Psychosocial Phases and Patient Reactions to Illness

Phases of the Informal Relationship

The phases of the informal relationship are:

1. Reaction orientation

First, observe the patient's reaction to the situation, both verbal and nonverbal aspects. Then consider how to address the situation.

2. Implementation (Outturn)

This phase consists of implementing the plan that was devised, attempting to guide the patient in seeking solutions.

3. Conclusion

The purpose is to ensure that the objective was achieved, i.e., the patient has received the help they needed.

Item 4: Psychosocial Aspects of Illness

In this module we will focus especially on the psychosocial aspects of illness. There are a number of psychological characteristics, present to varying degrees in patients. Among them are:

• Experiencing anxiety about the disease as a danger (fear of the consequences of the disease, fear of pain, fear of diagnostic tests, fear of being admitted to hospital, fear of what changes might mean for life, etc.).
• Helplessness, confusion, and frustration on noting that the body is failing and because we have to use sanitary facilities or need help with tasks we cannot manage alone.
• Feeling of inadequacy because the illness limits everyday life.

Stages of the Sick

1. Onset (Appearance) of Symptoms

The person notices something in their body does not function well, experiencing some symptoms.

Symptom interpretation

The interpretation of these symptoms depends on prior experience with the affected body part, personality, and other factors. For example, in the case of a cough:

A person may think it is due to smoking and perhaps fear it is cancer of the larynx because their grandfather, who smoked, had it.
Another person may think it is because this winter has been colder and the throat became inflamed and did not fully recover.

2. Acceptance of Illness

When a person accepts that they are ill they may elect to self-medicate, consult a health center, turn to alternative or folk medicine, etc. The patient feels insecure because they do not know what is happening and are afraid to learn the diagnosis.

3. Contact with Health Care

It is best that if symptoms or signs are important you contact health services.

The patient goes to the doctor either by their own volition or under pressure from their family. By going to the doctor they wish to know whether or not they have an illness, to learn what disease they may have, and to be given treatment.

If the patient accepts the diagnosis, they move beyond that stage.

4. Dependency

When the doctor confirms the disease, the person becomes dependent on health professionals.

If the illness requires hospitalization the situation is complicated by:

• Isolation from the outside world
• Depersonalization (hospital clothes, impersonal room)
• Loss of privacy
• Unit
• Change of lifestyle

Behavior: some patients feel protected and collaborate; others do not follow medical treatment; others become totally dependent.