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Topographies of ‘care pathways’ and ‘healthscapes’: Reconsidering the multiple journeys of people with a brain tumour

Llewellyn, H; Sampson, EL; Higgs, P; Jones, C; Lewis, T; (2017) Topographies of ‘care pathways’ and ‘healthscapes’: Reconsidering the multiple journeys of people with a brain tumour. Sociology of Health and Illness 10.1111/1467-9566.12630. (In press). Green open access

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Abstract

People diagnosed with brain tumours enter new and unfamiliar worlds in which they must make complex and previously unimaginable decisions about care, treatment and how to live their lives. While decisions are increasingly based around care pathways, these are embedded in values that often fail to accord with those of patients. In this article, we examine the cases of people with a brain tumour and how they, their families and healthcare professionals navigate and intervene in the course of life-threatening disease. We use ethnographic data (2014–16) and modified social theory to highlight: (1) patients’ interpretations of disease and care and how they might differ from dominant biomedical logics; (2) complexity and contingency in care decisions; (3) rapid and unanticipated change owing to disease and bodily change; and (4) how people find ways through a world that is continually in motion and which comes into being through the combined action of human and non-human agencies. Our modified ‘healthscapes’ approach provides an analytic that emphasises the constant precariousness of life with a brain tumour. It helps to explain the times when patients’ feel bumped off the pathway and moments when they themselves step away to make new spaces for choice.

Type: Article
Title: Topographies of ‘care pathways’ and ‘healthscapes’: Reconsidering the multiple journeys of people with a brain tumour
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/1467-9566.12630
Publisher version: http://dx.doi.org/10.1111/1467-9566.12630
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/1572228
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