Dr. safeyya Adeeb Alchalabi
Illness behavior refers to those behaviors that individuals engage in once they believe that they are ill.“It is not the symptoms themselvesthat are significant incomprehending illness behavior,but the way in which they aredefined.”
Symptom visibility & perceived importance of thisAssessment of symptom’s significancePotential for symptoms to disrupt communitySymptom denial for fear of confirmation of serious illnessDeferring response to symptoms because of competing social demandsAssessment of social & economic costs of responding to symptoms versus potential health-related benefitsAvailable information knowledge & cultural assumptions & understandings Symptom frequency & persistenceCompeting interpretations of symptoms
An understanding of a patient’s illness perception is necessary to help in a diagnosis. This can be difficult because perception is highly subjective and there's no absolute method of measuring it either from individual to individual, or even within one person’s perspective through time.Researchers have determined that reducing illness perception to its most basic elements can help patients describe what it is they are feeling. By organizing these components into a structure. patients can reconstruct the architecture of their beliefs about their illnesses
The first area of focus is identity. This component contains what the patient believes is true of the disease, including cause and symptoms. A patient who lists a number of experiences such as confusion, nausea, and anxiety as symptomatic of a particular disease may be more likely to experience those symptoms while simultaneously failing to recognize others that are just as likely to be part of the cluster.
The patient’s sense of timeline describes thethird component. This area is concerned withthe perceived illness’s initial appearance, itstrajectory, and its conclusion. Patients withthe illness perception that a sickness is or willbecome chronic are less likely to recover fromit quickly than those who believe it istemporary.
More successfulHealthierImprove under pressureEndure stress betterLive longerImportance of habitual patterns of subjectivebeliefs about the causes of events (“explanatorystyle”)
The fourth area of concern is consequences.Patients whose illness perception leads themto believe that it will have a profound andnegative effect on the quality of life are morelikely to become discouraged or depressedthan those who don’t have this particularperception. Patients who, in fact, do have aserious disorder but lack a strong sense ofconsequences might be better able to fight itor less equipped to handle the effects.
The fourth area of concern is consequences.Patients whose illness perception leads themto believe that it will have a profound andnegative effect on the quality of life are morelikely to become discouraged or depressedthan those who don’t have this particularperception. Patients who, in fact, do have aserious disorder but lack a strong sense ofconsequences might be better able to fight itor less equipped to handle the effects.
The general idea is that the individual who has fallen ill is not only physically sick, but now adheres to the specifically patterned social role of being sick. ‘Being Sick’ is not simply a 'state of fact’ or ‘condition’, it contains within itself customary rights and obligations based on the social norms that surround it. The theory outlined two rights of a sick person and two obligations:
This model assumes that the individual voluntarily accepts the sick role.Individual may not comply with expectations of the sick role, may not give up social obligations, may resist dependency, may avoid public sick role if their illness is stigmatized.Individual may not accept ‘passive patient’ role.
Going to see doctor may be the end of a process of help seeking behavior ,importance of 'lay referral system'- lay person consults significant lay groups first. This model assumes 'ideal' patient and 'ideal'doctor roles). Differential treatment of patient, and differential doctor patient relationship- variations depend on social class, gender and ethnicity.
Model fits acute illness (measles, appendicitis, relatively short term conditions). Does not fit Chronic/ long-term/permanent illness as easily, getting well not an expectation with chronic conditions such as blindness, diabetes. In chronic illness acting the sick role is less appropriate and less functional for both individual and social system. Chronically ill patients are often encouraged to be independent.
Do lessAvoid exerciseRestAvoid academic workExercise more & do more“The exploration of a patient’s biography is an important strategy in establishing a successful working relationship.”