Understanding Illness and Hospitalization

Illness and Hospitalization

• Illness is a highly personal state where a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished.
• It is not synonymous with disease and may or may not be related to disease.
• Illness is highly subjective.
• A person can have a disease and not feel ill, or feel ill without a discernable disease.
• Illness is the response of a person to a disease; an abnormal process where functioning changes compared to a previous level.
• Illness behaviour is a coping mechanism, involving how individuals describe, monitor, interpret symptoms, take remedial actions, and use healthcare.
• Illness behaviour is highly individualized and affected by variables like age, sex, occupation, socioeconomic status, religion, ethnic origin, psychological stability, personality, education, and coping methods.
• Suchman (1979) identified stages of illness: experiencing symptoms, assuming the sick role, medical care contact, assuming a dependent role, and achieving recovery and rehabilitation.

Types of Illness

• Acute Illness:

  • Onset is rapid and lasts a short time.
  • Symptoms appear abruptly and subside quickly.
  • May or may not require medical professional intervention, depending on the cause.

• Chronic Illness:

  • Permanent change caused by irreversible alterations in normal anatomy and physiology.
  • Requires special patient education for rehabilitation; long periods of care and support.
  • Includes remission and exacerbation.

Disease

• Disease is an alteration in body functions that causes a reduction of capacities or a shortening of the normal life span.
• Multiple factors interact in causing a disease and its response to treatment in an individual.

Impact on the Individual

• Illness affects many aspects of an individual's life, including privacy, autonomy, lifestyle, roles, finances, relationships, diet, activity, and sleep.
• Impacts on the individual can include anxiety, fear, anger, withdrawal, denial, changes in self-concept and body image, and a sense of hopelessness.

Impact on the Family

• The impact on the family depends on factors like the ill member, severity and duration of the illness, and cultural/social customs of the family.
• Impacts can include role changes, task reassignments, increased stress due to anxiety, financial constraints, loneliness, and changes in social customs.
• Potential challenges in coping can include maladaptive coping, excessive caregiving burden, and situational low self-esteem.

Coping Strategies

• Strong support systems enhance resilience and coping strategies, easing burdens.
• Spirituality and religious faith are mentioned as important coping mechanisms.
• Coping with chronic medical illnesses involves the patient's baseline coping strategies, current illness burden, and availability of support mechanisms.
• Coping is influenced by factors like non-adherence to treatment, denial of illness, substance abuse, and high use of healthcare.

Hospitalization

• Hospitalization is the act of placing a person in a hospital as a patient; resulting in the condition of being hospitalized.
• Admission (hospitalization for 24+ hours):
  • Emergent: patient arrives at the emergency department, and is hospitalized.
  • Elective: doctor requests the bed at a specific time.
• Roles of the nurse (during and after admission):
  • Assessment and monitoring of health status.
  • Providing direct and coordinated care.
  • Education to patients and family members
  • Discharge planning

Important concepts in Healthcare

• Entering and leaving a healthcare setting can produce anxiety for patients and family members.
• Continuity of care and community-based care are essential concepts in nursing.
• Admission involves an orientation phase for both the patient and the staff.
• Establishing an effective relationship with the patient is crucial to providing effective care. Admission paperwork includes personal, medical, and familial information.
• A nurse must know how to report patient care for transfers. Discharge includes establishing a plan with realistic goals to help patients return to their lives.

Common Activities for Admission

• Identification bracelet: contains patient's name, ID number and doctor's name.
• Initial interview by nurse, where legal/ethical issues are discussed.
• Forms of consent to treatment
• Advance directives/power of attorney are obtained.
• Patient's next of kin's information is acquired.
• Patient's bill of rights are explained.
• Preparing the unit for admission involves adjusting the physical environment to suit patient comfort and access, assembling necessary tools for assessments/testing, opening the mattress, and making sure the bedding is clean and organized.

Adherence and Medication

• Adherence is the extent to which a patient follows medical advice, like taking medications, following diets, or making lifestyle changes.
• Factors influencing adherence include client motivation, lifestyle changes required, severity of illness, treatment efficacy/duration, cost of therapy, and cultural beliefs.
• Nonadherence to medication can be impacted by past history with medications or procedures, taste and size of the medication, cost, the number of doses, forgetfulness, and perceived hopelessness from the treatment.

Factors Affecting Health and Illness

• Basic human needs, human dimensions (physical, emotional, environmental, intellectual, spiritual, sociocultural) and self-concept influence health and illness.

Research

• A link to a specific research article on coping with chronic illness is available.

References

• Various individuals and organizations are credited for their research and publications regarding illness, hospitalization, and other subjects pertinent to the content.

Explore the complex nature of illness and its distinction from disease in this quiz. Learn about illness behavior and the various factors influencing how individuals experience and respond to illness. Test your knowledge on the stages of illness as identified by Suchman.