CONCEPT OF ILLNESS

Sickness -is a state of social dysfunction 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 -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 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 -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)