Sociological Approaches to Chronic Illness PDF

Sociological Approaches to Chronic illness Dr. Thoalfikar Alaasam Community Medicine CHRONIC DISEASE Defined as All impairments or deviations from normal body functions and health parameters which should have one or more of the following characteristics : *Permanent (not...

Sociological Approaches to Chronic illness Dr. Thoalfikar Alaasam Community Medicine CHRONIC DISEASE Defined as All impairments or deviations from normal body functions and health parameters which should have one or more of the following characteristics : *Permanent (not curable) *Leave residual disability *Caused by a non-reversible pathology *Required special training of the patient for rehabilitation *Required long period of supervision, observation and care to maintain good individual health Groups of chronic Diseases -Cancers -Lifestyle-related (CVD, diabetes) -Genetic disorders -Disabling disorders -Occupational disorders -Nutritional conditions -Endocrine disorders -Substance abuse REASONS FOR THE PROMINENCE OF Chronic Diseases 1. Aging of the population 2. Impact of automobiles 3. Lifestyle changes 4. Tobacco addiction. It is the only and largest cause of preventable morbidity and mortality 5. Physical activity (lack , excessive, and unusual) 6. Social and behavioral factors Natural history of Chronic Diseases A. CHARACTERISTICS OF THE AGENT Absence of a single necessary agent Most NCDs are classified on the basis of manifestations rather than on etiology (e.g., CVD, renal disease, neoplasms) Known “causes” are risk factors e.g. obesity, elevated cholesterol levels, hypertension B. NATURE OF THE DISEASE - chronic in nature “chronic disease” - permanent - leaves residual disability caused by nonreversible pathological alterations - requires special training of the patient for rehabilitation - requires long periods of supervision, observation or care. C. Synergism in Disease Causation Asbestos and lung cancer (RR=8) Smoking + asbestos and lung cancer (RR=90) - Presence of synergism decreased latency (produce illness in the prime of life even with low level exposures) - Role of initiators and promoters Major Categories of Etiological Agents: A. Occupational B. General environmental C. Lifestyle and Illness Why Chronic illness is an important problem? - Demographic transition - Mortality at all ages has decreased, but esp. infancy and early adulthood - Average life expectancy has therefore increased - Disorders associated with adulthood and later life have grown in prominence  - Many of these conditions are chronic - Limitations of medical treatment - Many conditions can only be managed or treated palliative, not cured Epidemiological transition It is the general shift from acute infectious and nutritional deficiency diseases characteristic of under development to chronic NCDs characteristic of modernization and advanced level of development.  Detailed understanding of the impact of chronic illness and disability on daily life is necessary for the providers of medical and social services to offer appropriate care and support Stigma of having a chronic illness affect the person self-concept , capacity to adapt to the illness, and the quality of his/her social network. Chronic illnesses can elicit stigma, even when those illnesses are concealable. This stigmatization leads to a stigmatized identity, where stigma can be anticipated and internalized. Chronic illness affects one’s self- concept, as one reconstructs the self with illness incorporated. Disability Evidence shows that most chronic disorders are disabling in their effects Relationship between chronic illness and disability is a complex and disputed issue International Classification of Impairments, Disabilities or Handicaps ICIDH – attempted to classify consequences of disease Offered three concepts 1. Impairment – concerned with abnormalities in the structure or functioning of body 2. Disability – concerned with performance of activities 3. Handicap – concerned with broader social and psychological consequences of living with impairment and disability Thank you