Imaging and imagining chronic obstructive pulmonary disease (COPD): Uruguayans draw their lungs

Abstract

Purpose: This anthropological study investigated what people imagined chronic obstructive pulmonary disease to look like in their lungs, what may be influencing these images and how this imagery shapes embodiment. Method: Employing graphic elicitation, in one of multiple ethnographic interviews, participants were asked to draw their lungs: "If we could look inside your chest now, what would we see?" Lung drawings and accompanying narratives and fieldnotes from 14 participants were analyzed for themes and patterns. Results: The theme of "imaging/imagining" emerged and three distinct patterns within this theme were identified: the microscope perspective, the X-ray perspective and the reduced pulmonary capacity perspective. These patterns demonstrate how embodiment can be shaped by an integration and reinterpretation of the medical images that form part of everyday clinic visits and pulmonary rehabilitation. Conclusions: Medical technology and images impact patients' embodiment. Understanding this is important for rehabilitation practitioners who work in a challenging space created by potentially conflicting medical narratives: on the one hand, chronic obstructive pulmonary disease is incurable permanent damage, and on the other, improvement is possible through rehabilitation. Drawing could be integrated into pulmonary rehabilitation and may help identify perceptions of the body that could hinder the rehabilitation process. ä IMPLICATIONS FOR REHABILITATIONDrawings, when combined with interviews, can lead to a deeper and more complex understanding of patients' perspectives and embodiment. Rehabilitation practitioners should be concerned with how patients embody the medical technology and imagery they are exposed to as part of the educational component of pulmonary rehabilitation and healthcare generally. Asking patients to visualize their illness through drawing may help pulmonary rehabilitation practitioners identify perceptions of the body which could hinder the patient's ability to reap the full benefit of their treatment. ARTICLE HISTORY

Diagnostic Imaging of Chronic Obstructive Pulmonary Disease: A Ten Years Systematic Review

“…Wainwright, M (2018) 5 showed Medical technology and images impact patients'embodiment. Understanding this is import-ant for rehabilitation practitioners who work in a challenging space created by potentially conflicting med-ical narratives: on the one hand, chronic obstructive pulmonary disease is incurable permanent damage,and on the other, improvement is possible through rehabilitation.…”

‘The body says it’: the difficulty of measuring and communicating sensations of breathlessness

“…21 The primary focus of most studies of breathlessness sensation has been to determine whether different patterns of sensory qualities discriminate among various diagnoses, with more recent studies exploring the extent to which sensory qualities of breathlessness may vary with changes in health status within a single diagnosis. 22 The authors of the MDP assure us that the 'Content validity of the MDP items is strong because each item is based on earlier studies in which clinical experts and patients evaluated their clarity and salience'. 14 Two of these foundational studies assessed the validity of the investigator's descriptors of breathlessness by consulting a panel of experts.…”