5: sociological approaches to chronic illness Flashcards
(37 cards)
what are illness narratives?
the story-telling and accounting practices that occur in the face of illness
(most sociological researches based on this)
what do illness narratives offer?
offer a way of making sense of the disease to patient, and they perform certain functions
what are the different types of ‘work of chronic illness’?
– Illness work – Everyday life work – Emotional work – Biographical work – Identity work
what is illness work?
work to manage symptoms and cope with physical manifestation
describe the diagnosis period of illness work
May be prolonged period of uncertainty Diagnosis can be: - profoundly shocking - very threatening - a relief
describe managing symptoms in illness work
Central to the coping task is dealing with the physical
manifestations of illness
physical coping before social coping
overall what is the illness work?
patient works to manage symptoms and cope with physical manifestation
pros of The expert patient programme?
- Coping and condition management skills
- Aims to reduce hospital admissions
- Patient centred
cons of The expert patient programme?
- Responsibility for care placed on (very ill) patients
- Real agency and understanding?
- Little evidence of efficiency savings
what is coping (in chronic diseases)?
the cognitive processes involved in dealing with illness
what are strategies (in chronic diseases)?
actions and processes involved in managing the condition and its impact
what is everyday life work?
NORMALISATION:
pt tries to keep pre-illness lifestyle and identity intact (e.g. by disguising or minimising symptoms)
OR
redesignate new life as “normal life”
what is emotional work?
• Work that people do to protect the emotional well-being of others
how would patients doing emotional work appear?
• 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”
how can emotional work impact on role (e.g. within families)?
• Impact on role (breadwinner, wife, mother etc) may be
devastating
• Dependency: Feeling of uselessness to self and others
• May be especially devastating for young people
what is biographical work?
loss of self, future ideas and image
interaction between body and identity
what is identity work?
• Different conditions carry different connotations
• Affects how people see themselves and how others see
them
how does identity work come about?
Consequence of actual and imagined reaction of others
illness can become the defining aspect of identity
what is stigma?
negatively defined condition, attribute, trait or behaviour conferring “deviant” status
what does Control of the body mean?
we present ourselves in socially valued ways
what is narrative reconstruction?
process by which shattered self is reconstructed in a way that explains the appearance of illness
what does narrative reconstruction create?
stability and a sense of coherence
what is biographical disruption?
the identification of chronic illness as major disruptive experience
e.g. grief for pre-illness life / disruption of future life
what are the different types of stigma?
- Discreditable and Discrediting stigma
* Felt vs. Enacted stigma
