Communication & Medicine, Vol 8, No 2 (2011)

The everyday elasticity of compliance in a symptomless disease

Lina Klara Hoel Felde
Issued Date: 19 Jun 2012

Abstract


Medically, compliance refers to the extent to which a patient’s response to medical advice coincides with doctors’ orders. Rather than this absolute standard, this article treats compliance as an institutionally available discourse continually figured in practice. The aim of this article is to describe people’s everyday elasticity of compliance in shifting contexts in everyday life. The empirical material presented, based on interviews with people with elevated cholesterol, suggests that people with symptomless diseases can be perceived to be living in a virtual ‘temporal limbo’, living ‘here and now’ in the present from one episode to the next. Presentbound conditions create, from moment to moment, a temporal limbo that challenges and conditions the participants’ constructions of compliance. Using three contexts as examples, this article empirically demonstrates how people with a symptomless disease accomplish – reflexively produce and reproduce – compliance in and through shifting contexts. Compliance is ever-emerging and stretched, adapted to the circumstances at hand, ongoingly constructed through a reflexive interplay between compliance-in-practice and compliance practice in a discursive give-and-take. This elasticity of compliance reveals a reflexive critique of medical compliance as a moral standard and leads us to discuss how people are adequately compliant in everyday moral contexts.

Download Media

PDF (Price: £17.50 )

