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'Containment' as an analytical framework for understanding patient delay: A qualitative study of cancer patients' symptom interpretation processes

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  • Andersen, Rikke Sand
  • Paarup, Bjarke
  • Vedsted, Peter
  • Bro, Flemming
  • Soendergaard, Jens

Abstract

Recent decades have seen much variation in survival and mortality among European cancer patients, with rather small increases in survival, especially among patients in UK and Denmark. This poor outcome has been ascribed tentatively to patient delay since an estimated 20-25% of all cancer patients report having experienced cancer-related symptoms for more than three months before seeking care. In this article we analyse semi-structured interviews with 30 adult Danish cancer patients and their families. Special focus is given to symptom interpretation processes, and how these processes potentially delay care-seeking decisions. The paper adopts a contextual approach inspired mainly by the sociologist (Alonzo, 1979) and (Alonzo, 1984) concept of containment. Alonzo's theory is supplemented with recent anthropological and sociological literature on how people establish the relation between bodily sensations and symptoms and decide how to respond adequately to these. We present an analysis illustrating that bodily sensations and symptoms are potentially contained in a dynamic interplay of factors related to specific social situations, life biographies and life expectations and their accordance with culturally acceptable values and explanations. Finally, we discuss the implications of the analysis for future studies on patient delay.

Suggested Citation

  • 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.
    • Handle: RePEc:eee:socmed:v:71:y:2010:i:2:p:378-385
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    References listed on IDEAS

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    1. Facione, Noreen C. & Facione, Peter A., 2006. "The cognitive structuring of patient delay in breast cancer," Social Science & Medicine, Elsevier, vol. 63(12), pages 3137-3149, December.
    2. Alonzo, Angelo A., 1984. "An illness behavior paradigm: A conceptual exploration of a situational-adaptation perspective," Social Science & Medicine, Elsevier, vol. 19(5), pages 499-510, January.
    3. Low, Setha M., 1985. "Culturally interpreted symptoms or culture-bound syndromes: A cross-cultural review of nerves," Social Science & Medicine, Elsevier, vol. 21(2), pages 187-196, January.
    4. Corner, Jessica & Hopkinson, Jane & Roffe, Liz, 2006. "Experience of health changes and reasons for delay in seeking care: A UK study of the months prior to the diagnosis of lung cancer," Social Science & Medicine, Elsevier, vol. 62(6), pages 1381-1391, March.
    5. de Nooijer, Jascha & Lechner, Lilian & de Vries, Hein, 2003. "Social psychological correlates of paying attention to cancer symptoms and seeking medical help," Social Science & Medicine, Elsevier, vol. 56(5), pages 915-920, March.
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    1. Andersen, Rikke Sand & Vedsted, Peter, 2015. "Juggling efficiency. An ethnographic study exploring healthcare seeking practices and institutional logics in Danish primary care settings," Social Science & Medicine, Elsevier, vol. 128(C), pages 239-245.
    2. Macdonald, Sara & Conway, Elaine & Bikker, Annemieke & Browne, Susan & Robb, Kathryn & Campbell, Christine & Steele, Robert JC. & Weller, David & Macleod, Una, 2019. "Making sense of bodily sensations: Do shared cancer narratives influence symptom appraisal?," Social Science & Medicine, Elsevier, vol. 223(C), pages 31-39.
    3. Hansen, Ulla Møller & Cleal, Bryan & Willaing, Ingrid & Tjørnhøj-Thomsen, Tine, 2018. "Managing type 1 diabetes in the context of work life: A matter of containment," Social Science & Medicine, Elsevier, vol. 219(C), pages 70-77.
    4. 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.

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