scholarly journals Re-imagining patient narrative: exploring patient experience of genetic medicine through art practice

2017 ◽  
Author(s):  
◽  
Emma Frances O'Connor

I contend that art practice can critique and have an impact on the expectation and form of the patient narrative of genetic medicine, as promoted and experienced in medical contexts, and this is proposed as a contribution to knowledge. My second – methodological – contribution lies in the expansion of autoethnography to include autobiographical art practice to amplify possibilities for insight and new understanding. I construct and reflect upon my patient narrative as an artist and carrier of the CDH1 genetic mutation, associated primarily with Hereditary Diffuse Gastric Cancer. Art practice is proposed as a means of documenting, articulating, and analysing patient experience of genetic diagnosis and preventative surgery. Art works are employed to examine the relation between genetic diagnosis and patient narrative, with attention to the CDH1 genetic mutation. The discourse and structure of patient narrative are considered, questioning if current definitions accommodate the complex relation between genetic diagnosis and patient narrative. I trace the historical emergence of patient narrative (the means by which a selfidentifying patient or family member articulates personal experience of illness), examining dominant ideas in the field of patient narrative: biographical disruption, narrative reconstruction, and the sociologist Arthur Frank’s typologies of illness narrative. I explore Frank’s ideal illness narrative – the quest narrative – in my own quest, led by art practice, to locate my stomach. Contextualising my work in this field, I construct new ways to explore my patient experience through art practice, challenging existing models that fail to reveal what it means to be a patient of genetic medicine. Autoethnography is both a research methodology and outcome, informed by my experience. The work of others enhances my understanding of different approaches to narrative, providing models for addressing patient narrative in a meaningful way. Readings of two films by Jean-Luc Godard, Passion (1982) and Scénario du film ‘Passion’ (1982), and Dora García’s film The Joycean Society (2013) provide a framework for my practical experimentation as I discover narrative elements to explore through production. Recognising the experimental potential of narrative formation, I work with movement, rhythm, reflection, opacity, focus, emplotment, sequence, editing, fragment, sound, staging, framing, light, and documentation, investigating narrative forms – sonic, haptic, performed, embodied, book, digital – and singular, dialogic, and multiple narratives

2018 ◽  
Vol 94 (1116) ◽  
pp. 596-600 ◽  
Author(s):  
Jennifer L H Peterson

There is a premium placed on the maintenance of our privacy and confidentiality as individuals in society. For a productive and functional doctor–patient relationship, there needs to be a belief that details divulged in confidence to the doctor will be kept confidential and not disclosed to the wider public. However, where the information disclosed to the doctor could have implications for the safety of the wider public, for example disclosures with potential criminal implications, or have serious consequences for another individual, as is the case in genetic medicine, should doctors feel confident about breaching confidentiality? This essay firstly explores the legal rulings regarding cases in which confidentiality has been breached where there was risk of significant harm to others following the patient’s disclosure, and secondly, focusing on the evolving legal position with regard to confidentiality in contexts where information sharing would be beneficial to others, for example the evolving case of the implications of genetic diagnosis on families (eg, ABC v St George’s Healthcare NHS Trust; 2017).


2018 ◽  
Vol 5 (2) ◽  
pp. 57-60
Author(s):  
Arnon Broides ◽  
Ronit Gavrieli ◽  
Jacov Levy ◽  
Rachel Levy ◽  
Nurit Hadad ◽  
...  

Chronic granulomatous disease is a primary immunodeficiency disease caused by a genetic mutation in any of the 5 genes encoding the different components of the Nicotinamide Adenine Dinucleotide Phosphate reduced (NADPH)-Oxidase enzyme complex. Since primary immunodeficiency diseases are considered to be rare diseases, the genetic diagnosis of a certain primary immunodeficiency leads to the reasonable assumption that all patients with the same disease within the same family will have the same genetic mutation. We report 2 patients with chronic granulomatous disease from the same extended consanguineous family who had different genetic causes of their disease. Therefore, it is crucial to obtain a definitive genetic diagnosis of primary immunodeficiency disease even in patients from the same family, where the same genetic diagnosis is presumed to be the cause of the disease. Statement of novelty: Genetic causes of chronic granulomatous disease may be different in patients from the same family.