DOI: 10.1558/cam.v8i2.123

References


Adelswärd, V. and Sachs, L. (1998). Risk discourse: Recontextualization of numerical values in clinical practice. Text 18 (2): 191–210. http://dx.doi.org/10.1515/text.1.1998.18.2.191
Atkin, K. and Ahmed, W. (2000). Pumping iron: Compliance with chelation therapy among young people who have thalassemia major. Sociology of Health & Illness22 (4): 500–524. http://dx.doi.org/10.1111/1467-9566.00216
Baker, C. D. (2003). Ethnomethodological analysis of interviews. In J. A. Holstein and J. F. Gubrium (eds) Inside Interviewing – New Lenses, New Concerns 395–412. Thousand Oaks: Sage.
Barber, N. (2002). Should we consider non-compliance a medical error? QualSaf Health Care 11 (1): 81–84. http://dx.doi.org/10.1136/qhc.11.1.81
Benson, J. and Britten, N. (2002). Patients’ decisions about whether or not to take antihypertensive drugs: Qualitative study. British Medical Journal 325: 873–877. http://dx.doi.org/10.1136/bmj.325.7369.873
Bissonnette, J. M. (2008). Adherence: A concept analysis. Journal of Advanced Nursing 63 (6): 634–643. http://dx.doi.org/10.1111/j.1365-2648.2008.04745.x
Blaxter, M. and Cyster, R. (1984). Compliance and risk-taking: The case of alcoholic liver disease. Sociology of Health & Illness 6 (3): 290–310. http://dx.doi.org/10.1111/1467-9566.ep10491957
Britten, N. (1994). Patients’ ideas about medicines: A qualitative study in a general practice population. British Journal of General Practice 44: 465–468.
Bury, M. (1991). The sociology of chronic illness: A review of research and prospects. Sociology of Health & Illness 13 (4): 451–468. http://dx.doi.org/10.1111/j.1467-9566.1991.tb00522.x
Buston, K. M. and Wood, S. F. (2000). Non-compliance amongst adolescents with asthma: Listening to what they tell us about self-management. Family Practice 17(2): 134–138. http://dx.doi.org/10.1093/fampra/17.2.134
Button, A. D. (1956). The psychodynamics of alcoholism. A survey of 87 cases. Quarterly Journal of Studies of Alcohol 17: 296–305.
Cheek, F. E. and Laucius, J. (1972). The time worlds of three drug-using groups: Alcoholic addicts, heroin addicts and psychedelics. In H. Yaker, H. Osmond and F. Cheek (eds) The Future of Time 230–245. New York: Anchor.
Cochrane, G. M., Horne, R. and Chaney, R. (1999). Compliance in asthma. Respiratory Medicine 93 (11): 763–769. http://dx.doi.org/10.1016/S0954-6111(99)90260-3
Conrad, P. (1985). The meaning of medications: Another look at compliance. Social Science and Medicine 20 (1): 29–37. http://dx.doi.org/10.1016/0277-9536(85)90308-9
Davis, F. (1967). Why all of us may be hippies someday. Trans-Action 5 (2): 10–18.
Donovan, J. L. and Blake, D. R. (1992). Patient non-compliance: Deviance or reasoned decision-making? Social Science & Medicine 34: 507–513. http://dx.doi.org/10.1016/0277-9536(92)90206-6
Douglas, J. (1971). Understanding Everyday Life. London: Routledge&Kegan Paul.
Fineman, N. (1991). The social constitution of noncompliance: a study of health care and social service provides in everyday practice. Sociology of Health & Illness 13 (3): 354–74. http://dx.doi.org/10.1111/1467-9566.ep10492252
Foucault, M. (1977). Discipline and Punish. New York: Vintage.
Foucault, M. (1980). Power/Knowledge: Selected Interviews and Other Writings 1972–1977. London: Harvester.
Garfinkel, H. (1967). Studies of Ethnomethodology. Englewood Cliffs: Prentice-Hall.
Goffman, E. (1973). Frame Analysis. New York: Harper & Row.
Goffman, E. (1981). Forms of Talk. Philadelphia: University of Pennsylvania Press.
Gubrium, J. F. and Holstein, J. A. (1990). What is Family? Mountain View: Mayfield.
Gubrium, J. F. and Holstein, J. A. (1997). The New Language of Qualitative Methods. New York: Oxford University Press.
Gubrium, J. F. and Holstein, J. A. (2000). Analyzing interpretive practice. In N. K. Denzin and Y. S. Lincoln (eds) The Handbook of Qualitative Research 487–508. Thousand Oaks: Sage.
Gubrium, J. F. and Holstein, J. A. (2001). Institutional Selves. New York: Oxford University Press.
Gubrium, J. F. and Holstein, J. A. (2006). Couples, Kids, and Family Life. New York: Oxford University Press.
Gubrium, J. F. and Holstein, J. A. (2009). Analyzing Narrative Reality. Thousand Oaks: Sage.
Hazan, H. (1980). The Limbo People: A Study of the Constitution of the Time Universe among the Aged. London: Routledge&Kegan Paul.
Hickling, J., Rogers, S. and Nazareth, I. (2005). Barriers to detecting and treating hypercholesterolaemia in patients with ischaemic heart disease: primary care perceptions. British Journal of General Practice 55: 534–538.
Holstein, J. A. and Gubrium, J. F. (1995). The Active Interview. Thousand Oaks: Sage.
Holstein, J. A. and Gubrium, J. F. (2000a). The Self We Live By. New York: Oxford University Press.
Holstein, J. A. and Gubrium, J. F. (2000b). Constructing the Life Course. New York: General Hall.
Holstein, J. A. and Gubrium, J. F. (2003). Inside Interviewing – New Lenses, New Concerns. Thousand Oaks: Sage.
