L3- Adapting and coping with long term conditions Flashcards
70% of health and care spending is attributed to
to caring for people with LTCs
chronic diseases
are diseases which current medical interventions can only control and not cure
the life of a person with a chronic condition is
forever altered- there is no return to normal
chronic diseases encompasses
o Long term
o Significant impact on sufferers
o Co-morbidity
what is a long term condition
is a condition that cannot, at present, be cured but is controlled by medication and/or other treatment/therapies
- Increase with ageing population but not only older people who live with LTCS
e.g. rheumatoid arthritis
LTC are the
biggest challenge facing the NHS
a huge cultural change is needed to
put people at the centre of care
preventative, personalised, integrated and innovative approaches must become
the norm to transform peoples lives
theories of experience of illness (2)
1) functional
2) interpretive
Functional theory- experience of illness
- Parsons ‘sick role’
o Relationship between society and individual
o Not directly acknowledging role of the body
Interpretive theory
- Burys biological disruption
- Illness narrative
- Goffmans stigma
sick role described as
‘a temporary, medically sanctioned form of deviant behaviour’
sick role mechanism
- In order to be excused from normal duties and be considered not responsible for their condition the sick person is expected to seek profession advice and adhere to treatments
- Medical practitioners are empowered to sanction their temporary absence from the work force and family duties as well as to absolve them from blame
limitations of the sick role
- Not all illnesses are temporary
- Does not acknowledge differences between people
- Does not acknowledge individual agency in defining and coping with illness i.e. not involving medical profession
illness narratives
“Refer to story-telling and accounting practices that occur in the face of illness”
illness narrative are described as The Work of Chronic illness
1) Illness work
2) Everyday life work
3) Emotional work
4) Biological and narrative work
5) Identity work
illness work
getting a diagnosis
3 stages of getting a diagnosis
- pre-diagnosis
- diagnosis
- post-diagnosis
illness work also involves
managing the symptoms and self-management and normalisation
everyday life work
coping and strategic management
coping
cognition processes involved in dealing with illness
strategy
actions and processes involved in managing the condition and its impact e.g. mobilisation of resources
emotional work
- Work that people do to protect the emotional well-being of other
- Maintain normal activities becomes deliberately conscious
- People find friendships disrupted and may strategically withdraw
- May involving downplaying pain or other symptoms
- Presenting a ‘cheery self’
biographical work
loss of self
- Former self-image crumbles away without simultaneous development of equally valued new ones
o Constant struggle to lead valued lives and maintain positive definitions of self
o Argued that focus on physical discomfort minimised broader significance of suffer for people with chronic illness - Interaction between body and identity
Burys biographical disruption
Focuses on people’s experience of the onset of illness as a disruptive event
- Acknowledges differences between individuals
3 aspects of biographical disruption
- disruption of taken for granted behaviours
- disruption in explanatory systems
- Mobilisation of resources
limits of Burys biographical disruption
- Does not deal with conditions from birth
- Some social groups expect illness more than others
- Later work has shown that older people may see chronic illness as ‘biographically normal’
identity work
different conditions carry different connotations
affects how people see themselves and how others see them
consequence of actual and imagined reaction of others
illness can become the defining aspect of identity
Goffmans stigma outlines
- Distinction between ‘virtual social identity’ (how people are understood by others) and ‘actual social identity” (qualities a person possesses)
stigma occurs when
there is a discrepancy between virtual social identity (how people are understood by others) and ‘actual social identity’ (quals a person possesses’
discrepancy between virtual social identity (how people are understood by others) and ‘actual social identity’ (quals a person possesses’
spoils identity
stigma is a
a negatively defined condition, attribute, trait or behaviour conferring deviant status
how many stigma types
Stigma 1
Stigma 2
Stigma 1
discreditable or discredited
discreditable
Discreditable: nothing seen, but if found..
o Mental illnes/ HIV +ve
discredited
Physically visible characteristic or well known stigma which sets them apart
o Physical disability
o Known suicide attempt
conditions can be both
discreditable and discredited
stigma 2
felt vs enacted
felt stigma
real experience of prejudice, discriminated and disadvantage
o As the consequence of a condition
enacted stigma
fear of enacted stigma, also encompasses a feeling of shame (associated with havign a condition)
o Selective concealment
