Illness Illness versusversus Disease Disease

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Illness and Disease Illness and Disease IntroductionIntroduction

Topics discussed include:Topics discussed include: The Clinical IcebergThe Clinical Iceberg The Differences between Disease and IllnessThe Differences between Disease and Illness Doctors and Patients AgendaDoctors and Patients Agenda Illness BehaviourIllness Behaviour The Sick RoleThe Sick Role Assessing IllnessAssessing Illness

Illness and DiseaseIllness and Disease

Irritable Bowel Syndrome and Dyspepsia, Irritable Bowel Syndrome and Dyspepsia, have been associated with stress and have been associated with stress and anxiety in medical textbooks. In fact, anxiety in medical textbooks. In fact, control studies show that this is not the control studies show that this is not the case. However the more anxious sufferers case. However the more anxious sufferers consult their doctor. consult their doctor.

It is important to consider how this It is important to consider how this misunderstanding has come about.misunderstanding has come about.

The Clinical IcebergThe Clinical Iceberg

90% of people declare themselves to have 90% of people declare themselves to have been ill in the last 2 weeksbeen ill in the last 2 weeks

1 in 37 of symptom episodes will be 1 in 37 of symptom episodes will be declared to Primary Care. This is the declared to Primary Care. This is the Clinical IcebergClinical Iceberg

DiseaseDisease

What is Disease?What is Disease?

The biological process that doctors use to The biological process that doctors use to explain and understand illnessexplain and understand illness

Illness and DiseaseIllness and Disease

The process of diagnosing disease is The process of diagnosing disease is central to medical education. This central to medical education. This becomes the doctor’s agendabecomes the doctor’s agendaHowever in at least 25% of GP However in at least 25% of GP consultations, no disease specific consultations, no disease specific diagnosis is availablediagnosis is availableWe must understand then what the illness We must understand then what the illness means to the patient – the patient’s means to the patient – the patient’s agendaagenda

Illness Illness

What is Illness?What is Illness?

Definitions vary and patients and doctors will Definitions vary and patients and doctors will disagree!disagree!

The patients experience of a physical or The patients experience of a physical or psychological disturbancepsychological disturbance

Illness BehaviourIllness Behaviour

Symptoms of Illness may be differently Symptoms of Illness may be differently perceived, evaluated and acted upon by perceived, evaluated and acted upon by different kinds of people.different kinds of people.

This is sometimes called “Illness This is sometimes called “Illness Behaviour”Behaviour”

Illness BehaviourIllness Behaviour

CultureCulture

PresentationPresentation

Health beliefsHealth beliefs

SexSex

Social ClassSocial Class

Access to health careAccess to health care

Learned behaviourLearned behaviour

Triggers (home, work, TV, family and friends)Triggers (home, work, TV, family and friends)

The Sick RoleThe Sick Role

ObligationsObligations Must seek professional helpMust seek professional help Make an effort towards recoveryMake an effort towards recovery

PrivilegesPrivileges Exempt normal social obligationsExempt normal social obligations Not responsible for incapacityNot responsible for incapacity

Assessing the IllnessAssessing the Illness

Patient Centred ApproachPatient Centred Approach

Understanding the illness in the patient’s Understanding the illness in the patient’s termsterms

Responding to patient’s cuesResponding to patient’s cues

Exploring Ideas, Concerns, Expectations Exploring Ideas, Concerns, Expectations and Affect on daily livingand Affect on daily living

Guard against making assumptionsGuard against making assumptions