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Illness Behavior andPerceptions of Illness
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How do people determine when
theyre ill?
Illness is a condition of pronounced deviation
from the normal healthy state
Illness is a subjective experience
When do patients report illness?
When theyre unable to engage in day-to-day activities
When they have decreased stamina
When they feel pain, nausea, fatigue
When they just dont feel well
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Illness Behavior
What do you do when you feel ill?
Most people do not consult a doctor or a
health professional when they first feel ill
When and why do people seek
professional attention?
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Illness Behavior
Illness behavior is described as the state
when the individual feels ill and behaves in a
particular way
Illness is a psychological concept:
It has different meanings for different people
Its based upon an individuals personalevaluation of his/her bodily state and ability to
function
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Illness
Often it is difficult to decide objectively
whether someone is ill or not
Some suggest using scales that define illnessbased on a total score of symptoms
However, illness is a relative concept, and
is often functionally based
Lets return to your thoughts on how you
know when your ill
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Symptoms
Illness is recognized because of the presenceofsymptoms, either physical or mental
People respond to symptoms in a variety ofways including dismissing, ignoring, denying,and/or maximizing their symptoms
If we experience unusual symptoms, whichare severe enough, we may feel that we areill and then behave in certain ways
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Symptoms
Illness is recognized because of the presence
of symptoms
Recognition of symptoms can beaffected by a patient's beliefs and
expectations
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Symptoms Patient recognition of a symptom depends on
the cognitive schemata that the patient has of
the symptom The more we know, the more our awareness
of symptoms diagnoses increase
Health professionals themselves may be very
aware of physical symptoms and this may
contribute to professional stress
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Symptom Reporting
When do people decide its time to report
their symptoms?
People do not necessarily report all of their
symptoms and certainly choose to whom they
report them
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Symptom Reporting
Factors that influence symptom
reporting:
Number and persistence of symptoms Extent of the social and physical disability
resulting from the symptoms
Recognition and identification of thesymptom
Perceived severity of the symptoms
Symptom change
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Cultural Influences on Illness
Behavior
There are many cultural and demographic
influences on health and these affect illness
behavior
Consider Chinese traditional medicine with
Western medicine
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Cultural Influences
Chinese traditional medicine is based on the
forces of Yin and Yang and the interaction of
the five elements (metal, water, wood, fire,
and earth)
Traditional Chinese doctors look to balance
the Yin and Yang by the use of acupuncture,
Chinese herbs, and massage
This contrasts with Western medicine which
uses drugs or surgery to treat symptoms
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Cultural Influences Culture and the cancer pain experience Taoism: Pain results when Qi is blocked. Pain
relief comes via removing the blockage and living in
harmony with the universe
Buddhism: Pain is suffering; suffering is relieved by
following the 8 right ways (i.e., right view, right
intention, right speech, right action, right livelihood,
right effort, right mindfulness, and right
concentration)
Confucian: Pain is an essential element of life;
hence, endurance is the key
(Chen, Dodd, & Pantilat, 2008)
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Sociological and Demographic
Influences on Illness Behavior
More illness is found in community surveys in
lower socio-economic groups
However, people in higher socio-economic
groups are more likely to seek health care
Older people consult their doctorless than
younger people do in relation to their level of
illness
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Illness Representation
Symptom recognition is not necessarilyenough to make people think that they are ill
Symptoms on their own have no meaningand are merely bodily sensations
Different symptoms will be accounted for in
different ways
Consider the symptom of a backache
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Illness Representation
Illness representations interpret symptoms
and give them meaning
The course of action taken will be
determined by the representation
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Symptoms
Symptoms may also suggest the course ofthe illness
So, if symptoms disappear does this mean
the illness is over?
If they are tightly joined to one another, then
if the symptoms improve, the illness may bethought to have gotten better and the personmay stop treatment
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Symptoms
There is an asymmetrical relationshipbetween symptoms and the diagnosticlabel:
People with symptoms seek a diagnosticlabel
People given a diagnosis seek symptoms
Having recognized that they havesymptoms, what do people do?
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Self Medication
An Australian study evaluated theactions taken by 360 people who hadminor symptoms or condition in theprevious two weeks
Their actions included using:
Left over prescription medicines
Home remedies
Over-the-counter medicines
(Wilkinson et al., 1987)
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Self Medication
Elderly people were found to be twice aslikely to treat a minor illness with an over thecounter medication than any other option
Because drugs are available without aprescription, they may be thought to beharmless
Poly-pharmacy among elderly people isvery common and prescribed drugs may betaken in combination with over the countermedicines and the combination may change
their effectiveness
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Self Medication
The practice of taking over the counter
medicines may begin in early adulthood
Headaches are common in all age groups In a study of adolescents, it was found that
most of them used medication to cope with
headaches
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Self Medication
Self-medication is extremely common
It has been suggested that those who
take non-prescription medicine may beless likely to consult doctors
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The Sick Role
The sick role any activity undertaken forthe purpose of getting well by those whoconsider themselves ill
This is a social role
A patient who enters the sick role has both
rights and obligations There are positives and negatives to the sick
role
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The Sick Role
Advantages Exempt from many
daily activities
Able to rest and be
taken care of
Social support
Meaning
Workers
compensation,
disability
Disadvantages Behaviors are
scrutinized
Others may view
behaviors as
illegitimate attempt to
gain advantages
Confusion, discomfort,decreased
functioning, and
distress
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The Sick Role
People are not expected to will themselvesbetter by effort, and the illness is notconsidered to be their fault
However, the symptoms must be recognizedby others
Sick people are expected to want to getbetter
They are also expected to seek professionalhelp if needed and to comply with healthrecommendations
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The Sick Role
The (societal) obligations: The persons symptoms must correspond
with a diagnosis recognized by society
There must be overt symptoms before otherswill recognize the illness
The patient must accept the sick role, and isexpected to take steps to get well
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The Sick Rolemore (societal)
obligations
Sick people are expected to remainoptimistic and cheerful and not displaydistress
Not everyone is willing to act sick andsome people may conceal their symptoms
to avoid becoming dependent In some conditions this is seen as desirable
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The Sick Role
Most believe being ill is temporary and in mostcases, this is true
Chronic diseases bring about different
responsibilities and the person cannot stay inthe sick role forever
Most people have symptoms of one sort or
another at any one time, but whether or notthey enter the sick role may be only loosely
related to the severity or persistence of
symptoms
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THANK YOUReported by Tani Stevenson Telow RN, MN-
NAS(c)