MR OGUNDELE HUMAN BEHAVIOUR IN HEALTH AND ILLNESS

ILLNESS BEHAVIOUR Illness behaviour refers to “the way in which symptoms are perceived, evaluated, and acted upon by a person who recognizes some pain, discomfort or other signs of organic malfunction

ILLNESS BEHAVIOUR • The Sociologist, David Mechanic, also defined illness behaviour as ‗the ways in which given symptoms may be differently perceived, evaluated and acted (or not acted) upon by different kinds of persons (Mechanic, 1962). • It refers to any behaviour undertaken by an individual who feels ill to relieve that experience or to define the meaning of the illness experience.

ILLNESS BEHAVIOUR However, it is important to note that the study of illness behaviour is therefore the study of behaviour in its social context (which describes how people respond to their symptoms), rather than in relation to a physiological or. pathological condition

STAGES OF ILLNESS EXPERIENCE Edward Suchman (1965) devised an orderly approach for studying illness behaviour which are (1) symptom experience; (2) assumption of the sick role (3) medical care contact (4) dependent patient role (5) recovery and rehabilitation Each stage involves major decisions that must be made by the individual that determine whether the sequence of stages continue or the process is discontinued.

1. SYMPTOM EXPERIENCE • Symptoms are viewed as the manifestation of bodily malfunction. It enable a person to report self‐experiences of health on a day‐to‐day basis • Certain aetiologies such as those found in biomedicine maintain that disease occurs when an external pathogen enters the body and disrupts physiological homeostasis. Therefore, symptoms are not believed to be part of the ―patient‘s concept of his intact body

SYMPTOM EXPERIENCE In non‐traditional health care systems, symptoms are believed to be manifestations of the intrusion of the supernatural. On the other hand, non‐western ideologies explain disease causation as an object intrusion, spirit intrusion, an act of witchcraft, or the result of soul loss or neglected/transgressed social taboos (Low 1985).

IMPORTANCE OF SYMPTOMS EXPERIENCED a) The symptom is regarded as a vital part of the illness experience because it offers insight into the physiological and psychological aspects of the patient‘s body. In this way, the symptom symbolizes the roots of a tree, anchoring a societal understanding of medical knowledge and healing aetiologies

IMPORTANCE OF SYMPTOMS EXPERIENCED b)The concept of feelings, in the form of symptoms, are important because they often act as threads that bind the aspect of health to the personal concept of human emotion. The way an individual feels is a ―prime criterion of health, illness, and recovery‖ (Telles and Pollack 1981).

IMPORTANCE OF SYMPTOMS EXPERIENCED c) Symptoms add clarity to the complex ideas of sickness and healing in such a way that it is difficult to discuss either process without touching on these symbols.

2) ASSUMPTION OF THE SICK ROLE The sick role, one of the most fundamental concepts in medical sociology, was first introduced by Talcott Parsons in a 1948 journal article but elaborated in his 1951 book, The Social System. When one is ill, one does not simply exit normal social roles to enter a type of social vacuum; rather, one substitutes a new role – the sick role – for the relinquished, normal roles.

SICK ROLE The sick role and sick‐role behaviour could be seen as the logical extension of illness behaviour to complete integration into the medical care system. The sick role is, “also a social role, characterized by certain exemptions, rights, and obligations, and shaped by the society, groups, and cultural tradition to which the sick person belongs.

SICK ROLE • Within the context of social control responsibilities of medicine, society allows two explicit behavioral exemptions for the sick person but also imposes two explicit behavioral requirements. The exemptions are 1) The sick person is temporarily excused from normal social roles. The physician’s endorsement is required so that society can maintain some control and prevent people from lingering in the sick role. 2. The sick person is not held responsible for the illness. Society accepts that cure will require more than the best efforts of the patient and permits the patient to be “taken care of” by health care professionals and others.

SICK ROLE In order to be granted these role exemptions, however, the patient must be willing to accept the following two obligations: 1. The sick person must want to get well. The patient must not get so accustomed to the sick role or enjoy the lifting of responsibilities that motivation to get well is surrendered. 2. The sick person is expected to seek medical advice and cooperate with medical experts. If a patient fails to seek medical attention, the society and family may loose patience and sympathy for such individual.

3. MEDICAL CARE CONTACT • This is described as the point at which an individual sought professional medical care. Three factors that influence the decision to seek care: 1. The background of the patient. Factors such as age, gender, race and ethnicity, and social class can affect s health seeking behavior.

