L4: Adapting and coping with Long Term conditions Flashcards
Define chronic illness?
Disease in which current medical interventions can only control not cure
Life is forever altered there is no return to ‘normal’
Define long term condition?
LTC
Condition that cannot at present be cured but is controlled y medication and/or other treatment/therapies
What does the sociological approach to LTC look at?
Focuses on how LTC impacts on social interaction and role performance
Interested in how people manage and negotiate chronic illness in everyday life
What is the difference between the functional and interpretive experience of illness?
Functional: relationship between society and individual, not directly acknowledging role of the body
Interpretive: How individual makes sense of their illness, drawing on their physical experience and social understanding, how individuals rebuild their identity and sense of self
What is Parsons ‘sick role’?
A temporary, medically sanctioned form of deviant behaviour
People who were ‘sick/ill’:
1. Were not responsible for assuming the sick role
2. Exempted from carrying out some or all of normal social duties
3. Must try and get well – the sick role is only a temporary phase
4. Sick person needs to seek and submit to appropriate medical care
What are the limitations to the ‘sick role’?
Not all illnesses are temporary e.g. LTCs
People are different
Patient often self manage → not always necessary to seek medical help
Differences in people (money, time, resources)→ not everyone can be off work, or excused from family duties etc…
What are illness narratives?
The story-telling and accounting practice that occur in the face of illness
Peoples own experience of the illness
What is the link between chronic illness and illness narratives?
Sociological understanding of chronic illness is based on illness narratives
Narrative offer a way to make sense of chronic illness
What is meant by the work of chronic illness?
The work that has to be done everyday to live with chronic illness
What are the different categories of work of chronic illness?
Illness work Everyday life work Emotional work Biographical work Identity work
What is meant by illness work?
Period of getting a diagnosis and learning to live/manage the condition → symptoms, physical manifestations
Has to be done before coping with social relationships
Interaction between the body and identity
Bodily changes → self conception changes
What are the challenges with self management of illness? What support is there available?
Self management→ poor adherence to treatment, reduced quality of life, poor psychological wellbeing
Intervention→ can be brief (online, in-person or telephone consultations) which vary in effectiveness or more long term (DESMOND (diabetes), CDSMP ect..)
What are the pros and cons of self management?
Pros
- develop coping and condition management skills
- aims to reduce hospital admissions
- patient centred
Cons
- Responsibility for care placed on (very ill) patients
- Real agency and understanding
- Little evidence of efficiency savings
What is everyday life work?
Coping and strategy management
Normalisation
What is meant by coping and strategy management in everyday life work?
Coping is the cognitive processes involved with dealing with illness
Strategy is the actions and processes involved in managing the condition and its impact
What is meant by normalisation in everyday life work of chronic illness?
Patients try to preserve pre-illness identity and lifestyle at the same time as having to make their new life ‘normal’
What is meant by emotional work?
The work that patients have to do to protect the emotional well-being of others
Maintaining normal activities becomes deliberately conscious
Friendships are disrupted and patients withdraw or restrict social activities
Patients can down play pain and other symptoms
Present ‘cheery self’
What is biographical work?
Patient looses old self without developing a new equally valued one
Constant struggle to lead a valued life and maintain a positive definition of self
Often experience social isolation
What does Burys Biographical disruption describe?
Chronic illness as a disruptive event
Three different aspects
1. Disruption of taken for granted behaviours
2. Disruption in explanatory systems –> not always explained by medical knowledge (why me? why now?)
3. Mobilisation of resources –> rearranging personal and community involvements
What are the limitations of Burys biographical disruption?
Does not deal with conditions from birth
Some social groups expect illnesses more than others
Older people may see chronic illness as biographically normal
What is identity work?
Work done to maintain an acceptable identity
The illness can become the defining aspect of identity
Illness affects how others see them and how they see themselves
What is the difference between virtual social identity and actual social identity?
Virtual→ how people are understood by others
Actual→ qualities a person posseses
What is identity stigma?
Occurs when there is a discrepancy between how people are perceived and how they feel
It has the effect of cutting the person off from the society and from themself
What are the different types of stigma?
Negatively defined condition
Stigma 1→ discreditable or discrediting
Stigma 2→ felt or enacted
What is the difference between discreditable and discredited stigma?
Discreditable→ nothing seen but if found out they may be judged
Discredited→ physically visible characteristic or well known stigma which sets them apart
Not every disability is visible
What is the difference between felt and enacted stigma?
Enacted→ real experience of prejudice, discrimination and disadvantage, consequence of condition
Felt→ fear of enacted stigma also encompasses feeling of shame (associated with having the condition), selective concealment (hiding the condition)
