Sick Role, Healing Role and Health Seeking Behavior
Types of medical belief system: 1. Domestic (popular) medicine: Not-professional and not scientific such as mother treating her children. 2. Traditional (folk) medicine: Not scientific, but professional such as injectionists. Also involves (Alternative medicine & Self-help group). 3. Scientific medicine: Professional and scientific such as modern medicine.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.
Role: is the dynamic aspect of status, i.e. (the expected behavior of the person in particular status). 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.
Healing Role of Doctors: Definition: The expected behavior of someone who is becoming a doctor or physician and it represents the dynamic aspect of the doctor's status in the community.
The Community Expectations from the Doctor: 1. Effective curing ability. 2. Effective caring ability. 3. A respectful role model. 4. A good decision-making.
THE WHITE COAT OF THE DOCTOR: 1. Technical aspects (hygiene). 2. Symbolic aspects: A- Authority B- Science C- Reliability
CONFLICTS IN THE DOCTOR'S LIFE: 1. Shortage of time. 2. The problem of uncertainty about diagnosis and treatment 3. The knowledge that some diagnosis are unhelpful 4. Breaking bad news. 5. Conflict of right and honest decision. 6. Inability to resolve social predicaments as poverty. 7. The conflicts of other roles for doctors e.g., family recreation. 8. The conflicts of rest and tension .
Social Pathology
Battered Baby Syndrome:Definition: “A clinical condition in young children , who have received non-accidental wholly inexcusable violence or injury, on one or more occasions , including minimal as well as severe fatal trauma, for what is often the most trivial provocation, by the hand of an adult in a position of trust, generally a parent, guardian or foster parent. In addition to physical injury, there may be a deprivation of nutrition, care and affection in circumstances which indicate that such deprivation is not accidental".Battered Baby Syndrome:-This syndrome has been found in all social strata.-The incidence is not well established.-The most worrying sequels is mental and neurological complications.- 10-15 % of cases of cerebral palsy, 20-30% of mentally retarted children may be the results of “Battered Baby Syndrome”.Prevention: Mainly through child protective agencies.
Battered wife syndrome Battered spouse syndrome All these are parts of general global violence that characterized human in modern ages.
Street Children: A large no. of children live and work on the streets, a high proportion without any family support, particularly in the mega cities of the developing world. Street children are at high risk of : 1. Malnutrition and subsequent stunting of their growth. 2. Infectious diseases as T.B., STDs including HIV. 3. Skin diseases. 4. Drug abuse. 5. Prostitution. 6. Criminal exploitation.
Causes: 1. Major losses in family members. 2. Natural and man-made disasters. 3. Bye-product of wars and riots. 4. Poverty. 5. Rapid urbanization and industrialization. Incidence: A bout 100 millions around the world, - 40 millions in Latin America. - 25 millions in Asia. - 10 millions in Africa. - 25 millions in other areas and the developed world.
Control of street children: 1.The rehabilitation by the government and non-government voluntary agencies. 2. Counseling centers should be established for them. 3. They should be provided with free school facilities. 4. Job opportunity is another way in helping them.
Child Labor: Causes: 1. Poverty. 2. Unemployment. 3. Lack of education. Incidence: - According to surveys of ILO (International Labor Organization), over 79 millions children under age of 15 years were obliged to work, sometimes as young as 5 years in paid employment. - 70% of those children are in Asia and Africa.
It is impossible now to eliminate the problem through legislation, but the legislation can regulate this problem by regulating the condition of work in order to prevent those child from abuse and deviance.
Child Marriage: - In India, before 1951 (no legislation), the average age of marriage was 13 years. - In 1978 Legislation established, reached, 15 years, and in 1991, the average age of marriage reached 19 years. - This is a good example of how legislation can manage certain health problems at community level.
Prostitution: Is an age-old social evil. It is a social problem in most urban areas, and to a lesser extent in rural areas. Health effect of prostitution: 1. STD ( specially HIV/AIDS). 2. Illegitimate babies. 3. Breakdown families.
Underlying causes: 1. Changes in environment. 2. Breakdown of family relations. 3. Parental quarrels. 4. Want of affection. 5. Illegitimate love. 6. Easy money. 7. Low I.Q. 8. Low moral standards. 9. Poverty etc.
Dowry system: It is an innocent custom, a symbol of love from parents to their daughters on the eve of her marriage. But in recent years it has grown into a social evil with many instances of bride-burning and suicides. These are symptoms of societal corruption.
Drug Addiction: Definition: It is a state of periodic or chronic intoxication detrimental to the individual and society produced by repeated intake of habit-forming drug. " Drug culture" is fast making inroads into lives of young people from all walks of life.
To call a person a drug addict, the following criteria must be satisfied: 1. Psychological dependence: there is an overpowering desire (compulsion) to take the drug and obtain it by any means. 2. Physical dependence: when the drug is withdrawn, the patient shows " withdrawal symptoms" as violent behavior, nausea vomiting, watering of eyes and noise. 3. Development of tolerance: there is a tendency to increase the dose.
Treatment: 1. Medical treatment. 2. Change in environment. 3. Complete break between the patient and his group. 4. Psychotherapy. 5. Prevention through education for target population and general public through all media.
Handicapped: 1. The blind. 2. The deaf. 3. The orthopedically handicapped. 4. The leprosy affected. 5. The mentally retarded. 6. The emotionally and socially handicapped.
Doctor- Nurse Relationship:Medicine and nursing have common goals→ preservation and restoration of health. Yet their roles in achieving that are different.Primary role of medicine → diagnosis and treatment (cure process).Primary role of nursing → caring, helping, comforting and guiding (care process).
The guidelines for good doctor- nurse relationships: 1. The doctor should regard the nurse as a member of medical team. 2. The doctor should maintain good communication skills with all medical and paramedical staff and patient. 3. The doctor should take the nurse's notes seriously. 4. The doctor should usually health educate the nurse.
COPRA Is a piece of comprehensive legislation and recognizes 6 rights of the consumer (patients), namely: 1. Right to safety. 2. Right to be informed. 3. Right to choose. 4. Right to be heard. 5. Right to seek redress. 6. Right to consumer education.