Class 3 - The Shifting Perspective of Chronic Illness Flashcards
What characterizes a chronic illness?
-uncertain etiology
-risk factors
-long latency
-prolonged duration
-can be impairment or functional disability
What is the sick role?
the idea that the doctor is the expert and the person has to want to get well, this creates stigma
Disability
a difficulty in functioning at the body, personal, or societal level, in one or more life domains
Medical Model of Disability
says that disability is caused by disease and requires treatment from medical professionals
Social Model of Disability
says society creates the problem and calls for a political response
Bio-psycho-social Model of Disability
integrates the medical and social models
Illness Trajectory Model: Pre-trajectory
-past history
-onset of symptoms
Illness Trajectory Model: Trajectory Onset
-onset of symptoms
-communicating diagnosis
-seeking support
Illness Trajectory Model: Living With Progressive Disease
-enduring sequential treatments
-symptoms burden
-relentless vigilance
Illness Trajectory Model: Downward Phase
-oscillations of progressive disease
-acute episodes and moments of crisis
Illness Trajectory Model: Dying Phase
-being prepared or unprepared for death
What is the shifting perspectives model?
the idea that as reality of illness changes, people’s perspectives shift
What is a perspective?
a representative of beliefs, perceptions, expectations, attitudes, and experience
What do perspectives determine?
how people respond to disease, themselves, caregivers, and situations
Illness in the Foreground:
-focus on sickness, suffering, loss, burden
-chronic illness is destructive
-absorbed in illness experience
-overwhelmed
-helps person learn about and come to terms with a disease
-evidence that illness is real
Wellness in the Foreground:
-illness as opportunity for meaningful change
-revisions what is possible and normal
-views health as good despite disease
-self is not the diseased body or source of identity
How does one shift from wellness to illness?
-disease progression
-lack of skills to manage
-stigma
-cumulative effects of losses
-practitioners emphasize symptoms
Shifting from Illness to wellness:
-bouncing back with hope and optimism
-person recognizes a shift has occurred
-a need to return to the wellness perspective is identified
-implement interventions to resolve reason for shift to illness
-reframe situation
-activate resources
Spoon Theory:
-a person with chronic illness needs to understand their limits and how they manage their disease to prevent disease progression
Paradoxes of Chronic Illness:
-optimism is required, but so is addressing suffering and loss
How do HCPs contribute?
-assist people in identifying thier perspective
-create the context for shifting perspectives
-listen to them
-don’t use terms like “acceptance”, “denial’’, or “rehabilitating”
