Living through numbers; The spatial and temporal effects of numbers in diabetes self-management education
Nete Schwennesen (Copenhagen University )
Paper short abstract:
Paper long abstract:
In today's chronic disease management, numbers play a vital role in the mobilisation of the chronicly ill patient as a self-monitoring, active and responsible citizen. In response, it has been argued that patients need to have better numeracy skills (Perzynski et al. 2013) and a "numeracy gap" between health care providers and patients have been identified (Pighin et al. 2011). As such, the concern has been with how to communicate and present numbers to patients, in order for them to become able to understand numbers correctly. While such studies are important in their own right, this paper argues that it is necessary also to give attention to the spatial and temporal effects of numbers, if we are to understand the implications of the increasing use of numbers in chronic disease management. On the basis of ethnographic material, I explore how numbers (indicating bloodsugar) are interpreted in diabetes self-management education and the process through which numbers become meaningful in participant's everyday life. I propose an understanding of numbers as an element of the chronic care infrastructure (Langstrup 2013) that interrelate the home and the clinic, and illustrate that numbers become meaningful only through the attachment to other elements in the infrastructure, such as standards, medication, everyday practices and social relations. I argue that numbers have both place-making effects (the sense of place), which demands the emplacements of various objects, relations and activities in participants everyday life, and temporal effects (the sense of time), that creates a reorganisation of participants sense of the past and the future.
Technologies of care and participation: Shifting the distribution of expertise and responsibilities