Mellan två världar : Om konflikten mellan livets krav och doktorns önskningar. Lärdomar från familjer med ett diabetessjukt barn

Sammanfattning: Compliance is a prerequisite of the patient's recovery, and also closely in accord with the medical profession's own interests. Non-compliance is a familiar as well as a common phenomenon, but its causes has remained obscure. The present study endeavours to answer the question what these causes are. Starting from a critique of earlier research the study lays a new foundation for the understanding of noncompliance. A phenomenological framework is introduced and used in a qualitative study of a number of diabetes-stricken families and their everyday life. The onset of insulin dependent diabetes is considered to be a disruptiveevent, and a host of tasks confronting the afflicted families are isolated and analysed, together with the strategies used to adapt to the changed situation.Given the extent of the problems confronting the afflicted persons, non-compliance appears in a new and (as it where) explained light. It is not because people are uninterested, ignorant or ineducable that they deviate from biomedical advise. No, it is because of the fact that chronic illness involves so much more than a biomedical disturbance. Followingfrom this conclusion the concept of "lived illness" is introduced as a parallell to the biomedical concept of illness, and is asserted to be an equally meaningful definition of what illness actually is. How can this meaning have been overlooked. The answer which is given is based on the concept of "institutional blocking out"". By institutional blocking out ismeant not only the blocking out that is a direct consequence of the institutions basic system of ideas, but also the blocking out deriving from the totality of actual circumstances and processes whereby the institution's constitutive system of ideas is produced and reproduced.