The illness experience

Individuals living with chronic illness have to modify or adapt previous behaviours and roles to accommodate the chronicity of their condition. Societal expectations, their own expectations, and their health status all influence illness behaviour. This chapter provides an overview of the illness experience and corresponding behaviour demonstrated by those with chronic illness. It presents a sociological view of illness rather than a medical view. It is not meant to be a comprehensive review of the entire body of knowledge, which is vast. Chronic disease involves not only the physical body, but it also affects one’s relationships, self-image, and behaviour. The social aspects of disease may be related to the pathophysiological changes that are occurring but may be independent of them as well. The very act of diagnosing a condition as an illness has consequences far beyond the pathology involved (Conrad, 2005). Freidson (1970) discussed this more than 40 years ago in his writings about the meaning that is ascribed to a diagnosis by an individual. Commonly, healthcare providers are educated in the medical model and understand its applicability and use in practice. Clients enter a healthcare system with symptoms, which are then diagnosed based on pathological findings and as such are treated and/or cured with medical treatment. For acute disease this is the pattern. One is not concerned about the client’s illness behaviour associated with tonsillitis, a fractured leg, or appendicitis. An individual may be concerned the tonsillitis will return, the fractured leg may not heal normally, or there may be an adverse event associated with the appendectomy, but by and large these concerns pass quickly because of the acuteness of the event. Canada’s acute care–focused healthcare system acts on the pathology that is present, with the goal that an individual will fully recover from the condition and return to prior behaviours and roles. What happens however, when the recovery is incomplete or the illness continues or becomes chronic in nature? It is not merely pathology or a diagnosis anymore, and the individual and family develop their own meanings and perceptions of Chapter 3