PSYCHOLOGICAL AND SOCIAL ASPECTS OF PHYSICAL ILLNESS PSYCHOLOGICAL AND SOCIAL ASPECTS OF ILLNESS 1

PSYCHOLOGICAL AND SOCIAL ASPECTS OF ILLNESS 1

PSYCHOLOGICAL AND SOCIAL ASPECTS OF PHYSICAL ILLNESS


* PRESENTERS*KUDUISHE KISOWILE(SLIDES 10,11,16&17)

*REHEMA MTOI(SLIDE 3,4&24)*FIBINOREEN SIWALE(SLIDES 12&13)*KEVIN KASHAMBA(SLIDES 20&21 )*JORAM MAGESSA(SLIDES 23,25&26) *SADIKI NAFTALI(SLIDES 22,23,26&27)*GAMBUNA KOYA(SLIDES 19&28 )*FABIOLA NGOWI(SLIDES 5-9)

*ROSE SHUNDI(SLIDES 14,15&18)*MAGRETH NG’ONDYA(SLIDES 21 )


CONTENTS Introduction to physical illness.

What do people do when they fall ill?

Factors influencing psychological and social aspects of illness.

Impacts of physical illness on psychological and social aspects.


OBJECTIVES To understand the role of psychological and

social aspects in initial stages of illness

To understand the effects of psychological and social aspects in physical illness


*DEFINITION OF TERMS•Illness-a disease or period of sickness affecting the body or mind.(Wikipedia)•Psychology-the scientific study of the human mind and its functions, especially those affecting behavior in a given context.(Wikipedia)•Society-the aggregate of people living together in a more or less ordered community(Wikipedia)

Individual patients vary in the way they respond to both physical illness and emotional distress.

This is due to;• personality of the patient• his previous experience of illness• the nature of the current illness • and the way in which the case is managed by the

doctor.

* PSYCHOLOGICAL AND SOCIAL ASPECTS OF PHYSICAL ILLNESS


Mayo(1945),in his book, The Social Problems Of An Industrial Civilization, points out that in the training of students emphasis is put on technical training rather than social skills.

As a result, medical students leaves medical school well informed about anatomy, diagnostic procedures, materia medica, but ill informed about the psychological and social problems of their patients and about elementary principle of patient management.


*WHAT DO PEOPLE DO WHEN THEY FEEL ILL?

Consulting with lay peopleUndertaking non-medical self-care.eg lifestyle

changes, home remediesUndertaking medical self-care including self-

medicationSeeking professional care


*As a well-trained medical student, should ask yourself:

•Why does a patient delay seeking medical help when he needs it?•What is the attitude of the patient environment and community towards his/her illness?•Which psychological and social factors deserve special consideration in the management of the patient?•What are the psychological position , role and function of the doctor?


The above questions can be answered by the following stages:*DELAY IN PATIENT-DOCTOR CONTACT•Patients usually generalize symptoms, assuming that he has been working too much.•Also, refusal to admit illness, ignorance or mental deterioration due to old age.•E.g. a person gets genital itching•He may delay to contact the doctor because:


•Socially, the society believes that genital itching is due to dirtiness or sexual transmitted diseases, thus he is afraid of how the doctors will perceive his situation.•Psychologically, he may assume that he has been wearing not well dried pants and thus starts to hang his pants outside or cleaning his genitals more often,

This is a conscious or unconscious denial of seriousness of the condition, that may lead to worsening of the condition.


*SUPPRESSION OF SYMPTOMS•Especially when the prospect painful surgical procedures has to be used to suppress the symptoms to extent that the actual symptoms have disappeared by the time the patient get enough courage to consult a doctor.•E.g. toothache•Socially, friends and family may advise the patient to use some pills rather than undergoing painful and expensive procedures.•Psychologically, a person may say, ”I have no toothache anymore, why should I undergo this painful procedures?”



*INTIMATION OF DIAGNOSIS•The doctor may succeed in dispelling unwarranted fears or he may intensify them by the manner by which he pronounce the diagnosis.•Patients hope to be reassured by their doctors ,such reassurance may shatter the patients trust in their doctors or create a fantasy in their minds.


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*REACTION TO DIAGNOSIS•This varies from individual to individual and with the diagnosis.•Patients receive diagnosis with the sense of relief or they are shocked.


