Chronic Illness & Disability Flashcards
What are some of the features of the sociological approach to chronic illness?
- focus on how chronic illness impacts on social interaction & role performance
- interactionist approach
- experiences & meanings of chronic illness = “negotiated reality”
- how people manage & negotiate chronic illness in everyday life
What is an illness narrative?
Story-telling and accounting practices that occur in the face of illness
Way of “making sense” of illness
What are some of the difficulties involved in the diagnosis of chronic illness?
- Prolonged period of uncertainty (particularly due to episodic and insidious nature of symptoms)
- Ambivalent status of some diagnoses (diagnosis of exclusion e.g. IBS, chronic fatigue syndrome)
- Unpleasant process
- Can be shocking, threatening, or a relief
Define a chronic illness. What are some of the features of chronic illnesses?
Any disorder that persists over a long period and affects physical, emotional, intellectual, vocational, social, or spiritual functioning
- lay term
- profound influence on lives of sufferers
- often comorbid conditions
- manifestations may vary greatly from day-to-day (exacerbations & remissions —> unpredictability/uncertainty)
- controlled but not cured
- will increase aging population
What is illness work?
Dealing with the physical manifestation of the illness
Has to be done before coping with social situations e.g. eating, bathing, using the toilet
Interaction between body and identity e.g. weight gain affects self conception
What is everyday life work?
Coping = the cognitive processes involved in dealing with illness
Strategy = actions & processes involved in managing the condition and its impact, including mobilisation of resources and how to balance demands on others and remain independent
What is normalisation?
Redesignating post-illness life as “normal”
This may involve signalling changes in identity rather than preserving old ones
What is emotional work?
Work that people do to protect the emotional wellbeing of others (not only family/friends but also healthcare professionals)
- friendships disrupted —> may strategically withdraw or resist social terrain
- downplaying pain and other symptoms
- presenting “cheery self”
- impact on role e.g. “breadwinner”, “mother”, may be devastating
- dependency may cause feeling of uselessness to self and others (esp. when young and independence should be increasing)
What is biographical work?
Former self-image crumbles away without simultaneous development of equally valued new ones
Struggle to lead valued lives and maintain positive definitions of self
Argument that focusing on physical discomfort minimises the broader significance of suffering for people with chronic illness
Sense of “taken-for-granted” world threatened
New consciousness of the body & fragility of life, grief for former life
Biographical shift from a perceived normal trajectory to abnormal
What is identity work?
Different conditions carry different connotations
Affects how people see themselves and how others see them
Consequences of actual and imagined reaction of others
Illness can become defining aspect of identity
What are some of the negative effects of chronic illness on social relationships?
- patient scrutinises reactions of others for signs of discreditation
- foster dependence on others (but this strains relationships)
- relationships harder to maintain e.g. due to mobility, finance, etc. but increasing needs require more intimate contact
- inability to “do” leads to loss of social life
Why do people with chronic illnesses face stigma? What is the difference between felt and enacted stigma?
Control of body —> present ourselves in socially valued way
Loss of control —> stigma (negatively defined condition, attribute, trait, or behaviour conferring deviant status)
e.g. regarding loss of control of bodily functions
FELT STIGMA = fear of enacted stigma & feeling of shame associated with having the conditions —> selective concealment of conditions
e.g. hiding illness from employers
ENACTED STIGMA = real experience of prejudice, discrimination, and disadvantage as a consequence of condition
What is the difference between discreditable and discredited chronic illnesses?
DISCREDITABLE = nothing seen; worry if found out
e.g. mental illness, HIV+
DISCREDITED = physically visible characteristic/well known stigma
e.g. physical disability, known suicide attempt
note: some conditions encompass both e.g. epilepsy
What is narrative reconstruction when applied to chronic illness?
Process by which the shattered self is reconstructed in ways that explain the appearance of illness.
Reconstitute and repair ruptures between body, self, and world by linking up and interpreting different aspects of biography in order to realign present and past self with society
Create sense of coherence, stability, and order in aftermath of biographical disruption
e.g. linking episode of extreme physical exertion with onset of RA
How is chronic illness linked to disability? What are the criticisms of these theories?
Medical model:
- disability is a deviation from medical norms
- disadvantages are direct consequences of impairment
- needs medical intervention to cure/help
Criticism: lack of recognition of social & psychological factors, stereotyping/stigmatising language
Social model:
- problems are a product of environment (failure of environment to adjust)
- disability is a form of social oppression
- political action/social change is needed
Criticism: body is left out, overly drawn view of society, failure to recognise body realities and the extent to which these are solvable socially