The background of the patient Culture: culture defines the seriousness attached to an illness as well as the action to be taken Social class: people at the upper social class are more likely to report illness and seek medical attention then people of lower social class due to lack of necessary resources in the latter Stress: people under stress do not tolerate illness as much as those who are not stressed

The background of the patient Age: older people tolerate illness more than the younger ones because they attribute illness to old age Gender: women are seen as weaker sex and are culturally accepted to report illness more frequently than men Personality: personality difference make some people to exaggerate symptoms and other to minimize them

MEDICAL CARE CONTACT 2. The patient’s perception of the illness. Social trigger that influence the judgment that the symptoms need professional health care: (a)Perceived interference with vocational or physical activity, especially work‐related activity; (b)Perceived interference with social or personal relations; (c) A temporalizing of symptomatology (setting a deadline—if I’m not better by Monday, I’ll call the doctor); (d) Pressure from family and friends.

MEDICAL CARE CONTACT 3. The social situation. Even for pain that may relate to a serious condition, situational factors matter. Symptoms that begin during the week, rather than on the weekend, are more likely to motivate prompt contact with a physician, as do symptoms that appear at work and symptoms that appear when other people are present

STAGE 4: DEPENDENT‐PATIENT ROLE With the onset of the dependent‐patient role, the patient is expected to make every effort to get well. Some people, of course, enjoy the benefits of this role (e. g. , increased attention and escape for work responsibilities) and attempt to malinger.

STAGE 4: DEPENDENT‐PATIENT ROLE Major concerns people have during stage 4: • 1. Impairments of personal cognitive functioning. Patients may be concerned that their illness will progress to a point that their cognitive functioning ability may be impaired and probably have memory loss, reasoning ability, and capacity for communication. • 2. Loss of personal independence. Reliance on others may be a devastating thought—because of the inconvenience and, in a larger sense, the idea of becoming a burden on others. • 3. Changes in body image. For patients whose illness creates any dramatic alteration in physical image, a major readjustment may be needed.

DEPENDENT‐PATIENT ROLE • 4. Withdrawal from key social roles. Because so many people derive their identity from their work/occupation, any disruption in work pattern or work accomplishment is very threatening. If remuneration is affected, an extra emotional burden is created. • 5. The future. Any chronic or serious acute condition creates questions about the patient’s future and the extent to which there will be further incapacitation or physical or mental limitation, questions about financial indebtedness, and questions about permanent losses in daily activities.

STAGE 5: RECOVERY AND REHABILITATION The final stage varies depending on the type of illness. For acute patients, the process is one of relinquishing the sick role and moving back to normal role obligations. For chronic patients, the extent to which prior role obligations may be resumed ranges from those who forsake the sick role to those who will never be able to leave it.

KUBLER ROSE

Family support during sickness The more you know about your loved one’s illness, the better for your relative, your family and yourself. Family members who understand a relative’s illness find that they gain a measure of control over their own lives. In addition, sharing their concerns and experiences with others is an empowering experience with far‐reaching, positive effects.

1) The Family as Caregivers Family act as a primary caregivers or partners in care in both the hospital and the community. Families are generally deeply involved with their ill relative, but their insights and particular needs have often been overlooked. The attitude of the ill person determines the level of family involvement. Family members need to understand how their behaviour toward their relative can either be supportive or detrimental

2) Family must Know and understand the System Families must know how to be effective in getting help for a seriously ill relative. They need to know what questions to ask, whom to see, and especially where to go when they feel overwhelmed and discouraged. As a primary care giver, family must have detailed information about their relative, they system and how to interact with the system.

3) Family as an advocate Family needs to be familiar with Legal Services / Legal Aid. It is occasionally necessary for families to seek legal advice. Aside the medico‐legal issue, family must be aware of family law, health law, juvenile law, criminal law, landlord/tenant rights, employment law and the right to employment insurance or welfare. Family must be ready to advocate for their members at all time

4) FAMILY AS A SUPPORTER Families must at all times support their members physically, financially, spiritually and psychologically. Even if treatment is refused, it is very important that family members have access to information and support services.

Complementary and Alternative Medicine (CAM) is the use of treatments that are not commonly practiced by the medical profession

Faith Healing This is the use of suggestions, power and faith in God to achieve healing. Faith healing can be ü Self‐treatment through prayer. ü Treatment by a lay person thought to be able to communicate with God. ü Treatment by an official church leader for whom healing is only one of many tasks. ü Healing obtained from a person/ religious leader or group of persons who practice healing fulltime without affiliation with a major religious organization.

OTHERS Aromatherapy is the use of aromatic oils for relaxation. Acupuncture is an ancient Chinese technique of inserting fine needles into specific points in the body to ease pain and stimulate bodily functions. Homeopathy is the use of micro doses of natural substances to boost immunity.

OTHERS Naturopathy is based on the idea that diseases arise from blockages in a person‘s life force in the body and treatments like acupuncture and homeopathy are needed to restore the energy flow. Aryuveda This is an Indian technique of using oil and massage to treat sleeplessness, hypertension and indigestion.