Malcolm_COPD+SSM+article+final.pdf (165.1 kB)
Download file

Chronic obstructive pulmonary disease (COPD), illness narratives and Elias's sociology of knowledge

Download (165.1 kB)
journal contribution
posted on 03.10.2017, 13:41 by Dominic MalcolmDominic Malcolm, Mark W. Orme, Mike Morgan, Lauren SherarLauren Sherar
This paper draws on Elias’s sociology of knowledge to provide a critical assessment of illness narratives. Focusing on a cohort of chronic obstructive pulmonary disease (COPD) patients (n=26), the paper employs a comparative analysis of mixed method data derived from qualitative interviews, quantitative questionnaires, and physiological and accelerometer testing. The article firstly compares four narratives conveyed in interviews with the broader paradigmatic approach to illness narratives and existing COPD-specific studies. It then explores the relationship between these ‘stories’ and COPD patients’ biographical contingencies (e.g. age, wealth, context of diagnosis) and embodied condition (e.g. co-morbidities, lung function), demonstrating how illness narratives are shaped by both broader social structural factors and embodied experience. Invoking Elias we further find that different narrative subthemes are varyingly affected by patients’ emotional engagement and ontological security and thus that people are differently enabled or constrained to present illness narratives that are consistent with their broader social and physical condition. Consequently, while narratives, social structure and embodied experience are interdependent, our reading of ‘truth’ must be sensitive to the social positioning of the ‘teller’ and the specific content being relayed. The paper therefore presents a more systematic, comparative, bio-psycho-social analysis than has hitherto been produced.



  • Sport, Exercise and Health Sciences

Published in

Social Science & Medicine






MALCOLM, D. al., 2018. Chronic obstructive pulmonary disease (COPD), illness narratives and Elias's sociology of knowledge. Social Science & Medicine, 192, pp. 58-65.


© Elsevier


AM (Accepted Manuscript)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at:

Acceptance date


Publication date



This paper was published in the journal Social Science & Medicine and the definitive published version is available at