Sick Role and health seeking behavior Health: The absence of disease, or the presence of physical, mental and social well being. Disease: Defined in terms of objective pathology. Illness: Subjective experience of symptoms. Sickness: Expected behaviors of some one who is ill. * The absence of a disease is not a norm, because at any time, about 3/4 of population say to have symptoms and only 1/3 of those are seeking professional advice.
Normality: a person position on a normal distribution curve for such measured attributes as blood pressure. Abnormality: when a person position out of a normal distribution curve by cut-off point for such measured attributes as blood pressure. Qualitative normality: Is socially defined and so it is differ from one to other society as obesity. Culture: social legacy, which individual acquires from their group, it is a kind of blue print for all life's activities, learnt through generation, we are all ethnocentric assuming our own beliefs right and belief's of other (which conflict with our) is bad and vise versa.
Types of medical belief system: 1. Folk medicine: Experience about illness and treatment is handed down by tradition amongst non-specialist. ( several modern medical procedure originated from this type of medicine. 2. Traditional medicine: Highly organized with their own training as azande with doctors in Africa, who acts as both priests and doctors, so that supernatural is expected to play a part in both cause and cure. 3. Scientific medicine: Cause and effect depend on the empirical evidence of observation and experiment.
Reasons for the power of traditional ( folk ) medicine: 1.Short history of modern medicine. 2.Restricted fields of modern medicine ( inaccessible). 3.Traditional Dr. stress on interpersonal relationship. 4.Traditional Dr. is trusted. 5.Traditional Dr. shares the patient culture. 6.Many illnesses are either brief and self limiting or chronic and fluctuating. 7.In traditional medicine there are many explanation for failure.
Status: is the position of any one in relation to other person. A person may have different and several statuses depending on social relationship that are involved. Types of status: 1.Static ( ascribed): is that status which is given at birth and does not depend on the individual's own efforts e.g. sex, race and inherited anomalies. 2.Changing ( achieved ): it is that status that an individual gains according to certain efforts and abilities e.g. medical students are in process of achieving the status of the doctor ( it is important in motivating behavior). Both types of statuses often imply rights and obligations.
Role: is the dynamic aspect of status, .i.e. the expected behavior of the person in particular status. ( the expected behavior in a given social situation) In the society, individuals have allocated roles as people in drama and the role that an individual is trying to play becomes part of his personality. In a single day, a man may play a role of husband, father, employee, friend, son, brother, committee chairman, guest, neighbor. These roles in human life might lead to role conflicts and stress and actually role set are organized automatically within human and in relation to society. Sick Role: The expected behavior of someone who is becoming ill at first is to try to minimize the effect of illness on his environment because he already know that his illness is bias from normal status and may loose his social roles when becoming ill.
The stages of illness: Appearance of symptoms: depending on -Objective aspects of symptoms and -Socio-cultural variables Either the symptoms will be: Unrecognized ( end the event) or Recognized here depending on -Degree of sickness -Socio-cultural variables -Existence of health services Either he pass to Passive attitude ( end the event) or Active attitude here he will go to one of the following: -Officially established structure or -Traditionally established structure or -Home-remedies ( Folk medicine)
Process of Sick Role: O -Well Role I -Awareness of symptoms II - Exploration of social environment III - Registration of sick role by doctor IV - End of sick role ( cure, disable or died) From stage I and II up to III is called the process of requiring the sick role. From stage III up to IV is called the duration of sick role.
To be ill is more than a medical condition to the patient, the sick person has to behave in certain prescribed ways ,as he enter to hospital and strips off his clothes , he will also strips off his customary identity in the world and loss some of his roles in the society. He become subject to a time schedule and a pattern of activities not of his own making. He become passive for most parts , he may even become child-like.
Factors influencing sickness behaviors: 1.Culture 2.Social Class 3.Family pattern of behavior 4.Personal judgment of symptoms 5.Interference of symptoms with other needs 6.Personal tolerance to symptoms 7.Personal tendency to seek help 8.Availability of health services
Characteristics of Sick Role: 1.The patient is exempted from normal social responsibilities, this depend on severity of illness and sometimes he will be given a sickness certificate, 2. The patient is not responsible for his illness and can make claims on other for assistance. * the upper 2 points are usually given to ill persons. 3. The patient must want to get well because the sick role is regarded as a misfortune. 4. The sick person is obligated to seek medical advice and to cooperate with medical treatment to get well. * the last 2 points usually are needed from the patient.
Failure to fulfill the 4 aspects of sick role lead to resentment and label the that person who play a role of sick man as either; 1.Hypochondria tic 2.Hysteric person with conversion personality 3.malingerer 4.Neurotic
Types of Sick Roles: 1.Temporary sick role: as in all short and acute conditions, but in some primitive and poor society this is almost always the case because the society can not handle expense of the sick person so there you may see persons with constant and chronic sever illness as ca. but carry their normal roles. 2.Chronic Sick Role: as in chronic debilitating illness e.g. Rheumatoid arthritis, but this can be expanded for mild chronic diseases in certain countries where there is economy to support un-productive persons.
The Sick Role must be controlled: Because adequate health is necessary for society, and this can be done in 2 ways: 1.Social level: as altering the definition of illnesses , restriction of sickness certificate that have been given by a doctor in certain time and in special circumstances as in war. 2.Individual level: When sickness deprive the person from certain enjoyments and special gains.