Class 3 - The Shifting Perspective of Chronic Illness

Question 1

What characterizes a chronic illness?

Answer 1

-uncertain etiology
-risk factors
-long latency
-prolonged duration
-can be impairment or functional disability

Question 2

What is the sick role?

Answer 2

the idea that the doctor is the expert and the person has to want to get well, this creates stigma

Question 3

Disability

Answer 3

a difficulty in functioning at the body, personal, or societal level, in one or more life domains

Question 4

Medical Model of Disability

Answer 4

says that disability is caused by disease and requires treatment from medical professionals

Question 5

Social Model of Disability

Answer 5

says society creates the problem and calls for a political response

Question 6

Bio-psycho-social Model of Disability

Answer 6

integrates the medical and social models

Question 7

Illness Trajectory Model: Pre-trajectory

Answer 7

-past history
-onset of symptoms

Question 8

Illness Trajectory Model: Trajectory Onset

Answer 8

-onset of symptoms
-communicating diagnosis
-seeking support

Question 9

Illness Trajectory Model: Living With Progressive Disease

Answer 9

-enduring sequential treatments
-symptoms burden
-relentless vigilance

Question 10

Illness Trajectory Model: Downward Phase

Answer 10

-oscillations of progressive disease
-acute episodes and moments of crisis

Question 11

Illness Trajectory Model: Dying Phase

Answer 11

-being prepared or unprepared for death

Question 12

What is the shifting perspectives model?

Answer 12

the idea that as reality of illness changes, people’s perspectives shift

Question 13

What is a perspective?

Answer 13

a representative of beliefs, perceptions, expectations, attitudes, and experience

Question 14

What do perspectives determine?

Answer 14

how people respond to disease, themselves, caregivers, and situations

Question 15

Illness in the Foreground:

Answer 15

-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

Question 16

Wellness in the Foreground:

Answer 16

-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

Question 17

How does one shift from wellness to illness?

Answer 17

-disease progression
-lack of skills to manage
-stigma
-cumulative effects of losses
-practitioners emphasize symptoms

Question 18

Shifting from Illness to wellness:

Answer 18

-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

Question 19

Spoon Theory:

Answer 19

-a person with chronic illness needs to understand their limits and how they manage their disease to prevent disease progression

Question 20

Paradoxes of Chronic Illness:

Answer 20

-optimism is required, but so is addressing suffering and loss

Question 21

How do HCPs contribute?

Answer 21

-assist people in identifying thier perspective
-create the context for shifting perspectives
-listen to them
-don’t use terms like “acceptance”, “denial’’, or “rehabilitating”