IMPACT OF ILLNESS

Gunung Mahameru
Paramita Stella
Dyah Mustikaningtyas D.
 Definition
ILLNESS
a state in which a persons physical,
emotional, intellectual
social, developmental or spiritual
functioning is diminished or impaired
compared with previous experience.
not synonymous to disease
includes the disease process and the
effect of functioning and well being in all
dimensions.
i.e. CANCER, LEUKEMIA
 DISEASE vs. ILLNESS
The two represent one phenomenon
but 2 aspects of sickness
DISEASE ILLNESS
Primary biologic & Includes the
psycho-physiologic sufferers experience
disorder of the disease & the
broad range of
dislocations felt by
both the sufferer and
his family
Deeply embedded in
the social, cultural &
family context &
context of the person
Discovering the Meaning of
Illness for the Family
INVESTIGATE DISEASE INVESTIGATE ILLNESS
Examining clinical and Exploring the meaning of
laboratory evidences of illness to the patient and
biologic and psycho- the patients family
physiologic dysfunction
 Why Study Impact of
Illness?
1. Sickness of patient causes suffering and severe
dysfunction for the patients family
2. Particular illness sets in motion processes that are
disruptive of family life and hazardous to the health
of family members
Role reversal
because one member of the family cannot fulfill his/her tasks
anymore, there must be someone who will do his/her role for
the patient (i.e., mother now becomes the breadwinner)
Income loss
Because of medicines, treatment, etc.
Bawalmagkasakit; Mahalmagkasakit
Disruption of activities
Danger of transmission
because of close contact between the patient and the family
members
 Why Study Impact of
Illness?
3. Patients disease is embedded in a whole matrix of difficult family
problems that contribute to the disease process itself.
Poverty,
Unemployment,
Other sickness in the family
Chronic family dispute
Emotional burdens, stresses, etc.
Poor nutritional habit
Are the family members eating a balanced diet?
Inadequate housing condition
Key factor influencing sleep quality, indoor air, home safety,
accessibility, mould growth, perception of crime, and
residential quality.
4. The interaction that takes place between the health care system and
the patient & his family are dependent on:
setting of care
type of cure;
ability to pay; and
flexibility/responsiveness of the health care system
 Why Study Impact of
Illness?
5. Impact of illness minimized by
personalized care that is highly
responsive & flexible to the patient and
the family members
6. Illness, which is chronic and
complicated, results in structural change
within family system to the point that
leads to different roles and functions

 Types of Illness:
1. ACUTE ILLNESS short duration and is severe,
symptoms appear abruptly are intense and often
subside after a relatively short period of time.
2. CHRONIC ILLNESS persists usually longer than 6
months and can also affect functioning in any
dimension. The client may fluctuate between maximal
functioning and serious health relapses that may be
life threatening.
 CHARACTERISTICS OF CHRONIC
ILLNESS

Managing chronic illness involves more

than managing medical problems.
Associated psychological and social
problems must also be addressed.

Chronic illnesses usually involve many

different phases over the course of a
persons lifetime. There can be acute
periods, stable and unstable periods, flare
ups and remissions.
Keeping chronic conditions under
control requires persistent adherence
to therapeutic regimens.
One chronic disease can lead to
development of other chronic
conditions.
Chronic illness affects the whole
family. Family life can be dramatically
altered as a result of role reversals,
unfilled roles, loss of income, time
spent managing illness, decreases in
family socialization activities and the
costs of treatment.
 The major responsibility for the day to day
management of illness falls upon the shoulders
of chronically ill people and their families. The
home rather than the hospital is the center of
care.

The management of chronic conditions is a

process of discovery.

Managing chronic conditions is a collaborative

process.

The management of chronic illness is expensive.

Chronic conditions raise difficult
ethical issues for the patient, health
care professionals and the society.
Living with chronic illness means
living with uncertainty.
 Impact of the Family on
Chronic Illness
1. A significant correlation between the family and
disease outcome
Ex.An emotionally distant of disengaged family in which there is
inadequate supervision and parental support may result in
noncompliance with insulin and diet and, hence in poor diabetic
control
2. Clear family organization
good diabetic control
3. Dysfunctional psychosocial factors
(such as absent fathers, poor living conditions, chronic family
conflict, inadequate parental functioniong, and the lackfamily
involvement)
Increase the likelihood of poorly controlled diabetes
4. Low family cohesion and high conflict
5. Poor diabetic control
6. Parental indifference
Poor diabetic control and in the diabetic child
 PHASES OF CHRONIC
ILLNESS
1.PRETRAJECTORY PHASE
-is a stage where in a person is at risk for
developing
chronic conditions because of genetic factors or
lifestyle
behaviors which increases susceptibility to
chronic
illness.

