The significance of cultural norms and clinical logics for the perception of possible relapse in rural Northern Norway – sensing symptoms of cancer

Submitted: 3 October 2017
Accepted: 2 November 2017
Published: 31 December 2017
Abstract Views: 795
PDF: 413
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Little is known about the process from experiencing indeterminate bodily sensations to perceiving them as possible symptoms of cancer relapse. We explore how such processes are related to local values and to clinical practice in rural Northern Norway. One-year ethnographic fieldwork was conducted in a coastal village involving ten key participants residing in the village who had undergone cancer treatment from six months to five years earlier. The village has instability in primary health care staffing, which influences how and when indeterminate bodily sensations are presented to shifting GPs. The participants feel that they have to present clear symptoms, so they hesitate to see the doctor for such bodily sensations. Moreover, the personal evaluation of bodily sensations is embedded in local values in the village. Core values are to contribute to the common good, not be a burden, be positive and avoid focusing on difficult things. Participants’ inner dialogues with co-villagers and health personnel lead to not sharing concerns about bodily sensations, even though they might be symptoms of relapse. We suggest a rethinking and relocation of Hay’s analysis of social legitimation in sense-tosymptom processes in order to grasp the experiences of cancer in rural Northern Norway.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Harrington CB et al. It's not over when it's over: Long-term symptoms in cancer survivors - a systematic review. Int J Psychat Med. 2010;40(2):163-81. DOI: https://doi.org/10.2190/PM.40.2.c
Classen C. Foundations for an anthropology of the senses. Int Soc Sci J 1997;49(153):401-12. DOI: https://doi.org/10.1111/j.1468-2451.1997.tb00032.x
Hinton DE, Howes D, Kirmayer LJ. Toward a medical anthropology of sensations: Definitions and research agenda. Transcult Psychiatry. 2008;45(2):142-62. DOI: https://doi.org/10.1177/1363461508089763
Nichter M. Coming to our senses: Appreciating the sensorial in medical anthropology. Transcult Psychiatry. 2008;45(2):163-97. DOI: https://doi.org/10.1177/1363461508089764
Howes D. Sensual relations. Engaging the senses in culture and social theory. Ann Arbor: The University of Michigan Press; 2007.
Geurts KP. Culture and the senses : Bodily ways of knowing in an african community. Berkeley: University of California Press; 2002. DOI: https://doi.org/10.1525/9780520936546
Hay MC. Reading sensations: Understanding the process of distinguishing 'fine' from 'sick'. Transcult Psychiatry. 2008;45(2):198-229. DOI: https://doi.org/10.1177/1363461508089765
García-Hernández KY et al. This plant treats that illness? The hot-cold system and therapeutic procedures mediate medicinal plant use in San Miguel Tulancingo, Oaxaca, Mexico. J Ethnopharmacol. 2015;163:12-30. DOI: https://doi.org/10.1016/j.jep.2015.01.001
Rosendal M et al. Multiple perspectives on symptom interpretation in primary care research. BMC Fam Pract. 2013;14. DOI: https://doi.org/10.1186/1471-2296-14-167
Bagayogo IP, Interian A, Escobar JI. Transcultural aspects of somatic symptoms in the context of depressive disorders. Adv Psychom Som Med 2013. p. 64-74. DOI: https://doi.org/10.1159/000350057
Spoont MR et al. From trauma to PTSD: Beliefs about sensations, symptoms, and mental illness. Qual Health Res. 2009;19(10):1456-65. DOI: https://doi.org/10.1177/1049732309348370
Andersen RS et al. Patient delay in cancer studies: A discussion of methods and measures. BMC Health Serv Res 2009;9. DOI: https://doi.org/10.1186/1472-6963-9-189
Andersen RS et al. 'Containment' as an analytical framework for understanding patient delay: A qualitative study of cancer patients' symptom interpretation processes. Soc Sci Med. 2010;71(2):378-85. DOI: https://doi.org/10.1016/j.socscimed.2010.03.044
Brandner S et al. Symptomization and triggering processes: Ovarian cancer patients' narratives on pre-diagnostic sensation experiences and the initiation of healthcare seeking. Soc Sci Med. 2014;119:123-30. DOI: https://doi.org/10.1016/j.socscimed.2014.08.022
