HaDSoc 5.1 chronic illness and disability Flashcards
What are some features of a chronic illness?
- long term
- can treat but cannot cure
- manifestations can vary day to day
- often comorbid conditions
What is an illness narrative?
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.
What are the 5 ‘works’ of a chronic illness?
- Illness work
- Everyday life work.
- emotional work
- biographical work
- identity work
What are the different subdivisions of illness work?
- getting the diagnosis
- managing the symptoms
- self management
What is involved in illness work, diagnosis?
- 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
What is involved in illness work, managing the symptoms?
- 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)
Why is self management hard to achieve?
due to poor adherance,
poor psychological wellbeing,
lower quality of life
What is the expert patient program?
A progamme aimed to make patients their own expert on their illness.
What are some advantages of the expert patient program?
- patient centred
- aimed at reducing hospital admissions
- better coping and management skills for the patient
What are some disadvantages of the expert patient program?
- puts responsibility on ill patients
- There’s little evidence to show economic benefit
What is involved in everyday life work?
- 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
What are some issues with a chronically ill person trying to keep their pre-illness identity in tact?
- 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
What is involved in emotional work?
- 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)
What biographical work does someone with a chronic illness have to deal with?
- 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.
What identity work does someone with a chronic illness have to deal with?
- illness can affect how people see themselves, and how others see them
- carry different connotations
- can become the defining aspect of identity
- stigma
What is stigma?
a negatively defined connotation, attribute, trait or behaviour conferring deviant status.
What are the different types of stigma?
- discereditable
- discrediting
- felt
- enacted
What is discreditable stigma?
without telling someone, they wouldn’t know you had an illness, but telling them may affect their view of you, eg HIV.
What is discredited stigma?
Stigma associated with something that can be easily seen by others.
Eg physcial disability
What is enacted stigma?
the real experience of prejudice, discrimmination and disadvantage.
What is felt stigma?
The fear of prejudice, discrimmination and disadvantage. suggestive of feelings of shame.
What are the 2 different models of disability?
Medical model
social model
What is the medical model of disability?
it says that any disability is caused by a physiological or anatomical defect, and can be treated with surgery, medication or other medical intervention.
What is the social model of disability?
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.
What critiques are there of the 2 models of disability?
medical-
- lack of recognition of social factors
- use of stigmatizing language
social-
- body is left out
- only so much that is solvable socially
What is the ICIDH?
International classification os impairments, disabilities or handicaps.
Tried to classify the consequences of disease.
According to ICIDH, what is:
a) impairment
b) disability
c) handicap
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)
What are some problems with ICIDH?
- use of the word handicap (negative connotations)
- mainly uses the medical model
- implies the problems are intrinsic/inevitable.
What is ICF?
International classification of functions, disability and health.
Why is ICF better then ICIDH?
It attempts to combine both the medical and social models of disability.
What are the key components of the ICF?
- body structures and functions
- activites (and associated difficulties)
- participation (life situations)
