0716 - Health, Illness and Treatment Behaviour - EG Flashcards
define subjective and objective illness.
Subjective - self-perceived and self-reported sensations / experiences (pain, nausea, fatigue). Objective - observable, even measurable features reflecting underlying pathology (rash, fever, lab results)
How is the diagnosis of an illness linked to patient behaviour?
If a patient is convinced that an illness is diagnosed, real and present, it triggers a set of well known social, psychological and behavioural responses, which can impact both illness and management.
What is the “sick role”? What are two privileges and 2 expectations of a sick individual? What do physicians expect of a patient from this model?
a social role a patient assumes when a diagnosis has been made and accepted. Privileges: the individual: is not responsible for their illness and should be the focus of care and attention from others; has the right to be excused from normal social roles and responsibilities for the duration of the illness. Expectations: the individual: must be motivated to get well and must seek and comply with medical advice. Physicians expect that patients obtain social support to aid in recovery, seek and comply with medical assistance and make a genuine effort to recover.
Why is the sick role socially sanctioned deviant behaviour?
While socially acceptable, it still violates social and occupational role expectations and has a dysfunctional and burdensome impact on society.
List some reasons as the why patients and society may not comply with the “sick role” model.
(1) privileges may not always be pleasant - patients may be uncomfortable in passive role and there may be a negative effect of not being able to participate in normal roles and responsibilities, both for the individual and for their social constructs. (2) privileges may be difficult to give up if the patient does not want to return to their usual roles. (3) treatment may be uncomfortable. (4) society may blame the individual for their illness or stigmatise (e.g. AIDS). (5) sick role model is best suited to acute illness thus chronic illnesses may make privileges inappropriate.
What is the “impaired role”?
Model used for chronic illness, particularly for permanent impairments, which are not not grave, where patient is expected to modify their normal role responsibilities to be within the limits of their health condition. There is no expectation to get well, but person is encouraged to make the most of their remaining capabilities.
What are some problems with the impaired role model?
(1) the encouragement of normal behaviour and involvement may not be beneficial (2) resumption of former roles may be impossible (3) responsibility for medical care is transferred to the patient alone (4) patient may be denied support.
List and briefly describe the 5 interrelated components on which patients make judgements about their symptoms.
(1) Identity of their illness - how well the patient understand their condition and view the symptoms caused by the illness. (2) Causal beliefs - affect the treatment patients seeks, their health behaviour and emotional responses to illness. (3) Timeline beliefs - if inaccurately believe acute, chronic or cyclic illness may affect treatment compliance, particularly when taking medications. (4) Control or Cure of Illness - patients perception of the amount of personal control over the illness and how well it can be controlled or cured can influence their compliance. (5) Consequences - perceived severity of the impact on the individual personally influences compliance and management (consequence on work, family, lifestyle, finances, etc.)
What is the benefit of an “illness perception questionnaire” and what sort of information does it attain?
Helpful in understanding how well patients understand, adapt to and cope with their illness to predict treatment compliance and health behaviour. Asks patients about their perceptions on the identity of their illness, its timeline (acute, chronic, cyclic), consequence of illness, treatment control, personal control, causes, etc.
What is illness behaviour?
The way in which each individual experiences and responds to their illness. For example: cognitively do they accept and manage, or find it a catastrophe? behavioural responses appropriate or exaggerated? are they adaptive (compliant with treatment) or maladaptive (in denial and non-compliant?)
List and briefly describe the 7 dimensions of abnormal illness behaviour.
(1) general hypochondriasis - a fearful attitude towards illness in general. (2) disease conviction - irrational belief that something is mores serious than really is. (3) psychological vs somatic focusing - both on psychological cause and somatic dysfunction. (4) affective inhibition - difficulty in expressing and communicating personal feelings (alexithymia). (5) affective disturbance - illness evokes strong emotional distress. (6) denial - a belief in illness, but that also life would be perfect if had no illness (false). (7) irritability - easily angered, loses patience with others.
