Macdonald, S. , Blane, D. , Browne, S. , Conway, E., Macleod, U., May, C. and Mair, F. (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 and Medicine, 168, pp. 101-110. (doi: 10.1016/j.socscimed.2016.08.022) (PMID:27643844)
|
Text
123223.pdf - Accepted Version 431kB |
Abstract
How and when we use health services or healthcare provision has dominated exploration of and debates around healthcare access. Levels of utilisation are assumed as a proxy for access. Yet, focusing on utilisation conceals an important aspect of the access conundrum: the relationships that patients and potential patients have with the healthcare system and the professionals within those systems. Candidacy has been proposed as an antidote to traditional utilisation models. The Candidacy construct offers the ability to include patient-professional aspects alongside utilisation and thus promotes a deeper understanding of access. Originally applied to healthcare access for vulnerable populations, additional socio-demographic factors, including age and ethnicity, have also been shown to influence the Candidacy process. Here we propose a further extension of the Candidacy construct and illustrate the importance of illness identities when accessing healthcare. Drawing on a secondary data analysis of three data sets of qualitative interviews from colorectal cancer and heart failure patients we found that though similar access issues are apparent pre-diagnosis, diagnosis marks a critical juncture in the experience of access. Cancer patients describe a person-centred responsive healthcare system where their patienthood requires only modest assertion. Cancer speaks for itself. In marked contrast heart failure patients, describe struggling within a seemingly impermeable system to understand their illness, its implications and their own legitimacy as patients. Our work highlights the pressing need for healthcare professionals, systems and policies to promote a person centred approach, which is responsive and timely, regardless of illness category. To achieve this, attitudes regarding the importance or priority afforded to different categories of illness need to be tackled as they directly influence ideas of Candidacy and consequently access and experiences of care.
Item Type: | Articles |
---|---|
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Blane, Dr David and Conway, Dr Elaine and MacLeod, Dr Una and Browne, Dr Susan and Mair, Professor Frances and Macdonald, Professor Sara |
Authors: | Macdonald, S., Blane, D., Browne, S., Conway, E., Macleod, U., May, C., and Mair, F. |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
Journal Name: | Social Science and Medicine |
Publisher: | Elsevier |
ISSN: | 0277-9536 |
ISSN (Online): | 1873-5347 |
Published Online: | 18 August 2016 |
Copyright Holders: | Copyright © 2016 Elsevier |
First Published: | First published in Social Science and Medicine 168:101-110 |
Publisher Policy: | Reproduced in accordance with the copyright policy of the publisher |
University Staff: Request a correction | Enlighten Editors: Update this record