2. TRAJECTORY PHASE
-is characterized by the onset of symptoms or
disability associated with a chronic condition.
3. STABLE PHASE
-indicates that symptoms and disability
are being managed adequately.

4. UNSTABLE PHASE
-is characterized by an exacerbation of
illness symptoms, development of
complications or reactivation of an
illness in remission.
5. ACUTE PHASE
- is characterized by sudden onset of
severe or unrelieved symptoms or
complications that require
hospitalizations for their
management.
6. CRISIS PHASE
-is characterized by a critical or life
threatening situation that requires
emergency treatment or care.
7. COMEBACK PHASE
-is the period in the trajectory marked
by recovery after an acute period.

8. DOWNWARD PHASE
- marks the worsening of the condition.
Symptoms and disability continue to
progress despite attempts to gain
some control through the treatment
and management regimen.
9. DYING PHASE
- is characterized by the gradual or
rapid decline in the trajectory despite
efforts to halt the disorder or slow
the decline through illness
management; it is characterized by
failure of life maintaining body
functions.
 IMPACT OF ILLNESS IN CLIENT AND
FAMILY
1.BEHAVIORAL AND EMOTIONAL CHANGES
Short term, non life threatening illness evokes few
behavioral changes in the functioning of the client and
the family.

Severe illness, particularly one that is life threatening ,

can lead to more extensive emotional and behavioral
changes

Hopelessness/powerlessness

Loss of ability to carry out normal and treasured

activities, Sense of self-esteem, Dreams and plans for
the future
2. IMPACT ON BODY IMAGE
Body image is the subjective concept of
physical appearance. Some illnesses result in
changes in physical appearance and clients
and families react differently to these
changes.

When a change in body image occurs the

following phases is undergone.

SHOCK, WITHDRAWAL, ACKNOWLEDGEMENT,

ACCEPTANCE, REHABILITATION
3. IMPACT ON SELF CONCEPT
Self concept is a mental self image of
strengths and weaknesses in all aspect of
personality.

It depends in part of body image and roles

as well as other aspects of psychology and
spirituality.

Important in family relationships or

relationship with significant others. A client
whose self concept changes because of
illness may no longer meet family
expectations, leading to tension or conflict.
4. IMPACT ON FAMILY ROLES
When an illness occurs, parents and
children try to adapt to the major
changes resulting from a family
members illness.
ROLE REVERSAL is very common. It
leads to stress, conflicting
responsibilities or direct conflict over
decision making.
5. IMPACT ON FAMILY DYNAMICS
Family dynamics is a process by
which the family functions, makes
decisions, give support to individual
members and copes with everyday
changes and challenges.
 If a parent in a family becomes ill,
family activities and decision making
often come to a halt as the other
family members wait for the illness
to pass, or they delay action because
they are reluctant to assume the ill
persons roles and responsibilities.
 ILLNESS BEHAVIOR
It involves how people monitor their bodies,
define and interpret their symptoms, take
remedial actions and use the health care
system.

Affected by personal history, social

situations, social norms and the
opportunities or constraints of
community institutions.

Can be used as coping mechanisms view

illness as release from responsibilities or view
illness as added stressors or burden
VARIABLES INFLUENCING ILLNESS
AND ILLNESS BEHAVIOR

INTERNAL
PERCEPTION OF SYMPTOMS
If client believes symptoms disrupt their normal
routine they are more likely to seek health care
assistance than if they do not perceive the symptoms
to be disruptive

NATURE OF ILLNESS
Clients with acute illness are more likely to seek health
care assistance and comply readily with therapy. On
the other hand, clients with chronic illness with
symptoms which may not be cured but only partially
relieved may not be motivated to comply
EXTERNAL
VISIBILITY OF SYMPTOMS

SOCIAL GROUP/SOCIAL
SUPPORT
Client reacts more
positively when
there is social
support and at the
same time practicing
positive health
behavior.
CULTURAL BACKGROUND
Culture teaches the person how to be healthy, how
to recognize illness and how to deal with it. Ethnic
differences can influence decisions about health
care and the use of diagnostics as well as health
services.
ECONOMIC VARIABLE
Because of financial constraints, client
delays treatment and attempt to carry out
daily activities.
ACCESSIBILITY TO HEALTH CARE
SYSTEM
Economic variable and seeking health care
service are interrelated factors. For many
clients entry into the system is complex
and confusing.
** Illness is never an isolated life
event. Client and family must deal
with the changes resulting from the
illness and treatment
THANKYOU