Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, PO Box 600, Wellington 6140, New Zealand.
University of Victoria, Canada.
Soc Sci Med. 2013 Dec;99:49-55. doi: 10.1016/j.socscimed.2013.10.011. Epub 2013 Oct 24.
Influenza is a common infectious disease, yet its diagnosis is rarely confirmed, rather is presumed in the presence of non-specific clinical symptoms. Public health organisations enlist the lay person in the diagnostic process, as infection containment initiatives focus on encouraging individuals with influenza-like illness to stay at home, seeking medical attention only in the presence of complications. While lay self-diagnosis of influenza has been confirmed to be neither specific nor sensitive, little is known about how people with confirmed-influenza infection describe their illness. In this article we report the descriptions of influenza by 21 individuals with rapid antigen test-kit confirmation of influenza A or B and we discuss their recommendations for management of future influenza infection. Semi-structured interviews reveal that the variability in symptoms and severity of disease makes a standard description of influenza elusive. Almost all participants had a cough, sweats, runny nose and muscle aches, but the prominence of these symptoms varied significantly between participants. Most participants were preoccupied with diagnostic certainty, and would seek medical attention in a future similar illness episode. This study underlined a conditioned recourse to medical authority for confirmation of diagnosis which challenges current public health strategies and should be further explored in order to determine its wider impact.
流感是一种常见的传染病,但诊断很少得到确认,而是在存在非特异性临床症状的情况下进行推测。公共卫生组织在诊断过程中招募非专业人员,因为感染控制措施侧重于鼓励有流感样症状的人呆在家里,只有在出现并发症的情况下才寻求医疗帮助。虽然已经证实非专业人员自我诊断流感既不特异也不敏感,但对于已确诊流感感染的人如何描述他们的疾病知之甚少。在本文中,我们报告了 21 名经快速抗原检测试剂盒确诊为 A 型或 B 型流感的个体对流感的描述,并讨论了他们对未来流感感染管理的建议。半结构化访谈显示,症状的可变性和疾病的严重程度使得流感的标准描述难以捉摸。几乎所有参与者都有咳嗽、出汗、流鼻涕和肌肉疼痛,但这些症状在参与者之间的显著程度差异很大。大多数参与者关注的是诊断的确定性,如果将来出现类似的疾病发作,他们会寻求医疗帮助。这项研究强调了对医学权威的条件性依赖,以确认诊断,这挑战了当前的公共卫生策略,应该进一步探索,以确定其更广泛的影响。