Researching Experiences of Cancer Risk Through Online Blogs: A Reflexive Account of Working Toward Ethical Practice

Metaphors and decision making in parental blogs about their children with life-limiting diseases: who's afraid of the war metaphor?

The use of metaphors aids understanding by allowing us to think of complex problems in terms of relatively simple and more concrete information. As such, metaphors shape thought and guide future action. While metaphors are known to play a role in medical treatment decision-making, the effect of particular metaphors is unknown.This paper explores the metaphors West-European parents use for their child suffering from a life-limiting condition by analysing 15 blogs from Dutch, German and English and Welsh parents. The analysis found that all parents use war metaphors to describe their child and their disease. Describing their child in war metaphors, for example, 'fighter', 'hero' or 'trooper' allows parents to express their pride in their child. To describe the familial situation parents use both 'life as a fight' and a 'time as space' metaphor. Time is conceptualised as a space to be filled with positive experiences to allow the child to live as full a life as possible. In medical treatment decisions, parents balance 'fighting the disease' against their child's ability to live a good life. No evidence was found that the use of war metaphors increase a tendency to treat when benefit is unlikely. Instead, parents primarily use war metaphors as a conduit to express their love for their child and to empower them to manage the familial situation.

That one doctor. . . Qualitative thematic analysis of 49 women’s written accounts of their endometriosis diagnosis

Introduction:

One in nine women experience endometriosis, a common gynaecological disease, yet time to diagnosis averages 7 years. People are sharing their endometriosis experiences online. This research’s aim was to expose and synthesise the collective themes of diagnostic experience.

Method:

A qualitative thematic analysis of publicly accessible online autobiographical accounts of women and their endometriosis diagnosis. Themes were coded within NVIVO and thematic maps and tables created. Eighty-nine original accounts were identified, 26 were excluded. Saturation point was 49.

Results:

Women communicated long, painful and emotional journeys to diagnosis. Forty women experienced endometriosis symptoms before the age of 20, 33 before 15 years. Despite repeated GP presentation, 36 women had never heard of endometriosis before diagnosis. Women highlighted the positive impact of ‘that one doctor’ who said the word ‘endometriosis’ who listened, believed, investigated and provided prompt referral to specialists. Diagnosis gave relief and answers to the long journey, provided women a sense of community, hope and personal visibility after feeling alone. While this common disease is undiagnosed women suffer.

Conclusion:

‘That one doctor’ can transform a patient’s experience and create a positive diagnosis pathway towards endometriosis. The doctor patient alliance is vital for prompt diagnosis. Symptom dismissal with long diagnosis delays are having negative, physical and psychological consequences for women. Early detection, GP education and community awareness campaigns are imperative to reduce further delayed diagnosis and long-term negative impacts of undiagnosed endometriosis.