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Seeking help for atrial fibrillation: the role of the body in distributed decision making

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  • Hawking, Meredith K.D.
  • Swinglehurst, Deborah

Abstract

We adopt Rapley's (2008) concept of distributed decision making to explore the role of the body in people's decisions to seek medical care. We conducted in-depth interviews with patients diagnosed with atrial fibrillation (AF) who were taking long-term anticoagulants to prevent stroke. We interviewed seventeen patients recruited from English anticoagulant clinics using the biographic-narrative-interpretive method, and conducted thematic, structural and metaphorical analyses. This pluralistic analysis focused on how distributed decision-making was enacted through a range of socio-material, relational and embodied practices. Participants told how they experienced AF-related sensations that fluctuated in intensity and form. Some had no symptoms at all; others experienced sudden incapacitation – these experiences shaped different journeys towards seeking medical help. We draw on work by Mol (2002) to show how the body was differently observed, experienced and done across contexts as the narratives unfolded. We show that as part of a relational assemblage, involving social, material and technological actors over time, a new body-in-need-of-help was enacted and medical help sought. This body-in-need-of-help was collectively discussed, interpreted and experienced through distribution of body parts, fluids and technological representations to shape decisions.

Suggested Citation

  • Hawking, Meredith K.D. & Swinglehurst, Deborah, 2024. "Seeking help for atrial fibrillation: the role of the body in distributed decision making," Social Science & Medicine, Elsevier, vol. 350(C).
    • Handle: RePEc:eee:socmed:v:350:y:2024:i:c:s0277953624003885
    DOI: 10.1016/j.socscimed.2024.116944
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    References listed on IDEAS

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    1. Thomas, Elizabeth C. & Bass, Sarah Bauerle & Siminoff, Laura A., 2021. "Beyond rationality: Expanding the practice of shared decision making in modern medicine," Social Science & Medicine, Elsevier, vol. 277(C).
    2. Macdonald, Sara & Blane, David & Browne, Susan & Conway, Ellie & Macleod, Una & May, Carl & Mair, Frances, 2016. "Illness identity as an important component of candidacy: Contrasting experiences of help-seeking and access to care in cancer and heart disease," Social Science & Medicine, Elsevier, vol. 168(C), pages 101-110.
    3. Amar Dhand & Douglas Luke & Catherine Lang & Michael Tsiaklides & Steven Feske & Jin-Moo Lee, 2019. "Social networks and risk of delayed hospital arrival after acute stroke," Nature Communications, Nature, vol. 10(1), pages 1-8, December.
    4. Gardner, John & Dew, Kevin & Stubbe, Maria & Dowell, Tony & Macdonald, Lindsay, 2011. "Patchwork diagnoses: The production of coherence, uncertainty, and manageable bodies," Social Science & Medicine, Elsevier, vol. 73(6), pages 843-850, September.
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