L16: Chronic Illness

Question 1

Factors that affect a person’s response to illness

Answer 1

• Meaning/significance assigned to the illness - Severity of illness - Degree of visibility / invisibility of illness - Supportiveness of family / friends - Prior experiences with caregivers - Degree to which illness is stigmatized - Sociocultural beliefs around illness

Question 2

Distinguish between disease and illness.

Answer 2

• Disease: a change in bodily structure or function view from pathophysiologic model - Illness: human experience of suffering or dysfunction

Question 3

Emotional consequences of chronic illness

Answer 3

• Helplessness - Worthlessness - Social isolation (from family and society) or lacking energy for social involvement - Feeling of control/betrayal by one’s body - Perceived as downer - Emotional consequences from experience of pain or fear of pain - Distress regarding loss of rationality

Question 4

Which illnesses have the worst societal stigmas attached to them? Provide examples

Answer 4

• those that are chronic and self-inflicted - eg. Depression, AIDS, chronic smoker with COPD

Question 5

Distinguish chronic vs acute illness

Answer 5

• Acute illness: episodic, pt inexperienced and passive, cure commonly possible - Chronic illness: continuous, pt is expert often plays active role in course of illness, cure rare

Question 6

Name important ways physicians can help pts cope with chronic illness

Answer 6

• Legitimization of illness (giving pts “permission” to move into sick role and have accommodations made for their illness) - Helping pts regain sense of control - Emotional support - Providing care when cure is not possible

Question 7

Describe importance of family’s ethnic, religious and cultural beliefs about illness. What perspective or action should the physician take when thinking about these?

Answer 7

• Physicians need to be culturally sensitive. Each ethnic, religious and cultural group view, manage, treat, understand illnesses differently.