HaDSoc 5.1 chronic illness and disability Flashcards

1
Q

What are some features of a chronic illness?

A
  • long term
  • can treat but cannot cure
  • manifestations can vary day to day
  • often comorbid conditions
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2
Q

What is an illness narrative?

A

A type of qualitative interview in which the patient tells the story and their account of their illness.
Helps patient make sense of their illness.

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3
Q

What are the 5 ‘works’ of a chronic illness?

A
  • Illness work
  • Everyday life work.
  • emotional work
  • biographical work
  • identity work
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4
Q

What are the different subdivisions of illness work?

A
  • getting the diagnosis
  • managing the symptoms
  • self management
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5
Q

What is involved in illness work, diagnosis?

A
  • time a fear and anxiousness
  • may come as a shock, may be a relief
  • prolonged period of uncertainty
  • some diagnoses are ambivalent (eg chronic fatigue syndrome, IBS)
  • unpleasant time
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6
Q

What is involved in illness work, managing the symptoms?

A
  • managing the bodily changes (may change your view of yourself)
  • managing what you can and cant do.

(important to manage the symptoms before coping with social relationships)

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7
Q

Why is self management hard to achieve?

A

due to poor adherance,
poor psychological wellbeing,
lower quality of life

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8
Q

What is the expert patient program?

A

A progamme aimed to make patients their own expert on their illness.

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9
Q

What are some advantages of the expert patient program?

A
  • patient centred
  • aimed at reducing hospital admissions
  • better coping and management skills for the patient
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10
Q

What are some disadvantages of the expert patient program?

A
  • puts responsibility on ill patients

- There’s little evidence to show economic benefit

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11
Q

What is involved in everyday life work?

A
  • coping with the illness and everything that goes along with it
  • strategy (how they are going to manage and get around difficulties)
  • some will try to keep pre-illness identity in tact, others will accept the illness as part of their new identity
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12
Q

What are some issues with a chronically ill person trying to keep their pre-illness identity in tact?

A
  • they put on a front and try to carry on like before
  • they may not let people know they are struggling and may go to drastic measures to deal with the illness secretly
  • may not be totally honestly with HCPs
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13
Q

What is involved in emotional work?

A
  • trying to protect the emotions of those around them
  • maintaining normal activities becomes difficult and concious
  • friendships and relationships may be disrupted
  • may present ‘cheery self’
  • may disguise symptoms
  • can impact on their role (Eg as a mother, the breadwinner, wife)
  • may have to be dependant on others for certain things (can affect value of self)
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14
Q

What biographical work does someone with a chronic illness have to deal with?

A
  • loss of self, they will have had an idea of their plans for life but their illness may have caused these to change.
  • may have a new realisation of the preciousness of life
  • the image of their former self is lost, and a new one is not formed right away (and when it is, its often a lower image)
  • shift from percieved normal to abnormal.
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15
Q

What identity work does someone with a chronic illness have to deal with?

A
  • illness can affect how people see themselves, and how others see them
  • carry different connotations
  • can become the defining aspect of identity
  • stigma
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16
Q

What is stigma?

A

a negatively defined connotation, attribute, trait or behaviour conferring deviant status.

17
Q

What are the different types of stigma?

A
  • discereditable
  • discrediting
  • felt
  • enacted
18
Q

What is discreditable stigma?

A

without telling someone, they wouldn’t know you had an illness, but telling them may affect their view of you, eg HIV.

19
Q

What is discredited stigma?

A

Stigma associated with something that can be easily seen by others.
Eg physcial disability

20
Q

What is enacted stigma?

A

the real experience of prejudice, discrimmination and disadvantage.

21
Q

What is felt stigma?

A

The fear of prejudice, discrimmination and disadvantage. suggestive of feelings of shame.

22
Q

What are the 2 different models of disability?

A

Medical model

social model

23
Q

What is the medical model of disability?

A

it says that any disability is caused by a physiological or anatomical defect, and can be treated with surgery, medication or other medical intervention.

24
Q

What is the social model of disability?

A

It says disability is cuased by societ not being able to adapt to everyones needs, so problems are a product of the environment. To fix it, need to take political and social change.

25
Q

What critiques are there of the 2 models of disability?

A

medical-

  • lack of recognition of social factors
  • use of stigmatizing language

social-

  • body is left out
  • only so much that is solvable socially
26
Q

What is the ICIDH?

A

International classification os impairments, disabilities or handicaps.

Tried to classify the consequences of disease.

27
Q

According to ICIDH, what is:

a) impairment
b) disability
c) handicap

A

a) concerned with the abnormalities in the structure or functioning of body.
b) concerned with activities and performance
c) concerned with broader social and psychological consequences (eg ability to get a job)

28
Q

What are some problems with ICIDH?

A
  • use of the word handicap (negative connotations)
  • mainly uses the medical model
  • implies the problems are intrinsic/inevitable.
29
Q

What is ICF?

A

International classification of functions, disability and health.

30
Q

Why is ICF better then ICIDH?

A

It attempts to combine both the medical and social models of disability.

31
Q

What are the key components of the ICF?

A
  • body structures and functions
  • activites (and associated difficulties)
  • participation (life situations)