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Time and chronic illness: a narrative review

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Purpose: This narrative review is concerned with the ways in which the relationships between time and chronic illnesses have been chartered in recent literature. It aims to identify types of time (referred to here as temporal structures) most commonly reported in chronic illness literature and to assess their bearing on people's lived experiences. Methods: Literature searches of three electronic databases (Google Scholar, MEDLINE, and PubMed) were carried out in November 2014 of articles published between 1970 and 2013 using the following search terms (and derivatives): chronic illness AND time AND (patient OR carer). The review followed four procedural steps: (a) comprehensive search, (b) temporal structure appraisal, (c) synthesis of findings, and (d) critical appraisal. Results: Forty studies met the inclusion criteria and were included for review. Four types of called temporal structures had a strong presence in the literature: calendar and clocked time, biographical time, past-present-future time, and inner time and rhythms. The first three temporal structures are largely understood socially, and the fourth is predominantly understood in and through the body. Several studies reported more than one temporal structure as informing people's chronic illness experiences. A wide array of chronic illnesses were represented in these studies. Few studies reported on the experiences of people with multi-morbid chronic illnesses. Conclusion: Chronic illness induces new relationships to time. Drawing on Hyden (Sociol Health Illn 19(1):48-69, 1997), it is suggested that "narrative" storytelling-as a temporally informed analytic device-might prove effective for reconciling the tensions emergent from new and multiple relationships to time that chronic and multiple illnesses create. Opportunities exist for healthcare practitioners and health services to offer patients illness support that is cognisant of their relationships to time.
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REVIEW
Time and chronic illness: a narrative review
Tanisha Jowsey
1,2
Accepted: 22 October 2015 / Published online: 29 October 2015
ÓSpringer International Publishing Switzerland 2015
Abstract
Purpose This narrative review is concerned with the
ways in which the relationships between time and chronic
illnesses have been chartered in recent literature. It aims to
identify types of time (referred to here as temporal struc-
tures) most commonly reported in chronic illness literature
and to assess their bearing on people’s lived experiences.
Methods Literature searches of three electronic databases
(Google Scholar, MEDLINE, and PubMed) were carried
out in November 2014 of articles published between 1970
and 2013 using the following search terms (and deriva-
tives): chronic illness AND time AND (patient OR carer).
The review followed four procedural steps: (a) compre-
hensive search, (b) temporal structure appraisal, (c) syn-
thesis of findings, and (d) critical appraisal.
Results Forty studies met the inclusion criteria and were
included for review. Four types of called temporal struc-
tures had a strong presence in the literature: calendar and
clocked time, biographical time, past–present–future time,
and inner time and rhythms. The first three temporal
structures are largely understood socially, and the fourth is
predominantly understood in and through the body. Several
studies reported more than one temporal structure as
informing people’s chronic illness experiences. A wide
array of chronic illnesses were represented in these studies.
Few studies reported on the experiences of people with
multi-morbid chronic illnesses.
Conclusion Chronic illness induces new relationships to
time. Drawing on Hyden (Sociol Health Illn 19(1):48–69,
1997), it is suggested that ‘‘narrative’ storytelling—as a
temporally informed analytic device—might prove effec-
tive for reconciling the tensions emergent from new and
multiple relationships to time that chronic and multiple
illnesses create. Opportunities exist for healthcare practi-
tioners and health services to offer patients illness support
that is cognisant of their relationships to time.
Keywords Narrative Chronic illness Time
Qualitative Literature review Biographical
Introduction
Chronic illnesses are ‘health problems that require ongo-
ing management over a period of years or decades’’ [1].
Although chronic illnesses have different physiological,
biological, and pathological properties, they share a com-
mon thread—time. Severe chronic illnesses induce differ-
ent temporal rhythms and different relationships to time
than are experienced by the healthy person, or even the
person with acute illness. New practices may be developed
and routines established to manage chronic illness in per-
sonal and social contexts. As rhythms of bodily life alter, a
person’s expectations for the future might change, and their
relationships with other people (who have their own tem-
poral rhythms) might also adjust. Meanings attributed to
past and present experiences and practices, as well as
future plans and imaginings, acquire new significance with
chronic illness. As the time spent on health-related prac-
tices increases, meaning attributed to time expenditure may
also take on new valence.
&Tanisha Jowsey
t.jowsey@auckland.ac.nz
1
Centre for Medical and Health Sciences Education, Building
599, Level 12, Room 12.025, Auckland City Hospital,
University of Auckland, 2 Park Road, Grafton,
Auckland 1023, New Zealand
2
Australian Primary Health Care Research Institute, The
Australian National University, Canberra, Australia
123
Qual Life Res (2016) 25:1093–1102
DOI 10.1007/s11136-015-1169-2
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... U okviru istraživanja koja se bave proučavanjem hroničnih bolesti kroz prizmu vremena, od 1970-ih godina pa do danas, najčešće se nailazi na četiri koncepata tj. temporalne strukture: vreme kalendara i sata (CCT), biografsko vreme, vreme prošlosti-sadašnjosti-budućnosti i unutrašnje vreme i ritmovi (od kojih su prva tri društvena a četvrto individualno, telesno) (Jowsey 2016(Jowsey , 1093. Ono što čini nedostatak mnogih istraživanja jeste to što retko koriste više od jedne temporalne strukture, najčešće se fokusiraju samo na jednu hroničnu bolest i gotovo da ne postoje radovi o temporalnosti kod ljudi koji žive sa nekoliko hroničnih bolesti ili komorbiditeta, koji su sve češća pojava. ...
... Mi jedemo, spavamo, dišemo, varimo, razmišljamo, komuniciramo i radimo na ritmičan način. Kada se kombinuju "međusobno povezanim stopama", ritmični procesi proizvode telo koje funkcioniše (Jowsey 2016(Jowsey , 1097. Merlo-Ponti smatra da se vreme doživljava kroz telesna iskustva i prakse, tj. ...
... Drugim rečima, on govori o jazu između ova dva vremena i kakav uticaj taj jaz ima na pojedinca. Mekoj, koji se bavio odnosom unutrašnjeg i CCT vremena kod osoba sa HIV-om, primetio je da pojedinci često moraju da usklade svoje unutrašnje vreme sa spoljašnjim; na primer, u situaciji kada lek mora da se uzme uz jelo, pregovaranje -jer osoba možda nije gladna -nije moguće (Jowsey 2016). ...
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... We were also interested in examining recovery in the context of temporality. Recovery narratives often include transitions that demarcate who the person was before the illness, and who they became after (as well as during) demarcating turning points in the life narrative (Bury, 1982;Frank, 1995;Jowsey, 2016). The medical model might predict a recovery trajectory akin to what Frank (1995) calls a "restitution narrative," with the implication that the person essentially returns to the same sense of self after an illness experience. ...
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... In Western epistemologies, 'clock(ed) time' has become the dominant logic for dividing and measuring the unfolding of time in healthcare settings and beyond (Adam, 2006;Jowsey, 2016). Yet the multiple temporalities of illness and care practices, which operate at many interconnected scales and tempos, expose the insufficiencies of the clock as a singular organising device (Davies, 1994;Twigg, 2000). ...
... Jowsey, 2016Jowsey, , pp. 1093Jowsey, -1094. Clock time is endurance. ...
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