Illness and hospitalization
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Health care facility can be a scary, intimidating ‫مرعب‬
‫ومخيف‬place, not one in which most people choose to
spend time.
homeostasis ‫التوازن‬The ability regulates the internal
environment to maintain a relatively stable or constant
internal environment.
Illness
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Illness is a state of imbalance. It is an “abnormal process
in which aspects of the social, physical, emotional, or
intellectual condition and function of a person are
diminished or impaired, compared with that person’s
previous condition” (Anderson, Anderson, and Glanze,
2002).
It will adjust to the demands placed on it until it is no
longer capable of compensating. ‫تحدث عند ضعف القدرة على‬
‫التكيف‬
Psychological reaction to illness
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The illness experience is roughly divided into five
stages. Each stage is associated with certain perceptions,
decisions, and behaviors:
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Stage 1: Symptoms.
Stage 2:The Sick Role.
Stage 3: Medical Care.
Stage 4: Dependency.
Stage 5: Recovery and Rehabilitation.
Stage 1: Symptoms
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Person becomes aware of physical or emotional
discomfort, but something is perceived as wrong.
Analyzes and evaluates the change decide that the
change indicates an illness.
Judgment based on:
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Symptoms.
The knowledge of the individual.
The availability of treatment resources.
Mild vs. sever (seek medical attention) or deny.
Once the person recognizes the presence of a health
problem  progress to the next stage
Stage 2:The Sick Role
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A person will seek confirmation by talking to other
people, family members, fellow workers, and friends are
consulted for their opinions.
The individual either assumes the sick role OR
continues to deny the illness.
Assuming the sick role serves several purposes.
1.
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The person is excused from everyday duties and
responsibilities
Permission is given to rest and conserve energy for healing.
Relieving the social responsibilities of interacting with
others during illness.
Thus, the permission is given for the individual to focus
on restoring health.
Stage 3: Medical Care
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No relieve to the symptoms (home therapy does not
work) the person becomes motivated to seek medical
intervention.
Professional confirms illness, provides treatment, and
informs the causes, course, and future implications of the
illness.
A person either accept the diagnosis and treatment OR
continue to deny the problem.
Stage 4: Dependency
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The ill individual accepts the attentions of other people.
Rely care, sympathy, and protection from the demands
and stresses of life are provided by family, friends, or
health care providers.
The individual allowed to be passive and dependent.
The sick person grateful for the help but resentful of the
illness.
People in this stage need to be informed and emotionally
supported.
Stage 5: Recovery and Rehabilitation
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If medication work well, and recovery is rapid and
complete,
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the individual gradually gives up the sick role and resumes his
or her normal obligations and duties.
if recoveries are prolonged, long-term care is usually
necessary either at home of at another institution.
caregivers who understand the emotional aspects of
the illness experience are better able to plan and
implement effective client care.
IMPACTS OF ILLNESS
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Individuals may react to prolonged illness with:
Anxiety.
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Anger.
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Short-term denial helps mobilize resources.
Long-standing denial results in maladaptive behaviors.
Shock.
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directed inward or outward
Denial.
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Stress, feelings of apprehension, uncertainty about the illness.
unable to process the information within the environment.
Withdrawal.
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individual refuses to interact; is often a sign of depression.
IMPACTS OF ILLNESS
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One’s self-concept ‫فهم الذات‬could be affected if:
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Illness involving a change in physical appearance.
If the illness progresses beyond the expected time.
Tension and conflict with other family
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↓ confidence, and depressed.
IMPACTS OF ILLNESS
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On Family:
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Changes in routine add more pressure.
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↑ Workloads
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Because the obligations and responsibilities of the ill individual cannot
be met.
Experience situational stress  an imbalance in family
stability until new roles and habits are established.
HOSPITALIZATION
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Hospitalization is the placing of an ill or injured person
into an inpatient health care facility that provides
continuous nursing care and an organized medical staff.
Persons who are hospitalized are faced with physical,
emotional, and environmental problems all at the
same time.
People have different experiences relating to stays in a
hospital depending on:
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Previous experience.
What hear or read horror stories in newspaper.
