2023_Intro_to_Illness_PP_10D.pptx

Introduction to the Concept of lllness 1 Learning objectives • Discuss the concept of illness • Define acute vs chronic illness • Describe the stages of illness • Describe the sick role • Identify variables influencing illness behaviour • Identify the effects of illness on the family 2 Think o...

Introduction to the Concept of lllness 1 Learning objectives • Discuss the concept of illness • Define acute vs chronic illness • Describe the stages of illness • Describe the sick role • Identify variables influencing illness behaviour • Identify the effects of illness on the family 2 Think of your most recent experience of illness. What did you do? Why? 3 What is illness? 4 Illness • A highly personalized state in which the person’s • • • • • physical emotional intellectual social developmental functioning is thought to be diminished or changed when compared with a previous level • spiritual 5 • Is highly subjective • perceived only by the individual • Only person experiencing it can say that he is ill • This experience is unique for each person 6 Can health and illness co-exist? • YES • Many people find health within illness, they learn to manage their illness and feel healthy. • Example: living with a chronic illness like diabetes, celiac disease. 7 Illness • Is illness synonymous with disease? • NO • Examples: • An individual can have a disease (diabetes) and not feel ill • A person with a headache can feel ill yet have no disease • Disease can cause illness • ie: illness is the response of the person to a disease 8 Disease • An alteration in body functions, resulting in a reduction of capacities or a shortening of the normal lifespan • There is a pathologic change in the structure or function of the body or mind • It is an objective state(medical establishment’s perspective) • Multiple factors interact to cause disease and determine an individual’s response to treatment • Causation of disease = etiology 9 • Although you need to be familiar with different kinds of diseases and their treatments, be concerned more with illness • which includes not only the disease but also the effects on functioning and well-being in all dimensions which fall within the scope of nursing i.e physical,psychological,socio-cultural, and spiritual responses to actual and/or potential health problems (the whole person) 10 Risk factors for illness • A risk factor is something that increases a person’s chances for illness (or injury) • Modifiable factors • able to be changed, such as quitting smoking • Non-modifiable • unable to be changed, such as a family history of cancer, age • As the number of risk factors increases, so does the possibility of illness • Example: • An overweight executive, under pressure to increase sales, smokes and drinks alcohol in excess. These factors, combined with a family history of heart disease, place this person at higher risk for illness 11 Classifications of illness • Acute • Chronic 12 Acute illness (not so cute!) • Characterized by symptoms of relatively short duration • Symptoms appear abruptly and subside quickly • May or may not require medical intervention eg appendicitis • People may choose to use OTC meds • Most people return to normal level of wellness 13 Chronic illness • Lasts for an extended period (6 months or longer) & often for the persons lifetime eg. Diabetes, arthritis • Usually has a slow onset • Often there are periods of: • Remission (disease is still present but symptoms disappear) • Exacerbation (symptoms reappear) • Often require the use of multiple resources to maintain self-management 14 What are behavioural responses to illness? 15 Responses to illness • Denial • Acceptance • Want to recovery • Over dependency • Feeling of helplessness • Fear • Anxiety • Stress • Lifestyle changes • Rest and sleep 16 Stages of acute illness behaviours • Behaviours may occur in identifiable stages • Behaviours are the way people cope with alterations in function caused by the disease • There is no specific timetable for the stages-ofillness behaviours • may occur rapidly or slowly 17 STAGE 1 How do people determine when they are ill? 18 STAGE 1: EXPERIENCING SYMPTOMS • The person usually recognizes one or more symptoms that are incompatible with their personal definition of health • Pain is the most significant symptom indicating illness • Other common symptoms include a rash, fever, bleeding, swelling, cough, or difficulty breathing 19 STAGE 1: EXPERIENCING SYMPTOMS • If the symptoms last for a short time or are relieved by self-care, the person usually takes no further action • If the symptoms continue, however, the person enters the next stage 20 STAGE 2: ASSUMING THE SICK ROLE • The person now defines himself or herself as being “sick” • Most people focus on their symptoms and bodily functions 21 What do people do when they feel ill? • Most people do not consult a doctor or a health professional when they FIRST feel ill • People may… • Do nothing • Buy over-the-counter medications to relieve symptoms • Look online for home-made remedies • Turn to others for help 22 STAGE 2: ASSUMING THE SICK ROLE The person assumes the “sick role” 23 Sick role theory • Described by Talcot Parsons (1950s) • A way of explaining the particular rights and responsibilities of those who are ill 24 The sick role: Rights and responsibilities What are some “rights” of a sick person? • The sick person is exempt from normal social roles eg. school,work • The sick person is not responsible for their condition What are some responsibilities of the sick person? • The sick person should try to get well • The sick person should seek competent help and cooperate with the medical professional 25 What behaviours do you or friends or family members display when they assume the sick role? 26 Role conflict Have you ever experienced role conflict with the sick role and another role you hold? How did you manage this conflict? 