Medication, chronic illness and identity: The perspective of people with asthma

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Abstract

The issue of compliance with prescribed medication has traditionally been dominated by the perspective of the health professional although increasingly sociologists, using qualitative methods, have begun to present the patients' point of view. However, little has been published on asthma, despite the numbers of people suffering from this chronic condition and the amount of medication regularly prescribed. This paper focuses on the perspective of a sample of S. Wales (U.K.) asthma patients who have all been prescribed prophylactic medication in the last 12 months and explores their attitudes to medication in the context of their everyday lives, using inductive qualitative research methods. Two main groups were identified: the deniers and the accepters. They differed fundamentally in their readiness to accept the identity of asthma sufferer which, in turn, was associated with very different beliefs about the nature of their problem and the meaning of the medication prescribed for it. There was also marked differences in their strategies of self-presentation and disclosure and their pattern of medication use, particularly for prophylactic medication. A third group, the pragmatists, were also identified as a possible sub-group of the accepter category who are less open within self-presentation and less consistent in their beliefs about asthma but do not reject the label entirely. Identity work, i.e. the way the respondents interpreted the social identity of asthma sufferers and managed to reconcile it with other social identities, is proposed as the most useful way of understanding the observed variation in the way people diagnosed as asthmatic conceptualise and use their medication.

References (51)

  • R. Anderson et al.

    Living with Chronic Illness: the Experience of Patients and their Families

    (1988)
  • A. Arluke

    Judging drugs: patients' conceptions of therapeutic efficacy in the treatment of arthritis

    Human Organisation

    (1980)
  • M. Blaxter

    The Meaning of Disability

    (1976)
  • British Thoracic Society

    Statement by the British Thoracic Society, Research Unit of the Royal College of Physicians of London, King's Fund Centre, National Asthma Campaign

    Guidelines for the management of asthma in adults: II-acute severe asthma

    British Medical Journal

    (1990)
  • M. Bury

    Chronic illness as biographical disruption

    Sociology of Health and Illness

    (1982)
  • M. Bury

    The sociology of chronic illness: a review of research and prospects

    Sociology of Health and Illness

    (1991)
  • M. Calnan

    Health and Illness the Lay Perspective

    (1987)
  • A. Carr

    Editorial

    British Journal of General Practice

    (1990)
  • K. Charmaz

    Loss of self: a fundamental form of suffering in the chronically ill

    Sociology of Health and Illness

    (1983)
  • K. Charmaz

    Struggling for a self: identity levels among the chronically ill

  • G.M. Cochrane

    Therapeutic compliance in asthma: its magnitude and implications

  • P. Conrad

    The experience of illness: recent and new directions

    Research in the Sociology of Health Care

    (1987)
  • J.K. Cooper et al.

    Intentional prescription non-adherence (non-compliance) by the elderly

    Journal of the American Geriatric Society

    (1982)
  • J. Cornwell

    Hard-earned Lives: Accounts of Health and Illness from East London

    (1984)
  • J.F. Costello et al.

    Different Patterns of Asthma Mortality and their Association with Beta-agonist Therapy

    (1992)
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