Browsing by Author "Dennett E"

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    Accessing diagnosis and treatment: The experience of cancer as wrangling with the system
    (Elsevier B.V., 2024-06) Dew K; Chamberlain K; Egan R; Broom A; Dennett E; Cunningham C
    Long term cancer survival is increasingly prevalent, and the consequences are of sociological and clinical interest. In this paper we deploy the concept of wrangling to emphasise the everyday tussle of survivorship and processes of navigating pathways through what can be an unwelcoming environment. From 2020 to 2022 81 interviews were conducted with people, Māori and non-Māori, throughout Aotearoa New Zealand identified as exceptional cancer survivors, living with a diagnosis of cancer from four to 37 years. Categories of wrangling discussed by participants included wrangling with the public drug-buying agency in Aotearoa New Zealand, wrangling between private and public healthcare systems, subaltern wrangling and wrangling across regions. Wrangling could be driven by the person with the cancer diagnosis, undertaken on behalf of that person by others including family and health professionals, and undertaken by the community. We argue that for most people with long-term cancer survival wrangling is a social practice, but the capacity to succeed in that practice is dependent on a range of factors, including levels of economic, cultural, and social capital. The concept of wrangling provides a contrast to an overemphasis in the survivorship literature on cancer as an individual experience; one largely disconnected from the art and practice of managing (often unwieldy and flawed) systems of care.
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    Disruption, discontinuity and a licence to live: Responding to cancer diagnoses.
    (John Wiley and Sons Ltd on behalf of Foundation for the Sociology of Health & Illness, 2024-05-30) Dew K; Chamberlain K; Egan R; Broom A; Dennett E; Cunningham C
    Although a diagnosis of a life-limiting cancer is likely to evoke emotions, such as fear, panic and anxiety, for some people it can also provide an opportunity to live life differently. This article is based on research undertaken in Aotearoa New Zealand on the topic of exceptional cancer trajectories. Eighty-one participants who had been identified as living with a cancer diagnosis longer than clinically expected were interviewed, along with 25 people identified by some of the participants as supporters in their journey. For some participants the diagnosis provided the opportunity to rethink their lives, to undertake lifestyle and consumption changes, to be culturally adventurous, to take up new skills, to quit work and to change relationships with others. The concepts of biographical disruption and posttraumatic growth are considered in relation to these accounts, and it is argued that the event of a cancer diagnosis can give license for people to breach social norms.
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    Survival disparities in indigenous and non-indigenous New Zealanders with colon cancer: The role of patient comorbidity, treatment and health service factors
    (BMJ Publishing Group Ltd, 2010) Hill S; Sarfati D; Blakely T; Robson B; Purdie G; Chen J; Dennett E; Cormack D; Cunningham R; Dew K; McCreanor T; Kawachi I
    Background Ethnic disparities in cancer survival have been documented in many populations and cancer types. The causes of these inequalities are not well understood but may include disease and patient characteristics, treatment differences and health service factors. Survival was compared in a cohort of Maori (Indigenous) and non-Maori New Zealanders with colon cancer, and the contribution of demographics, disease characteristics, patient comorbidity, treatment and healthcare factors to survival disparities was assessed. Methods Maori patients diagnosed as having colon cancer between 1996 and 2003 were identified from the New Zealand Cancer Registry and compared with a randomly selected sample of non-Maori patients. Clinical and outcome data were obtained from medical records, pathology reports and the national mortality database. Cancer-specific survival was examined using Kaplan�Meier survival curves and Cox hazards modelling with multivariable adjustment. Results 301 Maori and 328 non-Maori patients with colon cancer were compared. Maori had a significantly poorer cancer survival than non-Maori (hazard ratio (HR)=1.33, 95% CI 1.03 to 1.71) that was not explained by demographic or disease characteristics. The most important factors contributing to poorer survival in Maori were patient comorbidity and markers of healthcare access, each of which accounted for around a third of the survival disparity. The final model accounted for almost all the survival disparity between Maori and non-Maori patients (HR=1.07, 95% CI 0.77 to 1.47).