•Psychologically, depend on what disease the patient expected to have, he may be relieved when diagnosis shows that he has less serious disease than what he expected to have, and vice versa is true.•Socially, the belief of the society on the disease will affect the way the patient will react to the diagnosis. Eg HIV diagnosis


*ADMISSION TO HOSPITAL•New fears arise in many patient minds when admission to hospital is suggested.•Psychologically, such suggestion signifies that the patient case is serious and that surgical intervassion may be contemplated.•But also admission to hospital means to many patients exchange of accustomed security of their own homes for the unknown unaccustomed hospital atmosphere.•In the society, being admitted means the case is serious and the patient becomes dependent and expenses may rise, this affects how the patient will react to being admitted.


* Factors influencing psychological and social aspects of illness:

(How do they affect clinical judgment)* Illusory correlation A patient who previously suffered from fever and was diagnosed with malaria may relate future fever encounters to malaria*Hindsight and overconfidenceAfter an illness occurs then we realize we could have prevented it.


*Self-confirming diagnoses


*Clinical versus statistical predictionMost clinicians and interviewers express more confidence in their intuitive assessment than in statistical data (such as using past grades and aptitude scores to predict success in graduate or professional school).Statistical predictions are indeed unreliable, but human intuition-even expert intuition-is even more unreliable.*Cultural background*Religious perception


*Effects Of Psychological And Social Aspects Of Physical

Illness Illness may change a person’s life suddenly and permanently and lead to social and psychological consequences that are difficult to deal with.Illness increases self-love When someone is ill, his ill-health is his main concern. Hence almost invariably chronically sick persons, especially after periods of prolonged hospitalization, become self-centered. The real or imagined seriousness of the illness and the nature of illness contribute to this.


Illness imposes dependency As healthy adults, we are expected to discharge our duties and to take fully responsibility for our actions. But if we are very ill, these responsibilities are taken off our shoulders and other people look after us as if we were babies.

Illness interfere with realistic outlook of life Patients believe that their doctors can repair what is beyond repair. Thus doctors should remember that everything they say and how they say it has an impact in their patients’ minds, interpreted as hopeful remark or heart-breaking one.


Illness makes for need of affection If a person is ill he naturally feels sorry for himself, and is in need of affection. People around him feels sorry for him, and even according to religions we are encouraged to show the sick affection. Psychologically, the patient may be frustrated, feels helplessness or afraid that he may die.


Illness mobilizes aggressiveness Chronic illness may lead to high temper, bitterness and envy of those who are more fortunate. The patient may feel as if he is a burden to people around him, this is projective defense mechanism.


Illness may evoke feeling of shame. For many persons illness is equivalent to weakness or failure, also depending on how the society judges his illness, eg.HIV/AIDS patients may feel ashamed because the society usually assume that those with HIV/AIDS have had many sexual partners. Illness affects a person’s mood. A patient’s mood varies with nature, course and duration of his illness. It fluctuates with ups and downs of his illness and with success or failure in treatment.


•SUMMARY “I am clay in your hands; you can make me or break me”, a patient told his doctor.A patient goes to a doctor because he wants help and because he is anxious to get well, his trust towards the doctor magnifies the doctor’s powers.It is therefore the role of the doctor to suppress the patient’s fears even when the condition is fatal, understanding the psychological and social aspects of the illness, helps the doctor to counsel the patient rightly, change how the society thinks about his condition thus fulfilling the patient’s fantasy.


*CONCLUSIONAs psychiatric and clinical psychologists diagnose and treat their clients, they may perceive illusory correlations.Hindsight explanations of people’s difficulties are sometimes too easy. Indeed, after-the-fact explaining can breed overconfidence in clinical judgment.*RECOMMENDATIONS All medical personnel should therefore be able to understand and observe the psychological and social aspects of physical illness in order to provide efficient health services.


REFERENCESE.Wittkower, MD, Psychological aspects of physical illness

Mayo(1945), The social problems of an industrial civilization

Dr. Abdelaziz M Elfaki, PhD, Social aspects of health and illness

A.C.P Sims and W.I. Hume, Lecture notes on behavioral sciences


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PSYCHOLOGICAL AND SOCIAL ASPECTS OF PHYSICAL ILLNESS PSYCHOLOGICAL AND SOCIAL ASPECTS OF ILLNESS 1