Gomersall Tim, Madill Anna
School of Health & Related Research.
Institute of Psychological Sciences, University of Leeds.
Health Psychol. 2015 Apr;34(4):407-16. doi: 10.1037/hea0000151. Epub 2014 Sep 8.
This article aims to elaborate chronotope disruption--a changed relation to time and space--as a sensitizing concept for understanding chronic illness narratives.
Sixteen men and 16 women with Type 2 diabetes were purposefully sampled. Each was interviewed about his or her experience of diabetes self-management using the biographical-narrative interview method. Transcripts were inspected for key moments defined as emotionally laden stories relevant to the purpose of the research. We present dialogically inflected discursive analysis of exemplar extracts.
The analysis demonstrates how the concept of chronotope disruption helps identify, and understand, important aspects of patients' chronic illness narratives. First, we investigate how medical advice can conflict with embodied experience and how progressive bodily deterioration can provoke a reevaluation of past illness (self-mis)management. Second, the increasing temporal and spatial intrusion of chronic illness into participants' lives is examined. Finally, we focus on the masquerade of health as an attempt to manage, hide, or deny that one is physically challenged.
Chronotope disruption offers a useful sensitizing concept for approaching chronic illness narratives and around which to organize analytical insights and to develop practice. Chronotope analysis fills an important gap in the science through compensating current health sciences' focus on rationality, cognition, and prospective time (prediction) with a patient-oriented focus on emotionality, embodiment, and retrospective time (nostalgia). Chronotope disruption could be used to develop practice by gaining empathic understanding of patients' life-worlds and provides a tool to examine how new technologies change the way in which the chronically ill have "being" in the world.
本文旨在阐述时空体扰乱——一种与时间和空间的变化关系——作为理解慢性病叙事的一个敏感概念。
有目的地抽取了16名患有2型糖尿病的男性和16名患有2型糖尿病的女性。采用传记叙事访谈法，就其糖尿病自我管理的经历对每个人进行访谈。检查访谈记录，寻找被定义为与研究目的相关的情感丰富的故事的关键时刻。我们对示例摘录进行了对话式话语分析。
分析表明时空体扰乱这一概念有助于识别和理解患者慢性病叙事的重要方面。首先,我们研究医学建议如何与身体体验相冲突，以及身体的逐渐恶化如何引发对过去疾病（自我）管理的重新评估。其次，研究慢性病在时间和空间上对参与者生活的日益侵入。最后，我们关注健康的伪装，这是一种管理、隐藏或否认自己身体有缺陷的尝试。
时空体扰乱为研究慢性病叙事提供了一个有用的敏感概念，围绕这一概念可以组织分析见解并发展实践。时空体分析弥补了当前健康科学侧重于合理性、认知和前瞻性时间（预测）的不足，以患者为导向关注情感、身体体验和回顾性时间（怀旧），从而填补了科学领域的一个重要空白。时空体扰乱可用于通过共情理解患者的生活世界来发展实践，并提供一种工具来审视新技术如何改变慢性病患者在世界上的“存在”方式。
