2.02 - Health, Illness & Treatment Behaviour Flashcards
Define: Health
The state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
Define: Illness
Illness is defined collectively by a set of:
Subjectively perceived and self reported sensation/experiences Objectively observable (& sometimes measurable) features reflecting underlying pathology
What is the sick role?
The Sick Role is the social role a patient assumes when a diagnosis has been made and accepted
What are the two privileges society grants the sick person?
The Sick individual is not held responsible for the illness, & society accepts a cure will require the patient to become the focus of care, attention & nurturing
Has the temporary right to be excused from normal social roles & responsibilities (occupational, family etc.) for the duration of the illness
What are the two expectations society imposes in the sick individual?
In order to be granted the privileges, the sick individual must:
Be motivated to get well despite any enjoyment of privileges afford them by the sick role, and resume their normal social roles as soon as possible
Seek & comply with medical advice
What are some of the problems with the sick-role model?
Privileges may not always be as pleasant as assumed (uncomfortable with passive patient role)
Complying with expectations may not always be desirable (difficult to give up)
Society may not always afford privileges (blame patient for their illness, do not recognise the need, stigmatise the illness)
Doesn’t apply to chronic illness (can’t expect them to get well)
What is the impaired role and how is it different to the sick role?
Applies to patients with chronic illness.
Sick role only applies when prognosis is grave and uncertain
Impaired role applies when the prognosis is known and not grave
Describe the impaired role
The individual has a permanent impairment and is expected to modify their normal role responsibilities within the limits of their health condition. Does not have to want to get well, but is encouraged to make the most of their capabilities.
It allows the impaired individual to manage their own condition (self-efficacy), resume role responsibilities (albeit modified) and results in less disability
What are some problems with the impaired-role model?
Encouraging normal behaviour may not always be beneficial
Resumption of former roles may be impossible
Most of the responsibility for medical care is transferred to the patient alone
What is ‘illness behaviour’?
Individuals have their own unique responses to the experience of illness: Illness Behaviour
“The collective responses – whether cognitive, affective, or behavioural – which any individual has to the personal challenge of illness”
Illness behaviour can be defined an Normal (Adaptive) or Abnormal (Maladaptive)
Describe Cognitive illness behaviour
The many ways in which individuals interpret the experience of illness & give it meaning
For example Acceptance (e.g. “it’s something I need to manage”) vs. Catastrophisation (e.g. “it’s the end of the world as I know it”)
Describe Affective Illness behaviour
The emotional responses individuals have to the occurrence of illness
May be appropriate (e.g. disappointment) or exaggerated (e.g. extreme fear)
Proportional to the severity of the illness
Describe Behavioural Illness Behaviour
Characterised largely by observable actions in response to the presence of Illness
May be adaptive (e.g. compliance with treatment strategies) or maladaptive (e.g. denial & non-compliance)
Describe how illness behaviour can affect management
Catastrophisation, exaggeration & maladaptive illness behaviour leads to problematic illness management, particularly in terms of:
Treatment compliance
Psychological health & wellbeing
What are the seven ‘dimensions’ for abnormal illness behaviour?
General hypochondriasis (a fearful attitude towards illness in general)
Disease conviction (a belief the illness is more severe than it really is)
Psychological vs. somatic focusing
Affective inhibition (extreme difficulty in expressing and communicating personal feelings even thought they are subjectively experienced)
Affective disturbance (The capacity of illness (particularly one’s own) to evoke strong emotional distress)
Denial (the belief that with the departure of the illness, life would be perfect.)
Irritability (where the patient is not easy to get on with when ill)
