Table 1 The Dimensions of candidacy
Candidacy dimension | Definition | Examples in MIA study |
|---|---|---|
Identification of candidacy | The ability of individuals to recognise their symptoms when they first manifest as requiring medical assistance or intervention | • Families’ perceptions of asthma • Parents’ recognition of asthma symptoms |
Navigation | The need for knowledge about services and the ability to mobilise a range of resources (practical, financial) that enable access to services | • Awareness about asthma services • Time off work for appointments |
Permeability | The ease with which people can gain access to different healthcare services | • GP practices as permeable • Practice nurses as assisting access • Need for negotiation of language differences |
Appearances at health services | The assertion of a claim to candidacy for medical attention or intervention by appearing at a service | • Getting a diagnosis • Managing emergency situations (attacks) • On-going management |
Adjudications | The judgements and decisions made by professionals, which allow or inhibit continued progression of candidacy | • Inconsistent management and unclear or contradictory advice given by different health professionals |
Offers and resistance | The offer of care or treatment made my services, and the resistance to those offers by users | • Refusal of annual reviews • Non-use of asthma medication |
Operating conditions and the local production of candidacy | Local or context-specific influences on interactions between patients and practitioners | • The uncertain and contingent nature of asthma • Local South Asian community networks |