Objectives: To

1.

Discuss the importance of knowing

the impact of illness
Discuss the concepts of disease &
illness in relation to individual &
family functions
Identify the different stages in family
illness trajectory
Identify characteristics that signal
ineffective family coping to impact of
illness

2.

3.
4.

What is the evidence that

stress play a role in
illness, & what is the
link between illness &
the family?

Engles research demonstrates

that:
1. Stress is frequently followed by
illness
2. Family support protects from
illness
3. Illness has an impact on the family
4. Family has an impact on illness

1.

Sickness of patient cause

suffering & severe
disruption for the patients
family way of life and
ability to function. Thus,
when a patient is sick, the
whole family suffer

2. Particular illness sets in

motion processes that are
disruptive of family life &
hazardous to the health of
family members. Thus,
there is role reversal, income
loss, disruption of activities,
& danger of transmission

3. Difficult family problems

that contribute to the
disease process itself;
poverty, chronic family
dispute, poor nutrition,
inadequate housing
condition , unemployment
etc.

Disease refers to primary biologic

& psycho-physiologic disorders.
Investigating a disease would
require clinical & laboratory
evidence of biologic & psychophysiologic dysfunction.
Illness involves the sufferers
experience of the disease & the
broad range of dislocation felt by
both the patient & the family.
Investigating of an illness would
require exploring the meaning of
illness to the patient & his family

a.

b.

c.

Normal course of the psychosocial

effects of disease for the patient &
the family
Knowledge of the trajectory allows
the physician to predict ,
anticipate, & deal with the familys
response to illness
Indicates normal & pathologic
response. Thus, enabling family
physician to formulate specific
therapeutic plan.

Stage I Onset of illness

Stage II Reaction to diagnosis;
Impact
Phase
Stage III Major therapeutic efforts
Stage IV Adjustment to Early
Recovery
Stage V Adjustment to the
permanency of the outcome

Onset of symptoms can be a warning

sign of malaise which initiates the
initial stage of illness trajectory. It is
the stage experienced prior to contact
with medical care provider.
Nature of onset role on impact of
illness.
Acute illness rapid , clear onset
little time for adjustments
predispose to crisis
Chronic illness gradual in onset
prolonged state of uncertainty

Two Areas by which Families React

1. Emotional Plane
Disbelief & anxiety emotional
upheaval
( anger, depression)
acceptance/accommodation
( therapeutic plan)
2. Cognitive Plane
Initial tension & confusion ( lack of
capacity for problem solving)
acceptance
( mobilize resources)

1.

2.

3.

Responsibilities of the physician:

The physician who presents the
diagnosis is responsible for making
clinical judgment about the amount of
information the patient can absorb given
his present level of anxiety or shock.
Disease & appropriate treatment can be
described in terms that patient can
understand
If diagnosis is serious, the patient &
family may be unable to receive much
information at this time, so, give small
dose over time.

1.

2.
3.

4.

Critical issues in Choosing Therapeutic

Plan
Psychological state and preparedness of
patient and family choice of
therapeutic plans & alternative choices.
Physician should check signs for noncompliance eg. Financial.
Duties & responsibilities of each member
of the family should be clear.
Cost of therapy reasonable level &
involving the family in major decisions.
Economic catastrophe to family.
Lifestyle & cultural characteristics

1.
2.
3.

Return from the hospital or major

therapy initiates period of gradual
movement from the role of being sick
to some form of recovery with
the corresponding adjustments of
relation within the family.
Responsibilities of the physician:
Deal with the immediate effect of
trauma.
Alleviate anxiety and assure adequate
rest.
Explore level of understanding of
patient and family and ask for support.

This points to the familys adjustment to

crisis.
Second crisis occurs as family realizes
that they must accept and adjust to a
permanent disability.
The whole family must begin and give up
hope for the patients full return to health.
Accept life must go forward and condition
believed to be temporary must be
accepted as permanent.

-Impact of the outcome to the family:

Death denial, anger, bargaining,
depression, acceptance
Acute illness potential for crisis ,
family routines are disrupted , anger if
family perceives care given is
inadequate
Chronic illness higher incidence of
illness among other members of the
family. Anger, resentment, guilt, etc.

Severe illness Trauma &

social dislocation of family
Economic catastrophe ( coping
with sudden financial burden )
An illness can very well wipe
out family savings & place the
entire family at risk

1.
2.
3.
4.

Excessive reaction to an illness

by the patient or family member
Symptoms similar to those of
the patient or family members
Suicidal ideation
History of prior psychotic
episodes in the patient or family
members

5. Excessive use of alcohol or other

drugs
6. Sudden change in the behavior of
the patient or family member
7. Scapegoating of a family member
8. History of poor family coping
patterns.

OBJECTIVES:

1. Proper care of a sick person.

2. How to prevent dehydration of the
sick person.
3. Precaution for caregivers

1. Comfort of the sick is the most

important.
-needs love and constant encouragement
-rest in a quiet, comfortable place with
plenty of fresh air and light.
-keep from getting too hot or cold
-relieve fever.
* fever is bodys way of fighting infection

2. Liquids
- needs to drink plenty of liquids: water,
juices, broths, soup etc.
3. Personal Cleanliness
- bathed every day
- if too sick, wash them with a sponge or
cloth and lukewarm water.
- persons sheets, clothes and covers kept
clean

4. Good Food
- eat a lot of nourishing food eg vegetables
- oatmeal, an all around good food for sick
people
- minimizes spices
- dont overcook food, heat breaks down
vitamins.
- avoid saturated fats such as bacon, butter

1. Use squeeze bottle or straw, ice chips

or
frozen ice pops for people too
weak to
drink.
2. Avoid alcohol or drinks with caffeine
such as colas, tea and coffee.

1. Avoid being face to face with the sick

person.
2. When holding sick children, place their
chin
on your shoulder.
3. Wash your hands often and the right
way,
4. Used alcohol based hand rub, if no
water and soap.
5. Wash your hands after touching the sick
person, their tissues and laundry.