Abandoning questionnaires

Improving quality of life in daily nephrology practice

Abstract

Care-concepts have proliferated over the past couple of years, and have been used to
study all kinds of practices, situations and sites. This begs the question: What is gained by
studying practices in terms of care? The paper addresses this question by using a specific
care-approach, which is the study of daily life dealings (Mol et al., 2010). It mobilises this
approach to investigate a particular object, namely a good provision of haemodialysis
treatment in nephrology practice. It does so in a given place, a dialysis unit in Austria.
Based on ethnographic fieldwork with a focus on how patients' quality of life was improved,
the paper reports how, in this dialysis unit, a quality of life questionnaire was introduced
but soon abandoned. It first analyses how the prominent ideal that quality of life is to be
measured with a questionnaire arrived in the goings-on in the unit. It then teases out how
connecting and disconnecting patients to dialysis machines, and seeing them during the
daily round enacted knowing, improving and quality of life in other ways than the prominent
practice. It argues that questionnaires, forms, protocols, and the prominent practice they
are part of may not only be made to fit into daily clinical practices or that daily life dealings
are other to prominent practices. Daily clinical practices may also be the basis upon which
questionnaires, forms, protocols, and the prominent practice they are part of are evaluated,
abandoned, and forgotten. Recommending further investigation into the conditions of
possibilities for alternative enactments of a good provision of health care to thrive, the
paper concludes that what has been gained by using this specific care-approach to study
this particular object are insights into daily life practices that have so far been othered in
nephrology practice and STS.