2021 ◽  
Author(s):  
◽  
Abdulmalik Hasanain

<p><b>Over the last decade, prostate cancer has been the most common cancer among men around the world. This study explores the experiences of this illness among a group of Jordanian Muslim men. The study aims to identify the impacts and challenges these men face throughout their experiences with cancer. Through the exploration, the study also focuses on the effects of these impacts and challenges on the men’s bodies, lives, and their identity, particularly gender. The study used ‘biographical disruption’ and ‘liminality’ theoretical concepts of illness narrative and the works of Connell (2000, 2002, 2005) on gender as a theoretical framework. It adopted a qualitative narrative approach in order to understand this cancer experience among these men. Fifteen Jordanian Muslim men, who had been treated with radiotherapy and hormonal therapy, were recruited, and interviewed to narrate their stories with prostate cancer. Three narrative analytical approaches (thematic, holistic form, and Bamberg’s positioning model) were used and integrated with the study’s theoretical framework for analysing the men’s stories.</b></p> <p>Five main key findings resulted from the analysis as follows. First, there is a range of common and specific disruptive impacts and challenges facing these men compared with other men who have similar experiences. Second, there are differing experiences of prostate cancer among these men across the cancer trajectory and over time. Third, the family of the affected men are involved and become a part of this illness experience along with the direct involvement of the healthcare providers with the men. Fourth, there are interactions and influences between the cancer experience and the men’s masculinity. Fifth, the complexity of this experience has an influence on the men’s identity as Jordanian Muslim men. The study, therefore, adds to the existing knowledge about the experience of prostate cancer by understanding how it can be from (Jordanian) Arabic Middle Eastern and Islamic contexts. The study concludes with implications and recommendations for nursing practice, for education, and for illness narrative and narrative research.</p>


2016 ◽  
Vol 12 (4) ◽  
pp. 308-319 ◽  
Author(s):  
Ulrike Manz

Objective The objective of this study is to explore the discriminatory impacts of genetic diagnosis for people living with the chronic illness of hereditary haemochromatosis in Germany. Methods Semi-structured interviews with 15 patients; all had tested positive for a genetic mutation associated with haemochromatosis and already displayed symptoms of the disease. Inductive approach, with interviews collaboratively interpreted by the research group in a vertical and horizontal analysis informed by a multi-person perspective. Results First, as the genetic diagnosis of the disease holds the promise of therapeutic intervention, the interviewees perceived it as leading to relief. Second, the interviewees felt stigmatized by their family members, they complained of social isolation and a lack of acknowledgement of their health problems. Third, they feared disadvantages for themselves or their children at their place of work, when buying insurance coverage, and when attempting to donate blood. Discussion The findings point to the need for an expanded view on genetic discrimination. Besides institutional discrimination, it appears necessary to systematically address interactional stigmatization and take anxieties and fears into account. Here we see starting points for providing essential support through specialist and self-help groups to those faced with the genetic diagnosis of haemochromatosis in addition to and beyond the legal protection against genetic discrimination that already exists.


2021 ◽  
Author(s):  
◽  
Abdulmalik Hasanain

<p><b>Over the last decade, prostate cancer has been the most common cancer among men around the world. This study explores the experiences of this illness among a group of Jordanian Muslim men. The study aims to identify the impacts and challenges these men face throughout their experiences with cancer. Through the exploration, the study also focuses on the effects of these impacts and challenges on the men’s bodies, lives, and their identity, particularly gender. The study used ‘biographical disruption’ and ‘liminality’ theoretical concepts of illness narrative and the works of Connell (2000, 2002, 2005) on gender as a theoretical framework. It adopted a qualitative narrative approach in order to understand this cancer experience among these men. Fifteen Jordanian Muslim men, who had been treated with radiotherapy and hormonal therapy, were recruited, and interviewed to narrate their stories with prostate cancer. Three narrative analytical approaches (thematic, holistic form, and Bamberg’s positioning model) were used and integrated with the study’s theoretical framework for analysing the men’s stories.</b></p> <p>Five main key findings resulted from the analysis as follows. First, there is a range of common and specific disruptive impacts and challenges facing these men compared with other men who have similar experiences. Second, there are differing experiences of prostate cancer among these men across the cancer trajectory and over time. Third, the family of the affected men are involved and become a part of this illness experience along with the direct involvement of the healthcare providers with the men. Fourth, there are interactions and influences between the cancer experience and the men’s masculinity. Fifth, the complexity of this experience has an influence on the men’s identity as Jordanian Muslim men. The study, therefore, adds to the existing knowledge about the experience of prostate cancer by understanding how it can be from (Jordanian) Arabic Middle Eastern and Islamic contexts. The study concludes with implications and recommendations for nursing practice, for education, and for illness narrative and narrative research.</p>


