Session 5 - Chronic Illness Flashcards
(40 cards)
What are ‘illness narratives’?
“Illness narratives refer to the story-telling and accounting practices that occur in the face of illness”
What are the general factors of the work of chronic illness?
Illness Work Everyday Life Work Emotional Work Biographical Work Identity Work
What is Illness work?
Managing symptoms
E.g. dealing with physical aspects such as eating, bathing or going to the toilet.
There is an interaction between the body and identity.
Bodily changes lead to self conception changes.
What is Everyday work?
Coping and strategic management.
Coping - the cognitive process involved with dealing with illness.
Strategy - actions and processes involved in managing the condition and its impact.
Have to make decisions about the mobilisation of resources and how to balance demands on others and remain independent.
What affect does chronic illness have on ‘the norm’?
Some people try to keep their pre-illness lifestyle intact by disguising or minimising symptoms.
Or you can re-designate new life as normal life - this may involve signalling changes in identity rather than preserving old ones.
What is Emotional Work?
Impact on role - breadwinner, wife, mother may be devastating.
Dependency - feeling of uselessness to self and others
May be especially devastating for young people.
What is Biographical work?
May feel a loss of self. Former self image crumbles away without the development of a new one. Therefore it can be seen as a struggle to live a ‘valued’ life.
Chronic illness threatens the taken-for-granted world e.g. a person imagines going to uni, getting a job e.t.c.
Grief for former life. Biographical shift from a perceived normal trajectory to an abnormal.
What is Identity Work?
Illness can become defining aspect of identity. Different conditions carry different connotations. Affects how people see themselves and how others see them.
What dilemmas can loss of self give rise to?
People scrutinise the reactions of others for signs of discreditation.
Foster dependance on others - however this puts strains on relationships.
Relationship harder to maintain as illness progresses but increasing needs require more intimate contact. (e.g. toilleting)
Inability to ‘do’ leads to loss of social life
What is the difference between discreditable and discrediting stigma?
Discreditable stigma is based on a factor that cannot be seen but if it was found out may be a cause for prejudice. e.g. HIV or mental illness.
Discrediting stigma is a factor that is physically visible or is something well known about a person that sets them apart e.g. physical disability or known suicide attempt.
What is the difference between felt and enacted stigma?
Felt stigma is the fear of enacted stigma, also encompasses a feeling of shame associated with having a condition - selective concealment
Enacted stigma is the real experience of prejudice, discrimination and disadvantage as a consequence of a condition.
What is narrative reconstruction?
The desire to create a sense of coherence, stability and order in the aftermath of biographical disruption E.g. a way of explaining their illness.
What ar some of the positives for self-mamagement?
Coping and condition management skills are developed.
Reduced hospital admissions
Patient centred.
What are some of the negatives for self-management?
Responsibility fro care is placed on very ill patients
Is there real agency and understanding?
There is little evidence of efficiency savings.
What is the medial definition of disability?
Disability is deviation from medical norms
Disadvantages are direct consequence of impairment and disabilities.
Needs medical intervention to cure or help.
What is the social definition of disability?
Problems are product of environment and the failure of the environment to adjust.
Disability is a form of social oppression.
Political action and social change are needed.
What are some of the critiques of the medical model?
There is a lack of recognition of social and psychological factors.
Stereotyping and stigmatising language.
What are some of the critiques of the social model?
Body is left out
Overly draw view of society
Failure to recognise bodily realities and the extent to which these are solvable socially.
Why measure health?
To have an indication of the need for health care
To target resources where they are most needed
To assess the effectiveness of healthcare interventions
To evaluate the quality of health services
To use evaluation of effectiveness to get better value for money.
To monitor patient’s progress.
Name some common measures of health
Mortality
Morbidity
Patient-based outcomes
What are some of the advantages/problems with measuring mortality?
Easily defined
It is not always correctly measured.
Not a very good way of assessing outcomes and quality of care.
What are some of the advantages/problems with measuring morbidity?
Routinely collected e.g. disease registers, hospital episode statistics
Collection not always reelable/accurate
Tells us nothing about patient experiences
Not always easy to use in evaluation.
What are Patient-based outcomes?
Attempt to assess well-being from patients point of view Health related quality of life (HRQoL), health status, functional abilities.
What are some examples of Patient-based outcomes?
Health related quality of life (HRQoL)
Health status
Functional abilities.
Patient Reported Outcome Measures (PROMS)
