the patient and the hospital

THE PATIENT AND THE

HOSPITAL

STUDY UNIT 9.2

BY C SETTLEY

LEARNING OUTCOMES

- Briefly describe stages of illness behaviour as described by Suchman:

- The symptom experience stage

- Assumption of the sick role

- The medical care contact stage

- The dependent patient role

- The operative phase

- The post-operative phase

- The recovery and rehabilitation

- The terminal phase

- Briefly discuss the stressful experiences associated with hospitalisation and contact -with other health facilities under the following headings:

- Loss of privacy

- Loss of independence

- Depersonalisation and the loss of identity

8 STAGES OF ILLNESS

BEHAVIOR. PAGE 201

1) The symptom experience stage

- Realization that something is wrong

- Self medication to alleviate symptoms

2) Assumption of the sick role

- Acknowledgement of sickness

- “off sick” at work

3) The medical care contact stage

- Doctors visit

- Sickness is substantiated by the medical doctor or

sangoma

8 STAGES OF ILLNESS

BEHAVIOR

4) The dependent patient role

- The sick person becomes the patient

- Subjected to diagnoses, sick role and treatment

5) The operative phase

- Mystery surrounding the disease

- Bodily functions

- Previous operations

6) The post operative phase

- Acute phase: the conscious and unconscious state

- Sub- acute phase: when the patients consciousness overrules the subconscious

- The will to survive becomes dominant

8 STAGES OF ILLNESS

BEHAVIOR

7) Recovery and Rehabilitation

8) The terminal phaseSymptom

experience

Role assumption

Medical care contact

Dependent patient

Operative phase

Post operative phase

Recovery and rehab

Terminal

STRESS ASSOCIATED

WITH HOSPITALIZATION

PAGE 203

LOSS OF PRIVACY

- Patients who demand single rooms

- Contagious diseases

- Facilities are shared

- Restriction of visiting hours

- Information shared among medical team

- Important aspects during handovers

STRESS ASSOCIATED

WITH HOSPITALIZATION

LOSS OF INDEPENDENCE

- Responsibility towards own health some what taken over

by medical team

- Patient may become unable to see to own care

- Social roles compromised

- Responsibilities are compromised

- Valuables and clothing. Referred to as ‘stripping’

STRESS ASSOCIATED

WITH HOSPITALIZATION

DEPERSONALISATION AND THE LOSS OF IDENTITY

- When patients are being referred to as a medical disease,

the number of their bedroom, organs, procedures

- Reduces patient’s self-esteem, humanity

Study unit 9.3

PATIENT RELATIONSHIPS IN HOSPITAL

PATIENT RELATIONSHIPS

IN HOSPITAL

THE PATIENT AND

THE DOCTOR

- Medical staff become important to a patient once admitted

- Doctor contact and communication

- Privacy

- Doctors rounds

- Sometimes Patients are frightened to approach doctors themselves

THE PATIENT AND THE

NURSING PERSONNEL

- Nursing profession

responsible for 24 hour

care of patients

- Nurses have administrative

and educational roles to

fulfill at the same time

- Obliged to delegate

- Estrangement due to

perception of public

PATIENT RELATIONSHIPS

IN HOSPITAL

THE PATIENT AND HIS/HER

FELLOW- PATIENTS

- Relationships are

formed

- Speculation about

complaints, treatment,

etc

- Variety of norms

PATIENT RELATIONSHIPS

IN HOSPITAL

THE NURSING PROFESSIONAL AND THE

PATIENT’S FAMILY

- Difficult to define

- Family must be regarded as clients

- The patient is the primary client

- The family is the secondary client

- Interference in progress of health

- Potential threat to nursing professionals

- They share the same objective- recovery of the patient

- Value to family participation

- Family members expect nurses to be available at all times. Makes it difficult to pay equal attention to all patients

- Complaints about Domestic problems

PATIENT RELATIONSHIPS

IN HOSPITAL

THE NURSING PROFESSIONAL AND THE

PATIENT’S FAMILY

- The silent family

- Minimal/no active force

- The routine family

- Some or other direct action

- Wants nursing personnel to be aware of them

- May constitute a potential threat

- They may have complaints, and become emotional and may interfere with the treatment

- Routine: these family members are accepted as more or less part of the routine; in other words they are not too pleasant, but still tolerable

- The crisis family.

- Direct threat to medical team/nursing staff

- Intrude on privacy between the patient and the nursing staff

- Eg when asking the family member to leave the ward, it might end in conflict

REFERENCE

Du Toit, D.A. & Van Staden S.J. (2009). Nursing Sociology. 4th

Edition. Pretoria: Van Schaik