Health maintenance, meaning, and disrupted illness trajectories in people with low back pain: a qualitative study

‘It seems like you're going around in circles’: recurrent biographical disruption constructed through the past, present and anticipated future in the narratives of young adults with inflammatory bowel disease

“…Evidence of biographical disruption as not only being a one-time event experienced at illness onset supports other recent findings (e.g. Sanders et al 2015, Sanderson 2011; and in the case of Samuel the recurrent disruption appears to be felt just as severely each time around, showing consistency with arguments made by Larsson and Grassman (2012) that subsequent experiences of illness, even when anticipated, can be equally as devastating as the initial biographical disruption.…”

“…Recent work has focused on proactive strategies people use in their ongoing health maintenance (Sanders et al . ); strategies that can be culturally specific (Liamputtong and Suwankong ).…”

“…Sanders et al . () argue that the nature of non‐specific low back pain means it must be seen as requiring a fluid, fluctuating process of adaption and re‐adaption, and thus the ‘mobilisation of resources’ (Bury ) in responding to illness is not a distinct event. Similarly, in relation to rheumatoid arthritis, Sanderson et al .…”

“…Another criticism of the original biographical disruption concept relates to the representation of individuals as passively experiencing disruption, which has led to subsequent research, including later work by Bury himself, to place more focus on individual agency in responding to illness (Bury 1991, Morden et al 2015, Williams 1984. Recent work has focused on proactive strategies people use in their ongoing health maintenance (Sanders et al 2015); strategies that can be culturally specific (Liamputtong and Suwankong 2015).…”

“…In addition to the role of life context in influencing whether or not illness is experienced as disruptive, the relevance of biographical disruption to conditions with non-linear trajectories has been explored. Sanders et al (2015) argue that the nature of non-specific low back pain means it must be seen as requiring a fluid, fluctuating process of adaption and re-adaption, and thus the 'mobilisation of resources' (Bury 1982) in responding to illness is not a distinct event. Similarly, in relation to rheumatoid arthritis, Sanderson et al (2011) propose the concept of 'shifting normalities' whereby people can present different conceptualisations of normality at different junctures in their illness trajectory; a shift driven by the meanings they ascribe to changes in symptoms and bodily experiences as brought on by an unpredictable and fluctuating condition.…”