Horne, R. (2000). Patients’ beliefs about treatment: the hidden determinant of treatment outcome? Journal of Psychosomatic Research 47 (6): 491–495. http://dx.doi.org/10.1016/S0022-3999(99)00058-6
Horne, R., Clatwathy, J. Polmear, A. and Weinman, J. (2001). Do hypertension patients’ beliefs about their illness and tretament influence medication adherence and quality of life? Journal of Human Hypertension 15 (Supplement 1): S65–68. http://dx.doi.org/10.1038/sj.jhh.1001081
Horne, R and Weinman, J. (2000). Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. Journal of Psychosomatic Research 47 (6): 555–567. http://dx.doi.org/10.1016/S0022-3999(99)00057-4
Howson, A. (1999). Cervical screening, compliance and moral obligation. Sociology of Health & Illness 21 (4): 401–425. http://dx.doi.org/10.1111/1467-9566.00164
Hughes, E.C. (1984[1942]). Going concerns: The study of American institutions. In D. Riesman and H. S. Becker (eds.) The Sociological Eye: Selected Papers 52–64. New Brunswick: Transaction.
Hunt, L. M., Jordan, B. Irwin, S. and Browner, C. H. (1989). Compliance and the patient’s perspective: Controlling symptoms in everyday life. Culture, Medicine and Psychiatry 13 (3): 315–334. http://dx.doi.org/10.1007/BF00054341
Jones, R. C. M., Hyland, M. E., Hanney, K. and Erwin, J. (2004). A qualitative study of compliance with medication and lifestyle modification in chronic obstructive pulmonary disease (COPD). Primary Care Respiratory Journal 13: 149–154. http://dx.doi.org/10.1016/j.pcrj.2004.05.006
Kedward, J. and Dakin, L. (2003). A qualitative study of barriers to the use of statins and the implementation of coronary heart disease prevention in primary care. British Journal of General Practice 53: 684–689.
Lupton, D. (1995). The Imperative of Health. London: Sage.
Lupton, D. and Chapman, S. (1995). ’A healthy lifestyle might be the death of you’: Discourses on diet, cholesterol control and heart disease in the press and among the lay public. Sociology of Health & Illness 17 (4): 477–494. http://dx.doi.org/10.1111/1467-9566.ep10932547
Marsiglio, W. and Hinojosa, R. (2006). Stepfathers and the family dance. In J. F. Gubrium and J.A. Holstein (eds.) Couple, Kids, and Family Life 178–196. New York: Oxford University Press.
Monaghan, L. (1999). Challenging medicine? Bodybuilding, drugs and risk. Sociology of Health & Illness 21 (6): 707–734. http://dx.doi.org/10.1111/1467-9566.00180
Ogedegbe, G., Harrison, M., Robbins, L., Mancuso, C. A. and Allegrante, J. P. (2004). Barriers and facilitators of medication adherence in hypertensive African-Americans: A qualitative study. Ethnicity & Disease 14 (1): 3–12.
Pollner, M. (1987). Mundane Reason. New York: Cambridge University Press.
Riessman, C. K. (1990). Divorce Talk: Women and Men Make Sense of Personal Relationships. New Brunswick: Rutgers University Press.
Sachs, L. (1996). Causality, responsibility and blame – core issues in the cultural construction and subtext of prevention. Sociology of Health & Illness 18 (5): 632–652. http://dx.doi.org/10.1111/1467-9566.ep10934515
Sarangi, S. (2010) Practising discourse analysis in healthcare settings.In I. Bourgeault, R. DeVries and R. Dingwall (eds.) The SAGE Handbook of Qualitative Methods in Health Research 397–416. London: Sage.
Scott, M. B. and Lyman, S. (1968). Accounts. American Sociological Review 33 (1): 46–62. http://dx.doi.org/10.2307/2092239
Smith, D. (1990). The Conceptual Practices of Power – A Feminist Sociology of Knowledge. Toronto: University of Toronto Press.
Taylor, S. A., Gabraith, S. M. and Mills, R. P. (2002). Causes of non-compliance with drug regimens in glaucoma patients: A qualitative study. Journal of Ocular Pharmacology and Therapeutics 18 (5): 401–409. http://dx.doi.org/10.1089/10807680260362687
Tolmie, E. P., Lindsay, G. M., Kerr, S. M. Brown, M. R., Ford, I. and Gaw, A. (2003). Patients’ perspectives on statin therapy for treatment of hyperchoelsteroleamia: A qualitative study. European Journal of Cardiovascular Nursing 2 (2): 141–149. http://dx.doi.org/10.1016/S1474-5151(03)00028-8
Townsend, A., Hunt, K. and Wyke, S. (2003). Managing multiple morbidity in mid-life: a qualitative study of attitudes to drug use. British Medical Journal 327: 837–841. http://dx.doi.org/10.1136/bmj.327.7419.837
Trostle, J.A. (1988). Medical compliance as an ideology. Social Science & Medicine 27 (12): 1299–1308. http://dx.doi.org/10.1016/0277-9536(88)90194-3
Trostle, J. A., Hauser, W. A., Susser, I. S. (1983). The logic of noncompliance: management of epilepsy from the patient’s point of view. Culture, Medicine and Psychiatry 7: 35–56. http://dx.doi.org/10.1007/BF00249998
Wieder, D. L. (1974). Language and Social Reality. The Hague: Mouton.
Wittgenstein, L. (1958). Philosphical investigations. New York: Macmillan.

Refbacks

  • There are currently no refbacks.





Equinox Publishing Ltd - 415 The Workstation 15 Paternoster Row, Sheffield, S1 2BX United Kingdom
Telephone: +44 (0)114 221-0285 - Email: [email protected]

Privacy Policy