Experiencing chronic illness Flashcards
Why has chronic illness become a characteristic feature of 21st C?
reflects decline in mortality from infections that started post-19th C
- also reflects increased life expectancy after WW2
- now forma a major source of disability
Where is the focus of healthy policy shifted to now?
consequences of long term illness
causes of chronic and degenerative illness
How does social class affect chronic illness and co-morbidity?
- lower social class are more likely to experience financial, domestic and work-related challenges
- reflects the lack of social care and extra direct costs from having restricted mobility and co-morbidities etc
What is ‘Crisis/labelling theory’?
[deterministic and static model for chronic illness]
= focus on social reaction rather than physical impact of chronic illness
- Dx of chronic illness IRREVERSIBLY changes the status of person (LABELLING)
- Primary deviance: illness labelling is seen as a change from the norm of healthiness
similar to anti-social behaviour
difference diseases will carry a different set of ‘social meanings’ that carry different implications for that individual in society
STD vs MS
this results in propagation of SHARED STEREOTYPES
How does labelling theory propose stereotypes for an illness are created and impact?
a given illness carries certain ‘social implications’
this can propagate shared stereotypes for that illness and therefore the person with that illness
these stereotypes then go on to shape reaction of the society as a whole on that labelled individual
What is primary deviance?
any characteristic or action that is difference the norm of health or social acceptance
e.g. public Dx or labelling of an individual as having a chronic illness
What is secondary deviance?
introspective change in self-regard in response to a labelling (for chronic illness) and the associated perceived implications
this may affect that person’s willingness to engage socially
can be a ‘self-fulfilling’ prophecy
What is stigma? How is does affect labelling of individuals with chronic disease?
less informed by social process of labelling a disease a deviant
more to do with the stigmatising consequences of that process (of Dx, labelling etc) for that individual
derives from:
- societal reaction (‘enacted stigma’)
- imagined social reaction (‘felt stigma’)
What is the negative feedback loop between stigmatisation, self-esteem and social engagement/
impairment and disability -> reduced social interaction -> negative labelling -> low self-esteem and felt stigma -> social isolation -> lack of confidence -> reduced social interaction
ALSO in negative labelling:
- impairment and disability
- negatives stereotypes transmitted in mass
loop is continuous
What is the ‘negotiation model’?
chronic illness = loss of ‘self’ in a struggle to maintain TRAJECTORY over time
more dynamic and temporal than the crisis/labelling model
What is ‘biological disruption’?
concept that relationships do not guarantee a particular response
meanings may change when they are tested
reflects gradual changes in social interactions and relationships over time following Dx
usually followed by loss of confidence in both physical body and social interaction
What is ‘comeback’ in the negotiation model?
active coping mechanism to illness
renegotiating their existing relationships
relativistic coping: individuals ability to adapt to living with chronic condition (more fluid)
What is the notion of ‘uncertainty’ in chronic illness?
Charmaz 2000
defining feature of chronic illness, in relation to:
- development
- progression
- Rx
Questions arising after D relate to:
- cause
- functioning
- prognosis
Is there a relationship between biological and social factors in chronic illness?
intimate connection
body is central to see-conception for an individual
biological facts can become social facts: others will respond to the physical nature of that individual
reciprocal nature:
- changes in bodily experience, feeling and actions
- consequence of disabilities that define that chronic illness
