530-534. Adjustment to Chronic Illness and Disability

Question 1

What is meant by the term “sick role”?

Answer 1

A role of sanctioned deviance (allows people to break away from the normal strict rigor of life in civilisation)

Question 2

What are the rights of people who need to adopt a sick role?

Answer 2

Exempted from normal social roles

Not blamed for illness

Question 3

What are the responsibilities of a person in the sick role?

Answer 3

Try to get better

To seek help and cooperate with help given

Question 4

Define what is meant by “illness behaviour”

Answer 4

The way in which symptoms are perceived, evaluated, and acted upon by a person who recognises some pain, discomfort or other signs of organic malfunction

Question 5

What 5 elements have been identified as facilitating successful adjustment to chronic illness?

Answer 5

1. Successful performance of adaptive tasks
2. Absence of psychiatric disorder
3. Presence of high positive affect
4. Adequate functional status
5. Satisfaction and wellbeing in various life-domains

Question 6

List some of the symptoms which may be induced by cytokine activity in chronic illness

Answer 6

Non-specific illness:
Anorexia
Fatigue
Weakness
Lethargy

Can also influence psychological symptoms e.g. after MI, diabetes, cancer, stroke

Question 7

List illness behaviours which can impact someone’s adjustment to illness

Answer 7

Consulting behaviours

Adherence to treatment

Health promoting behaviours

Avoidance - social, physically not leaving the house

Unhelpful coping strategies

Question 8

What are the 5 stages of grief?

Answer 8

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

Question 9

Define the term “locus of control”

Answer 9

The degree to which a person believes that control to influence events resides within themselves or others

Question 10

What does it mean if someone has an internal locus of control?

Answer 10

Believe they have agency in their behaviour and ability to influence the world around them

Take responsibility in their illness - adjust better

However, extremes can lead to a person feeling very responsible, guilty and anxious

Question 11

What does it mean if someone has an external locus of control?

Answer 11

Believe they have little control over what happens to them and believe that outcomes are determined by others or fate

Question 12

Why is locus of control important in chronic illness?

Answer 12

Determines how much control a patient believes they have over the illness/symptoms; and illness related events (e.g. treatment, consultations)

Can affect how the patients sees their relationship with professionals - in partnership or place full responsibility on them

Can determine patient’s beliefs on what influences the outcomes

Question 13

What does secondary gain mean?

Answer 13

When something unconsciously perpetuates or reinforces illness being there for benefit

Question 14

List some of the chronic coniditions that have stigma attached to them

Answer 14

Mental disorders
HIV
STIs
Skin diseases
Facial disfigurement

Question 15

List some of the ways in which a person may need to adjust to chronic illness

Answer 15

Need for emotional support

Need for medical support

Managing uncertainty of the future

Dealing with loss of control

Having a need for openness

Searching for meaning

Question 16

List the barriers to adjustment

Answer 16

Characteristics of the illness

Characteristics of treatment

Societal barriers - stigma, rejection, discrimination

Co-morbid psychiatric illness

Personality/locus of control

Social circumstances - finances, social support

Question 17

What are some of the potentially positive experiences of illness?

Answer 17

Changed priorities
? Improved health
Creativity
Adaptability
Reappearing values
Changes in life choices and relationships