Accepted Paper:

Reflections on the meanings, interpretations and impact of chest pain  
Helen Cramer (University of Bristol)

Paper short abstract:

This paper examines the experiences of people visiting rapid access chest pain clinics, the meanings that are co-created and the evolving impact, adjustments and continued uncertainties that people undergo.

Paper long abstract:

Sitting down with a clinician in a rapid access chest pain clinic to describe and answer questions about recent chest pain is an intimate act of collaboration. In the chest pain consultation clinicians and people jointly consider the body and its signs, articulate and agree on a language for the pain or chest discomfort, reflect on heart problems amongst kin and admit to certain habits such as smoking. For some people this initial consultation is the start of an ongoing bodily collaboration with clinicians as they submit to further testing involving peddling on bikes wired to heart monitors, radioactive dyes and needles. For clinicians this collaboration seeks to create more definitive 'evidence' for the pains and potentially leads to repairs and the strengthening of weak tubes. Similarly people need to adjust to a new (often medicalised) understanding of their bodies and its vulnerabilities but also engage in wider life and self reflection. For others the consultation in the chest pain clinic may mark the end of their collaboration with clinicians. While some people may re-assess the possible meanings they attributed to the chest pain and be completely reassured, others may continue to seek new collaborative engagements on a journey of uncertainty and anxiety as they attempt to secure more satisfactory explanations for their experiences. This presentation reports on the emerging findings of a qualitative longitudinal study of chest pain patients in the UK. It involved observations in clinics, repeat in-depth interviews with 24 chest pain patients and interviews with clinicians.

Panel P108
From bodily sensation to symptoms: consequences for healthcare seeking?