Hospitalization Crisis
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Types of hospitalization:
Planned admission, one has time to experience the
anxieties, prepare themselves and their loved ones, both
physically and emotionally.
Emergency admission, one has no time to prepare.
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lives have suddenly been disrupted.
The actual crisis in both cases:
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Removed from one’s familiar home environment to be cared
for by strangers in an impersonal, and uncomfortable setting.
Hospitalization Crisis
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Common feeling:
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The name band around the wrist
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Exchange his role as a functioning adult patient.
Passive submission
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Caregivers can identify one by an armband or a number.
Hospital gown
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Being out of control and dependent on the mercy,
knowledge, and expertise of unknown care providers.
To physical and psychological examination.
Give up privacy:
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Is offered in exchange for treatments and interventions that
will return him or her to wellness.
Hospitalization
How people react to hospitalization?
Regular Hospitalization
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“every person will react in his or her way.”
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The executive who controls a company:
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Commonly reacts by attempting to gain control over his or her
hospital environment.
The woman dominated on her spouse or helpless
individual
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Reaction to hospitalization depend on how they react to
other crises.
Makes independent decisions without other opinion, and the often
becomes more so in the hospital.
Symbolic meaning of not ordinary illness.
The elderly people
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the hospital is the place where one goes to die.
It is also seen as a place of respite (interval of rest) ‫ نقاهة‬where
one is removed from the stresses of daily living.
Psychiatric Hospitalization
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The experience of entering a psychiatric treatment facility
differs from hospitalization for physical reasons in several
ways.
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The individual and family must cope with the stigma of mental
illness. ‫وصمة‬
Friends maybe reluctant to discuss the illness or feel awkward
‫االحراج‬about offering their support.
Employers may question the individual’s fitness for the job, and
insurance companies may deny payment for treatment.
The ill person has received a diagnostic label that one is crazy.
There are also numerous stories about life in psychiatric hospitals.
Fear of other clients’ behaviors.
ALL can create anxiety
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support from the health care staff during the admission and adjustment
period help clients cope with the anxieties of psychiatric hospitalization.
Stages of hospitalization
Overwhelmed sensation.‫االحسلس بالقهر‬
1.
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Feeling exhausted because energies needed to cope with the
illness were diverted to:
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Surviving the admission process.
Separating from loved ones.
Tolerating various diagnostic procedures.
As a result
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Many clients withdraw into themselves and interact only when
necessary Trying to save and regain their energy.
Stages of hospitalization
2.
Stabilization
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The person gradually gains the strength to reestablish some
personal identity.
Individuals can become self-centered in this phase.
The intellectual understanding that one is not the only
person requiring care exists
Still needs the emotional reassurance and personal
interest frequently must be asserted.
Stages of hospitalization
Adaptation
3.
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Person regained enough of a personal identity to adapt.
Becomes interested in and willing to learn about health
problems, coping techniques, or preventive measures.
Regain energy, the body feels better, and emotional responses
are stable.
Reorganization has taken place, and most people are again
able to function effectively.
Persons who transferred to another institution, the crisis
begins again.
Crisis Intervention
How to relieve the hospitalization crisis?
Crisis Intervention
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Immediate Care .
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interventions must be taken to ensure safety and prevent harm
reduce anxiety levels.
Control.
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The care provider must quickly assume control, because
the people experiencing a crisis are often unable to exercise
control until the client is able to recover self-control.
Some people are relieved that someone else is in control,
whereas others resort to physical aggression ‫العدوان‬
‫الجنسي‬during a crisis.
To help patient to work with the problems that triggered the
crisis.
Crisis Intervention
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Assessment.
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Is the first step in the care process
Ask “what happened?” Have the client explain the situation and
review the events of the past 2 weeks.
A quick and accurate assessment helps to determine the best
therapeutic interventions.
Determine client’s disposition. ‫تصرف‬
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Intervention therapy is to help clients manage their problems
more effectively.
Crisis Intervention
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Referral.
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Once emotionally stabilized and in control, clients are referred
to professional, community, or support group resources.
The most successful referrals match the client’s needs with the
most appropriate service.
Know what resources are available within your community
before interacting with the client.
Follow-up.
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A follow-up telephone call will often reveal new problems that
prevent the client from receiving needed care.