Concepts of Ill Health How do you view ill health? There are different ideas as to what ill health is. The following are concepts of ill health which look at how individuals and society view ill health. Illness, Disease & Disability Iatrogenesis The sick role The clinical iceberg
Are Illness, Disease & Disability Indicators of Ill Health? • What do you consider to be ill health? • Does someone with a prosthetic leg and who can do all the things that an able bodied person do, have a disability? • Do all people with disabilities have ill health? • Do all illnesses and diseases cause ill health?
What is Illness? • Illness is subjective. • “I feel ill” can mean different things to different people. • Both these boys have the same symptoms, one feels ‘ill’ and one doesn’t.
What is Disease? • Disease is Objective. • Symptoms have been diagnosed and have been given a specific name, eg Chickenpox or Cancer or Depression or Multiple Sclerosis etc • Either you have a disease or you don’t. This child has measles
The Clinical Iceberg This theory says that because only 1/3 of patients present their symptoms to a health professional we are never really sure how many people have ill health. It gives an indication that peoples’ concepts of ill health are different. Why do you think only 1/3 of people visit the doctor?
The Clinical Iceberg What is mental ill health? Why might people not see health professionals about having mental ill health?
Iatrogenesis Ivan Illich (1976) identified that some medical interventions could cause ill health. He called this ‘Iatrogenic Ill health’ Imagine the surgeon slipped – what might happen to the patient?
Clinical Iatrogenesis • Prescribed drugs often cause side-effects like: • dizziness • tiredness • headache • nausea Ill health caused by medical intervention such as an unwanted reaction to a prescribed drug or an infection acquired while under medical care, eg MRSA Research a prescription drug and list ALL the side- effects caused.
Social Iatrogenesis:The loss of the ability to COPE This maybe linked to: • the medicalisation of everyday life (can’t cope with life without medication) • the instititutionalisation of individuals in medical settings such as psychiatric hospitals. ‘One Flew Over The Cuckoos Nest’. The majority of patients were ‘voluntary’ and felt unable to live life by themselves because they relied on the institution.
Cultural Iatrogenesis • The loss people experience from the unrealistic expectations raised by modern medicine. • We expect to be treated for EVERYTHING that is wrong with us by medical professionals, and so we do not expect to suffer at all. • Illich says we are unable to cope with normal pains or suffering because we expect a ‘magic wand’. • Therefore, cultural Iatrogenesis is where we experience a feeling of loss because we can’t be made better. The doctors have not ‘made’ us ill, but our belief in them means that we expect to be perfectly healthy all the time, and so the doctors have given us unrealistic expectations of health, which means that when we suffer we feel it much more than generations before us because they did not have those expectations.
Talcott Parsons’ Theory:The Sick Role • Parsons said that society applies ‘rules’ to people who are ill. • The sick person AND the society have obligations: • Sick Person: To seek appropriate medical help AND to want to get better. • Society: To excuse the sick person from normal social roles (eg worker, mother etc) AND to not hold the patient responsible for their condition AND for the sick person to be taken care of • These obligations must be fulfilled for the person to be allowed to be in the ‘sick role’.
Talcott Parsons’ Theory:The Sick Role The sick role is a functionalist theory If this person is sick then they cannot put into society in the way they usually do. Society But they can receive from society in the same way. The sick role is therefore seen as a deviant role. A functionalist would want the sick person to get better so they can start contributing to society again.
Talcott Parsons’ Theory:The Sick Role • If you were the person in the sick role, what roles would YOU be exempt from? • What would you be excused from having to do? Society
How many people don’t seek medical help? What reasons do they have? Do sick people alwayswant to get better? Describe situations when they don’t. Analysing The Sick Role Lets go back to the obligations of the sick person: To seek appropriate medical help AND to want to get better.
Analysing The Sick Role Lets go back to the obligations of the society:To excuse the sick person from normal social roles AND to not hold the sick person responsible for their condition. Are people always excused from their normal social roles?List situations when they are not. Does society always not hold the person responsible for their condition? List situations when they are.
Concepts of Health • Negative concept of health: The absence of disease or illness. (Related to the Medical Model of Health) • Positive concept of health: A state of well being. • World Health Organisation Definition:A state of complete physical, mental and social well being, not merely the absence of disease or infirmity (WHO 1946)