Time and chronic illness: a narrative review
Accepted: 22 October 2015 / Published online: 29 October 2015
ÓSpringer International Publishing Switzerland 2015
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
Chronic illnesses are ‘‘health problems that require ongo-
ing management over a period of years or decades’’ .
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.
Centre for Medical and Health Sciences Education, Building
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University of Auckland, 2 Park Road, Grafton,
Auckland 1023, New Zealand
Australian Primary Health Care Research Institute, The
Australian National University, Canberra, Australia
Qual Life Res (2016) 25:1093–1102