Health Psychology- Adjustments and Adaptations to Dealing with Chronic Illness

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The experience of illness requires many adaptation and adjustments. Discuss the processes involved in coping with a serious illness. “It is more important to know what kind of patient has the disease, than what kind of disease the patient has”- William Osler Different individuals react differently to developing a chronic illness. Their reactions depend on many factors, such as their coping skills and personalities, the social support they have, the nature and consequences of their illness and the impact of the illness on their daily functioning. At the very least, having a chronic condition involves frequent impositions on the patient and their families that require adaptation and adjustment. Leventhal and colleagues (Leventhal, Meyer & Nerenz, 1980; Leventhal & Nerenz, 1985) defined illness beliefs as a patient’s own implicit, common sense beliefs about his or her illness. They proposed that these beliefs provide a framework, or schema, for coping with and understanding an illness, and for telling us what to look out for if we believe that we are becoming ill. Using interviews with patients suffering from a variety of illnesses, Leventhal et al. identified five dimensions of illness beliefs: 1. Identity refers to the label given to the illness (the medical diagnosis) and the symptoms experienced 2. The perceived cause of the illness – this may be biological (e.g. a virus) or psychosocial (e.g. stress or health-related behaviour). Patients may also hold representations of illness that reflect a variety of different causal models; for example, ‘My illness was caused by a virus’ versus ‘My illness was caused by being run-down’. 3. Time line refers to beliefs about how long an illness will last, whether it is acute (i.e. short term) or chronic (i.e. long-term); for example ‘My illness will be over in a few days’. 4. Consequences refer to the patient’s perceptions of the possible effects of the illness on his or her life. These may be physical (e.g. pain, lack of mobility), emotional (e.g. loss of social contact, loneliness) or a combination of factors. 5. Curability and controllability refers to the patient’s beliefs about whether their illness can be treated and cured, and the extent to which its outcome is controllable (either by themselves or by others): for example, ‘If I rest, my illness will go away’, and ‘If I get medicine from my doctor, my illness will go away’ Coping can be defined as a psychological defence to a stress, which is in this case a chronic illness. Coping strategies vary both within (they change over time) and between (they are person specific) individuals. Coping effectiveness demands a good balance between the person and their environment and the coping strategies adopted to manage the illness. (Moos & Schaefer 1986) Successful coping requires a flexible and versatile repertoire of coping strategies and the combined use of both problem-focused and emotional focused efforts. (Lazarus & Folkman 1984) That is, problem focused may be more adaptive under changeable and controllable conditions while emotional focused coping may be more adaptive under unchangeable and uncontrollable situations. Regardless of their level of effectiveness, coping strategies may be viewed as a mediating factor between stressful encounters (illness) and the ultimate psychosocial outcomes. (Zeidner & Saklofske 1996) Examples of coping strategies for chronic health problems include, seeking information about the health problem and the treatment procedures. Learning to provide one’s own medical care, such as self-administrating insulin shots, with this patients gain a sense of control and personal effectiveness. Setting attainable goals and recruiting instrumental and emotional support from family and friends. Gaining a manageable perspective on the health problem and its treatment by finding long-term “purpose” or “meaning” for the experience. Patients often do this by applying religious beliefs or by recognising...
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