Non-disclosure of chronic kidney disease in primary care and the limits of instrumental rationality in chronic illness self-management

Social Science & Medicine
Gavin Daker-WhiteCarolyn Chew-Graham

Abstract

Early detection of long term conditions is predicated on assumptions that lifestyle changes and medications can be used to reduce or manage the risk of condition progression. However, ambiguity remains about the nature and place of diagnostic disclosure to people in newly recognised or asymptomatic 'pre' conditions such as early stage chronic kidney disease (CKD). The disclosure of a diagnosis is relevant to instigating strategies which rely on actively engaging patients as self-managers of their own care. Whilst primary care routinely records a diagnosis of early stage CKD, little is known about how patients learn about the fact that they have CKD or how they respond to this. This study aimed to explore patients' experiences of disclosure of CKD in primary care settings. A nested qualitative study of participants recruited to a trial of an intervention for CKD patients in Greater Manchester, UK was undertaken. A purposive sample of 26 patients, with a mean age of 72 years (range 59-89, median 71), were interviewed during 2012. Interview transcripts were analysed using constant comparative techniques. Narrative accounts reflected limited or partial disclosure of CKD; often cast in vague terms as "nothing to worry about". How pa...Continue Reading

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Citations

Sep 9, 2017·Chronic Illness·Sandra Joan Campbell-Crofts, Janet Roden
Mar 30, 2018·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Helen TwohigCaroline Mitchell
Nov 26, 2016·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Roger Jones
Mar 19, 2020·Journal of Renal Care·Helen RaineyNicola Thomas
May 1, 2020·Global Public Health·Janet SeeleyUNKNOWN ARK Consortium
Jul 28, 2018·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Sally A HullDavid C Wheeler
Jun 5, 2019·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Sally A HullNeil Ashman
Nov 6, 2020·Journal of Medical Ethics·Patrick Burch, Soren Holm
Dec 20, 2020·International Journal of Environmental Research and Public Health·Chiu-Chu Lin, Shang-Jyh Hwang
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Aug 3, 2021·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Tiffany H TaftLinda Nguyen

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