Managing the (In)visibility of Chronic Illness at Work: Dialogism, Parody, and Reported Speech

Qual Health Res. 2019 Jul;29(8):1213-1226. doi: 10.1177/1049732319825843. Epub 2019 Feb 9.

Abstract

Interactionally, the workplace may be dilemmatic for a person with "invisible" chronic illness. Risks of stigmatization exist if they disclose their condition to colleagues. Meanwhile, not disclosing threatens well-being and entitlements. Using Bakhtin's dialogism as a theoretical framework, we explored these social aspects of illness: inductively analyzing narratives from 20 participants with multiple sclerosis (MS). Capitalizing on concepts from dialogical and conversation analysis, links between (in)visibility, knowledge, and belief were examined with respect to symptoms and co-worker judgment. Perceived medical legitimacy creates a core social dilemma. At the intersection of genre and action, participants systematically used parody to subvert the traditional workplace hierarchy. "Oh-prefaced" direct reported speech (OPDRS) was deployed to exaggerate workplace interactions, undermining managers/colleagues who misattributed (in)visible symptoms. Parodic OPDRS index emotive interactional dilemmas. As subversions of organizational power, OPDRS denote those very areas where employees feel disempowered. Sensitivity to OPDRS can provide diagnostic support and complement evaluation frameworks.

Keywords: United Kingdom; chronic illness; conversation analysis; dialogical analysis; focus groups; job retention; multiple sclerosis; parody; qualitative; reported speech.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chronic Disease / psychology*
  • Female
  • Health Status
  • Humans
  • Male
  • Mental Health
  • Multiple Sclerosis / physiopathology
  • Multiple Sclerosis / psychology
  • Qualitative Research
  • Stereotyping
  • United Kingdom
  • Workplace / psychology*