Marilyn Dodd Flashcards
Theory of Illness Trajectory
- refers to theoretical formulations regarding
coping with uncertainty through the cancer
illness trajectory
Theory of Illness Trajectory
- is a key concept in the Theory of Illness Trajectory
Managing uncertainty
- is situated in a biographical context
Life
- are rooted in the physical body and are
formulated based on the perceived capability to
perform usual or expected activities
Conceptions of self
Key elements in the biographical context are as follows:
Identity
Temporality
Body
Key elements in the biographical context are as follows:
- The conception of self at a given time that
unifies multiple aspects of self and is situated in the
body
Identity
Key elements in the biographical context are as follows:
Biographical time reflected in the
continuous flow of the life course events;
perceptions of the past, present, and possible
future interwoven into the conception of self
Temporality
Key elements in the biographical context are as follows:
Activities of life and derived perceptions
based in the body
Body
- particularly cancer, disrupts the usual or
everyday conception of self and is compounded
by the perceived actions and reactions of others
in the sociological context of life. resulting in
states of uncertainty.
Illness
Illness Trajectory: States of Uncertainty
- Domain
- Sources of Uncertainty
- Dimensions of Uncertainty
Domain
- UNCERTAIN TEMPORALITY
- UNCERTAIN BODY
- UNCERTAIN IDENTITY
Domain:
- Taken-for-granted expectations regarding
the flow of life events are disrupted.
UNCERTAIN TEMPORALITY
Domain:
- Changes related to illness and treatment
are centered in one’s ability to perform
usual activities involving appearance,
physiological functions, and response to
treatment.
UNCERTAIN BODY
Domain:
- Interpretation of self is distorted as the
body fails to perform in usual ways, and
expectations related to the flow of events
(temporality) are altered by disease and
treatment
UNCERTAIN IDENTITY
Sources of Uncertainty:
- The self of the past is viewed differently.
Expectations of the present self are distorted by
illness and treatment. Anticipation of the future
self is altered.
Dimensions of Uncertainty:
- Duration: How long
- Pace: How fast
- Frequency: How often the experience (stretched
out, constrained, or limitless)
Sources of Uncertainty:
- Faith in the body is shaken (body failure). The
conception of the former body (the way it used
to be) co-mingles with the altered state of the
body at present and the changed expectations
for how the body may perform in the future.
Dimensions of Uncertainty:
*What is being done to the body
*Jeopardized body resistance
*Efficacy and risks of treatment
*Disease recurrence
Sources of Uncertainty:
- Body failure and difficulty reading the new body
upset the former conception of self
- -Expected life course is shattered.
- -Evidence gleaned from reading the body is not
interpretable within the usual frame of
understanding. Hope is sustained despite
changing circumstances
Types of work are organized around the following four
lines of trajectory work performed by patients and
families:
- Illness-related work
- Everyday-life work
- Biographical work
- Uncertainty abatement work
Types of work are organized around the following four
lines of trajectory work performed by patients and
families:
- Diagnostics, symptom
management, care regimen, and crisis prevention
Illness-related work
Types of work are organized around the following four
lines of trajectory work performed by patients and
families:
- Activities of daily living, keeping a
household, maintaining an occupation, sustaining
relationships, and recreation
Everyday-life work
Types of work are organized around the following four
lines of trajectory work performed by patients and
families:
The exchange of information,
emotional expressions, and the division of tasks through
interactions within the total organization
Biographical work
Types of work are organized around the following four
lines of trajectory work performed by patients and
families:
Activities enacted to
lessen the impact of temporal, body, and identity
uncertainty
Uncertainty abatement work
- activities to lessen the effect of the varied states
of uncertainty induced by undergoing cancer
chemotherapy.
Uncertainty Abatement Work
- resting or changing usual activities
Pacing
- Using terminology related to illness and
treatment
Becoming “professional” patients
- Comparing self with persons who are in worse
condition
Seeking reinforcing comparisons
- Looking back to reinterpret symptoms and
interactions with others in the organization
Engaging in reviews
- Looking toward the future to achieve desired
activities
Setting goals
- Masking signs of illness or related emotions
Covering up
- Establishing a place where, or people with whom,
true emotions and feelings could be expressed in
a supportive atmosphere
Finding a safe place to let down
- Selective sharing with individuals deemed to be
positive supporters
Choosing a supportive network
- Asserting the right to determine the course of
treatment
Taking charge
