L4: Adapting and coping with Long Term conditions

Question 1

Define chronic illness?

Answer 1

Disease in which current medical interventions can only control not cure
Life is forever altered there is no return to ‘normal’

Question 2

Define long term condition?

Answer 2

LTC

Condition that cannot at present be cured but is controlled y medication and/or other treatment/therapies

Question 3

What does the sociological approach to LTC look at?

Answer 3

Focuses on how LTC impacts on social interaction and role performance
Interested in how people manage and negotiate chronic illness in everyday life

Question 4

What is the difference between the functional and interpretive experience of illness?

Answer 4

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

Question 5

What is Parsons ‘sick role’?

Answer 5

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

Question 6

What are the limitations to the ‘sick role’?

Answer 6

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…

Question 7

What are illness narratives?

Answer 7

The story-telling and accounting practice that occur in the face of illness
Peoples own experience of the illness

Question 8

What is the link between chronic illness and illness narratives?

Answer 8

Sociological understanding of chronic illness is based on illness narratives
Narrative offer a way to make sense of chronic illness

Question 9

What is meant by the work of chronic illness?

Answer 9

The work that has to be done everyday to live with chronic illness

Question 10

What are the different categories of work of chronic illness?

Answer 10

Illness work 
Everyday life work 
Emotional work 
Biographical work 
Identity work

Question 11

What is meant by illness work?

Answer 11

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

Question 12

What are the challenges with self management of illness? What support is there available?

Answer 12

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..)

Question 13

What are the pros and cons of self management?

Answer 13

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

Question 14

What is everyday life work?

Answer 14

Coping and strategy management

Normalisation

Question 15

What is meant by coping and strategy management in everyday life work?

Answer 15

Coping is the cognitive processes involved with dealing with illness
Strategy is the actions and processes involved in managing the condition and its impact

Question 16

What is meant by normalisation in everyday life work of chronic illness?

Answer 16

Patients try to preserve pre-illness identity and lifestyle at the same time as having to make their new life ‘normal’

Question 17

What is meant by emotional work?

Answer 17

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’

Question 18

What is biographical work?

Answer 18

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

Question 19

What does Burys Biographical disruption describe?

Answer 19

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

Question 20

What are the limitations of Burys biographical disruption?

Answer 20

Does not deal with conditions from birth
Some social groups expect illnesses more than others
Older people may see chronic illness as biographically normal

Question 21

What is identity work?

Answer 21

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

Question 22

What is the difference between virtual social identity and actual social identity?

Answer 22

Virtual→ how people are understood by others

Actual→ qualities a person posseses

Question 23

What is identity stigma?

Answer 23

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

Question 24

What are the different types of stigma?

Answer 24

Negatively defined condition
Stigma 1→ discreditable or discrediting
Stigma 2→ felt or enacted

Question 25

What is the difference between discreditable and discredited stigma?

Answer 25

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

Question 26

What is the difference between felt and enacted stigma?

Answer 26

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)