27 When do people seek help? • When they’re unable to engage in day-to-day activities • When they have decreased energy • When they feel pain, nausea, fatigue, etc • When home remedies have failed • When they just don’t feel well 28 Stage 2 (cont’d) • When help from the doctor is sought, the person becomes a patient and enters the stage 3 29 STAGE 3: ASSUMING A DEPENDENT ROLE • The patient decides to accept the diagnosis and follow the prescribed treatment plan • The patient often requires assistance in carrying out ADLs and needs emotional support through acceptance, approval, social interaction • If the disease is serious (such as a heart attack or stroke), the patient may enter the hospital for treatment • If the symptoms can be managed by the patient or family alone, the patient is cared for at home 30 STAGE 4: Achieving recovery and rehabilitation • Recovery and rehabilitation might begin in the hospital and conclude at home, or may be concluded at a rehabilitation center • The patient gives up the dependent role and resumes normal activities and responsibilities • If the plan of care includes health education, the individual may return to health at a higher level of functioning and health than before the illness 31 What influences a person’s response to illness? 32 What influences a person’s response to illness? • Self perceptions of symptoms • Nature of the illness • Visibility of symptoms • Social group • Cultural background • Economic variables • Accessibility of the health care system 33 Perception of symptoms • If people believe that symptoms disrupt their normal routine, they are more likely to seek health care assistance • If people believe that the symptoms are serious or perhaps life threatening, they are also more likely to seek assistance • Note: Sometimes such a perception also has the opposite effect. Some people fear serious illness and react by denying it and not seeking medical assistance 34 Nature of the illness • Acute vs chronic • People with acute illnesses are likely to seek health care and adhere readily with therapy • But, a person with a chronic illness, in which the symptoms are not curable but only partially relieved, is sometimes not motivated to adhere with the tx plan • Patients with chronic illnesses sometimes become less actively involved in their care, experience greater frustration, and adhere less readily with care 35 The visibility of the symptoms • A person with a visible symptom is more likely to seek assistance than a person who does not have visible symptoms 36 A person’s social group • Can assist them in recognizing the illness or may support the denial of illness • Families, friends, and co-workers all influence a person’s illness behaviour 37 Cultural and Ethnic background • Can teach a person how to be healthy, how to recognize illness, and how to be ill 38 Economic variables • Because of economic constraints, a person will delay treatment and in many cases continue to carry out daily activities 39 A person’s access to the health care system • For many, entry into the system is complex or confusing • Some seek non-emergency medical care in the Emergency dept because they do not know how to obtain health services otherwise • The physical proximity to a health care agency often influences how soon a person may enter the system after deciding to seek care 40 How does illness affect the family? • Assist with hygiene • Assist with mobilization • Assist with med admin • Changes in meal preparation • Make time for follow-up visits to doctors and clinics • Shift in family roles re: childcare, household maintenance, employment • Family members may become anxious, angry • Family members may withdraw 41 Effects of illness on the family • Will differ when the family is confronted with recovery from an acute illness episode vs the responsibilities on an ongoing basis, as with chronic illness 42 Effects of illness on the family In what way does an illness whether acute or chronic have an impact on the family? How does a nurse support the family members? 43 Readings: Potter: • Ch 1 p. 1-3 (Up to Classifications of Health Conceptualizations) • Ch 4 p. 54 People Living with Chronic Conditions and Disabilities (this paragraph only) • Ch 20 p. 327 Box 21.1 Self-Management of Chronic Illness • Ch 27 p. 462 definition of Sick Role only • • Lewis: Ch 5 p. 64 Health, Acute Illness, and Chronic Illness • • https://www.slideshare.net/suhanlayhunbaek/schumanns-sta ges-of-illness 44 45