Sociological Approaches To Chronic Illness Flashcards
What are features of the onset of symptoms at the beginning of a chronic illness?
Symptoms can be striking
However more often slow in their onset
Other explanations for the symptoms are often available
What is the impact on someone’s life that being diagnosed with a long-term condition can have?
Often a period of uncertainty
Ambivalent status of some diagnoses eg IBS or chronic fatigue syndrome
Process can be quite unpleasant eg the investigations
Diagnosis can be shocking, threatening, a relief
What are illness narratives?
The story-telling and accounting practices that occur in the face of illness
Offer a way of making sense of the illness and can perform certain functions
A lot of sociological research on chronic illness is based on people’s narratives.
What is biographic disruption?
Identifies chronic illness as a major disruptive experience
- can involve grief of pre-illness life
- can encompass disruption of future plans
What is narrative reconstruction?
Process by which the shattered self is reconstructed in ways that explain the appearance of illness.
Comes from a desire to create a sense of coherence, stability and order in the aftermath of biographical disruption.
What is everyday life work?
Managing daily living
Trying to keep pre-illness lifestyle and identity in tact eg disguising/minimising symptoms
Re-designate new life as normal life
What are the different types of ‘works’ of chronic illness?
Illness work - symptom management
Everyday life work - manage activities of daily living
Emotional work - managing one’s own emotions and those of others
Biographical work - reconstruction of biography in face of biographical disruption
Identity work - work to maintain an acceptable identity - how they and others see them
What emotional work is there with a LTC?
Managing one’s own emotions and those of others
-the work that patients do to protect the emotional well-being of others eg downplaying pain or other symptoms
Impacts on social relationships
The impact on role may be devastating eg mother, breadwinner - especially if it involves a switch to dependency
Define stigma?
A negatively defined condition, attribute, trait or behaviour conferring ‘deviant’ status; a spoiled identity
Define discredited stigma
Physically visible characteristic which sets the patient apart
The patient is discredited, thus affects not only the patient’s behaviour but the behaviour of others
What is discreditable stigma?
Nothing seen, but can be found out
Ie stigma not yet to be revealed so can be kept secret, revealed intentionally or by a factor the patient cannot control
Give an example of a condition associated with discreditable stigma
HIV, mental illness
Give an example of a condition associated with discredited stigma
Physical disability
Known suicide attempt
Give an example of a condition with both types of stigma
Epilepsy
Define enacted stigma
The real experience of prejudice, discrimination and disadvantage
Discrimination has actually occured
Define felt stigma
The fear of enacted stigma
Encompasses a feeling of shame
Discrimination has not actually occurred, but stigma is the fear of it
What is the medical model of disability?
Disability is the change from medical norms
Disadvantages are a direct consequence of impairment and disabilities
Medical intervention needed to cure or help
What are problems with the medical model?
Lack recognition of psychological and social factors, focussing purely in the biological
Uses stereotyping and stigmatised language
What is the social model of disability?
Disability is a form of social oppression
Disadvantages are a product of the environment and its failure to adjust
Political action and social change are needed to help
What are problems with the social model of disability?
Leaves out biological factors, with an overly drawn view of society
Fails to recognise bodily realities and the extent to which these are solvable socially
What does the international classification of impairments, disabilities or handicaps (ICIDH) do?
Attempts to classify the consequences of disease.
What is impairment concerned with?
Abnormalities in the structure or functioning of the body
What is disability
Concerned with the performance of activities
What is disability concerned with?
The performance of activities
What is handicap concerned with?
Broader social and psychological consequences of living with impairment and disability
What are the classifications of ICIDH?
Impairment
Disability
Handicap
Give an example of how a disease fits into each of the categories of the ICIDH classification
Arthritis
Impairment - stiff joints
Disability - hard to walk
Handicap - find a job
What are problems with ICIDH?
Handicap is now generally avoided
Model implies problems are intrinsic or inevitable
What is the international classification of functions, disability and health? (ICF)
The WHO’s framework to measure health and disability at both individual and population levels
Describes and measures health and disability and attempts to integrate medical and social models.
What are the measurements in ICF?
Body structures and function - impairment
Activities undertaken by the individual - any limitations/difficulties
Participation or involvement in life situations - any restrictions
