1 / 29

Chronic Illness and the Life Course: the case of Ulcerative Colitis

Chronic Illness and the Life Course: the case of Ulcerative Colitis. Professor Mike Kelly Health Development Agency and the London School of Hygiene and Tropical Medicine. Ulcerative Colitis. Disease of the lining layer of the gut Chronic unpredictable diarrhoea Passage of blood and mucous

colette-barton
Download Presentation

Chronic Illness and the Life Course: the case of Ulcerative Colitis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chronic Illness and the Life Course: the case of Ulcerative Colitis Professor Mike Kelly Health Development Agency and the London School of Hygiene and Tropical Medicine

  2. Ulcerative Colitis • Disease of the lining layer of the gut • Chronic unpredictable diarrhoea • Passage of blood and mucous • Haemorrhage • Development of cancer

  3. Treatment • Sulphasalazine • Steroids • Surgery

  4. Epidemiology • Young to early adulthood • More common in females • Prevalence 100 per 100,000 • Incidence 5-10 per 100,000 • Family connection 10% cases

  5. Subjects • Had all had total colectomy and ileostomy for ulcerative colitis

  6. Sample • Medical and surgical outpatient clinics • Ileostomy association • Volunteers • Snowball sample

  7. Methods • Fifty in-depth interviews • tape recorded • manual transcription • identification of key themes • intellectual craftsmanship

  8. The impact of serious illness

  9. Primary social attachments • Family • Friends • Work

  10. The start of the trouble • initial uncertainty • “I must do something about this” • symptom escalation • an acute episode • “you really are ill”

  11. Diagnosis • X rays and barium enemas • colonoscopy • resistance • acceptance

  12. Living with chronic disease • variable symptoms • pain and uncertainty • loss of control • diet • relationships

  13. Fighting back

  14. Carrying on regardless

  15. Making sense of it all • Trying to understand cause • hope of recovery • extreme ill health • risks of cancer

  16. Consenting to surgery

  17. The immediate impact of surgery • Pain • Fears • Dependency experiences • Relief • Grief

  18. Becoming an ileostomist • Disgust • Management issues • Fears • Complications • learning the skills

  19. Difficult micro hand skills • Availability of help varies • Incorporation of skills into lifestyle • Can never be entirely forgotten about or ignored

  20. Being different • Incontinence • Carrying faeces around • Incorporation of oddities into self conception • Minimalizing • Resolutely carrying on as normal • Doubts and worries remain

  21. Information management

  22. Imperatives versus irrelevance • Control over information flow • Inability to control information

  23. Relationships • Irrelevance • Paralysis • Openness • Anxiety

  24. The right to be taken seriously as a sexual partner

  25. Complications and problems • Medical and surgical • Perineal wound • Skin • Blockages and dehydration

  26. Types of coping • Technical • Intrasubjective • Interpersonal • Intersubjective

  27. Self • A sense of who and what I am

  28. Identity • What other people believe me to be

  29. Conclusion • Situated self • Substantial self • situated identity • substantial identity

More Related