Sociological approaches to Chronic Illness Flashcards
What is different about getting a diagnosis for chronic illnesses?
May be prolonged period of uncertainty
Ambivalent status of some diagnoses (e.g. chronic fatigue syndrome, irritable bowel syndrome)
Process can be very unpleasant
Diagnosis can be: - profoundly shocking - very threatening - a relief
Why is it hard to reach optimum levels of self management?
Optimum self-management is difficult to achieve, poor rates of adherence to treatment, reduced quality of life and poor psychological wellbeing
What is coping?
Coping – the cognitive processes involved in dealing with illness
What is strategy?
Strategy – actions and processes involved in managing the condition and its impact e.g. decisions about mobilisation of resources and how to balance demands on others and remain independent
What is normalisation?
You can try to keep your pre-illness lifestyle and identity intact (e.g. by disguising or minimising symptoms)
Or redesignate your new life as “normal life” – This may involve people signalling changes in identity rather than preserving old ones
What emotional changes are seen with chronic diseases?
Maintaining normal activities becomes deliberately conscious
People find friendships disrupted and may strategically withdraw or restrict their social terrain
May involve downplaying pain or other symptoms
Presenting “cheery self”
Impact on role (breadwinner, wife, mother etc) may be devastating
Dependency – Feeling of uselessness to self and others
What does loss of self mean in the context of chronic illness?
Former self-image crumbles away without simultaneous development of equally valued new ones – Constant struggle to lead valued lives and maintain positive definitions of self – Argued that focus on physical discomfort minimised broader significance of suffering for people with chronic illness
What biographical disruption occurs in chronic illness?
New consciousness of the body and fragility of life, grief for a former life
Biographical shift from a perceived normal trajectory to an abnormal
What does chronic illness do in term of changing identity and what is a stigma?
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
Stigma is a negatively defined condition, attribute, trait or behaviour conferring “deviant” status
What are the two types of stigma?
Stigma – discreditable and discredited
Discreditable – Nothing seen, but if found out – e.g. mental illness / HIV +ve
Discredited – Physically visible characteristic or well known stigma which sets them apart – e.g. physical disability, known suicide attempt
What’s the difference between felt and enacted stigma?
Enacted stigma – The real experience of prejudice, discrimination and disadvantage (as the consequence of a condition)
Felt stigma – Fear of enacted stigma, also encompasses a feeling of shame (associated with having a condition) – Selective concealment
What’s the difference between defining disability medically or socially?
Medical – Disability as deviation from medical norms – Disadvantages are direct consequence of impairment and disabilities – Needs medical intervention to cure or help
Social – Problems are product of environment and failure of environment to adjust – Disability is a form of social oppression – Political action and social change needed
What are the critiques of the medical and social definitions of disability?
Medical – Lack of recognition of social and psychological factors – Stereotyping and stigmatizing language
Social – Body is left out – Overly drawn view of society – Failure to recognise bodily realities and the extent to which these are solvable socially
What are the international Classification of Impairments, Disabilities or Handicaps
Impairment: concerned with abnormalities in the structure or functioning of body
Disability: concerned with performance of activities
Handicap: concerned with broader social and psychological consequences of living with impairment and disability