Youll J, Meekosha H. Always look on the bright side of life: Cancer and positive thinking. J Sociol. 2013;49(1):22-40. DOI: https://doi.org/10.1177/1440783311417742
Brandes K et al. Unraveling the determinants of cancer patients intention to express concerns. J Health Commun. 2016;21(3):327-36. DOI: https://doi.org/10.1080/10810730.2015.1080325
Larsen IK. Cancer in Norway 2014 - cancer incidence, mortality, survival and prevalence in Norway. Oslo: Kreftregisteret Norge; 2015.
Coleman MP et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995-2013; 2007 (the international cancer benchmarking partnership): An analysis of population-based cancer registry data. Lancet. 2011;377(9760):127-38. DOI: https://doi.org/10.1016/S0140-6736(10)62231-3
Olsen RE. Towards a sociology of cancer caregiving: Time to feel. Surrey, England: Ashgate; 2015. DOI: https://doi.org/10.4324/9781315550619
la Cour K, Johannessen H, Josephsson S. Activity and meaning making in the everyday lives of people with advanced cancer. Palliat Support Care. 2009;7(4):469-79. DOI: https://doi.org/10.1017/S1478951509990472
Miller LE. “People don’t understand that it is not easy being a cancer survivor”: Communicating and negotiating identity throughout cancer survivorship. Southern Communication Journal. 2015;80(1). DOI: https://doi.org/10.1080/1041794X.2014.936971
Folkvord S, Foss N. Kombinering av konvensjonell og alternativ behandling ved lettere muskel- og skjelettlidelser2013 17 August 2015. Available from: http://munin.uit.no/bitstream/handle/10037/5788/article.pdf?sequence=1&isAllowed=y.
Flick U. Qualitative Sozialforschung - Eine Einfuehrung. Hamburg: Rowohlt Taschenbuch Verlag; 2012.
Wager EaK, S. Chapter 50: Responsible research publication: International standards for authors. A position statement developed at the 2nd world conference on research integrity. In: N MTS, editor. Promoting research integrity in a global environment. Singapore: Imperial College Press/ World Scientific Publishing; 2011. p. 309-16.
Damsgaard JB et al. Back pain - a feeling of being mistrusted and lack of recognition: A qualitative study. International Journal of Orthopaedic and Trauma Nursing. 2016;21:11-20. DOI: https://doi.org/10.1016/j.ijotn.2016.01.001
Sara Marie Hebsgaard O, Peter V, Rikke Sand A. ‘The good citizen’: Balancing moral possibilities in everyday life between sensation, symptom and healthcare seeking. Anthropology in Action. 2017;24(1):6-12.
Gullestad M. Det norske sett med nye øyene. Oslo: Universitetsforlaget; 2002.
Aarsæther N. Håkon lorentzen og line dugstad: Den norske dugnaden. Historie, kultur og fellesskap. Sosiologisk tidsskrift. 2012;20(01):98-101.
Dahl KV. Fikk regning da hun ikke møtte på dugnad. 23 april. 2015. Www.Byavisa.no.
Foss N. Nerves in northern norway: The communication of emotions, illness experiences, and health-seeking behaviors. Qual Health Res. 2002;12(2):194-207. DOI: https://doi.org/10.1177/104973202129119838
Sollien K. Fastlegene flykter fra distriktene. 01 February 2016. Dagens Medisin.
Abelsen B, Gaski M, Brandstorp H. Fastlegeordningen i kommuner med under 20 000 innbyggere. UIT Norges arktiske universitet - Tromsø: NSDM; 2016.
Evans J, Ziebland S, McPherson A. Minimizing delays in ovarian cancer diagnosis: An expansion of andersen's model of ‘total patient delay’. Fam Pract. 2006;24(1):48-55. DOI: https://doi.org/10.1093/fampra/cml063
Andersen RS, Vedsted P. Juggling efficiency. An ethnographic study exploring healthcare seeking practices and institutional logics in danish primary care settings. Soc Sci Med. 2015;128:239-45. DOI: https://doi.org/10.1016/j.socscimed.2015.01.037
Good BJ. Medicine, rationality, and experience : An anthropological perspective. Cambridge: Cambridge University Press; 1994.
Mol A. The body multiple: Ontology in medical practice. United States of America: Duke University Press; 2002. DOI: https://doi.org/10.1215/9780822384151

Supporting Agencies

The project was funded by the Research Council of Norway.

How to Cite

Skowronski, Magdalena, Mette Bech Risør, and Nina Foss. 2017. “The Significance of Cultural Norms and Clinical Logics for the Perception of Possible Relapse in Rural Northern Norway – Sensing Symptoms of Cancer”. Qualitative Research in Medicine and Healthcare 1 (3). https://doi.org/10.4081/qrmh.2017.7116.