Since the 1970s research on how people take, or "adhere" to prophylactic medications, has been dominated by individualistic approaches emphasising the role of attitudes in explaining adherence, with limited predictive success. Such limitations may be related to a restricted conceptualisation of talk about medicine taking as an accurate representation of individuals' attitudes. Using asthma as a case example, this thesis explored whether we can more productively view such talk as social action reflecting the interactional and social conditions in which it is produced. This enables us to examine interactional issues with specific influence on everyday decisions about medicine taking. Key amongst these issues are likely to be moral discourses of illness management. Using ideas and tools associated with Discursive Psychology and Linguistic Ethnography, the author examined a range of data sources for how moral discourses of asthma management structured talk of people with asthma in face-to-face interview and focus group settings. Participants could be seen to deploy a range of rhetorical devices to justify medicine taking, positioning versions of their asthma management, views and themselves within a range of moral discourses that can be seen to circulate different social spaces. Building on Goffman's term "performance," these findings indicated that people's talk about medicine taking can be seen as transference of linguistic resources across contexts, manifested in different interactions. The "meaning" of performances is therefore a result of how different criteria, set up within interactions about illness management, match available resources deployed by individuals with chronic illness. These findings suggest that rather than seeing lay-professional discussions of medicine taking as being about persuading people to adopt particular attitudes, this approach allows us to see how mutually-agreed treatment decisions may, instead, require us to identify appropriate linguistic resources for facilitating discussion of patients' everyday concerns about illness management, within that interaction.
|University of East Anglia
|Electronic Thesis or Dissertation
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