Research Unit for General Practice, Department of Public Health, University of Aarhus, Bartholins Alle 2, 8000 Århus, Denmark.
Department of Anthropology, Archeology and Linguistics, University of Aarhus, Denmark.
Soc Sci Med. 2010 Jul;71(2):378-385. doi: 10.1016/j.socscimed.2010.03.044. Epub 2010 Apr 27.
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's (1979, 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.
近几十年来，欧洲癌症患者的生存率和死亡率存在很大差异，尤其是在英国和丹麦的患者中，生存率的增长幅度相当小。这种不佳的结果被暂时归因于患者的延误，因为据估计，所有癌症患者中有 20-25%的人在寻求治疗之前经历了超过三个月的与癌症相关的症状。在本文中，我们分析了对 30 名丹麦成年癌症患者及其家属的半结构化访谈。特别关注症状解释过程，以及这些过程如何潜在地延迟寻求医疗的决策。本文采用了一种受社会学家 Alonzo（1979，1984）的遏制概念主要启发的语境方法。Alonzo 的理论补充了最近关于人们如何在身体感觉和症状之间建立关系以及如何对此做出适当反应的人类学和社会学文献。我们提出了一个分析，说明了身体感觉和症状可能在与特定社会情况、生活传记和生活期望及其与文化上可接受的价值观和解释的一致性相关的因素的动态相互作用中得到遏制。最后，我们讨论了该分析对未来关于患者延误的研究的影响。
