The lived experience of patients with uncertain medical diagnosis following a serious injury: a qualitative study

Abstract

Purpose. This paper examines the lived experience of uncertain medical diagnosis in patients with a serious injury.

Method. Data reported in this article are from the qualitative component of a multi-method study. Nineteen participants were purposively selected from a longitudinal quantitative study (n  ==  2856) undertaken in five regions of New Zealand, investigating the outcomes of injury. This article reports results from qualitative interviews taking place approximately 6 months after the injury event.

Results. The results section focuses on the lived experience of the injured patient who does not have a definite diagnosis. It describes the difficulty of persuading both health professionals and the workplace to take ongoing injury effects seriously, when the diagnosis cannot be clearly articulated. Issues associated with health professionals as gatekeepers to resources are raised, and also the potential for extended uncertainty to stigmatise the patient. Finally, the emotional impact of injury is discussed as an issue that is not often recognised.

Conclusion. Vague diagnostic labels attached to serious but invisible injury potentially reduce legitimate access to rehabilitation and the sick role. The socio-cultural context within which medicine is administered produces specific tensions in the clinical encounter. It is hypothesised that patients with uncertain diagnosis may be particularly at risk of the emergence of disability.

Keywords:

• Diagnosis
• injury
• compensation
• New Zealand

Acknowledgements

Prof. John Langley, Dr. Chrys Jaye, Dr. Sarah Clark and the journal reviewers are thanked for their helpful comments and suggestions on an earlier version of this article.

Declaration of interest: This paper was written while the first author was supported by an ACC Postdoctoral Research Fellowship. The Health Research Council of New Zealand and the Accident Compensation Corporation funded the Prospective Outcomes of Injury Study. Views and/or conclusions in this article are those of the authors and may not reflect the position of ACC.