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Social issues in diagnosis: An Introduction for Students and Clinicians

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Title: Social issues in diagnosis: An Introduction for Students and Clinicians

Edited by: Annemarie Goldstein Jutel and Kevin Dew

Publisher: Johns Hopkins University Press

Reviewer: Anne Olaitan, community NHS South East London

What was it like?

This book provides an historical account of the origins of medical diagnosis. Furthermore illustrates the complexity and uncertainty of relying health news to a client, within the constraints of a medical framework. The index for each chapter takes the reader through the process of formal diagnosis to errors In diagnosis. However, further coverage could have included perspectives of when expected bad news turns out to be positive and would have benefitted from examples on how clients dealt with the waiting process.

What were the highlights? 

Highlights include the range of perspectives gathered from different disciples and areas of the world that provides the reader with a balanced and global critique of diagnosis. I particularly enjoyed the chapter on lay diagnosis that adds insight to the patient’s experience, moving beyond the clinical picture. Other chapters encourage the reader to consider the different perspectives of diagnosis such as, reasons and the acceptance of a long term condition. The strategy of breaking the information into stages such as technical knowledge, emotional follow up and grieving enables the clinician time to absorb the client’s impact and to know how to deliver a person centred consultation. In addition the consideration to the environment in which the diagnosis is given enlightens the clinician to the importance of room management, interruptions and privacy.

Strengths & weaknesses:

The chapter on technology and diagnosis reminds the reader that testing is not a 100 percent reliable and in-addition can introduce a wait for test results but testing does not provide answers on how to manage for the moment. Those diagnostics can create more anxiety and dilemma for the client around how to utilise the information. Yet the book pays credence to this factor by acknowledging a new way of being for the client while waiting for results. The suggestion being that this time may contribute to the planning and management of future health care needs. Along with the notion that services need to be open to peoples narratives, which are influenced by a range of agencies such as public health statistics and media campaigns, alongside other HCP’s who can also diagnose such as radiologist, paediatricians and now  non-medical prescribers .The overall message is that everybody is responsible for the process of diagnosis, and that specialists can be the end point.

Who should read it?

Strong points are the exercises, take away points and discussion questions. As the chapters are short accompanied with clear prose it is an easy read. The client accounts add colour and depth to the supporting research and provide a balance of information, which as a result is probably more suitable for pre-registration student nurses, professionals in training and background reading to foundation programmes.

Social issues in diagnosis

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