Background: Chronic venous disease (CVD) is a prevalent, progressive vascular condition that significantly impacts quality of life but is often underestimated institutionally and culturally. Frequently termed a "Cinderella disease," CVD illustrates how chronic, non-fatal conditions can be marginalized in clinical hierarchies and health policy. This study explores how vascular surgeons construct and interpret the clinical and social significance of CVD and how professional perceptions contribute to its marginalization. Methods: A qualitative study using semi-structured online interviews was conducted with 20 vascular surgeons across Italy. Interviews were recorded, transcribed verbatim, and analyzed through inductive thematic analysis following Braun and Clarke's six-phase approach, adhering to COREQ standards. Results: Five themes emerged: (1) a systemic mismatch between the clinical complexity of CVD and its low institutional priority; (2) recognition of patients' substantial clinical and social burden; (3) framing of CVD as a "Cinderella disease," linked to delayed care-seeking and patient resignation; (4) systemic barriers, including fragmented care pathways, weak primary care integration, and regional inequalities; and (5) medical subjectivity and professional hierarchies influencing disease legitimacy and clinical attention. Conclusions: CVD's marginalization is socially produced through professional cultures, organizational structures, and policy priorities. Addressing this requires greater institutional recognition, improved care pathways, and a broader sociological understanding of chronic vascular disease in contemporary healthcare systems.
Beyond the “Cinderella Disease”: A Sociological Study of Vascular Surgeons’ Perspectives on Chronic Venous Disease
Costa, Davide;Serra, Raffaele
2026-01-01
Abstract
Background: Chronic venous disease (CVD) is a prevalent, progressive vascular condition that significantly impacts quality of life but is often underestimated institutionally and culturally. Frequently termed a "Cinderella disease," CVD illustrates how chronic, non-fatal conditions can be marginalized in clinical hierarchies and health policy. This study explores how vascular surgeons construct and interpret the clinical and social significance of CVD and how professional perceptions contribute to its marginalization. Methods: A qualitative study using semi-structured online interviews was conducted with 20 vascular surgeons across Italy. Interviews were recorded, transcribed verbatim, and analyzed through inductive thematic analysis following Braun and Clarke's six-phase approach, adhering to COREQ standards. Results: Five themes emerged: (1) a systemic mismatch between the clinical complexity of CVD and its low institutional priority; (2) recognition of patients' substantial clinical and social burden; (3) framing of CVD as a "Cinderella disease," linked to delayed care-seeking and patient resignation; (4) systemic barriers, including fragmented care pathways, weak primary care integration, and regional inequalities; and (5) medical subjectivity and professional hierarchies influencing disease legitimacy and clinical attention. Conclusions: CVD's marginalization is socially produced through professional cultures, organizational structures, and policy priorities. Addressing this requires greater institutional recognition, improved care pathways, and a broader sociological understanding of chronic vascular disease in contemporary healthcare systems.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
