kolk, Annemarie M., 1997. "Sex differences in physical symptoms: The contribution of symptom perception theory," Social Science & Medicine, Elsevier, vol. 45(2), pages 231-246, July.
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    1. Catherine Cook & Margaret Brunton & Tepora Pukepuke & Ai Ling Tan, 2018. "Exploring communication during the journey from noticing bodily changes to a diagnosis of endometrial cancer," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(5-6), pages 1262-1275, March.
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    3. Frances Marjorie May Lloyd & Alistair Hewison & Nikolaos Efstathiou, 2018. "“It just made me feel so desolate”: Patients’ narratives of weight gain following laparoscopic insertion of a gastric band," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(3-4), pages 732-742, February.

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