2021 ◽  
Author(s):  
◽  
Abdulmalik Hasanain

<p><b>Over the last decade, prostate cancer has been the most common cancer among men around the world. This study explores the experiences of this illness among a group of Jordanian Muslim men. The study aims to identify the impacts and challenges these men face throughout their experiences with cancer. Through the exploration, the study also focuses on the effects of these impacts and challenges on the men’s bodies, lives, and their identity, particularly gender. The study used ‘biographical disruption’ and ‘liminality’ theoretical concepts of illness narrative and the works of Connell (2000, 2002, 2005) on gender as a theoretical framework. It adopted a qualitative narrative approach in order to understand this cancer experience among these men. Fifteen Jordanian Muslim men, who had been treated with radiotherapy and hormonal therapy, were recruited, and interviewed to narrate their stories with prostate cancer. Three narrative analytical approaches (thematic, holistic form, and Bamberg’s positioning model) were used and integrated with the study’s theoretical framework for analysing the men’s stories.</b></p> <p>Five main key findings resulted from the analysis as follows. First, there is a range of common and specific disruptive impacts and challenges facing these men compared with other men who have similar experiences. Second, there are differing experiences of prostate cancer among these men across the cancer trajectory and over time. Third, the family of the affected men are involved and become a part of this illness experience along with the direct involvement of the healthcare providers with the men. Fourth, there are interactions and influences between the cancer experience and the men’s masculinity. Fifth, the complexity of this experience has an influence on the men’s identity as Jordanian Muslim men. The study, therefore, adds to the existing knowledge about the experience of prostate cancer by understanding how it can be from (Jordanian) Arabic Middle Eastern and Islamic contexts. The study concludes with implications and recommendations for nursing practice, for education, and for illness narrative and narrative research.</p>


Genes ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 131 ◽  
Author(s):  
Suzannah Bell ◽  
Samantha Malka ◽  
Ian Christopher Lloyd ◽  
Mariya Moosajee

Childhood cataract affects 2.5–3.5 per 10,000 children in the UK, with a genetic mutation identified in 50–90% of bilateral cases. However, cataracts can also manifest in adolescence and early adulthood in isolation, as part of a complex ocular phenotype or with systemic features making accurate diagnosis more challenging. We investigate our real-world experience through a retrospective review of consecutive bilateral cataract patients (0–25 years) presenting to the ocular genetics service at Moorfields Eye Hospital between 2017 and 2020. Fifty-four patients from 44 unrelated families were identified, with a median age of 13.5 years (range 1 to 68 years) and a median age at diagnosis of 43.9 months IQR (1.7–140.3 months); 40.7% were female and 46.3% were Caucasian. Overall, 37 patients from 27 families (61.4%) were genetically solved (50%) or likely solved (additional 11.4%), with 26 disease-causing variants (8 were novel) in 21 genes; the most common were crystallin genes, in 8 (29.6%) families, with half occurring in the CRYBB2 gene. There was no significant difference in the molecular diagnostic rates between sporadic and familial inheritance (P = 0.287). Associated clinical diagnoses were retinal dystrophies in five (18.5%) and aniridia in three (11.1%) families. Bilateral cataracts were the presenting feature in 27.3% (6/22) of either complex or syndromic cases, and isolated cataract patients were 11.5 years younger (rank-sum Z = 3.668, P = 0.0002). Prompt genetic investigation with comprehensive panel testing can aid with diagnosis and optimise management of cataract patients.


2017 ◽  
Vol 23 ◽  
pp. 258
Author(s):  
Elizabeth Wendt ◽  
Maria Bates ◽  
Reese Randle ◽  
Jason Orne ◽  
Cameron Macdonald ◽  
...  

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