CONCEPT OF ILLNESS

GILANG RAJASA, M.Pd.

Sickness
-is a state of social dysfunction. Likes to remain
away from social activities.
Disease
- is maladjustment (Physiological/ Psychological)
of the human being to its environment
-pathological change in the structure or function
of the body or mind
Illness
 is a subjective state of person who feels aware of
not being well with evident sign and symptoms.
-abnormal process in which the persons level of
functioning is changed when compared to the
previous level
Illness is of two types
-acute
-chronic
Acute illness
-generally has a rapid onset of symptoms and last only a
relatively short time
-some acute illness are life threatening, many don’t require
medical attention
Stages of acute illness
Stage 1-experiencing symptoms
-first indication of an illness usually is recognizing one or
more symptoms that are incompatible with ones personal
definition of health. Eg.pain,fever
- the symptoms usually relieved by self care, if not entered
into next stage
Stage 2- assuming the sick role
-the person now defines himself as being sick, seeks
validation of experience from others, give up normal
activities and assume a sick role
-the person may choose to do nothing, may seek out health
care provider for diagnosis and treatment
-when help from the health care provider is sought, the
person become a patient and enters the next stage
Stage 3-assuming a dependent role
This stage is characterized by the patients
decisions to accept the diagnosis and follow
the prescribed treatment plan. The person
conforms to the opinion of others, often
requires assistance in carrying out activities
of daily living and need emotional support
through acceptance, approval and protection
Stage 4- achieving recovery and rehabilitation
It might begin in the hospital and conclude at
home. In this stage the person gives up the
dependent role and resumes normal activities
and responsibilities. If health education
given, the individual may return to health at a
higher level of functioning than before the
illness
Chronic illness
-it is a permanent change
-it causes, or is caused by irreversible
alteration in normal anatomy and physiology
-it require special patient education for
rehabilitation
-it require a long period of care and support
-Chronic illness usually have a slow onset and
many have periods of remission ( even
though disease is present, patient doesn’t
experience symptoms) and exacerbation ( the
symptom of the disease reappear)
Eg. Heart problem, diabetes etc
Illness behaviour
-people who are ill generally adopt illness behaviour
. These behaviour affect how people monitor their
bodies, define and interpret their symptoms, take
remedial actions and use the health care systems
( mechanic, 1982)
-if people perceive themselves to be ill, illness
behaviour act as coping mechanism
Variables influencing illness bahaviour
-external
-internal
External variables
-it include visibility of symptoms, social group,
cultural background, economic variables,
accessibility of health care and social support
Internal variables
-it include patients perception of symptoms and the
nature of illness
-if they perceive symptoms as descriptive, they seek
medical care
-patient with acute illness, seek medical care and
adhere readily with therapy
-patient with chronic illness, not motivated to adhere
with therapy
Impact of illness on patient and family
-an illness of a family member affect the function
of the entire family
1.Behavioral and emotional change
-individual’s behavioral and emotional reactions
depend on the nature of illness, the patients
attitude towards it, the reaction of others to it
and the variables of illness behaviour
-short term , non life threatening illnesses evolve few
behavioural changes in the functioning of the patient
and family
Eg. A husband and father who has a cold, lack the energy
and patience to spend time in the family activities and
is irritable and prefers not to interact with the family
( its a behavioural change, but doesn’t last long)
-severe illness have more emotional and behavioural
change
2. Impact on body image
-body image is the subjective concept of
physical appearance. Some illnesses result in
the change in physical appearance. The
reaction is depend up on the type of change
( eg. Loss of a limb), adaptive capacity of the
person, rate at which change take place, and
the support services available
-initially the change shocks the patient. As the
patient and family recognize the reality, they
become anxious. As the patient acknowledge
the change, they accept the loss. During
rehabilitation, they learn how to adapt the
change
3. Impact on self concept
-self concept is your mental self image of all
aspect of your personality
-a patient whose self concept changes, because
of illness is sometimes no longer able to meet
family expectations, leading to tension or
conflict. As a result, family member change
their interaction with the patient
4. Impact on family roles and family dynamics
-people may have many roles in life such as
wage earner, decision maker etc. when the
illness occur, the role change. Such a change
is either short term or long term
-patient adjust more easily to short term
change, but guidance and counseling is
required for long term change
-family dynamics is the process by which the
family functions, make decisions, give support
etc.
-because of the illness, family dynamics often
change. Another family member some times need
to assume the patients usual role and
responsibilities. This often create tension and
anxiety . It may lead to conflicting responsibilities
Health illness continuum
-it is one way to measure a persons level of health
-this model views health as a constantly changing
state with high level wellness and death being on
opposite end of a graduated scale or continuum
-this continuum illustrate the dynamic state of
health, as a person adapts to change in the internal
and external environment to maintain a state of
well being
- A patient with a chronic illness may view
himself at different points on the continuum
at any given time, depending on how well the
patient believes he or she is functioning with
the illness
Causes and risk factor for developing diseases
DEFINITION OF RISK FACTOR
-An attribute or exposure that is significantly
associated with the development of disease
-a determinant that can be modified by
intervention, thereby reducing the possibility of
occurrence of disease or other specified
outcome
-Risk factors are often suggestive, ie, presence
of a risk factor does not imply that the
disease will occur, and in its absence diseases
will not occur.
-Risk factors may be causative (eg, smoking for
CA lung), contributory (lack of physical
exercise for CHD) or predictive (eg, illiteracy
for prenatal mortality).
Prominent risk factors
Heart disease- smoking, high BP, high cholesterol ,
diabetes, obesity
Cancer-smoking, alcohol, radiation, pollution, dietary
factors
Stroke- smoking, high BP, high cholesterol
Motor vehicle accidents-alcohol, speed, non use of
seat belt
Cirrhosis of liver-alcohol
Risk group / target group
1. Biological situation
-age group eg. Toddler more prone to accidents
-sex eg. Male more prone to Ca lung
-physiological state eg. Anemia is common in
pregnant mother
-genetic factors eg. Family history of genetic disorder
like mental retardation, down syndrome, diabetes
-other health conditions eg.high blood
pressure lead to stroke
2. Physical situations
-rural (malnutrition), urban (CAD)
-living conditions, over crowding (asthma,
nutritional deficiency)
-environment (cholera due to impure water)
3.Socio cultural factors
-social class (high class more prone to CAD)
-ethnic and cultural group
-family disruption (stress), education (infant mortality
rate), housing ( asthma)
-customs ,habit, behaviour ( smoking, lack of exercise,
over eating, drug addiction)
-access to health service (rural people)
-lifestyle and attitude(lack of exercise)